Intro to abx

Question 1

What are the types of antimicrobials

Answer 1

antibacterials, antifungals, antiviral, antiprotozoa (malaria), antihelminthic (roundworm, fluke, tape worm)

Question 2

What are the 4 MOA

Answer 2

1. Inhibit cell wall synthesis
2. Inhibit translation/transcription
3. Inhibit DNA synthesis/integrity
4. Inhibit folate synthesis

Question 3

What antibacterials inhibit cell wall synthesis

Answer 3

Penicillins (beta lactams)
Cephalosporin
Glycopeptides (Vancomycin)
TB meds

Question 4

What are the inhibitors of transcription and translation

Answer 4

tetracycline
macrolides (Z- pack) 
clindamycin 
oxazolidinones
aminoglycosides
spectinomycin
TB meds

Question 5

What are inhibitors of DNA synthesis/inhibitors of folate synthesis

Answer 5

Sulfonamides, trimethoprim

quinolone

Question 6

What is the difference between bactericidal and bacteriostatic

Answer 6

Bactericidal: medication kills the organism. Generally inhibit cell wall synthesis
Bacteriostatic: med weakens organism so our body can kill it. Generally inhibit protein synthesis

Question 7

What are the types of bactericidal abx

Answer 7

Time dependent killing: penicillin (beta lactam) and vancomycin
Concentration-dependent killing: amino glycoside, quinolone

Question 8

What are the types of bacteriostatic abx

Answer 8

tetracycline, macrolide, sulfonamide

Question 9

What is the post-antibiotic effect

Answer 9

persistent suppression of bacterial growth after limited exposure to antimicrobial agent

Question 10

What are the proposed mechanisms of the post-antibiotic effect

Answer 10

Slow recovery after non-lethal damage to organism
Persistence of drug at binding site
Need to synthesize new enzymes before microorganisms can resume growth

Question 11

What antimicrobials need to be adjusted in renal impairment

Answer 11

Aminoglycosides 
Carbapenems
Cephalosporins
Penicillins
Vancomycin 
Trimethoprim-sulfamethoxazole

Question 12

What antimicrobials are contraindicated in renal impairment

Answer 12

Nitrofurantoin
Sulfonamides
Tetracycline

Question 13

What antimicrobials need to be adjusted in hepatic impairment

Answer 13

Chloramphenicol
Clindamycin
Erythromycin
Metronizadole

Question 14

What are the narrow spectrum penicillins

Answer 14

Penicillinase-susceptible: Penicillin VK

Penicillinase-resistant: Naficillin, Oxacillin

Question 15

What are the wide spectrum penicillins

Answer 15

Amoxicillin, Ampicillin

Question 16

How is penicillin cleared

Answer 16

rapid renal elimination

some biliary clearance of ampicillin/naficillin

Question 17

What are the adverse effects of penicillins

Answer 17

Hypersensitive reactions
Maculopapular rash (ampicillin)

Question 18

What organism is covered by amoxicillin but NOT penicillin

Answer 18

Haemophilus Influenza

Question 19

What are the narrow spectrum penicillins good for treating

Answer 19

Staph, Strep, Meningococcal, Syphillis

Question 20

What are the wide spectrum penicillins good for treating

Answer 20

Greater activity and Gram - bacteria

Question 21

What are the different generations of cephalosporins

Answer 21

First gen: Cephalexin 
Second gen: Cefuroxime 
Third gen: Ceftriaxone, Cefixime 
Fourth gen: Cefipime
Fifth gen: Ceftaroline

Question 22

How are cephalosporins administered

Answer 22

Most older drugs are oral

Most newer drugs are IV

Question 23

How are cephalosporins eliminated

Answer 23

Renal elimination

third generations enter CNS

Question 24

What are the adverse effects

Answer 24

hypersensitivity
Complete cross-reactivity between cephalosporins
First gen partially cross react with penicillins

Question 25

What cephalosporin do you not give newborns

Answer 25

Ceftriaxone. It is cleared in the biliary tract, which is not yet developed in babies

Question 26

What are the clinical uses of the cephalosporins

Answer 26

1 gen: skin, soft tissue, UTI
2 gen: S. pneumo, H. influenza, B. fragilis
2 gen: PNA, meningitis, gonorrhea