Intro to Antibiotics Flashcards
Penicillin G belongs to which drug class?
Penicillins
Ampicillin belongs to which drug class?
Aminopenicillins
Amoxicillin belongs to which drug class?
Aminopenicillin
Methicillin belongs to which drug class?
Penicillinase-Resistant Penicillins
Nafcillin belongs to which drug class?
Penicillinase-Resistant Penicillins
Oxacillin belongs to which drug class?
Penicillinase-Resistant Penicillins
Dicloxacillin belongs to which drug class?
Penicillinase-Resistant Penicillins
Piperacillin belongs to which drug class?
Anti-Pseudomonal Penicillins
Cefazolin belongs to which drug class?
First Generation Cephalosporins
Cephalexin belongs to which drug class?
First Generation Cephalosporins
Cefuroxime belongs to which drug class?
Second Generation Cephalosporins
Cefaclor belongs to which drug class?
Second Generation Cephalosporins
Cefprozil belongs to which drug class?
Second Generation Cephalosporins
Cefotetan belongs to which drug class?
Cephamycins
Cefoxitin belongs to which drug class?
Cephamycins
Cefotaxime belongs to which drug class?
Third Generation Cephalosporins
Cefixime belongs to which drug class?
Third Generation Cephalosporins
Cefdinir belongs to which drug class?
Third Generation Cephalosporins
Ceftibuten belongs to which drug class?
Third Generation Cephalosporins
Ceftazidime belongs to which drug class?
Third Generation Cephalosporins
Ceftriaxone belongs to which drug class?
Third Generation Cephalosporins
Cefpodoxime Proxetil belongs to which drug class?
Third Generation Cephalosporins
Cefditoren Pivoxil belongs to which drug class?
Third Generation Cephalosporins
Cefepime belongs to which drug class?
Fourth Generation Cephalosporins
Ceftaroline Fasamil belongs to which drug class?
Fifth Generation Cephalosporins
Ceftolozane belongs to which drug class?
Fifth Generation Cephalosporins
Imipenem belongs to which drug class?
Carbapenems
Meropenem belongs to which drug class?
Carbapenems
Doripenem belongs to which drug class?
Carbapenems
Ertapenem belongs to which drug class?
Carbapenems
Aztreonam belongs to which drug class?
Monobactams
Vancomycin belongs to which drug class?
Glycopeptides
Telavancin belongs to which drug class?
Lipoglycopeptides
Dalbavancin belongs to which drug class?
Lipoglycopeptides
Oritavancin belongs to which drug class?
Lipoglycopeptides
CLavulanic Acid belongs to which drug class?
Beta-Lactamase Inhibitors
Sulbactam belongs to which drug class?
Beta-Lactamase Inhibitors
Tazobactam belongs to which drug class?
Beta-Lactamase Inhibitors
Linezolid belongs to which drug class?
Oxazolidinones
Tedizolid belongs to which drug class?
Oxazolidinones
Erythromycin belongs to which drug class?
Macrolides
Clarithromycin belongs to which drug class?
Macrolides
Azithromycin belongs to which drug class?
Macrolides
Fidaxomicin belongs to which drug class?
Macrolides
Telithromycin belongs to which drug class?
Ketolides
Quinupristin belongs to which drug class?
Streptogramins
Dalfopristin belongs to which drug class?
Streptogramins
Doxycycline belongs to which drug class?
Tetracyclines
Tetracycline belongs to which drug class?
Tetracyclines
Minocycline belongs to which drug class?
Tetracyclines
Demeclocycline belongs to which drug class?
Tetracyclines
Tigecycline belongs to which drug class?
Glycylcyclines
Streptomycin belongs to which drug class?
Aminoglycosides
Gentamicin belongs to which drug class?
Aminoglycosides
Tobramycin belongs to which drug class?
Aminoglycosides
Amikacin belongs to which drug class?
Aminoglycosides
Neomycin belongs to which drug class?
Aminoglycosides
Paromomycin belongs to which drug class?
Aminoglycosides
Moxifloxacin belongs to which drug class?
Fluoroquinolones
Ciprofloxacin belongs to which drug class?
Fluoroquinolones
Ofloxacin belongs to which drug class?
Fluoroquinolones
Gatifloxacin belongs to which drug class?
Fluoroquinolones
Gemigloxacin belongs to which drug class?
Fluoroquinolones
Levofloxacin belongs to which drug class?
Fluoroquinolones
Sulfamethoxazole belongs to which drug class?
Sulfonamides
Trimethoprim belongs to which drug class?
Benzylpyrimidines
Polymixin B belongs to which drug class?
Polymixins
Colistin belongs to which drug class?
Polymixins
What is another name for penicillin class?
Beta Lactam
Penicillin MOA
Cell wall synthesis inhibitor –> interfers with the transpeptidase reaction
Inhibiting the penicillin-binding protein/transpeptidase inhibits peptidoglycan cell wall cross linking
What are the forms of resistance to penicillins?
- Beta lactamases break the beta lactam ring of penicillin
- Alteration of the molecular structure of penicillin binding protein/transpeptidase
- Upregulation of penicillin efflix pumps
Types of penicillins?
- Penicillin G
- Aminopenicillins
- Penicillinase Resistant Penicillins
- Antipseudomonal penicillins
Penicillin G kills which bacteria?
S. pneumoniae S. pyogenes S. viridans N. meningitidis T. pallidum C. perfringens
Major reaction to penicillin-class drugs?
Hypersensitivity
What are aminopenicillins commonly combined with?
Beta-lactamase inhibitors
(increases spectrum to include beta-lactamase producing bacteria
Aminopenicillins kills which bacteria?
E. coli Proteus Salmonoella Shigella H. influenzae Klebsiella B. fragilis
What is special about penicillinase-resistant penicillins?
They were developed as a modified penicillin G to decrease its susceptibility to beta-lactamase
Which class of bacteria is penicillinase-resistant penicillins effective against?
Staphylococcal (aureus and epidermidis)
How do bacteria develop resistance to penicillinase-resistant penicillins?
Reduced affinity for the P-R-P in the binding pocket of transpeptidase
Antipseudomonal penicillins were developed to treat which bacteria?
Pseudomonas aeruginosa
Also treats Klebsiella pneumoniase, E. coli, H. influenzae, and B. fragilis
What kind of drug is antipseudomonal penicillin commonly combined with, and what classes of bacteria does this combination treat?
Combined with a beta-lactamase inhibitor (piperacillin + tazobactam)
Treats s. aureus and Enterococcus faecalis
MOA of Cephalosporin family
Inhibits the formation of the cell wall by binding to and inhibiting transpeptidase
What is the primary mechanism that renders Cephalosporin drugs inactive?
Beta-lactamases
They break the beta-lactam ring, rendering the cephalosporin inactive. HOWEVER, cephalosporins are most stable than penicillins
Which two bacteria are resistant to cephalosporins?
Klebsiella and E. Coli
Other mechanisms of bacterial resistance to cephalosporins?
- Altering porins
- Altering the molecular structure of transpeptidase
- Upregulation of cephalosporin efflux pumps
General trends of cephalosporin coverage
First generation has better gram (+) coverage
Third generation has better gram (-) coverage
Main side effect of cephalosporins?
Hypersensitivity - maculopapular rash develops several days post-therapy
Sometimes accompanied with eosinophilia or fever
First generation cephalosporins available in the US
Cefazolin
Cephalexin
Main bacteria treated by first-generation cephalosporins?
Gram (+) cocci such as staph aureus
EXCEPTIONS: MRSA, enterococci, and staph epidermidis
Other bacteria covered by first-generation cephalosporins?
Moderate gram (-) Anaerobic cocci (NOT b. fragilis)
Second generation cephalosporins available in the US
Cefaclor
Cefprozil
Cefuroxime
Also: cefotetan and cefoxitin, but these are cephamycins that are structurally similar
Coverage of second-generation cephalosporins?
Same as the first generation, with expanded gram (-) to include Klebsiella
Cefaclor, Cefprozil, and Cefuroxime have activity against which bacteria?
H. influenzae, N. meningitidis, S. pneumoniae
Moderate coverage of E. coli and Klebsiella
Cefoxitin and Cefotetan have activity against which bacteria?
B. fragilia and Serratia
these are cephamycins
What bacteria is NOT covered by second generation cephalosporins?
P. aeruginosa
DO NOT TREAT ENTEROBACTER WITH 2ND GEN
Adverse reactions to second generation cephalosporins?
Hypersensitivity
Cefotetan - hypothrombinemia and bleeding, can cause a disulfiram-like reaction (do not drink alcohol while using)
Which third generation cephalosporins are available in the US?
Cefotaxime, cedixime, cefdinir, ceftibuten, ceftazidime, ceftriaxone, cefpodoxime proxetil (–> cefpodoxime), cefditoren pivoxil (–> cefditoren)
Spectrum of coverage by third generation cephalosporins?
Compared to first generation: more gram (-) bacteria, less gram (+) (especially strep and staph)
Specific classes of bacteria covered by third generation cephalosporins?
Neisseria and Haemophilus
Which third generation cephalosporin is active against P. aeruginosa?
Ceftazidime
Cefotaxime and ceftriaxone have poor activity against _____?
B. fragilis
Are cefpodoxime and cefditoren more or less potent than cefotaxime?
Less
Third generation cyclosporin active against e. coli, h. influenzae, p. mirabilis, and s. pyogenes
Cefixime, Cefpodoxime, Cefdinir, and Ceftibuten
Adverse effects of third generation cyclosporins?
Hypersensitivity
Ceftriaxone: neonatal jaundice, biliary pseudolithiasis
Name the single fourth generation cyclosporin
Cefepime
Which species of bacteria are covered by fourth generation cyclosporins?
Enterobacter and Pseudomonas
Name the fifth generation cyclosporins
Ceftaroline fosamil (–>ceftaroline) and ceftolozane
What other drug is ceftolozane co-formulated with?
Tazobactam (beta-lactamase inhibitor)
What kind of bacteria is ceftaroline effective against? How?
MRSA, penicillin-resistant S. pneumoniae
Has increased binding to transpeptidase
What kind of bacteria is ceftolozane effective against?
Pseudomonas
Co-formulated with beta-lactamase inhibitor tazobactam to increase activity against Enterobacteriaceae
