last minute ID Flashcards
Name the four classes of cell wall inhibitors
penicillins
cephalosporins
cabrpenems
glycopeptices
What drugs are in the penicillin class? What is the MOA
Benzyl penicillins (penicillin G, penicillin V) Aminopenicillin (ampicillin, amoxicillin) Isoxazyolyl penicillin (cloxacillin, methicillin, nafcillin, oxacillin)
All of the above are beta-lactams
What is the MOA of penicillins?
Bactericidal
Beta lactam inhibits cell wall synthesis
What is special about amox-clav and pip-tazo?
They pair a beta lactam (amoxicillin, piperacillin)
with a beta-lactamase inhibitor (clavulanate, tazobactam)
Some bacteria produce beta-lactamase: this counters that.
What is the mechanism of action of cephalosporins?
Bactericidal
Beta lactam inhibits cell wall synthesis
Less susceptible to penicillinases
What are the subgroups of cephalosporins?
Generations
1: cephalexin (Keflex), cefazolin (Ancef)
2: cefuroxime, cefprozil
3: cefixime, ceftriaxone
4: cefepime
What is the MOA of carbapenems?
Beta lactam inhibits cell wall synthesis
What drugs are in the carbapenem class?
imipenem, meropenem, ertapenem
What is the MOA of glycopeptides?
glycopeptid sterically inhibits cell wall synthesis
What drugs are in the glycopeptide class?
Vancomycin only
What Abx classes are protein synthesis inhibitors?
50S ribosome:
- Macrolides
- Lincosamides
30S ribosome:
- Aminoglycosides
- Tetracyclines
Which drugs are macrolides?
erythromycin
clarithromycin
azithromycin
Which drugs are lincosamides?
clindamycin
chloramphenicol
linezolid
Which drugs are aminoglycosides?
gentamycin
tobramycin
amikacin
Which drugs are tetracyclines?
tetracycline
minocucline
doxycycline
tigecycline
Which drugs are topoisomerase (DNA) inhibitors?
fluoroquinolones:
ciprofloxacin
norfloxacin
ofloxacin
Respiratory:
Levofloxicin
moxifloxacin
Which drugs are anti-metabolites?
trimethoprim-sulfamethazole (Septra, Bactrim)
nitrofurantoin
Which drugs are anti-mycobacterials?
isoniazid
rifampin
ethambutol
pyrazinamide
Name the classes of antifungals
polyenes - amphociterin B, nystatin imidazoles - clotrimazole, miconazole, ketoconazole triazoles - fluconazole, itraconazole, voriconazole, posaconazole allylamines - terbinafine echinocandins - caspofungin, micafungin, anidulafungin
What are the most common causes of acute rhinitis? What antimicrobial should be used?
rhinovirus, coronavirus, influenza, RSV, parainfluenza, adenovirus
None
What are the most common causes of pharyngitis? What antimicrobial should be used?
rhinovirus, adenovirus, influenza, parainfluenza, coxsackievirus, coronavirus
None
What are the most common causes of strep pharyngitis?
What antimicrobial should be used?
Group A beta-hemolytic streptococcus
Penicillin, then macrolide (eg erythromycin), then cephalosporin (eg cephalexin)
What are the most common causes of sinusitis?
What antimicrobial should be used?
S. pneumoniae, H. influenzae, M. catarrhalis, S. aureus
Penicillin, Penicillin/beta-lactamase inhibitor, cephalosporin in kids fluoroquinolone in adults
What are the most common causes of bronchitis?
What antimicrobial should be used?
H. influenzae, parainfluenza, coronavirus, rhinovirus, RSV
None
What are the most common causes of CAP (outpt w/o comorbidity)?
What antimicrobial should be used?
S. pneumoniae, M. pneumoniae, C. pneumoniae
Penicillin, or one of the macrolides (-romycin); 2nd line is doxycycline
What are the most common causes of CAP (outpt w/ comorbidity)?
What antimicrobial should be used?
S. pneumoniae, M. pneumoniae, C. pneumoniae, H. influenzae
Beta lactam, plus macrolide or doxy, or -floxacine
What are the most common causes of diarrhea?
What antimicrobial should be used?
Enterotoxogenic e. coli, ampylobacter, salmonella, shigella, viruses, protozoa
If >3BM/d, fever, blood:
fluoroquinolone (-floxacin), or if SE asia azithryomycin
What are the most common causes of diarrhea after Abx?
What antimicrobial should be used?
c. diff!
mild-mod: metronidazole
Severe (WBC>15, Cr >1.5x baseline): vancomycin
What are the most common causes of PUD?
What antimicrobial should be used?
H pylori (after NSAIDs)
Penicillin + macrolide (clarithromycin), + PPI.
What is the treatment for gonorrhea/chlamydia?
ceftriaxone 250mgIM + azithromycin 1g PO
or, doxycycline
What are the common skin flora?
Coagulase-negative staphylococci, corynebacterium, C. acnes, Bacillus, S. aureus
What are the common oropharyngeal flora?
viridans group steptococci, haemophilus, neisseria, anarobes (peptostreptococcus, bacteroides, veillonella, fusobacterium, actinomyces, prevotella)
What are the common small bowel flora?
e. coli, anaerobes (low numbers)
What are the common colon flora?
E. coli, Klabsiella, enterobacter, enterococcus, anaerobes (Bacteroides, peptostreptococcus, clostridium)
What are the common vaginal flora?
lactobacillus acidophilus, viridans group streptococci, coagulase-negative streptococci, facultative Gram-negative bacilli, anaerobes
What are the common gram-positive anaerobic cocci?
peptostreptococcus, C. acnes
What are the common gram-positive anaerobic bacilli?
Clostridium
- c. difficile
- c. tetani
- c botulinum
- c. perfringens
What are the common gram-negative anaerobes?
Only Bacilli
bacteroides: B. fragilis
What are the common gram-positive aerobic cocci?
Staph (eg aureus)
Strep (pneumoniae, pyogenes = GAS, agalactiae = GBS)
Enterococcus: e. faecalis
What are the common gram-positive aerobic bacilli?
Bacillus:
- b. anthracis
- listeria
- nocardia
What are the common gram-negative aerobic bacilli?
Enterobacteriaceae - e. coli, salmonella, shigella, campylobacter, yersinia Klebsiella Legionella Pseudomonas Haemophilus (H influenzae)
What are the common gram-negative aerobic diplococci?
Neisseria (meningiditis, gonorrheae)
Moraxella (catarrhalis)
What are the common non-gram stain bacteria?
Acid fast:
Mycobacteria (tuberculosis, leprae, avium complex)
What common bacteria are obligate intracellular?
Rickettsiae
Chlamydia (trachomatis)
Chlamydophila (pneumonia)
Which bacteria have no cell wall?
Mycoplasma
Which bacteria are spirochetes?
trepnema pallidum
Cocci in clusters: what is it?
Staphylococcus
Cocci in lines: what is it?
Streptococcus
