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Pharm > microbio drugs > Flashcards

microbio drugs Flashcards

1
Q

penicillin

A

CW synth inhibitor - B-lactam
binds penicillin-binding proteins –> peptidoglycan cross linking
bactericidal

gram (+), gram (-), spirochetes

AE: hypersensitivity, hemolytic anemia

penicillinase sensitive (B-lactamase)

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2
Q

amoxicillin

ampicillin

A

CW synth inhibitor - B-lactam
binds penicillin-binding proteins –> peptidoglycan cross linking

extended spectrum penicillin - H influenzae, H pylori, E coli, Listeria, Proteus, Salmonella, Shigella, enterococci (HHEELPSS)

AE: hypersensitivity, rash, pseudomembranous colitis

penicillinase sensitive - use w/ clavulanic acid

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3
Q

methicillin
dicloxacillin
naficillin
oxacillin

A

CW synth inhibitor - B-lactam
binds penicillin-binding proteins –> peptidoglycan cross linking

narrow spectrum penicillin - S aureus

AE: hypersensitivity, interstitial nephritis

penicillinase resistant

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4
Q

piperacillin

ticaricillin

A

CW synth inhibitor - B-lactam
binds penicillin-binding proteins –> peptidoglycan cross linking

Pseudomonas. gram (-) rods

AE: hypersensitivity

penicillinase sensitive - use w/ B-lactamase inhibitor

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5
Q

clavulanic acid
sulbactam
tazobactam

A

B-lactamase inhibitors

added to PCN abx to protect from destruction by penicillinase

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6
Q

cefazolin, cephalexin
cefoxitin, cefaclor, cefuroxime
ceftriaxone, cefotaxime, cefazidime
ceftaroline

A

(-) CW synthesis - interfere w/ peptidoglycan cross linking
B-lactam, less susceptible to penicillinases
bactericidal

H influenzae, Enterobacter, Neisseria, Proteus, E coli, Klebsiella, Serratia
serious gram (-) resistant to other B-lactams 
Pseudomonas

AE: hypersensitivity, AI hemolytic anemia, disulfiram-like rxn, vit K deficiency, increase nephrotoxicity of aminoglycosides

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7
Q 
doripenem 
ertapenem 
imipenem 
meropenem 
(carbapenems)
A

CW synth inhibitor - B-lactam
binds penicillin-binding proteins –> peptidoglycan cross linking

broad spectrum

AE: GI distress, skin rash, CNS toxicity (seizures)
*use limited

always use w/ cilastatin to decrease inactivation in renal tubules

B-lactamase resistant

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8
Q

aztreonam

monobactam

A

binds PBP3 –> prevents peptidoglycan cross linking
less susceptible to B-lactamases
synergystic w/ aminoglycosides
no cross allergenicity w/ penicillins

gram (-) rods only

AE: usually nontoxic, occasional GI upset

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9
Q

vancomycin

A

(-) peptidoglycan synthesis by binding D-ala D-ala portion of CW precursors

gram (+) only - MRSA, S epidermidis, Entercoccus, C diff

AE: nephrotoxicity, ototoxicity, thrombophlebitis, red man syndrome (flushing)

not susceptible to B-lactamase

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10
Q 
gentamicin 
neomycin 
amikacin 
tobramycin 
streptomycin 
(aminoglycosides)
A

bind 30s subunit –> irreversible inhibition of initiating complex, misreading of mRNA, blocks translocation
require O2 for uptake
bactericidal

severe gram (-) rod infxns
synergistic w/ B-lactams
neomycin for bowel surgery

AE: nephrotoxicity, neuromuscular blockade, ototoxicity, teratogen

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11
Q

tetracycline

doxycycline

A

bind 30s –> prevent attachment of aminoacyl tRNA
GI absorption deceased w/ calcium or magnesium ingestion, or iron containing preparations

Borellia burgdorferi, M pneumoniae, Rickettsia, Chlamydia
acne

AE: GI distress, discoloration of teeth & (-) bone growth in children, photosensitivity

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12
Q

chloramphenicol

A

blocks peptidyltransferase at 50s
bacteriostatic

meningitis (H influenzae, N meningitidis, S pneumoniae), RMSF

AE: anemia (dose dependent), aplastic anemia (dose independent), gray baby syndrome
*use limited due to tox.

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13
Q

clindamycin

A

blocks peptide transfer (translocation) at 50s
bacteriostatic

anaerobic infxns in aspiration PNE, lung abscesses, & oral infxns (anaerobic infxns above diaphragm)
invasive group A strep

AE: pseudomembranous colitis, fever, diarrhea

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14
Q

linezolid (oxazolidinones)

A

inhibits protein synth at 50s, prevents formation of initiation complex

gram (+), MRSA, VRE

AE: BM suppression, peripheral neuropathy, serotonin syndrome

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15
Q

azithromycin
clarithromycin
erythromycin
(macrolides)

A

block translocation, bind 23s rRNA of 50s
bacteriostatic

atypical PNE - Mycoplasma, Chlamydia, Legionella
STIs
gram (+) cocci
B pertussis

AE: GI motility issues, arrhythmia - prolonged QT, acute cholestatic hepatitis, rash, eosinophilia, increases conc of theyophillines & oral anticoag, inhibit cyt P450

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16
Q

trimethoprim

A

inhibits Dihydrofolate Reductase
bacteriostatic
in combo w/ sulfonamides (TMP-SMX)

UTI, Shigella, Salmonella, Pneumocystis prophylaxis, toxoplasmosis prophylaxis

AE: megaloblastic anemia, leukopenia, granulocytopenia
supplement w/ folic acid

17
Q

sulfonamides

A

inhibit folate synth - PABA antimetabolites inhibit Dihydropteroate Synthase
bacteriostatic alone, bactericidal w/ TMP

gram (+), gram (-), Nocardia, Chlamydia, UTI

AE: hypersensitivity, hemolysis in G6P deficiency, nephrotoxicity - tubulointerstitial nephritis, photosensitivity, kernicterus, displaces other drugs from albumin (warfarin)

18
Q

dapsone

A

closely related to sulfonamides

Lepromatous leprosy

19
Q

ciprofloxacin

fluoroquinolones

A

inhibit prokaryote Topoisomerase II & IV
bactericidal
cannot take w/ antacids

gram (-) rods of urinary & GI tract, Neisseria, some gram (+)

AE: GI upset, superinfections, skin rash, HA, dizziness, tendonitis or tendon rupture, contraindicated in pregnancy due to cartilage damage

20
Q

daptomycin

A

lipopeptide that disrupts cell memb of gram (+) cocci

S aureus skin infxns (esp MRSA), bacteremia, endocarditis, VRE
(not for PNE - inactivated by surfactant)

AE: myopathy, rhabdomyolysis

21
Q

metronidazole

A

forms toxic free radical metabolites –> famage DNA
bactericidal, antiprotozal

Giardia, Entamoeba, Trichomonas, Gardnerella, Anaerobes, H pylori
(anaerobic infxns below diaphragm)

AE: disulfiram-like rxn, HA, metallic taste

22
Q

rifampin

rifabutin

A

(-) DNA-dependent RNA polymerase

mycobacteria
prophylaxis of H influenzae & N meningitidis close contacts

AE: hepatotoxicity, induce cyt P450, orange body fluids,

monotherapy –> resistance

23
Q

isonizaid

A

(-) synth of mycolic acids
req bacterial catalase peroxidase to convert into active metabolite

TB

AE: neurotoxicity (give pyridoxine/B6) , hepatotoxicity, drug-induced lupus

24
Q

pyrazinamide

A

uncertain mechanism
prodrug, converted to active metabolite - pyrazinoic acid

TB

AE: hyperuricemia, hepatotoxicity

25
Q

ethambutol

A

block arabinosyltransferase –> dec carbohydrate polymerization of CW

TB

AE: optic neuropathy (red-green color blindness)

26
Q

amphotericin B

A

binds ergosterol –> pores in membrane –> leakage of electrolytes

serious, systemic mycoses

AE: fever/chills, hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis
(hydration dec nephrotox, supplement w/ K & Mg)

27
Q

nystatin

A

binds ergosterol –> pores in membrane –> leakage of electrolytes

topical fungal infxns only
oral candidiasis, diaper rash, vaginal candidiasis

28
Q

flucytosine

A

conversion to 5-FU –> (-) DNA & RNA synthesis

systemic fungal infxns in combo w/ amphotericin B
(esp cryptococcal meningitis)

AE: BM suppression

29
Q

fluconazole
itraconazole
ketoconazole
voriconazole

A

(-) cyt P450 converting lanosterol to ergosterol

local mycoses, less serious systemic mycoses

fluconazole: chronic suppression of cryptococcal meningitis in AIDS pts, candida infxns
itraconazole: blastomyces, coccidioides, histoplasma

AE: (-) testosterone synth = gynecomastia (esp w/ ketoconazole), liver dysfunction

30
Q

terbinafine

A

(-) squalene epoxidase

dermatophytoses

AE: GI upset, HA, hepatotoxicity, taste disturbance

31
Q

anidulafungin
capsofungin
micafungin
(echinocandins)

A

(-) B-glucan synth = (-) CW synth

invasive aspergillosis, candida

AE: GI upset, flushing

32
Q

griseofulvin

A

interferes w/ MT fxn, disrupts mitosis

PO trx of superficial infxns, inhibits growth of dermatophytes

AE: teratogenic, carcinogenic, confusion, HA, increased CYP & warfarin metabolism

Pharm (8 decks)

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