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Pharmacology > Microbiology > Flashcards

Microbiology Flashcards

0
Q

This drug is used to treat Gram (-) rod infections. It blocks initiation factor II @ 30s. Inhibits formation of Initiation Complex and cause misreading of mRNA. Requires O2 for uptake. SE: Nephrotoxicity, Ototoxicity (esp. w/Loop diuretics), and it’s a teratogen.

A

Aminoglycosides

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1
Q

Aminoglycoside: antibiotic that has been marketed the longest, and has the most SEs including Nephrotoxicity.

A

Gentamycin

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2
Q

Aminoglycoside: best used for tuberculosis and Tularemia.

A

Streptomycin

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3
Q

Aminoglycoside: used in bowel surgery.

A

Neomycin

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4
Q

Aminoglycoside: only one in this drug family that undergoes Hepatic metabolism, renal excretion. Not nephrotoxic.

A

Amikacin

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5
Q

This bacteriostactic drug binds to the 30s ribosome. Prevents attachment of aminoacyl-tRNA. Limited CNS penetration. Do not take with milk, antacids, or iron containing prep.

A

Tetracyclines

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6
Q

How does resistance against tetracyclines work? Two ways:

A
  1. Decrease uptake of the drug into cells.

2. Increased Efflux- out of cells by plasmid encoded Transport Pumps.

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7
Q

Tetracyclines are used to treat 4 main organisms: what are they?

A
  1. Borrelia Burgdorferi
  2. Mycoplasma Pneumoniae
  • -> accumulates intracellularly:
    3. Rickettsia
    4. Chlamydia
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8
Q

Side effects of this drug include: GI Distress, discoloration of teeth, inhibition of Bone Growth in children, photosensitivity, and transport pumps cause resistance.

A

Tetracyclines

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9
Q

This drug is the only tetracycline that is hepatically excreted.

A

Doxycycline

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10
Q

This tetracycline is an AHD antagonist, it can be used as a diuretic in SIADH.

A

Demeclocycline

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11
Q

This tetracycline is effective against acne.

A

Minocycline

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12
Q

MOA: binds to penicillin-binding proteins, blocks transpeptidase cross linking of peptidoglycans, activate autolytic enzymes.
Resistance: Beta lactamases cleave beta lactam ring. SE: hypersensitivity reactions, hemolytic anemia (most important SE because hypersensitivity is too common). What is this drug?

A

Penicillin

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13
Q

This drug is mostly for G(+) organisms. S.Pneumo, S.Pyopenes, Actinomyces, Syphilis.
Bacteriocidal for: Gram (+) cocci, Gram (+) Rods, Gram (-) Cocci, spirochetes.

A

Penicillin

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14
Q

IV form of Penicillin is called what?

Oral form of penicillin is called what?

A

IV form is called Penicillin G

Oral form is called Penicillin V.

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15
Q

What makes penicillinase resistant penicillins? What is the clinical use for it?

A

S.Aureus except MRSA - resistance due to altered binding protein target site.

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16
Q

Name the three penicillinase-resistant penicillins:

A

Methicilin (which causes interstitial nephritis), Nafcillin, and Dicloxacillin

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17
Q

What is the name of the type of drug that works in the same way as a penicillin, but has a wider spectrum, and is combined with clavulanic acid to protect against beta-lactamase?

A

Aminopenicillins

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18
Q

This drug has SE like: HYP RXNs, ampicillin rash, Pseudomembranous colitis. This drug is used to treat: extended spectrum penicillins, H. Influenza, E. Coli, Listeria Monocytogenes, Proteus Mirabilis, Salmonella, Shigella, and enterococci.

A

Aminopenicillins

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19
Q

Name the two types of Aminopenicillins, and which one has a greater oral bioavailability?

A

Ampicillin (can cause a rash)

Amoxicillin = greater oral bioavailability

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20
Q

These drugs are used to treat Gram (-) rods and Pseudomonas. They are susceptible to penicillinase and should be used with Clavulanic Acid.
SE: Hypersensitivity reactions.

A

Anti-pseudomonals

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21
Q

Name all three antipseudomonals:

A

Ticarcillin, Carbenicillin, Piperacillin.

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22
Q

Beta-Lactamase Inhibitors: Name 4 agents added to penicillins in order to prevent against B-lactamase (aka-penicillinase):

A

Clavulanic acid, sulbactam, Avibactamand tazobactam.

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23
Q

MOA: Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinase (cannot be inactivated as easy as other drugs). SE: hypersensitivity reactions, Vitamin K deficiency, cross-hypersensitivity with penicillins in 5-10% of Px, increased Nephrotoxicity of aminoglycosides, disulfiram-like reactions with ethanol (if it has a methylthiotetrazole group).

A

Cephalosporins

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24
Q

First Generation cephalosporins are used to treat these organisms: Proteus mirabilis, E. coli, Klebsiella Pneumoniae. Name the two drugs:

A

Cefazolin and Cephalexin.

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25
Q

Second generation Cephalosporins treat what organisms?

A 
HEN PEcKs: 
H. Influenza, 
Enterobacter Aerogenes, 
Neisseria Spp, 
Proteus Mirabilis, 
E. Coli, 
Klebsiella Pneumoniae, 
Serratia Marcescens.
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26
Q

Name the three medications for the Second Generation Cephalosporins used to treat: HENPEcKS:

A

Cefaklor, Cefoxitin, Cefuroxime

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27
Q

Third Generation Cephalosporins are used to treat severe/serious gram (-) infections resistant to other B-lactams. Name the three drugs, plus effects on the liver:

A

Ceftriaxone (used to treat meningitis and gonorrhea), Cefotaxime, Ceftazidime (pseudomonas).

tri, tax, taz!!!

Inhibits cytochrome P-450

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28
Q

Fourth generation Cephalosporins increase activity against Pseudomonas and Gram (+) Organisms. Name the drug in this category.

A

Cefepime

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29
Q

Both of these drugs work the same way. They block peptide bond formation at the 50s. One drug causes dose dependent anemia, dose independent aplastic anemia, and gray baby syndrome. The other drug causes Pseudomembranous colitis, fever and diarrhea. Name the drugs:

A

Chloramphenicol - causes the Anemias + GBS

Clindamycin- clinical use: anaerobic infections above the diaphragm, aspiration pneumonia, and lung abcess.

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30
Q

MOA: bacteriostatic. Blocks translocation at the 50s to inhibit protein synthesis. Resistance: methylation of the rRNA binding site. At the 23s of the 50s Subunit. SE: prolonged QT interval, GI discomfort, acute cholestatic hepatitis, Eosinophilia, skin rashes, increases serum concentrations of: theophyllines, oral anti-coagulants. What is this drug?

A

Macrolides- “mac-ro-slides”

Erythromycin (incr. QT intervals), Azithromycin (ok in pregnant women), and the one that causes the most disgusia is clarithromycin.

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31
Q

This drug is used to treat: Atypical Pneumonias- mycoplasma, Chlamydia, Legionella.
URIs, STDs, Gram (+) Cocci, streptococcal infections in patients allergic to penicillin, also for neisseria. What is this drug?

A

Macrolides - erythromycin, azithromycin, etc.

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32
Q

MOA: Bacteriocidal. Inhibits DNA gyrase-aka Topoisomerase II. Bacterial DNA cannot separate-leads to inhibition of cell replication. Resistance: chromosome encoded mutation in DNA gyrase. Clinical use: Gram (-) Rods of urinary and GI tracts (Pseudomonas), Neisseria, and some Gram (+) organisms. What is this drug?

A

Fluoroquinolones

33
Q

What are the names of some fluoroquinolones, and their side effects?

A

Ciprofloxacin, Norfloxacin, Enoxacin, Naldidixic Acid (quinolone), etc.

SE: GI upset, super infections, skin rashes, headache, dizziness, C/I in pregnant and children (causes cartilage damage), tendinitis and tendon rupture in adults, leg cramps and myalgias in kids.

34
Q

MOA: Bacteriocidal and Anti-protozoal. It forms free radicals –> non-enzymatically reduced to react with reduced Ferredoxin, which is generated by Pyruvate Oxido-reductase. Leads to Anaerobe Cell Death. SE: metallic taste, disulfiram reaction w/alcohol (inhibits alcohol dehydrogenase–> leads to increase in aldehydes), flushing, sweating, nausea, head ache, hypotension.

A

Metronidazole

35
Q

This drug is used to treat: Giardia, Entamoeba, Trichomonas, Gardenerella, Anaerobes (below the diaphragm), H. Pylori. What is this drug?

A

Metronidazole

36
Q

MOA: binds to PBP3, preventing Peptidoglycan Crosslinking. Clinical use: gram (-) Rods only. Px with a penicillin allergy, Px with renal insufficiency and isn’t able to take aminoglycosides. What is this drug?

A

Aztreonam

37
Q

MOA: Beta-Lactamase resistant carbapenem. Clinical use: Gram (+) cocci, Gram (-) Rods, Anaerobes. Has a limited use due to serious side effects that include CNS toxicity-seizures, GI Distress, and skin rash. What is this drug and why is Cilastatin added?

A

Imipenem+Cilastatin, Meropenem.

Cilastatin is added to prevent inactivation of the drug.

38
Q

Clinical use: Gram (+) only. Resistant Organisms- Clostridium dificile, MRSA, Enterococci.
MOA: inhibits cell wall Peptidoglycan formation. Binds D-ala D-ala.
SE: Nephrotoxicity, Ototoxicity, Thrombophlebitis, flushing.

A

Vancomycin

39
Q

MOA: Bacteriostatic, inhibit dihydropteroate synthase (through PABA Antimetabolites).
Clinical use: Gram (+), Gram (-), Nocardia, Chlamydia, Simple UTIs.
SE: hypersensitivity RXNs (bec. of sulfur), Nephrotoxicity, photosensitivity, kernicterus, hemolysis (if G6PD deficient). Resistance: altered enzyme, decreased uptake, increased PABA synth.

A

Sulfonamides

40
Q

MOA: Bacteriostatic. Inhibits bacterial Dihydrofolate Reductase. Clinical use: as a combination TMP-SMX. –> UTI, Shigella, Salmonella, Pneumocystis jirovecii Pneumoniae (in AIDS Px). SE: Megaloblastic anemia, Leukopenia, Granulocytopenia, possible use of Leucovorin to alleviate.

A

Trimethoprim

41
Q

MOA: inhibits DNA dependent RNA polymerase; rapid resistance if used by itself. Clinical use: Mycobacterium tuberculosis, Leprosy, Meningococcal Prophylaxis. SE: Orange/Red-Orange body fluids and secretions. Hepatotoxicity. What is the name of this drug?

A

Rifampin

42
Q

MOA: Decrease Synthesis of mycolic acids. Kay G (Bacterial Catalase-Peroxidase) needed to activate it. Clinical use: mycobacterium tuberculosis (as prophylaxis). SE: Neurotoxicity (need to supplement with Vitamin B6 [pyridoxine] to reduce SEs), hepatotoxicity.

A

Isoniazid

43
Q

MOA: unknown
Clinical use: Mycobacterium tuberculosis
SE: Hyperuricemia, hepatotoxicity.

A

Pyrazinamide

44
Q

MOA: blocks Arabinosyltransferase–> decreases carbohydrate polymerization of cell wall.
Clinical use: Mycobacterium tuberculosis
SE: Optic neuropathy–> red/green color blindness.

A

Ethambutol

45
Q

What 4 drugs are used to treat Mycobacterium Tuberculosis?

A

RIPE:

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

46
Q

MOA: Binds ergosterol to form leaky membrane pores. Clinical use: cryptococcus, Blastomyces, Coccidioides, Histoplasma, Candida, Mucor.
SE: Optic neuropathy –> Red/Green color blindness, fever, chills, hypotension, Nephrotoxicity, arrhythmias, anemia, and IV Phlebitis.

A

Amphotericin B (Antifungal)

47
Q

Binds ergosterol to form leaky membrane pores.

Clinical use: Oral Candidiasis, Topical: Diaper rash, vaginal candidiasis.

A

Nystatin (Antifungal)

48
Q

MOA: Inhibit fungal sterol synthesis by inhibition of P-450. Clinical use: Cryptococcal Meningitis in AIDS, Blastomyces, Coccidioides, Histoplasma, Candida. SE: inhibition of testosterone synthesis (gynecomastia), and liver dysfunction (inhibits P-450).

A

Azoles (Antifungal)

Fluconazole, ketoconazol, etc…

49
Q

MOA: inhibits DNA and RNA synthesis. Converted to 5-Fluorouracil (SE: bone marrow suppression) by cytosine deaminase. Clinical use: Cryptococcal Meningitis combined with Amphotericin B.

A

Flucytosine (Antifungal)

50
Q

MOA: inhibit cell wall synthesis by inhibition of Beta-1, 3-D-glucan. Clinical use: invasive Aspergilosis, Candida. SE: GI upset, Flushing, Histamine released.

A

Echinocandins- Caspofungin, Micafungin, Anidulafungin (Antifungals).

51
Q

MOA: inhibits fungal squalene epoxidase. Clinical use: Dermatophyte infections. SE: Abnormal liver function tests (LPTs), visual disturbances.

A

Terbinafine (Antifungal)

52
Q

MOA: interferes with microtubule function during mitosis. Clinical use: superficial infections (oral treatment), Dermatophyte infections. SE: carcinogenic, teratogenic, confusion, headaches, and induce P-450 (it crosses the BBB).

A

Griseofulvin

53
Q

MOA: Blocks detoxification of Heme–> Heme accumulates. Clinical use: plasmodial infections except P. Falciparum. SE: retinopathy

A

Chloroquine (Antiprotozoal)

54
Q

Antiprotozoan Therapy- Pyrimethamine treats what?

A

Toxoplasmosis

55
Q

Antiprotozoan Therapy- medication for treatment of Trypanosoma brucei

A

Suramin and Melarsoprol

56
Q

Antiprotozoan Therapy- what medication is used to treat Trypanosoma Cruzi?

A

Nifurtimox

57
Q

Antiprotozoan Therapy- what medication is used to treat Leishmaniasis?

A

Sodium Stibogluconate

58
Q

What medications are used for antihelminthic therapy?

A

Pyrimethamine, pyrantel pamoate, ivermectin, Diethylcarbamazine, praziquantel.

59
Q

MOA: inhibit influenza neuraminidase–> decreased viral release (lysogeny). Clinical use: Influenza A and B –> prevention and or treatment. SE: retinopathy
What medications are involved (2)?

A

Zanamivir and Oseltamivir

60
Q

MOA: inhibit synthesis of guanine nucleotides–>through competitively inhibiting IMP Dehydrogenase. Clinical use: RSV, chronic hepatitis C. SE: hemolytic anemia, extremely teratogenic.

A

Ribavirin (Antivirals)

61
Q

MOA: guanosine analogs. Inhibits viral DNA polymerase by chain termination–> Monophosphorylated HSV/VZV thymidine kinase initiates phosphorylation (cellular enzymes add additional phosphates). Clinical use: HSV and VZV.
Resistance: viral thymidine kinase mutation

A

Acyclovir, famciclovir, valacyclovir

62
Q

MOA: Inhibits viral DNA polymerase –> CMV viral kinase causes Phosphorylation (cellular kinases add additional phosphates). Clinical use: CMV
SE: Leukopenia, neutropenia, thrombocytopenia, Nephrotoxicity. Resistance: CMV DNA polymerase Mutation, abnormal kinase, or CMV retinitis. Name the associated drug:

A

Ganciclovir (Antivirals)

63
Q

MOA: inhibits viral DNA polymerase. Binds to pyrophosphate Binding site of enzyme. No viral kinase required. Clinical use: CMV retinitis if Ganciclovir fails. SE: Nephrotoxicity
Resistance: DNA polymerase mutation

A

Foscarnet (Antivirals)

64
Q

MOA: inhibits viral DNA polymerase. No viral kinase phosphorylation required. Long half life.
Clinical use: CMV retinitis if Ganciclovir fails. Acyclovir-resistant HSV. SE: Nephrotoxicity (to reduce toxicity, coadminister with Probenacid and IV solution).

A

Cidofovir (Antivirals)

65
Q

MOA: Comp/rev. Inhibit nucleotide binding to reverse transcriptase. Needs thymidine kinase to be active. SE: bone marrow suppression, peripheral neuropathy, lactic acidosis (nucleosides), rash, megaloblastic anemia (ZDV). What drug is at hand?

A

AIDS- NRTI

66
Q

What type of drugs are being described? Abacavir, Tenofovir (does not need phosphorylation by thymidine kinase), zalacitabine, lamivudine, stavudine, didanosine (painful neuropathy and pancreatitis).

A

AIDS- NRTI

67
Q

MOA: inhibit pol gene. –> Prevents maturation
SE: hyperglycemia, GI intolerance, Lipodystrophy. These drugs end in “-navir”
What’s drug is at hand?

A

Protease inhibitors - Lopinavir, Atzanavir, Idinavir (can cause crystallization in the urine), Ritonavir (liver disease).

68
Q

MOA: Bind to reverse transcriptase at a different site. Do not need thymidine kinase to be activated. SE: bone marrow suppression, peripheral neuropathy, lactic acidosis (nucleosides), rash, megaloblastic anemia (ZDV). Medication contains “vir” in middle… What drug is at hand?

A

NNRTI- Nevirapine, Efavirenz, Delavirdine

69
Q

MOA: inhibits HIV genome integration into host cell chromosome by reversibly inhibiting HIV integrase. SE: hypercholesterolemia
Name the type of drug and its name:

A

Integrase inhibitor- Raltegravir

70
Q

What is the 5th generation cephalosporin and what does it treat?

A

Caftaroline - 1-4 gen, plus kills LAME bacteria

Lame: listeria, atypicals (chlamydia and mycoplasma), MERSA, enterococci

71
Q

Prevents peptidoglycan cross-linking by inhibiting penicillin-binding protein 3. Synergistic with aminoglycosides. No cross-allergicity (ok for Px with penicillin allergy). Used for Gram (-) rods only. No activity against G(+) rods or anaerobes. What medication is this??

A

Aztreonam (monobactams)

72
Q

This drug is a tetracycline derivative, but in its own family. Broad spectrum antibiotic that treats multi-drug resistant organisms (MRSA, VRE), or infections requiring deep tissue penetration. What drug is this?

A

Glycylcyines - Tigecycline

73
Q

This antibiotic inhibits protein synthesis by binding to 50s subunit and preventing formation of the initiation complex. Clinical use is for gram (+) species including MRSA and VRE.
SE: bone marrow suppression (esp. thrombocytopenia), peripheral neuropathy, serotonin sd.

A

Oxazolidinones - Linezolid

74
Q

This drug produced cation polypeptides that bind to phospholipids on cell membrane of gram (-) bacteria. Disrupt cell membrane integrity —> leakage of cellular components—> cell death.

A

Polymyxins - Colistin (polymyxin B)

75
Q

This medication is similar to Sulfonamides but structurally distinct agent. Clinical use: Leprosy, pneumocystis jirovecii

A

Dapsone

76
Q

This medication MOA: Lipopeptide that disrupts cell membranes of gram (+) cocci by creating transmembrane channels. Clinical use: S. Aureus (especially MRSA) bacteremia, endocarditis, VRE. what is it, and why is it not used for pneumonia?

A

Daptomycin

—> avidly binds yo and is inactivated by pneumonia.

77
Q

What is the treatment for anti-louse therapy?

A

Permethrin

MOA: inhibits Na+, Ach-esterase inhibitor, and lindane (blocks GABA action)

78
Q

What is the MOA of Chloroquines and what does it kill??

A

Blocks detox of heme, thus it accumulates and is toxic.

For all plasmodium species except Plasmodium falciparum. P. Falciparum is treated with quinidine/quinine.

79
Q

What are the 2 Fusion inhibitors, and their MOAs??

A

Enfuvirtide - binds to gp41 inhibiting viral entry. SE: rash at site of injection.

Maraviroc- binds CCR-5 on surface of T cells/monocytes, inhibiting interaction with gp120

80
Q

What are the 4 medications approved for Hep C treatment??

A

Ledipasvir, Ribavirin, Simeprevir, Sofosbuvir

Pharmacology (9 decks)

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