Most missed points Flashcards
Static antibiotics
- sulfonamide
- trimethoprim
- nitofurantoin
- tetracyclines
- tigecyclines
- chloramphenicol
- macrolides (erythromycin, clarithromycin, azithromycin)
- ketolide (telithromycin)
- clindamycin
- linezoid
Effective against MRSA
- trimthroprim
- vancomysin
- daptomycin
- linezoid
- quinupistin/dalfopristin
effective against gram positive ONLY
- metronidazole
- antistaphlococcal penicillins (Methicillins)
- vancomycin
- daptomycin
- macrolides (erythromycin, clarithromycin, azithromycin)
- clindamycin
- linezoid
- quinupistin/dalfopristin
effective agains gram negative ONLY
- methenamine
- naturally occurring penicillins (G&V)
- monobactams
- polymyxins
- aminoglycosides
concentration dependent
***exhibit a considerable post-antibiotic effect
- quinolones
- daptomycin
- aminoglycosides
time dependent
- beta-lactams (penicillins, cephalosporins, monobactams, carbapenems)
- macrolides (erythromycin, clarithromycin, azithromycin)
- clindamycin
- linezoid
given by IV route only
- monobactams
- carbepenems
- vancomycin
- daptomycin
- aminoglycosides
given only topically
bacitracin
metabolized by the liver and can cause liver problems
- rifamprin
- ketolide (telithromycin)
effective against pseudomonas
- 4th generation cepholosporins
- carbapenems
- anti-pseudomonal penicillins
- aminoglycosides
- MACROLIDES
effective against C. difficile
vancomycin (and MRSA and severe colitis)
“floxacins”
quinolones
beta-lactams
- penicillins
- cephalosporins
- monobactams
- carbapenems
-enems
carbapenems
azetreonam
monobactam
3 beta lactamase inhibitors
- clavulanic acid
- sulbactam
- tazobactam
*used in combination with beta-lactam antibiotics
bacteria that lacks a cell wall so is inherently resistant to beta-lactams, vancomyocin, and bacitracin
mycoplasma
streptomyocin and neomyosin
aminoglycosides
telithromycin
ketolide
protein synthesis inhibitors that only bind to 30S subunit
tetracycline
tigecycline
protein synthesis inhibitors that bind to both 30S and 50S
aminoglycosides
used as treatments in hospitals
- carbapenems (“restricted” for severe nosocomial)
- polymyxins
- aminoglycosides
mechanism: inhibits dihydropteroate synthase
sulfonamide
mechanism: inhibits dihydrofolate reductase
trimethoprim
mechanism: binds to and inhibits RNA polymerase
rifamprin
mechanism: “poison” DNA gyrase A and uncoil replication fork
quinolones
mechanism: forms oxygen free radicals that bind and affect DNA function
- nitrofurantoin
- metronidazole
mechanism: hydrolize acidic pH to form formaldehyde
methenamine
mechanism: mimics D-ala-D-ala structure and ties up transpeptidase
penicillins
cephalosporins
mechanism: inhibits B-lactamases by binding to serine
B-lactamase inhibitors
mechanism: binds to carboxy terminus of D-ala-D-ala and:
1. inhibits peptidoglycan synthase
2. inhibits transpeptidation reaction
vancomysin
mechanism: binds to isoprenyl-phosphate lipid carrier
bacitracin
mechanism: acts as cationic detergent to disrupt cell membrane of Gm - bacteria
polymyxins
mechanism: inserts lipophilic tail into cell membrane and works very quickly
daptomycin
first line anti-tuberculosis drug
rifpamrin (also use quinolones)
spectrum has four generations that start out as being effective towards gm + but then switch to being effective against gm -
cephalosporins
“restricted” drug used against serious nosocomial infections
carbapenems
“suicide” inhibitors that bind irreversibly
b-lactamase inhibitors
resistance is a major issue for this drug and can lead to hearing loss and REDNECK syndrome
vancomycin
only offered topically
bacitracin
methicillin type of penicillin that has a very serious resistant strain known as MRSA
anti-staphlococcal
*nafacillin, oxacillin, cloxacillin
three types of anti-pseudomonal penicillins
carbenicillin
piperacillin
ticarcillin
has a limited clinical use because of fatal aplastic anemia (gray baby syndrome)
chlorophenicol
effective against M. pneumoniae, legionnaire’s disease, clamydia, pneumonias and other RESPIRATORY dieases
macrolides (erythromycin, clarithromycin, azithromycin)
has toxicities such as kernicterus that cross the BBB and dose related hypersensitivity that results in STEPHEN JOHNSON SYNDROME
sulfonamide
involves with P. jaroveci in AIDS as well as slight blood dyscrasia and anemia in pts that are folate deficient
trimethoprim
toxicities include liver damage —> jaundice
rifamprin
induces hepatic micorsomal enzymes and can therefore inc metabolism and dec the half-life of HIV proteases
rifamprin
generally well tolerated but should avoid ciprofloxacin with children bc it can rupture tendons
quinolones
poor renal function leads to toxicity and eventually pulmonary fibrosis
nitrofurantoin
relatively non-toxic but direct toxic effects in the kidney are noted as well as hyper toxicity
penicillins
cephalosporins
can be toxic if reaches the CNS cause seizures
carbapenems
used in combination with B latam drugs to expand their spectrum
B-lactamase inhibitors
shows nephrotoxicity in pts with renal disease
polymyxins
cannot be used on lung infections because it gets inactivated by pulmonary surfactant
daptomycin
displays:
ototoxicity- cochlear hair cell death
nephrotoxicity
neuromuscular blockade in pts with MYAESTHENIA GRAVIS
aminoglycosides
binds to bone and teeth, can stain teeth and retort bone growth
tetracyclines
***tigecyclines DO NOT have this, big difference
used for complicated intra-abdominal and skin infections
should not be used in bacteremias bc of low serum levels
tigecyclines
effective against macrolide resistant strains
ketolide (telithromycin)
effective against penicillin-resistant strains
also used as topical acne medication
clindamycin
