Overview Of Antibacterial Therapy (word Doc) Flashcards
Staph, Strep, and Enterococci are what category of bacteria?
Gram Positive Cocci
N gonorrheae, N meningitidis, and M catarrhalis are what category of bacteria?
Gram negative cocci
Bacillus anthracis, Listeria monocytogenes are what category of bacteria?
Gram positive rods
H influenzae, E coli, and Pseudomonas aeruginosa are what category of bacteria?
Gram negative rods
Clostridium difficile, tetani, and botulinum are what category of bacteria?
Anaerobes: Gram Positive rod
Bacteroides fragilis is what category of bacteria?
Anaerobe: Gram negative rod
Chlamydia, Mycoplasma, and Rickettsia are what category of bacteria?
Atypical
Name the 8 bacteria most commonly seen in meningitis. (Hint: BEHLN-SSS)
- Bacteroides
- E coli
- H influenza
- Listeria monocytogenes
- N meningitidis
- Staph aureus
- Strep pneumo
- Strep pyogenes
Name the 4 bacteria most commonly associated with skin and soft tissue infections. (Hint: CPSS)
- Clostridia species
- Pseudomonas aeruginosa
- Staph aureus
- Strep pyogenes
Name the 3 most common bacteria assoc. w/ Endocarditis. (Hint: SSS)
Staphy aureus
Srep pyogenes
Strep viridans
Name the 2 most common bacteria assoc. w/ URI’s. (Hint: SS)
Strep pneumoniae
Strep pyogenes
Name the 3 most common bacteria assoc. w/ Lower respiratory tract infections. (Hint: CMS)
Chlamydia pneumoniae
Mycoplasma pneumoniae (walking pneumonia)
Strep pneumo
Name the two most common bacteria assoc. w/ hospital acquired lung infections. (Hint: BP)
Bacteroides fragilis
Pseudomonas aeruginosa
Name the 3 most common bacteria assoc. w/ PID (pelvic inflammatory disease) (Hint: BCN)
Bacteroides species
Chlamydia trachomatis
N gonorrhea
Name the 2 most common bacteria assoc. w/ UTI’s. (Hint: EP)
E Coli
Pseudomonas aeruginosa
Name the 3 most common bacteria assoc. w/ intra-abdominal infections. (Hint: CEB)
C difficile
E coli
Bacteroides fragilis
Name one bacteria assoc. w/ liver and pancreas infections.
Bacteroides fragilis
Name the most common bacteria related to mouth infections.
Strep viridans
Name the 4 most common bugs assoc. w/ bone and joint infections. (Hint: NPSS)
N gonorrhoeae
Pseudomonas aeruginosa
Strep pneumo
Staph aureus
Name the 2 most common bugs assoc. w/ genital infections. (Hint: CN)
Chlamydia trachomatis
N gonorrhoeae
Name the 4 types of abx that have MOA’s for cell wall synthesis. (Hint: VPMC)
- Vancomycin (glycopeptide, gram pos, MRSA)
- Penicillins (Gram pos bugs)
- Monobactams (Aztreonam, Gram Neg, Pseudomonas)
- Cephalosporins (1st gen gram pos Cephalexin/Cefazolin, 2nd gen more gram neg Cefuroxime, 3rd gen less gram pos more gram neg Ceftriaxone/Cefotaxime/Cefpodoxime, 4th gen Cefepime covers Pseudomonas, 5th gen Ceftaroline covers MRSA)
Name the 4 types of abx whose MOA works on nucleic acids (ie: DNA gyrase, RNA polymerase, and DNA) (HINT: FRMN)
1) Fluoroquinolones: Gram neg/pos, good respiratory penetration
- Ciprofloxacin (covers Pseudomonas, only one non-respiratory, used for UTI and lower abd infx)
- Levofloxacin (covers pseudo)
- Moxifloxacin (only one that doesn’t cover pseudomonas)
2) Riffffffampin for H infffffffluenzae
3) Metronidazole (anaerobic below diaphragm)
4) Nitrofurantoin (used for UTI’s and ear infections)
Name the 4 types of abx whose MOA works on inhibition of protein synthesis. (TAMC)
1) tetracyclines: Gram pos, MRSA coverage
- doxycycline
- tetracycline
- minocycline
2) Aminoglycosides: Gram Neg with anti-Pseudomonal activity; toxicities assoc. w/ them such as ototoxic and nephrotoxic
- Gentamicin
- Tobramycin
- Amikacin
3) Macrolides (azithro, erythro, clarithromycin)
- atypical pneumonia coverage, H influenzae
- azithro (strep pneumo is resistant)
4) Clindamycin
- Gram pos and good anaerobic coverage
Name one abx whose MOA is protein synthesis (tRNA).
- Oxazolidinones: Gram Pos, MRSA, VRE
- Linezolid
- Tedizolid
Name two abx whose MOA’s work on cell membranes.
1) Lipopeptide: Gram Pos MRSA and VRE; NO LUNG PENETRATION
- Daptomycin
2) Polymyxins: used in abx skin ointments like bacitracin
Name the one abx whose MOA works on Folic Acid Metabolism.
-Trimethoprim Sulfamethoxazole (Bactrim): Gram Neg and MRSA
Selective toxicity: bacteria must synthesize folate intracellularly while mammalian cells can take up folate from the environment. Which abx class acts on folate metabolism?
Trimethoprim sulfamethoxazole (Bactrim)
Selective toxicity: certain abx can work on protein synthesis, specifically ribosomes, because humans have 40s/60s ribosomes whereas bacteria have 30s/50s ribosomes. What 4 abx work on protein synthesis inhibition?
- Aminoglycosides (gentamicin)
- Tetracyclines (doxycycline)
- Lincosamides (clindamycin)
- Macrolides (azithromycin, clarithromycin, etc)
Selective toxicity: bacterial nucleic acid synthesis is different from humans. Bacteria use DNA gyrase for their circular DNA, while humans use topoisomerase. Name the 4 abx classes that work on nucleic acid synthesis. (Hint: FRNN)
- Fluoroquinolones (cipro, levo)
- Rifampin
- Nitroimidazole (Metronidazole)
- Nitrofurantoin
Selective toxicity: human cells don’t have a cell wall. What 5 abx classes inhibit cell wall synthesis? (Hint: LPMCC)
- Lipopeptide (Vancomycin)
- Penicillins (amoxicillin)
- Cephalosporins (cefepime, ceftaroline)
- Monobactams (Aztreonam)
- Carbapenems (dori, erta, miri)
What is the major constituent of fungal membranes, whereas cholesterol is that in humans?
Ergosterol
What are the 3 bactericidal mechanisms?
- Inhibition of cell wall synthesis
- disruption of cell membrane function
- interference with DNA function or synthesis
What are the 2 bacteriostatic mechanisms?
- Inhibition of protein synthesis (exception is aminoglycosides, which are -cidal; gentamycin, amikacin, tobramycin)
- inhibition of intermediary metabolic pathways
Narrow spectrum abx are effective against gram + OR -. Name the 6 mentioned by French.
- Aminoglycosides (gentamycin)
- Penicillinase-resistant penicillins (augmentin, pip-tazo, dicloxacillin)
- Clindamycin (Lincosamide)
- Vancomycin (glycopeptide)
- Metronidazole
- Penicillin G, V
Exented spectrum work on both gram pos AND gram neg. Name the 4 mentioned by French.
Extended-spectrum penicillins (amoxicillin, ampicillin, amox-clav, pip-tazo)
Cephalosporins
Fluoroquinolones (cipro, levo)
Carbapenems
What 5 abx readily enter CSF and cross BBB?
- Chloramphenicol
- Trimethoprim-Sulfamethoxazole
- Cephalosporins (3rd/4th)
- Rifampin
- Metronidazole
What 4 abx enter CSF poorly?
Aminoglycosides (gentamycin)
Cephalosporins (1st/2nd)
Erythromycin (Macrolide)
Clindamycin (Lincosamide)
Name the 6 drugs that should be used with caution or avoided during pregnancy.
- Aminoglycosides (D: gentamycin)
- Metronidazole (1st trimester)
- Chloramphenicol (C)
- Tetracyclines (D)
- Fluoroquinolones (C)
- Voriconazole (D)
Selective distribution:
Name the 4 beneficial accumulation abx mentioned by French.
1) Clindamycin into bone (osteomyelitis)
2) Macrolides like clarithromycin into pulmonary cells (URI)
3) Tetracyclines like doxy into gingival fluid and sebum (periodontitis and acne)
4) Nitrofurantoin rapidly excreted into urine (UTIs)
Selective distribution:
Name the 2 abx referenced for selective accumulations that can increase the potential for toxicity.
1) Aminoglycosides (gentamycin, amikacin, tobramycin) ototoxicity and nephrotoxicity
2) Tetracyclines (doxy) binds to Ca2+ in developing bone and teeth (abnl bone growth and brown teeth)
