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Clinical Pharmacology > Overview of Antimicrobials > Flashcards

Overview of Antimicrobials Flashcards

1
Q

MOA - disrupt cell wall production

A
  1. B-lactam: PCN, Cephalosporins, Carbapenems (workhorses)
  2. Monobactams (Aztreonam)
  3. Glycopeptides (Vanco)
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2
Q

MOA - inhibit DNA synthesis

A
  1. FQ

2. Metronidazole

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3
Q

MOA - destabilize cell membranes (ice pick puncturing balloon)

A
  1. cyclic lipopeptides
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4
Q

MOA - destabilize cell wall & cell membrane

A
  1. lipoglycopeptides
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5
Q

MOA - inhibit protein synthesis

A

50S ribosome

  1. macrolides (Azithro)
  2. lincosamides (Clindamycin)
  3. oxazolidinones (Linezolid)
  4. pleuromutilins

30S ribosome

  1. aminoglycosides (AG)* - Genta, Tobra
  2. tetracyclines (TTC) - Doxy
  3. glycylcyclines
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6
Q

MOA - inhibit folic acid synthesis

A
  1. TMP-SMX
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7
Q

3 general mechanisms of Abx resistance

A
  1. decrease intracellular [drug]
  2. drug inactivation by enzymes (Beta lactamases)
  3. abx target modification - decreased affinity for PBP (old key, new deadbolt), DNA topoisomerase mod, rRNA methylation
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8
Q

Bolded bactericidal vs. bacteriostatic

When is bactericidal preferred?

A

Bactericidal: b-lactam, FQ

Bacteriostatic: TTC, macrolides

-cidal agents preferred if host is compromised or host defense do not operate well

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9
Q

What is concentration-dependent killing?

A

Increased drug concentration increases bactericidal effects.

Large, infrequent doses enhance efficacy and minimize toxicity. Think of a tsunami.

e.g. AG, FQ, glycopeptides, lipoglycopeptides

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10
Q

What is post-antibiotic effect?

A

Short exposure to abx prevent microbe from growing even after abx has been removed.

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11
Q

What is time-dependent killing?

A

Drug is effective as long as concentration is > MIC.

Small frequent doses or continuous infusion.

e.g. b-lactam

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12
Q

Abx active against intracellular organisms

A
  1. FQ

2. Macrolides

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13
Q

Anti-anaerobic abx

A
  1. Clindamycin
  2. Metronidazole
  3. PO Amox/Clav
  4. IV ampicillin/sulbactam & pip/taz
  5. all carbapenems
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14
Q

“Bioequivalent” Abx

A
  1. FQ
  2. TTC
  3. Metronidazole
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15
Q

Abx renal excretion

A
  1. b-lactam (most)
  2. monobactam
  3. glycopeptide
  4. cyclic lipopeptides/lipoglycopeptides
  5. AGs
  6. FQs (split excretion)
  7. TTC/glycylcyclines (split excretion)
  8. Oxazolidinones (split excretion)
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16
Q

Abx hepatic excretion (memorize these so you don’t have to know renal)

A
  1. Ceftriaxone*
  2. Nafcillin
  3. Clindamycin
  4. All Macrolides*
  5. Rifampin
  6. Metronidazole*

MUST KNOW THE STARRED

17
Q

What anti-anaerobic abx would you use if above the diaphragm, such as the oropharynx?

A

Clindamycin

18
Q

What anti-anaerobic abx would you use if below the diaphragm, such as in the colon?

A

Metronidazole

Clinical Pharmacology (54 decks)

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