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Year 2 Resp Exam 2 > Overview of antimicrobials Part II, J Kinder, DSA > Flashcards

Overview of antimicrobials Part II, J Kinder, DSA Flashcards

1
Q

MOA Fluoroquinolones

A

[ ] dependent, targets DNA gyrase and topoisomerase IV

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2
Q

how does R form to fluoroquinolones

A

mutation in bacterial chromosome genes encoding DNA gyrase or topoisomerase IV or by active transport out of cell

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3
Q

spectrum of coverage with FQ

A

E coli, Salmonella, Shigella, Enterobacter, Campylobacter, Neisseria, Pseudomonas, S aureus
limited Strep

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4
Q

Therapeutic use of FQ

A

UTI, prostatitis, STI, travelers diarrhea, shigellosis, bone, joint, SSTI infections, diabetic foot infections, propylaxis in neutropenic patients

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5
Q

Respiratory specific FQ cover what pathogens

A

S pneumoniae, H influenzae, Morazella, S aureus, M pneumoniase, C pneumoniae, Legionella

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6
Q

Cipro covers what additional pathogen

A

pseudomonas

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7
Q

What are the FQs

A

Cipro, levofloxacin, moxifloxicin

PO, IV, topical

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8
Q

Adverse effects FQs

A

GI 3-17% (nausea, comiting
CNS: HA, dizziness, rare halucinations
rash photosensitivity
Achilles tendon rupture

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9
Q

What are the aminoglycosides

A

gentamycin IV, IM, topical

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10
Q

MOA aminoglycosides

A

[ ] dependent, bind 30S ribosomes and disrupt normal cycle of ribosomal function by interfering with protein synthesis

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11
Q

how do aminoglycosides reach the site of action

A

diffusion through porin proteins in outer cell membrane of gram negative bacteria and electron transport/Oxygen dependent movement across cytoplasmic membrane

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12
Q

What is the post antibiotic effect of aminoglycosides

A

residual bactericidal activity after serum [ ] below MIC

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13
Q

how does R form to aminoglycosides

A

AG metabolizing enzymes, impaired transport of drug into cell, altered ribosomes

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14
Q

Spectrum covered by aminoglycosides

A

aerobic gram - bacteria

if combined with B lactam of vancomycin then kill gram +

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15
Q

Gentamycin is really active against what microbe

A

Serratia

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16
Q

Therapeutic use AGs

A

UTI
if there is R to other agents
pneumonia, HAP, peritoniitis assoc with dialysis

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17
Q

adverse effects of AGs

A

ototoxicity, nephrotoxicity, NMblock and apnea

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18
Q

What are the tetracyclines and glycylcyclines

A

doxycycline PO IV

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19
Q

MOA doxy

A

bacteriostatic, inhibits bacterial protein synthesis by binding 30S ribosomes and preventing access of aminoacyl tRNA to acceptro site on mRNA complex

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20
Q

R to doxy occurs how

A

decreased influx, acquisition of energy dependent efflux, ribosomal protection proteins, enzymatic inactivation

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21
Q

spectrum of doxy

A

wide range aerobic and anaerobic gram + and gram - activity as well as: Rickettsia, Coxeilla, Mycoplasma, Chlamydia spp, Legionella, Pasmodium, Borrelia, Treponema
B anthracic, Listeria, MRSA, H influenza, Helicobacter

22
Q

What is R to doxy

A

Pseudomonas spp

23
Q

Therapeutic use doxy

A

CAP, atypical CAP, community acquired SSTIs, community acquired MRSA, acne, Rickettsial infections(Rocky mountain spotted fever), Q fever, anthrax

24
Q

adverse effects doxy

A

GI (epigastric burining, abdominal discomfort, nausea, vomiting, diarrhea
superinfections of C difficile, photosensitivity, teeth discoloration, thrombophlebitis

25
Q

What are the macrolides/ketolids

A

Azithromycin PO IV

26
Q

MOA zpak

A

bacteriostatic, binds reversibly to 50S ribosomal unit

inhibits translocation where newly synthesized peptidyl tRNA molecule moves to donor site

27
Q

R to zpaks occur how

A

drug efflux, ribosomal protection proteins, hydrolysis, ribosomal mutations

28
Q

spectrum of zpaks

A

aerobic gram + cocci and bacilli

Clostridium perfringens, Corynebacterium diphteria, Listeria

29
Q

Therapeutic use of zpaks

A

respiratory tract infections, alternative for otitis media, sinusitis, bronchitis, SSTIs, Pertussis, gastroenteritis, H pylori, mycobacterial infections

30
Q

adverse effects of zpaks

A

GI: epigastric distress
hepatotoxicity
arrhythmia
QT prolongation

31
Q

Drug interactions with zpaks

A

CYP3A4 inhibition

prolongs effects of digoxin, valproate, warfarin, others

32
Q

What are the lincosamides

A

Clindamycin PO, IV, IM topical

33
Q

MOA clinda

A

binds 50S and suppresses protein synthesis

34
Q

R to clinda

A

ribosomal methylation

35
Q

Spectrum clinda

A

penumococci, S pyogens, viridans, streptococci, MSSA, anaerobes like B fragilis

36
Q

What are R to clindamycin

A

all aerobic gram - bacilli

37
Q

Therapeutic uses of clinda

A

SSTIs, nectrotizing SSTIs, lung abscesses, anaerobic lung and pleural space infections, topically for acne vulgaris

38
Q

adverse effects of clinda

A 
GI diarrhea
pseudomembranous colitis
skin rashes
reversible increase in aminotransferase activity
may potentiate neuromuscular blockade
39
Q

What are the streptogramins

A

quinipristin/dalfopristin (IV)

*non respiratory

40
Q

What are the oxazolidinones

A

Linezolid PO, IV

41
Q

MOA linezolid

A

inhibits proteins synthesis binding P of 50S subunits, preventing formatino of larger ribosomal fmet-tRNA complex that initiates protein synthesis

42
Q

R to linezolid occurs how

A

ribosomal mutations

43
Q

Spectrum of linezolid

A

gram + staphy and strep, enterococci, gram + anaerobic cocci and rods

44
Q

linezolid is bactericidal against what and bacteriostatic against what

A

bacteriocidal against strep

bacteriostatic against staphy and enterococci

45
Q

Therapeutic use of linezolid

A

CRE faecium, nosocomial pneumonia caused by MSSA and MRSA, CAP, complicated SSTI infections, uncomplicated SSTIS

46
Q

linezolid is reserved for what

A

multiple drug resistanc organisms

47
Q

adverse effects linezolid

A

myelosuppresion, minor GI complaints, HA, rash

48
Q

drug interactions with linezolid

A

weak nonspecific inhibitor monoamine oxidase, concomitant adrenergic or serotonergic may lead to serotonin syndrome (palpitations, HA, HTN crisis)
short term use

49
Q

What are the polymyxins

A

Colistin and Polymyxin B

** not respiratory

50
Q

What are the lipopeptides

A

daptomycin

** not respiratory

Year 2 Resp Exam 2 (33 decks)

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