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Deck of Secret Knowledge > Pharm: Antimicrobials > Flashcards

Pharm: Antimicrobials Flashcards

0
Q

Where is Nafcillin and Oxacillin excreted?

A

Bile

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1
Q

What substance inhibits the tubular secretion of penicillins AND fluoroquinolones via the kidney?

A

Probenecid

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2
Q

Which penicillin is known to cause interstitial nephritis?

A

Methicillin

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3
Q

Which penicillin is known to cause neutropenia?

A

Nafcillin

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4
Q

Which cephalosporins are excreted mainly in bile?

A

Ceforperazone and Ceftriaxone

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5
Q

What is the main route for elimination of penicillins and cephalosporins?

A

Renal excretion

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6
Q

Which penicillin undergoes enterohepatic recycling?

A

Ampicillin

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7
Q

Which two 3rd generation Cephalosporin are unable to penetrate the BBB?

A

Cefoperazone and Cefixime

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8
Q

Which penicillin causes interstitial nephritis?

A

Methicillin

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9
Q

The methylthiotetrazole group in cefamandole cefoperazone and cefotetan cause which 2 adverse effects?

A

Disulfiram reactions with alcohol and hypoprothrombinemia

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10
Q

Besides cefoxitin give another cephalosporin with activity agains B. frag.

A

Cefotetan

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11
Q

Aztreonam only has activity against?

A

Gram negative bacteria

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12
Q

Cilastin given with imipinem is an inhibitor of?

A

Renal dehydropeptidase 1

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13
Q

Rapid infusion with vancomycin results in?

A

Red man syndrome

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14
Q 
Among protein synthesis inhibitors chloramphenicol and tetracyclines are known to have: 
A. Broad
B. Moderate
C. Narrow
Spectrum of activity?
A

Broad

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15
Q

Chloramphenicol is usually bacteriostatic except for the following organisms in which it is cidal.

A 
No Boyfriend (Since) HS
Neisseria meningitidis
Bacteroides spp
(Streptococcus pneumoniae)
Haemophilus influenzae

Note: S. pneumo not mentioned in Katzung but included in lecture

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16
Q

Aplastic anemia and gray baby syndrome are adverse effects of which drug?

A

Chloramphenicol.

Gray baby syndrome: cyanosis decreased RBC and cardiovascular collapse

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17
Q

Resistance to tetracyclines are thought what mechanism?

A

Efflux pumps

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18
Q

Bacitracin is active against?

A

Gram positive organisms. Limited to topical use due to nephrotoxicity.

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19
Q

Tooth enamel dysplasia with vestibular toxicity is probably due to which protein synthesis inhibitor?

A

Tetracyclines (doxycycline)

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20
Q

Which macrolide attains highest tissue levels?

A

Azithromycin

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21
Q

Which macrolide DOES NOT inhibit cyp p450?

A

Azithromycin

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22
Q

Which tetracycline can be used against ADH secreting tumors?

Characteristic toxicity?

A

Demeclocycline

Photosensitivity

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23
Q

What is a known adverse effect of streptogramins after it has been give via IV?

A

Pain and the arthralgia myalgia syndrome

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24
Q

What is the main resistance mechanism to aminoglycosides? Which 2 aminoglycosides are NOT affected by these?

A

Inactivating enzymes in the form of: Group transferases

Amikacin and streptomycin

25
Q

Which aminoglycoside is used as backup drug for N. gonorrhea?

A

Spectinomycin. Technically only an aminocyclitol related to aminoglycosides.

26
Q

What is the major AE in the use of streptomycin?

A

Ototoxicity

27
Q

Aminoglycosides depend on concentration OR time dependent killing of organisms?

A

Concentration dependent

28
Q

With normal renal function, the elimination half-life of aminoglycosides is:

A

2 - 3 hours

29
Q

Three reason why aminoglycosides are bacteriocidal

A
  1. Block formation of initiation complex
  2. Cause misreading of the code on the mRNA template
  3. Inhibit translocation
30
Q

Which aminoglycosides are more likely associated with auditory dysfunction? Vestibular dysfunction?

A

Auditory: Kanamycin, Amikacin
Vestibular: Gentamicin, Tobramycin

31
Q

Side effects of beta lactamase inhibitors

A

Hypersensitivity and cholestatic jaundice

32
Q

Clindamycin is NOT effective against?

A

Gram negative organisms

33
Q

Narrow spectrum macrolide selective for gram positive aerobes and anaerobes; used in C. difficile colitis

A

Fidaxomicin

34
Q

Antibiotic also used in diabetic gastric argh she to its stimulation of motilin receptors

A

Erythromycin

35
Q

Which among the adverse effects of aminoglycosides are IRREVERSIBLE? Nephrotoxicity, ototoxicity or neuromuscular blockade.

A

Nephrotoxicity

36
Q

How does one decrease the solubility of sulfonamide a in urine?

A

Acidify the urine

37
Q

Which sulfonamide is the longest acting?
Sulfadoxine
Sulfamethoxazole
Sulfiaoxazole

A

Sulfadoxine

38
Q

Sulfonamides compete with what substance for the enzyme dihydropteroate synthase?

A

P-aminobenzoic acid

39
Q

What is the drug of choice for BOTH nocardiosis and pneumocystis pneumonia?

A

TMP-SMX

40
Q

What form of nephrotoxicity is seen in aminoglycosides?

A

Acute tubular necrosis?

Remember: Methicillin interstitial nephritis!

41
Q

Ketolide structurally related to macrolides with a similar MOA/activity as erythromycin; used in macrolide-resistant strains.

Adverse effects include prolongation of QT interval

A

Telithromycin

42
Q

Antibiotic implicated in serotonin syndrome when used in px taking SSRI

A

Linezolid

43
Q

Sulfonamide inhibits which enzyme? Trimethoprim?

A

Sulfonamide: dihydropteroate synthase

Trimethoprim: dihydrofolate reductase

44
Q

Most common mechanism of resistance to trimethoprim

A

Production of dihydrofolate reductase that has a reduced affinity for the drug.

45
Q

Most common adverse effect of quinolones

A

Gastrointestinal distress.

Other ADEs include rashes, headache, dizziness, insomnia, abnormal LFTs, phototoxicity, tendinitis and tendon rupture.

46
Q

Bacteriostatic protein synthesis inhibitor given for Vancomycin resistant E. faecium.

Characteristic toxicity?

A

Quinupristin-dalfopristin
(Streptogramins)

Arthralgia-myalgia syndrome
CYP450 inhibition

47
Q

What is the treatment for aminoglycoside induced respiratory paralysis?

A

Calcium, neostigmine and ventilators support.

48
Q

Which generation of fluroquinolones has the greatest activity against gram negative bacteria?

A

2nd gen, cipro and ofloxacin

49
Q

What kind of anemia can be caused by trimethoprim? Ameliorated by what drug?

A

Megaloblastic anemia; folinic acid

50
Q

What is the fluoroquinolone that does not need dose adjustment for patients with renal insufficiency?

A

Moxifloxacin. Eliminated partly by hepatic and biliary mechanisms

51
Q

What adverse effect is caused by Fluoroquinolones on children?

A

Arthropathy. It can also cause tendinitis and tendon rupture.

52
Q

Ototoxicity of aminoglycosides is increase by use of:

A

Loop diuretics

53
Q

Aminoglycoside MOST likely to cause allergic skin reaction

A

Neomycin

54
Q

The use of sulfonamides in the third trimester of pregnancy can result in?

A

Kernicterus due to displacement of bilirubin from plasma proteins. Also displaces warfarin and methotrexate!

55
Q

This quinolone is associated with development of diabetes

A

Gatifloxacin, currently discontinued

56
Q

What is the MOA of metronidazole?

A

Form reactive cytotoxic products to interfere with nucleic acid synthesis. Ferredoxin bioactivates nitro group of metronidazole.

57
Q

What drug has both disulfiram like reaction with alcohol and potential ion of coumarin anticoagulant effects?

A

Metronidazole

58
Q

What is the MOA of mupirocin?

A

Inhibits protein synthesis by binding to isoleucyl-tRNA synthetase

59
Q

What do nitrofurantoin, nalidixic acid and merge amine have in common?

A

Oral drugs RAPIDLY EXCRETED into the urine and act there to suppress bacteria.

Deck of Secret Knowledge (57 decks)

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