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AUC Hematology, Oncology, Immunology > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

B-lactam antibiotics

A

Type/class of antibiotics that inhibit cell wall synthesis. Identified via four-membered ring. Follow time-dependent kinetics. Binds PBP, inhibiting cross links in peptidoglycan chain. Not effective against Mycoplasma.

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2
Q

Glycopeptides

A

Type/class of antibiotics that inhibit cell wall synthesis. Follow time-dependent kinetics.

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3
Q

Penicillins.

A

Family of B-lactam antibiotics. Primarily effective against Gram positive bacteria (streptococcal infections, neonatal meningitis, endocarditis, listeria), spirochetes (syphilis), Gram negative cocci (meningococcal meningitis), and anaerobes (actinomycosis, gas gangrene).

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4
Q

Beta-lactamase

A

Also known as penicillinase. Breaks down four-membered beta-lactam ring, inhibiting the antibiotic. Provides resistance to the bacteria. Common in Staphylococci.

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5
Q

MRSA

A

Methicillin resistance in Staphylococci aureus. Caused by a structural change in the PBP

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6
Q

Penicillin G

A

Only administered intravenously or intramuscularly. Can be used prophylactically to prevent newborn infection from group B streptococci.

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7
Q

Benzathine penicillin G

A

Only administered intramuscularly. Can be used prophylactically to prevent Group A strep (GAS) in rheumatic fever.

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8
Q

Probenecid

A

Interferes with renal secretion of beta-lactam antibiotics, increasing their half-life

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9
Q

Adverse effects of penicillins

A

1) Severe IgE-mediated anaphylaxis. (These patients are usually treated with non B-lactam drugs)
2) Can cause seizures in high doses
3) Can cause Jarisch-Herxheimer reaction in secondary syphilis

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10
Q

Ampicillin

A

Extended-spectrum penicillin. Used to treat listeria infections and Enterococci in addition to streptococci. Usually administered intravenously. Can be used prophylactically to prevent newborn infection against Group B streptococci.

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11
Q

Amoxicillin

A

Given orally. Used to treat H. Pylori, E. Coli, H. Influenza, Moraxella, and Pasteurella. Used in dog bites, acute otitis media, and prophylaxis in dental procedures.

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12
Q

Piperacillin

A

Treats pseudomonas. Greater activity against P. Aeruginosa. Typically injected.

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13
Q

Methicillin

A

Penicillinase-resistant penicillin. Not available for clinical use due to nephritis. Treats staph infections.

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14
Q

Nafcillin

A

Penicillinase-resistant penicillin. Treats staph infections (MSSA)

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15
Q

Dicloxacillin

A

Penicillinase-resistant penicillin. Used to treat staph infections (MSSA)

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16
Q

Oxacillin

A

penicillinase-resistant penicillin. Used to treat staph infections (MSSA)

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17
Q

Clavulanic acid

A

B-lactamase (penicillinase) inhibitor. BLIs allows B-lactan drugs to also target B-lactamase producing bacteria. Commonly paired with amoxicillin.

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18
Q

Tazobactam

A

B-lactamase (penicillinase) inhibitor. BLIs allows B-lactan drugs to also target B-lactamase producing bacteria. Commonly paired with piperacillin.

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19
Q

Sulbactam

A

B-lactamase (penicillinase) inhibitor. BLIs allows B-lactan drugs to also target B-lactamase producing bacteria. Commonly paired with ampicillin.

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20
Q

Adverse effects of extended spectrum penicillins

A

Diarrhea from Pseudomembranous colitis caused by C. Difficile, typically due to ampicillin. Can sometimes cause a rash.

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21
Q

Cephalosporins

A

A family of B-lactam antibiotics. Not resistant to extended-spectrum B-lactamases, but are more resistant to B-lactamases than penicillin. Typically ineffective against Listeria, atypical Mycoplasma, MRSA, and Enterococci with a few exceptions. Inhibits transpeptidase to prevent peptidoglycan linkage.

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22
Q

1st generation cephalosporins

A

Effective against Gram positive streptococci, Staph infections (MSSA), gram negative E. Coli, Klebsiella (PEK) and P mirabilis. Used to treat UTIs, cellulitis, and pharyngitis.

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23
Q

Cephalexin

A

Oral first generation cephalosporin

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24
Q

Cefazolin

A

Injected first generation cephalosporin. Drug of choice for surgical prophylaxis against staph infections (MSSA).

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25
Q

2nd generation cephalosporins

A

Effective against anaerobic bacteria, H. Influenza, B. Fragilis, and Gram positive bacteria.

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26
Q

Cefuroxime

A

Oral second generation cephalosporin, used to treat H. Influenza.

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27
Q

Clindamycin

A

Second generation cephalosporin, used to treat anaerobes above the diaphragm. Can be used prophylactically in dental procedures against streptococci Viridians.

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28
Q

Metronidazole

A

Second generation cephalosporin used to treat anaerobes below the diaphragm

29
Q

3rd generation cephalosporins

A

More effective against Gram negative bacteria than second generation, but less effective against gram positive bacteria than first generation.

30
Q

Cefotaxime

A

Injected 3rd generation cephalosporin. Used to treat meningitis, acute pyelonephritis, and typhoid fever

31
Q

Ceftriaxone

A

Injected third generation cephalosporin. Used to treat meningitis, acute pyelonephritis, typhoid fever, and gonorrhea when used with tetracycline or azithromycin

32
Q

Ceftazidime

A

Injected third generation cephalosporin. Used to treat pseudomonas.

33
Q

Cefepime

A

Fourth generation cephalosporin that covers both gram positive and gram negative bacteria. Resistant against B-lactamase, and is effective in bacterial meningitis and pseudomonas

34
Q

Ceftaroline

A

5th generation cephalosporin used to treat MRSA

35
Q

Carbapenems

A

A family of beta-lactam antibiotics. Highly effective against Gram positive, Gram negative, and anaerobic bacteria. Not effective against MRSA. Typically used for severe infection against multi-drug resistant bacteria. Treats intra-abdominal infections and UTI and ESBL producing bacteria.

36
Q

Imipenem

A

A carbapenem antibiotic. Inactivated by renal dehydropeptidase, and so often administered with cilastatin (inhibits renal dehydropeptidase). Adverse effects can include seizures in renal failure.

37
Q

Monobactams

A

A family of B-lactam antibiotics. Active against aerobic gram positive rods, used particularly to react patients with renal insufficiency who can’t tolerate Aminoglycosides. Can be used in patients who are allergic to penicillin.

38
Q

Vancomycin

A

A Glycopeptide antibiotic (non-B-lactam). Inhibits transglycosylase to destroy cell wall. Can treat MRSA, C. Difficile pseudomembranous colitis, or enterococcal endocarditis. Not effective against gram negative bacteria.

39
Q

Adverse effects of vancomycin

A

Red man syndrome (histamine release), nephrotoxicity, dress syndrome, needs plasma monitoring (especially in renal failure).

40
Q

Tetracycline

A

Family of protein synthesis inhibitors that bind reversible to the A site of 30s ribosomes. Bacteriostatic. Cations interfere with absorption. E. coli and S. Pneumoniae are resistant to increased efflux via active transport. Can target Gram positive, Gram negative, Chlamydiae, and Rickettsiae. Used to treat severe acne, cholera, chlamydial infection, and Rocky Mountain spotted fever.

41
Q

Aminoglycosides

A

Family of protein synthesis inhibitors that bind irreversibly to the D or P sites of 30s ribosomes. Not absorbed well orally. High concentration in kidney and inner ear. Nephrotoxicity and ototoxicity. Effective against aerobic gram-negative bacteria. Concentration dependent, possess post-antibiotic effect. Contraindicated in pregnancy

42
Q

Macrolides

A

Protein synthesis inhibitors that bind to the 50s ribosome. Examples include erythromycin, clarithromycin, and azithromycin. Inhibits translocation step. Primarily Bacteriostatic. Esterases in gram negative or methylase in gram positive bacteria confer resistance

43
Q

Chloramphenicol

A

Protein synthesis inhibitor that binds to 50s ribosome subunit

44
Q

Gentamicin

A

Most common aminoglycoside. Treats plague. Can be used in conjunction with ampicillin to treat enterococcal infections or listeria infections. Can be used with ceftazidime, or piperacillin/tazobactam to treat pseudomonas.

45
Q

Streptomycin

A

Aminoglycoside used to treat TB

46
Q

Neomycin

A

Aminoglycoside used orally in colorectal surgery prophylaxis. Treats hepatic encephalopathy.

47
Q

Doxycycline

A

A prototype tetracycline.

48
Q

Tigecycline

A

Derivative of tetracycline, used in MRSA, VRSA, VRE, and anaerobic infections. Can cause increased risk of death.

49
Q

Adverse effects of tetracycline

A

Bone deformity and teeth discoloration in children, photosensitization

50
Q

Erythromycin

A

A Macrolide used to treat gram positive infections, namely diphtheria prophylaxis and acne vulgaris. Can cause cholestactic hepatitis. Used as a penicillin substitute.

51
Q

Clarithromycin

A

Macrolide that inhibits CYP 450

52
Q

Azithromycin

A

Macrolide that is safe with pregnancy. Minimal CYP 450 inhibition. Can be used to treat community acquired pneumonia.

53
Q

Fidaxomicin

A

Macrolide used to treat C. Difficile infections.

54
Q

Chloramphenicol

A

Bacteriostatic antibiotic that binds to 50s ribosome subunit. Used to treat severe rickettsial disease. Can cause aplastic anemia or gray baby syndrome.

55
Q

Clindamycin

A

Lincosamide used to treat anaerobic infections, prophylaxis of endocarditis in dental procedures, aspiration lung abscess, and acne. Can cause C. Difficile induced pseudomembranous colitis due to superinfection.

56
Q

Linezolid

A

An oxazolidinone that is used to treat MRSA as well as vancomycin resistant enterococci (VRE). Can cause thrombocytopenia, lactic acidosis, and can act as a weak MAO-inhibitor.

57
Q

Streptogramins

A

Family of antibiotics that inhibit protein synthesis in the same manner as macrolides. Used primarily for MRSA and VRE infections.

58
Q

Sulfonamides

A

A group of antibiotics that inhibit folic acid synthesis. Analogs of PABA. Bacteriostatic when alone, Bactericidal when used with trimethoprim. Can cause photosensitivity, Stevens-Johnson syndrome, Hemolysis in G6-PD deficiency, and should be avoided in pregnancy. Displaces bilirubin and warfarin.

59
Q

Trimethoprim-sulfamethoxazole

A

TMP-SMX is a bactericidal combination. Inhibits sequential steps in THF synthesis. Used to treat UTIs and PCP/PJP

60
Q

Fluoroquinolones

A

A family of antibiotics that inhibits DNA synthesis by blocking either DNA gyrase (topoisomerase II, gram negative bacteria) or topoisomerase IV (gram positive bacteria). Primarily used against gram-negative aerobic bacteria. Can also be used against atypical bacteria, such as chlamydia or mycoplasma. Antacids interfere with their absorption. Great against salmonella (typhoid fever) and prophylaxis/anthrax treatment.

61
Q

Ciprofloxacin

A

2nd generation Fluoroquinolone. Best against pseudomonas. Inhibits CYP 450 metabolism and may produce seizures.

62
Q

Levofloxacin

A

Second generation Fluoroquinolone that is active against S. Pneumoniae

63
Q

Moxiflaxin

A

Third generation Fluoroquinolone that is very active against S. Pneumoniae.

64
Q

Adverse effects of fluoroquinolones

A

Tendinitis, photosensitivity, cartilage damage to infants/young children (avoid in pregnancy).

65
Q

Lower UTI

A

Can be cystitis, urethritis, or cervicitis

66
Q

Upper UTI

A

Pyelonephritis.

67
Q

Nitrofurantoin

A

Used to treat lower UTIs or prevention of acute uncomplicated cystitis. Can cause Hemolytic anemia in G6DP

68
Q

Fosfomycin

A

Single oral dose for uncomplicated cystitis that is safe in pregnancy.

AUC Hematology, Oncology, Immunology (4 decks)

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