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Pharmacology of Antibiotics Flashcards

1
Q

What ADRs are associated with sulfa antibiotics?

A

Rashes, crystalluria, Steven-Johnson syndrome

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2
Q

The B-lactamase inhibitor clavulanic acid is combined with what drug for effective treatment?

A

Amoxicillin

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3
Q

What are the common Marcolides?

A

Azithromycin, Clarithromycin, Erythromycin

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4
Q

How is Moxifloxacin eliminated?

A

Via the liver

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5
Q

What are the fourth-generation Cephalosporins?

A

Cefepime, Cefpirome, Cefditoren

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6
Q

When should Daptomycin not be used?

A

Pneumonia, with combined statin use

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7
Q

Ceftolozane is used in what cases?

A

Severe pseudomonas infection

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8
Q

True/False. Bacteriostatic antibiotics are less effective in patients without an intact immune system.

A

True. Bacteriostatic antibiotics only inhibit growth and require a strong immune response to kill and clear bacteria.

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9
Q

What Macrolide is capable of penetrating the biofilm of bacteria?

A

Clarithromycin

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10
Q

With what drug should calcium not be simultaneously administered?

A

Ceftriaxone - salt formation and organ damage

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11
Q

C. diff infection is an ADR of this antibiotic due to its concentration in bile.

A

Clindamycin - should be avoided in elderly & nursing patients

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12
Q

What are the clinical indications for the use of a Carbapenem?

A

Drug-resistant hospital-acquired infections, polymicrobial infections, G+/G- aerobes/anaerobes, neutropenic patients

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13
Q

What sufla antibiotic combination may be used for the treatment of MRSA?

A

Trimethoprim/Sulfamethoxazole

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14
Q

What are the most common Generation 3 Cephalosporins?

A

Cefdinir, Ceftriaxone, Cefixime, Ceftazadime

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15
Q

What is the MOA of sulfa antibiotics?

A

Blocks folate synthesis

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16
Q

Where is metronidazole metabolized?

A

Liver

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17
Q

What is the MOA of Nitroimidazoles?

A

DNA fragmentation

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18
Q

Erythromycin is indicated for use against what bacteria?

A

G+ aerobes, no effectiveness against G- and anaerobes

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19
Q

What drug is used orally to treat diarrhea associated with C. diff in adults?

A

Fidaxomycin

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20
Q

What adverse effects are most associated with B-lactams?

A

Immediate, severe - Anaphylaxis
Delayed, mild - rash & maculopapular rash (children)

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21
Q

What adverse reaction is most associated with piperacillin?

A

Thrombocytopenia - low platelet count

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22
Q

What antibiotic is contraindicated in patients taking an SSRI due to the potential of serotonin syndrome?

A

Linezolid

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23
Q

Milk, antacids, and iron should be avoided when taking what class of antibiotics?

A

Tetracyclines

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24
Q

What adverse effects are associated with vancomycin?

A

Red man syndrome, nephrotoxicity, ototoxicity

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25
Q

A 5yo child develops a rash after starting amoxicillin to treat strep pharyngitis. The physician decides to switch the patient to another B-lactam drug. What is the most likely candidate?

A

Cefdinir (Generation 3 Cephalosporin) - broad-spectrum, highly resistant to B-lactamases, effective in children

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26
Q

What is the drug of choice for syphilis treatment?

A

Penicillin G

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27
Q

What drug classes are protein synthesis inhibitors?

A

Lincosamides, Macrolides, Tetracyclines, Aminoglycosides

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28
Q

True/False. Aminoglycosides should only be administered via IV.

A

True, oral forms are ineffective

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29
Q

How is Ceftriaxone metabolized and excreted?

A

Metabolized in the liver and excreted in bile - drug recommended for renal impaired patients

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30
Q

What categories of antibiotics inhibit cell wall synthesis?

A

B-lactams & glycopeptides

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31
Q

Why is Cilastatin used in combination with Imipenem?

A

Prevents Imipenem metabolism into a toxic metabolite by the kidney, decreasing renal clearance and nephrotoxicity

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32
Q

What penicillin drugs may be used to treat MSSA?

A

Oxacillin
Nafcillin - severe
Dicloxacillin - mild to moderate

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33
Q

What effect will antacids and dairy products have on Levofloxacin?

A

Decrease bioavailability by reducing absorption

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34
Q

Doxycycline is indicataed for the treatment of…?

A

CLARA The Stupid CAT

Chlamydia, Lyme Disease, Anthrax, Rickettsia, atypical Pneumonia, Trachomonatis, Staph aureus, Cholera, Acne, Traveler’s Diarrhea

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35
Q

What ADRs are associated with tetracyclines?

A

Phototoxicity, teeth discoloration, GI discomfort, chelation with Ca2+

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36
Q

What are the common Marcolides?

A

Azithromycin, Clarithromycin, Erythromycin

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37
Q

What are the two mechanisms of action for bacteriocidal antibiotics?

A

Inhibit cell wall & DNA synthesis

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38
Q

What ADRs are associated with Macrolides?

A

Liver enzyme inhibitor, QT prolongation

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39
Q

Neurotoxicity is an adverse drug reaction associated with what B-lactam drug?

A

Cefepime (4th generation Cephalosporin)

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40
Q

What are the clinical indications for use of a Third Generation Cephalosporin?

A

Multi drug-resistant G- infection & hospital-acquired infections

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41
Q

Metronidazole & Tinidazole can be used against what pathogens?

A

Anaerobic bacteria & protozoa (except malaria)

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42
Q

Ceftazadime may only be delivered via IV. What bacterial infection is it usually used to treat?

A

Pseudomonas

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43
Q

Antibiotics with what MOA are indicated in immunocompromised patients?

A

Bacteriocidal - inhibit cell wall & DNA synthesis

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44
Q

What adverse effects are associated with Moxifloxacin?

A

Chondrotoxicity, aneurysm, QT prolongation, glycemic fluctuations, phototoxicity

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45
Q

What ribosome subunit is targetted by Lincosamides & Macrolides?

A

50S

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46
Q

How are most 3rd generation Cephalosporins administered?

A

IV

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47
Q

What are the most common Generation 1 Cephalosporins?

A

Cephalexin & Cefazolin

48
Q

What is the MOA of Daptomycin?

A

Cell membrane inhibitor

49
Q

What Macrolide is contraindicated in pregnant women?

A

Erythromycin

50
Q

How does the MOA of glycopeptides differ from B-lactams?

A

Inhibit transglycosylation in cell wall synthesis instead of binding to the transpeptidase

51
Q

What are the contraindications for the use of tetracyclines?

A

Pregnancy, women who are nursing, infants, children,

52
Q

Fourth-generation Cephalosporins are reserved for use when?

A

Multi-drug resistant infections, pseudomonas, G- bacteria, immunocompromised patients

53
Q

Metronidazole use is contraindicated in what patients?

A

Alcoholics, patients on lithium or warfarin, patients in their first trimester of pregnancy

54
Q

How are most B-lactams excreted?

A

Kidney

55
Q

Penicillin VK is the drug of choice for what disease?

A

Strep pharyngitis

56
Q

What third generation Cephalosporin may be used against respiratory infections, UTIs, & gonorrhea?

A

Cefixime

57
Q

What are the commonly used Carbapenems?

A

Imipenem, Meropenem, Ertapenem

58
Q

What B-lactamase inhibitor is combined with piperacillin for effective treatment?

A

Tazobactam

59
Q

What are the common aminoglycosides?

A

Gentamycin, amikacin, tobramycin, streptomycin

60
Q

What adverse effects are associated with metronidazole?

A

Metallic taste, brown-red urine, nausea, psychosis, disulfiram-like reaction

61
Q

What Monobactam is used as a first-aid ointment against G+ cocci?

A

Bacitracin

62
Q

Imipenem is not used in children. Why is this?

A

Can cause seizures in children

63
Q

What is the penicillin drug of choice to treat Pseudomonas?

A

Piperacillin with tazobactam

64
Q

What penicillin drugs may be used to treat MSSA?

A

Oxacillin
Nafcillin - severe
Dicloxacillin - mild to moderate

65
Q

What Fluoroquinolone is not indicated for use in renal or urinary infections?

A

Moxifloxacin - indicated for anaerobes

66
Q

What is a common adverse effect of Ceftriaxone use?

A

Bile stones & induration after injection

67
Q

What are the clinical indications for Ciprofloxacin use?

A

Pseudomonas, anthrax, complicated UTIs & STIs

68
Q

How are the uses of Generation 2 Cephalosporins differentiated?

A

Cefuroxime generally treats severe infections above the waist, while Cefoxitin treats infections below the waist

69
Q

What B-lactam drug is indicated in patients with a B-lactam allergy infected with a G- aerobe?

A

Aztreonam (Monobactam)

70
Q

What classes of drugs are B-lactams?

A

Penicillins, Cephalosporins, Carbapenems, Monobactams

71
Q

What penicillin antibiotic is safe for use during pregnancy and breast feeding?

A

Ampicillin

72
Q

What is a major contraindication for the use of a sulfa antibiotic?

A

Allergy, pregnancy

73
Q

What Carbapenem is most effective against Enterobacteriaceae?

A

Meropenem

74
Q

True/False. The effectiveness of Cephalosporins against G+ bacteria increases with each generation.

A

False. Generation 1 Cephalosporins are very effective against G+ bacteria, but this decreases with each generation as effectiveness against G- bacteria increases

75
Q

What is the most common side effect of erythromycin?

A

GI disturbances due to increased peristalsis

76
Q

Moxifloxacin has good activity against what type of bacteria?

A

Anaerobes

77
Q

What is the MOA of Fluroquinolones?

A

Binds to the bacterial topoisomerase to inhibit DNA synthesis

78
Q

What adverse reaction is most associated with piperacillin?

A

Thrombocytopenia - low platelet count

79
Q

The kidney excretes most B-lactams. What are the exceptions to this?

A

Nafcillin - bile excretion
Moxifloxacin - liver excretion

80
Q

What are the clinical indications for Vancomycin use?

A

Severe G+ infection, MRSA, B-lactam allergy, prophylaxis

81
Q

What tetracycline should be administered via IV?

A

Tigecycline

82
Q

What are the 4 MOA for antibiotics?

A

Inhibit cell wall synthesis
Inhibit DNA/RNA synthesis
Inhibit folate synthesis
Inhibit protein synthesis

83
Q

What are the most common glycopeptides?

A

Vancomycin, Telavancin, Bacitracin

84
Q

What ADRs are associated with aminoglycosides?

A

Renal toxicity & ototoxicity

85
Q

Amoxicillin is used for the treatment of what?

A

Strep pharyngitis (in children) & acute otitis media

86
Q

Clindamycin is recommended for treatment of infections caused by what types of bacteria?

A

G+ cocci & anaerobes, generally infections above the diagphragm

87
Q

What B-lactamase inhibitor is combined with ampicillin for effective treatment?

A

Sulbactam

88
Q

Clindamycin belongs to what drug class?

A

Lincosamides

89
Q

What are the most common Generation 2 Cephalosporins?

A

Cefuroxime, Cefoxitin

90
Q

What is the MOA of Fidaxomycin?

A

Binds to the RNA polymerase to inhibit RNA synthesis

91
Q

What is the effect of Probenecid on B-lactams?

A

The half-life of B-lactams is prolonged and the dose must be reduced

92
Q

What is the only B-lactam antibiotic with coverage against MRSA?

A

Ceftaroline (5th generation Cephalosporin)

93
Q

Describe the PK of B-lactams.

A

Short half-life with good tissue distribution, kidney elimination

94
Q

What is the MOA of B-lactam antibiotics?

A

Bind to transpeptidase (PBP) to prevent cross-linkage of the peptidoglycan wall

95
Q

Aminoglycosides are indicated for the treatment of infections by what bacteria?

A

G- aerobes

96
Q

What antibiotic is associated with the ADR gray baby syndrome?

A

Chloramphenicol

97
Q

What penicillin can be administered only via IV or IM?

A

Penicillin G. Only Penicillin VK can be administered PO

98
Q

What classes of drugs are DNA synthesis inhibitors?

A

Nitroimidazoles - Metronidazole, Tinidazole

Fluoroquinolones - Ciprofloxacin, Levoflaoxacin, Moxifloxacin

99
Q

How is Clindamycin metabolized?

A

By the liver and excreted in feces

100
Q

What antibiotics are often used for surgical prophylaxis?

A

Generation 1 Cephalosporins - Cephalexin & Cefazolin

101
Q

What ribosome subunit is targetting by Tetracyclines & Amingoglycosides?

A

30S

102
Q

A patient is diagnosed with a mycoplasma infection. What antibiotic is relatively cheap and extremely effective for treatment?

A

Azithromycin

103
Q

What are the contraindications for the use of tetracyclines?

A

Pregnancy, women who are nursing, infants, children

104
Q

Cephalexin & Cefazolin are most effective against what types of bacteria?

A

Staph & strep, skin infections, aerobes (NO anaerobic coverage)

105
Q

A patient is prescribed a Cephalosporin to treat meningitis. Soon after, they develop eosinophilia, decreased Hb, nausea, and vomiting. What Cephalosporin were they likely prescribed?

A

Cefuroxime (Generation 2)

106
Q

Methicillin-sensitive staph infections may be treated with what penicillin drugs?

A

Nafcillin, oxacillin, dicloxacillin

107
Q

Nafcillin, oxacillin, and dicloxacillin are most commonly used to treat…?

A

Mild to moderate staph infections that are methicillin-sensitive (systemic staph, osteomyelitis, endocarditis)

108
Q

Sepsis, pseudomonas, and hospital-acquired pneumonia can all be treated with what penicillin drugs?

A

Ticarcillin & Piperacillin

109
Q

Steven-Johnson Syndrome is associated with what drug class?

A

Aminopenicillins

110
Q

Amoxicillin is most commonly used to treat…?

A

Strep pharyngitis, acute otitis media, lyme disease, sinusitis, H. pylori

111
Q

What is the only Cephlasporin effective against Mrs.A?

A

Ceftaroline

112
Q

What is the empiric treatment of gonorrhea?

A

Ceftriaxone, IM administration

113
Q

What Cephlasporin is the empiric treatment for meningitis?

A

Ceftriaxone

114
Q

What Cephalosporin is used as surgical prophylaxis?

A

Cefazoline, Cephalexin

115
Q

What antibiotic classes bind the 30S ribosomal subunit?

A

Tetracyclines & aminoglycosides

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