S13C158 - Pharmacology of Antimicrobics, antifungals, antivirals Flashcards
1
Q
-beta-lactams and glycopeptide MOA
A
- beta-lactam=penicillins and cephalosporins
- glycopeptides = vancomycin, teicoplanin, daptomycin
- cell wall active agents
- bind to bacterial cell wall, weaken it and cell lyses
- glycopeptides prevent cross-linking
- resistance occurs from mutations to the pcn-binding proteins that reduce binding of the abx to the cell wall
2
Q
-protein synthesis inhibitors
A
- aminoglycosides, macrolides, linezolid, tetracyclines, clindamycin
- bind to ribosomes w/in bacteria, block protein synthesis
- aminoglycosides/tetracylines = 30S subunit
- macrolide/clindamycin = 50s subunit
- resistance occurs from resistance of cell wall permeability or pump that removes abx from the cell
3
Q
-fluoroquinolones/rifampin/macrobid MOA
A
- nucleic acid inhibitors
- fluoroquinolones = inhibits DNA gyrase
- resistance occurs from decreased cell wall permeability
- rifampin inhibits RNA synthesis by binding RNA polymerase
- macrobid damages DNA (bacteria rarely become resistant)
4
Q
-sulfonamides/trimethoprim
A
- enzyme inhibitors
- block steps in formation of folic acid
- resistance occurs from enzyme mutations
5
Q
-examples of: natural penicillins
A
-pen G and V
6
Q
-examples of: aminopenicillins
A
- ampicillin
- amoxicillin
7
Q
-examples of: penicillinase-resistant penicillins
A
- oxacillin
- cloxacillin
- dicloxacillin
- nafcillin
8
Q
-examples of: antipseudomonal penicillins
A
- piperacillin
- ticarcillin
9
Q
-examples of: beta lactam/beta lactamase inihibior combos
A
- amox-clav
- ticarcillin-clavulanic acid
- ampicillin-sulbactam
- pip-tazo
10
Q
-examples of: monobactams and carbapenems
A
- aztreonam
- ertapenem
- meropenem
- imipenem
11
Q
-examples of: aminoglycosides
A
- gentamicin
- neomycin
- streptomycin
- tobramycin
12
Q
-examples of: fluoroquinolones
A
- moxifloxacin
- ciprofloxacin
- levofloxacin
13
Q
-examples of: 1st gen cephalosporin
A
- cefazolin (ancef) IV
- cephapirin
- cephalexin
- cefadroxil
14
Q
-examples of: 2nd gen cephalosporin
A
- cefaclor PO
- cefotetan IV
- cefuroxime PO
- cefproxil PO
- cefoxitin IV
- cefuroxime IV
15
Q
-examples of: 3rd gen cephalosporin
A
- ceftibuten PO
- cefotaxime IV
- ceftazidime IV
- ceftriaxone IV
- cefpodoxime PO
16
Q
-examples of: 4th generation cephalosporin
A
-cefepime (IV)
17
Q
-examples of: macrolides/tetracyclines
A
- erythromycin IV/PO
- azithromycin IV/PO
- clarithromycin PO
-tetracycline, minocycline, doxycycline
18
Q
–examples of: folate inhibitors
A
- septra (trimethroprim-sulfamethoxazole)
- trimpex (trimethoprim)
19
Q
-Bacteria cause and Abx tx of: pharyngitis
A
- GAS
- pcn
- alt: macrolide
20
Q
-Bacteria cause and Abx tx of: sinusitis
A
- strep pneumo, h flu
- amox or amox-clav, or cefuroxime
- alt: macrolide or doxy
21
Q
-Bacteria cause and Abx tx of: epiglottitis
A
- h flu, GAS
- CTX
- alt: cefuroxime
22
Q
-Bacteria cause and Abx tx of: CAP
A
- s pneumoniae, viral, mycoplasma
- azithromycin
- alt: levofloxacin
23
Q
-Bacteria cause and Abx tx of: CAP aspiration
A
- aerobes, anaerobes
- clindamycin
- alt: pip-taz, or CTX plus flagyl
24
Q
-Bacteria cause and Abx tx of: CAP EtOH
A
- s pneumoniae, klebsiella
- CTX
- alt: levofloxacin
25
-Bacteria cause and Abx tx of: UTI
- e coli, enteric gm- rods
- septra
- alt: cipro, cephalexin, macrobid
26
-Bacteria cause and Abx tx of: cellulitis
- GAS, staph aureus
- cephalexin
- alt: dicloxacillin, clinda, septra, vanco
27
-Bacteria cause and Abx tx of: necrotizing fasciitis
- polymicrobial
| - imipenem, meropenem plus vanco
28
-Bacteria cause and Abx tx of: cat bite
- pasteurella, mixed flora
- amox-clav
- clindamycin, cipro
29
-Bacteria cause and Abx tx of: meningitis
- s pneumoniae, n meningitides, s aureus
| - ctx, vanco
30
-Bacteria cause and Abx tx of: meningitis immunocompromised
- listeria, h flu
| - add ampicillin
31
-Bacteria cause and Abx tx of: acute abdomen
- gm- rods, anaerobes, enterococci
| - pip-taz
32
-Common side effects: aminoglycosides
- nephrotoxicity (usually reversible)
| - ototoxicity
33
-Common side effects: clindamycin
-pseudomembranous colitis (c diff)
34
-Common side effects: tetracyclines
-deposits and discolors teeth and bone
35
-Common side effects: vancomycin
-red person syndrome (phlebitis)
36
-Common side effects: fluoroquinolones
- long QT
| - tendonitis, tendon rupture
37
-Common side effects: sulfonamides
- SJS
- hepatitis
- crystalluria
38
clindamycin does not cross the BBB effectively
True, therefore not good for meningitis (same with macrolides)
39
Contraindications: fluoroquinolones
- long QT
- tendonitis
- myasthenia gravis
40
Contraindications: flagyl
-first trimester of pregnancy
41
Contraindications: sulfonamides
-pregnancy at term
42
Abx drug interactions: aminoglycosides
- neuromuscular blockers (prolonged resp depression)
| - loop diuretics - increased auditory toxicity
43
Abx drug interactions: fluoroquinolones
-antacids reduce absorption of fluoroquinolones
44
Abx drug interactions: macrolides
-clarithromycin increases levels of warfarin, cyclosporin, lovastatin
45
Abx drug interactions: penicillins
- allopurinol- increased rash with ampicillin
| - probenicid reduces renal clearance of the abx
46
Abx drug interactions: tetracyclines
- antacids reduce oral absorption
| - cause OCP failure
47
-Abx drug interactions: septra
-increases serum levels of phenytoin
