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Tintinalli Section 13 - Infectious Diseases > S13C158 - Pharmacology of Antimicrobics, antifungals, antivirals > Flashcards

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
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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
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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)
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4
Q

-sulfonamides/trimethoprim

A
  • enzyme inhibitors
  • block steps in formation of folic acid
  • resistance occurs from enzyme mutations
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5
Q

-examples of: natural penicillins

A

-pen G and V

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6
Q

-examples of: aminopenicillins

A
  • ampicillin

- amoxicillin

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7
Q

-examples of: penicillinase-resistant penicillins

A
  • oxacillin
  • cloxacillin
  • dicloxacillin
  • nafcillin
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8
Q

-examples of: antipseudomonal penicillins

A
  • piperacillin

- ticarcillin

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9
Q

-examples of: beta lactam/beta lactamase inihibior combos

A
  • amox-clav
  • ticarcillin-clavulanic acid
  • ampicillin-sulbactam
  • pip-tazo
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10
Q

-examples of: monobactams and carbapenems

A
  • aztreonam
  • ertapenem
  • meropenem
  • imipenem
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11
Q

-examples of: aminoglycosides

A
  • gentamicin
  • neomycin
  • streptomycin
  • tobramycin
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12
Q

-examples of: fluoroquinolones

A
  • moxifloxacin
  • ciprofloxacin
  • levofloxacin
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13
Q

-examples of: 1st gen cephalosporin

A
  • cefazolin (ancef) IV
  • cephapirin
  • cephalexin
  • cefadroxil
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14
Q

-examples of: 2nd gen cephalosporin

A
  • cefaclor PO
  • cefotetan IV
  • cefuroxime PO
  • cefproxil PO
  • cefoxitin IV
  • cefuroxime IV
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15
Q

-examples of: 3rd gen cephalosporin

A
  • ceftibuten PO
  • cefotaxime IV
  • ceftazidime IV
  • ceftriaxone IV
  • cefpodoxime PO
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16
Q

-examples of: 4th generation cephalosporin

A

-cefepime (IV)

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17
Q

-examples of: macrolides/tetracyclines

A
  • erythromycin IV/PO
  • azithromycin IV/PO
  • clarithromycin PO

-tetracycline, minocycline, doxycycline

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18
Q

–examples of: folate inhibitors

A
  • septra (trimethroprim-sulfamethoxazole)

- trimpex (trimethoprim)

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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
Q

-Bacteria cause and Abx tx of: UTI

A
  • e coli, enteric gm- rods
  • septra
  • alt: cipro, cephalexin, macrobid
26
Q

-Bacteria cause and Abx tx of: cellulitis

A
  • GAS, staph aureus
  • cephalexin
  • alt: dicloxacillin, clinda, septra, vanco
27
Q

-Bacteria cause and Abx tx of: necrotizing fasciitis

A
  • polymicrobial

- imipenem, meropenem plus vanco

28
Q

-Bacteria cause and Abx tx of: cat bite

A
  • pasteurella, mixed flora
  • amox-clav
  • clindamycin, cipro
29
Q

-Bacteria cause and Abx tx of: meningitis

A
  • s pneumoniae, n meningitides, s aureus

- ctx, vanco

30
Q

-Bacteria cause and Abx tx of: meningitis immunocompromised

A
  • listeria, h flu

- add ampicillin

31
Q

-Bacteria cause and Abx tx of: acute abdomen

A
  • gm- rods, anaerobes, enterococci

- pip-taz

32
Q

-Common side effects: aminoglycosides

A
  • nephrotoxicity (usually reversible)

- ototoxicity

33
Q

-Common side effects: clindamycin

A

-pseudomembranous colitis (c diff)

34
Q

-Common side effects: tetracyclines

A

-deposits and discolors teeth and bone

35
Q

-Common side effects: vancomycin

A

-red person syndrome (phlebitis)

36
Q

-Common side effects: fluoroquinolones

A
  • long QT

- tendonitis, tendon rupture

37
Q

-Common side effects: sulfonamides

A
  • SJS
  • hepatitis
  • crystalluria
38
Q

clindamycin does not cross the BBB effectively

A

True, therefore not good for meningitis (same with macrolides)

39
Q

Contraindications: fluoroquinolones

A
  • long QT
  • tendonitis
  • myasthenia gravis
40
Q

Contraindications: flagyl

A

-first trimester of pregnancy

41
Q

Contraindications: sulfonamides

A

-pregnancy at term

42
Q

Abx drug interactions: aminoglycosides

A
  • neuromuscular blockers (prolonged resp depression)

- loop diuretics - increased auditory toxicity

43
Q

Abx drug interactions: fluoroquinolones

A

-antacids reduce absorption of fluoroquinolones

44
Q

Abx drug interactions: macrolides

A

-clarithromycin increases levels of warfarin, cyclosporin, lovastatin

45
Q

Abx drug interactions: penicillins

A
  • allopurinol- increased rash with ampicillin

- probenicid reduces renal clearance of the abx

46
Q

Abx drug interactions: tetracyclines

A
  • antacids reduce oral absorption

- cause OCP failure

47
Q

-Abx drug interactions: septra

A

-increases serum levels of phenytoin

Tintinalli Section 13 - Infectious Diseases (14 decks)

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