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Pharmacology > Spectrums > Flashcards

Spectrums Flashcards

1
Q

Imipenem

A

Carbapenem (P) (Needs to be paired with Cilastatin to inhibit dehydropeptidase)

G+:

  • Staph (not MRSA)
  • Strep (including PRSP)
  • Listeria
  • Enterococcus

G-:

  • H. Influ
  • Neisseria
  • Enterobacteriaceae
  • Pseudomonas
  • Acinetobacter

Anaerobes:

  • Most (except C diff)

SMAC are RESISTANT

Spirochete, MRSA, Atypicals, C diff

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2
Q

Meropenem

A

Carbapenem (P)

G+:

  • Staph (not MRSA)
  • Strep (including PRSP)
  • Listeria
  • Enterococcus

G-:

  • H. Influ
  • Neisseria
  • Enterobacteriaceae
  • Pseudomonas
  • Acinetobacter

Anaerobes:

  • Most (except C diff)

SMAC are RESISTANT

Spirochete, MRSA, Atypicals, C diff

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3
Q

Ertapenem

A

Carbapenem (P)

G+:

  • Staph (not MRSA)
  • Strep (including PRSP)
  • Listeria

G-:

  • H. Influ
  • Neisseria
  • Enterobacteriaceae

Anaerobes:

  • Most (except C diff)

SMAC APE are RESISTANT

Spirochete, MRSA, Atypicals, C diff, Acinetobacter, Pseudomonas, Enterococcus

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4
Q

Aztreonam

A

Monobactam (P)

G- (ONLY):

  • Pseudomonas
  • Serratia
  • Enterobacteriaceae

Alternative for AG’s in G- infections

NO GRAM POS OR ANAEROBE ACTIVITY

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5
Q

Vancomycin

A

Vancomycin (P) (ORAL FORMULATION FOR C DIFF)

Bacteriocidal: Prevent Transglycosylation and subsequent transpeptidation reaction

G+:

  • MRSA
  • VRSA (w/ an aminoglycoside)
  • PRSP (w/ a G3 Cephalosporin)
  • Enterococci (NOT VRE)

Anaerobes:

  • C diff (GIVEN ORALLY FOR THIS)
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6
Q

Televancin

A

Televancin (P) (reserve for resistant gram positives)

Bacteriocidal: Like vancomycin (prevents transglycosylation) but also disrupts bacterial membane

G+:

  • MRSA
  • VRSA
  • VRE
  • PRSP

Anaerobes:

  • C Diff
    *
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7
Q

Bacitracin

A

Bacitracin (T) (often combined with Neomycin or Polymixin topically)

Topically for Skin and Occular (Oral for C Diff Colitis RARELY)

Block step 2 of CWS with Blocking Bactoprenol Phosphate

G+:

  • Streptococcus
  • Staphylococcus
  • Enterococcus (INCLUDING VRE)

G-:

  • Some

Anaerobes:

  • ALL (INCLUDING C DIFF)
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8
Q

Fosfomycin

A

Fosfomycin (O)

Similar to Phosphoenolpyruvate structurally; ireversibly inhibits Enolpyruvate transferase- blocks synthesis of UDP MurNAc (step 1)

Used Primarily for UTIs (good distribution to bladder, kidneys, prostate and seminal vess)

  • Enterobacteriaceae
  • Serratia
  • Proteus
  • Ecoli
  • Citrobacter
  • Klebsiella
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9
Q

Tobramycin

A

Aminoglycoside (poorly absorbed in stomach and intestines) (more expensive then Genta)

Bactericidal: Irreversible binding to the 30S subunit to inhibit INITIATION

Reserved for serious G- infections resistant to less toxic drugs (Aminoglycosides have best action against aerobic gram - but are also often more toxic)

G+:

  • MRSA (w/ Vancomycin)
  • Listeria (w/ Ampicillin)
  • Streptococcus

G-:

  • Pseudomonas (w/ piperacillin)
  • Enterobacteriaceae
  • H Influenza
  • Mycobacteria

INEFECTIVE AGAINST ANAEROBES and ENTEROCOCCI

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10
Q

Amikicin

A

Aminoglycoside

Reserved for organisms resistant to other AGs (more resistant to drug modifying enz)

G+:

  • MRSA
  • Listeria (w/ Ampicillin)
  • Streptococcus

G-:

  • Pseudomonas (w/ piperacillin)
  • Enterobacteriaceae
  • H Influenza
  • Mycobacteria (MDR- TB) (better than Genta or Tobra)

INEFECTIVE AGAINST ANAEROBES and ENTEROCOCCI

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11
Q

Neomycin

A

Aminoglycoside (T) (Most Nephrotoxic so limited to Topical use w/ bacitracin and polymixin)

Used as PROPHYLAXIS FOR COLORECTAL SURGERY (HSR with long term use)

Gram + and Gram -

BUT NO ANAEROBES

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12
Q

Gentamicin

A

Aminoglycoside

G+:

  • Enterococci (w/B-Lac or Vanc)
  • MRSA (w/ Vancomycin)
  • Listeria (w/ Ampicillin)
  • Streptococcus

G-:

  • Pseudomonas (+ piperacillin)
  • Enterovacteriaceae
  • H Influenza
  • Mycobacteria:various

INEFFECTIVE AGAINST ANAEROBES

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13
Q

Streptomycin

A

Aminoglycoside

Least toxiv but also least active against G- and resistance is developed quickly

G+:

  • Enterococci

G-:

  • Francisella Tularensis
  • Yersinia Pestis
  • Brucellosis
  • Mycobacterial TB

INEFFECTIVE AGAINST ANAEROBES AND PSEUDOMONAS

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14
Q

Tetracycline

A

Tetracyclines (O) (food decreases absorption)

Broad Spectrum

Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION

Absorption is decreased by Polyvalent cations

G+:

  • Streptococcus (PRSP
  • Staphylococcus (CA-MRSA)
  • Enterococcus
  • Listeria

G-:

  • H. Influenza
  • Neisseria Meningitides
  • Enterobacteriaceae

Anaerobes:

  • Most (except C. Diff)
  • PROPRIONIBACTERIUM (ACNE)

Biological Warfare:

  • Brucellosis
  • Y Pestis
  • F. Tularensis (w/ an aminoglycoside
  • Bacilus anthracis

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Atypicals

  • Mycoplasma Pneumonia
  • Chlamydia Trachomatis
  • Erlichia

Rickettsiae:

  • RMSF

Mycobacteria:

  • Mycobacteria (TB, M. Leprae)

PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)

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15
Q

Doxycycline

A

Tetracyclines (O,P) (Hepatic) (Food does NOT decrease absorption)

Broad Spectrum

Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION

Absorption is decreased by Polyvalent cations

G+:

  • Streptococcus (PRSP
  • Staphylococcus (CA-MRSA)
  • Enterococcus
  • Listeria

G-:

  • H. Influenza
  • Neisseria Meningitides
  • Enterobacteriaceae

Anaerobes:

  • Most (except C. Diff)
  • PROPRIONIBACTERIUM (ACNE)

Biological Warfare:

  • Brucellosis
  • Y Pestis
  • F. Tularensis (w/ an aminoglycoside
  • Bacilus anthracis

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Atypicals

  • Mycoplasma Pneumonia
  • Chlamydia Trachomatis
  • Erlichia

Rickettsiae:

  • RMSF

Mycobacteria:

  • Mycobacteria (TB, M. Leprae)

PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)

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16
Q

Minocycline

A

Tetracyclines (O,P) (food does NOT decrease absorption)

Broad Spectrum

Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION

Absorption is decreased by Polyvalent cations

G+:

  • Streptococcus (PRSP
  • Staphylococcus (CA-MRSA)
  • Enterococcus
  • Listeria

G-:

  • H. Influenza
  • Neisseria Meningitides
  • Enterobacteriaceae

Anaerobes:

  • Most (except C. Diff)
  • PROPRIONIBACTERIUM (ACNE)

Biological Warfare:

  • Brucellosis
  • Y Pestis
  • F. Tularensis (w/ an aminoglycoside
  • Bacilus anthracis

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Atypicals

  • Mycoplasma Pneumonia
  • Chlamydia Trachomatis
  • Erlichia

Rickettsiae:

  • RMSF

Mycobacteria:

  • Mycobacteria (TB, M. Leprae)

PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)

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17
Q

Tigecycline

A

Tetracyclines (P) (Biliary)

Broad Spectrum

Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION BUT IT BINDS WITH 5X THE AFFINITY OF TETS

Additional coverage to tetracyclines

  • PRSP
  • MRSA (CA+HA)
  • VRSA
  • VRE

SAME AS TETRACYCLINES BELOW

G+:

  • Streptococcus (PRSP
  • Staphylococcus (CA-MRSA)
  • Enterococcus
  • Listeria

G-:

  • H. Influenza
  • Neisseria Meningitides
  • Enterobacteriaceae

Anaerobes:

  • Most (except C. Diff)
  • PROPRIONIBACTERIUM (ACNE)

Biological Warfare:

  • Brucellosis
  • Y Pestis
  • F. Tularensis (w/ an aminoglycoside
  • Bacilus anthracis

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Atypicals

  • Mycoplasma Pneumonia
  • Chlamydia Trachomatis
  • Erlichia

Rickettsiae:

  • RMSF

Mycobacteria:

  • Mycobacteria (TB, M. Leprae)

PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)

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18
Q

Erythromycin

A

Macrolides (absorption dec by food) (all macrolides billiary)

Bacteriostatic: Binds 50S and blocks translocation (macro slide prevents sliding)

G+:

  • Staphylococcus (NOT MRSA)
  • Streptococcus (NOT PRSP)
  • C diptheria

G-:

  • Neisseria Meningitidis
  • Bordetella Pertussis
  • Campylobacter
  • H. INfluenza

Atypicals:

  • Chlamydia
  • Mycoplasma Pneumonia
  • Legionella Pneumophillia

Rickettsieae

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Anaerobes:

  • PROPRIONIBACTERIUM
  • All (EXCEPT C DIFF)
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19
Q

Azitromycin

A

Macrolides (absorption dec by food) (all macrolides billiary)

Bacteriostatic: Binds 50S and blocks translocation (macro slide prevents sliding)

ERythro (seen below) Plus

  • Moraxella
  • MAC

G+:

  • Staphylococcus (NOT MRSA)
  • Streptococcus (NOT PRSP)
  • C diptheria

G-:

  • Neisseria Meningitidis
  • Bordetella Pertussis
  • Campylobacter
  • H. INfluenza

Atypicals:

  • Chlamydia
  • Mycoplasma Pneumonia
  • Legionella Pneumophillia

Rickettsieae

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Anaerobes:

  • PROPRIONIBACTERIUM
  • All (EXCEPT C DIFF)
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20
Q

Clarithromycin

A

Macrolides (absorption IS DELAYED BY FOOD NOT DEC) (all macrolides billiary)

Bacteriostatic: Binds 50S and blocks translocation (macro slide prevents sliding)

ERythro (seen below) Plus

  • Moraxella
  • MAC
  • H Pylori (w/ amoxicillin and omeprazole)

G+:

  • Staphylococcus (NOT MRSA)
  • Streptococcus (NOT PRSP)
  • C diptheria

G-:

  • Neisseria Meningitidis
  • Bordetella Pertussis
  • Campylobacter
  • H. INfluenza

Atypicals:

  • Chlamydia
  • Mycoplasma Pneumonia
  • Legionella Pneumophillia

Rickettsieae

Spirochetes:

  • Treponema Pallidum
  • Borrelia Burgdorferi

Anaerobes:

  • PROPRIONIBACTERIUM
  • All (EXCEPT C DIFF)
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21
Q

Clindamycin

A

Lincosamide (absorption not affected by food) (Unchanged when renally excreted)

Bacteriostatic: binds 50S to block Initiation complex AND block translocation step

G+:

  • Streptococcus (PRSP)
  • Staphylococcus (CA-MRSA)

Anaerobes:

  • MOST (EXCEPT C DIFF)

NO GRAM NEGATIVE EFFECT DUE TO INEFFICIET PORIN PENETRATION

22
Q

Chloramphenicol

A

Chloramphenicol (P) (inactivated by glucuronosyl transferase host enzyme) abosrbed well in gut (last resort drug rarely used in US)

Bacteriostatic: binds to 50S to block Petidyl transferase and prevent peptide bond formation

chloRAMPHEnicol

  • Ricettsiae
  • Anaerobes and Atypicals
  • Meningococci
  • Pneumococci
  • H Influenza
  • Enterobacteriaceae
23
Q

Sulfamethoxazole

A

Sulfonamide (O) (broad spectrum) (almost always combo therapy with DHFI) (low solubitiy=Crystalluria)

Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA

G+:

  • Streptococcus
  • Staphylococcus (CA-MRSA)
  • Listeria

G-

  • Enterobacteriaceae
  • Y. Enterocolitica
  • E. Coli
  • Salmonella
  • Shigella
  • H. Influenza
  • Nocardia
  • Pneumocystis Carinii
24
Q

Sulfisoxazole

A

Sulfonamide (O) (broad spectrum) (almost always combo therapy with DHFI) (Highly soluble little renal toxicity)

Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA

(COMBO WITH ERYTHROMYCIN FOR OTITIS MEDIA IN KIDS)

G+:

  • Streptococcus
  • Staphylococcus (CA-MRSA)
  • Listeria

G-

  • Enterobacteriaceae
  • Y. Enterocolitica
  • E. Coli
  • Salmonella
  • Shigella
  • H. Influenza
  • Nocardia
  • Pneumocystis Carinii
25
Q

Sulfasalazine

A

Sulfonamide (O) (broad spectrum) (almost always combo therapy with DHFI) (Poorly absorbable=good for gi and IBD)

Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA

Metabolites have further antibiotic and antiinflammatory 5ASA activity

G+:

  • Streptococcus
  • Staphylococcus (CA-MRSA)
  • Listeria

G-

  • Enterobacteriaceae
  • Y. Enterocolitica
  • E. Coli
  • Salmonella
  • Shigella
  • H. Influenza
  • Nocardia
  • Pneumocystis Carinii
26
Q

Silver Sulfadiazine

A

Sulfonamide (TOPICAL) (broad spectrum) (almost always combo therapy with DHFI) (low solubitiy=Crystalluria)

Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA

Inhibits NEARLY ALL BACTERIA AND FUNGI USED IN BURN/SKIN INFECTIONS
BUT CAN LEAD TO SUPERINFECTIONS

G+:

  • Streptococcus
  • Staphylococcus (CA-MRSA)
  • Listeria

G-

  • Enterobacteriaceae
  • Y. Enterocolitica
  • E. Coli
  • Salmonella
  • Shigella
  • H. Influenza
  • Nocardia
  • Pneumocystis Carinii
27
Q

Trimethoprim

A

Dihydrofolate Reductase Inhibitor

Competitive inhibitor of dihydrofolate reductase much stronger for bacterial than human

Concentrates in acidic fluid like the prostate and vagina

CAN BE USED ALONE IN UTI AND PROSTATE INFECTIONS BUT USUALLY PAIRED WITH SULFONAMIDES

G+:

  • Streptococcus
  • Staphylococcus (CA-MRSA)
  • Listeria

G-

  • Enterobacteriaceae
  • Y. Enterocolitica
  • E. Coli
  • Salmonella
  • Shigella
  • H. Influenza
  • Nocardia
  • Pneumocystis Carinii
28
Q

Nalidixic Acid

A

Quinolone

Urinary accumulation only: so only used for UTI

29
Q

Norfloxicin

A

G1 Fluoroquinolone (Broad Spectrum) (absorption decreases with multivalent cations)

Bactericidal: inhibits DNA topoisomerase II (DNA Gyrase) and Topo IV (seperates circular chromosomes after DNA replication decatenation-fluoros block the religation) , thus damaging DNA

Urinary accumulation only so only used for UTI

G+:

G-:

Atypicals:

Mycobacteria:

*

30
Q

Ciprofloxacin

A

G2 Fluoroquinolone

31
Q

Ofloxacin

A

G2 Fluoroquinolone

32
Q

Levofloxacin

A

G3 Fluoroquinolone

33
Q

Moxifloxacin

A

G3 Fluoroquinolone (Biliary)

34
Q

Gemifloxacin

A

G3 Fluoroquinolone

35
Q

Quinupristin-Dalfopristin

A

Protein Synthesis inhibitor 50S Binding (P) (Biliary)

36
Q

Linezolid

A

23S Binding Protein Synthesis inhibitor (O,P)

37
Q

Daptomycin

A

Lipo-Peptide (P)

38
Q

Mupirocin

A

Mupirocin (T)

39
Q

Isoniazid

A

TB Drug First Line CWSI (O)

40
Q

Ethambutol

A

TB Drug First Line CWSI (O)

41
Q

Rifampin

A

Rifamycin TB First Line Drug (O)

42
Q

Rifabutin

A

Rifamycin TB First Line Drug (O)

43
Q

Rifapentine

A

Rifamycin TB First Line Drug (O)

44
Q

Pyrazinamide

A

TB First Line Drug (O)

45
Q

TB Second Line Drugs

A

Aminoglycosides: Streptomycin, Amikacin, Kanamycin, capreomycin Fluoroquinolines: Moxi, Levo, Cipro, Gatifloxacin CWSI: Ethionamide, cycloserine Sulfonamide: PAS

46
Q

Capreomycin

A

Aminoglycoside TB 2nd line (IM)

47
Q

Ethionamide

A

CWSI TB 2nd line (O)

48
Q

PAS

A

inhibits acetylation of INH

49
Q

Leprosy Drugs

A

Sulfonamide: Dapsone (O) Clofazimine (O) Thalidomide (O)

50
Q

Thalidomide

A

(O)

51
Q

First Line TB Drugs

A

(O) CWSI: isoniazid, ethambutol Rifamycins: Rifampin, Rifabutin, Rifapentine Pyrazinamide

Pharmacology (5 decks)

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