Antibiotics (from Forystek table) – Flashcards
Unlock all answers in this set
Unlock answersquestion
| Penicillins (drugs) |
answer
| Penicillin G Penicillin V |
question
| Penicillins (MOA) |
answer
| Competitive inhibition of transpeptidase enzyme (penicillin binding proteins) a inhibits cell wall synthesis |
question
| Penicillins (pharm profile) |
answer
| Procaine and benzathine pen G are IM, IV Penicillin V is oral |
question
| Penicillins (uses) |
answer
| Strep, Staph, Clostridia N. meningitides Syphilis |
question
| Penicillins (side effects) |
answer
| Serum sickness: Ag/Ab complex causing hemolytic anemia |
question
| Aminopenicillins (drugs) |
answer
| Ampicillin Amoxicillin |
question
| Aminopenicillins (MOA) |
answer
| Competitive inhibition of transpeptidase enzyme (penicillin binding proteins) ? inhibits cell wall synthesis |
question
| Aminopenicillins (pharm profile) |
answer
| Amoxicillin- PO |
question
| Aminopenicillins (uses) |
answer
| Broader GM- coverage HELPS kill entercoccus (Haemophilus, E. coli, Listeria, Proteus, Salmonella and Enterococcus) |
question
| Aminopenicillins (side effects) |
answer
| Maculopapular rash in patients with mono, CLL, or taking Allopurinol Pseudomembranous colitis |
question
| Penicillinase-R penicillins (drugs) |
answer
| Nafcillin Oxacillin (IV/PO) Methicillin |
question
| Penicillinase-R penicillins (MOA) |
answer
| Competitive inhibition of transpeptidase enzyme (penicillin binding proteins) ? inhibits cell wall synthesis |
question
| Penicillinase-R penicillins (pharm profile) |
answer
| IV |
question
| Penicillinase-R penicillins (uses) |
answer
| S. aureus (except MRSA) Nafcillin- severe (IV 4 hrs) Dicloxacillin- mild |
question
| Penicillinase-R penicillins (side effects) |
answer
| Interstitial nephritis (methicillin), not used Increases liver enzymes |
question
| Carboxy/Ureidopenicillins (drugs) |
answer
| Ticarcillin Carbenicillin Piperacillin |
question
| Carboxy/Ureidopenicillins (MOA) |
answer
| Competitive inhibition of transpeptidase enzyme (penicillin binding proteins) ? inhibits cell wall synthesis |
question
| Carboxy/Ureidopenicillins (uses) |
answer
| Extended GM- rod coverage, Pseudomonas and anaerobes (B. fragilis) |
question
| Carboxy/Ureidopenicillins (side effects) |
answer
| TCP Takes care of pseudomonas and B. fragilis Lower dose in kidney failure |
question
| ?-Lactamase inhibitors (drugs) |
answer
| Clavulanic acid Tazobactam |
question
| ?-Lactamase inhibitors (combinations) |
answer
| Clavulanic acid + amoxicillin= augmentin Clavulanic acid + ticarcillin = timentin Tazobactam + piperacillin = Zosyn Ampicillin + sulbactam = Unasyn |
question
| ?-Lactamase inhibitors (uses) |
answer
| Coverage against ?-lactamase producing species (aureus, influenza, fragilis) |
question
| Cephalosporins - 1st generation (drugs) |
answer
| Cefazolin Cephalexin |
question
| Cephalosporins - 1st generation (MOA) |
answer
| Same as penicillins (?-lactam drugs inhibit cell wall synthesis) Less susceptible to penicillinases |
question
| Cephalosporins - 1st generation (uses) |
answer
| GM+ cocci prophylaxis surgery PECK- proteus, ecoli, and klebsiella |
question
| Cephalosporins - 1st generation (mnemonic) |
answer
| Fazoli’s symbol is phelex (phallic) |
question
| Cephalosporins - 2nd generation (drugs) |
answer
| Cefaclor Cefoxitin Cefuroxime |
question
| Cephalosporins - 2nd generation (MOA) |
answer
| Same as penicillins (?-lactam drugs inhibit cell wall synthesis) Less susceptible to penicillinases |
question
| Cephalosporins - 2nd generation (uses) |
answer
| GM+ cocci Anaerobes (cefoxitin/cefotetan) HEN PECK Haemophilus, enterobacter, neisseria, proteus, ecoli, klebsiella) |
question
| Cephalosporins - 2nd generation (mnemonic) |
answer
| It’s a FACt that FOX has FUR |
question
| Cephalosporins - 3rd generation (drugs) |
answer
| Ceftriaxone Cefixime Ceftaxidime |
question
| Cephalosporins - 3rd generation (MOA) |
answer
| Same as penicillins (?-lactam drugs inhibit cell wall synthesis) Less susceptible to penicillinases |
question
| Cephalosporins - 3rd generation (uses) |
answer
| Multidrug resistant GM- infections Bacterial meningitis Gonorrhea (ceftriaxone/cefixime) Pseudomonas (ceftaxidime) |
question
| Cephalosporins - 3rd generation (mnemonic) |
answer
| TRI and FIX TAZ |
question
| Cephalosporins - 3rd generation (pharm profile) |
answer
| Penetrates BBB well (especially ceftriaxone) Ceftriaxone- IM Cefixime- PO |
question
| Cephalosporins - 4th generation (drugs) |
answer
| Cefepime Cefpiramide |
question
| Cephalosporins - 4th generation (MOA) |
answer
| Same as penicillins (?-lactam drugs inhibit cell wall synthesis) Less susceptible to penicillinases |
question
| Cephalosporins - 4th generation (uses) |
answer
| Regains some GM+ coverage Pseudomonas |
question
| Cephalosporins - 4th generation (mnemonic) |
answer
| E pime on my piramide |
question
| Monobactam (drugs) |
answer
| Azetreonam |
question
| Monobactam (MOA) |
answer
| Binds to PBP in GM- only (No GM+ or anaerobe) |
question
| Monobactam (uses) |
answer
| Serious nosocomial GM- (klebsiella, Pseudomonas, serratia) |
question
| Monobactam (side effects) |
answer
| Does not cross react with penicillin allergy |
question
| Carbapenems (drugs) |
answer
| Imipenem/Cilastatin Meropenem Doripenim |
question
| Carbapenems (MOA) |
answer
| ?-lactam |
question
| Carbapenems (pharm profile) |
answer
| Imipenem inactivated in kidney by dihydro-peptidase (must give with cilastatin) |
question
| Carbapenems (uses) |
answer
| VERY broad spectrum (GM+ cocci, GM- rods, Pseudomonas, anaerobes) Drug choice of choice Enterobacter- most reliable activity against ES?L |
question
| Carbapenems (side effects) |
answer
| Seizures (decrease threshold) Carbapenamases: KPC + metallo-?-lactamases, hydrolyse carbapenams, must report |
question
| Sulfonamides (drugs) |
answer
| TMP-SMX |
question
| Sulfonamides (MOA) |
answer
| TMP inhibits DHF reductase (DHF? THF) SMX is PABA analogue that inhibits dihydropteroate synthase Overall, they decrease folate and DNA, RNA, and proteins |
question
| Sulfonamides (pharm profile) |
answer
| Affects protein binding displaces rifampin, warfarin, MTX and phenytoin May decrease heme s/e by giving leukovorin (folonic acid) ? is in CNS |
question
| Sulfonamides (uses) |
answer
| TMP-Smx Tree (respiratory) M (mouth, GI tract) ? Gm- diarrhea P (Pee)? prostatitis, UTI, urethritis SMX (syndrome) AIDS ? P. jirovecii, prohpylaxis or others such as toxoplasmosis, nocardia, rheumathic fever, and kansaii |
question
| Sulfonamides (side effects) |
answer
| Hematopoietic in AIDS patients (megaloblastic anemia, leucopenia) Erythema nodosum Hypersensitivity to sulfa Not in pregnancy or breast feeding because kernicterus (SMX) Hemolysis in G6PD deficiency |
question
| Floroquinolones (drugs) |
answer
| Ciprofloxacin Moxifloxacin Gemifloxacin Levofloxacin Sparfloxacin |
question
| Floroquinolones (MOA) |
answer
| Inhibit bacterial DNA gyrase (topo II) Gm- or Topo 4 (Gm+) Inhibits DNA synthesis BacteriCIDAL |
question
| Floroquinolones (pharm profile) |
answer
| Binds to antacids, sulfurate |
question
| Floroquinolones (uses) |
answer
| Gm- rods of GI/GU Community acquired pneumo (levo, spar GM+ atypical) Pseudomonas: cipro GM+ levo moni gemi |
question
| Floroquinolones (side effects) |
answer
| Tendonitis with tendon rupture CNS effects, photosensitivity Not in pregnancy or children because of cartilage damage. Resistance is due to an altered target, or binding/inactivating enzyme |
question
| Metronidazole (drugs) |
answer
| Metronidazole |
question
| Metronidazole (MOA) |
answer
| Metabolized INSIDE anaerobic bacteria and damages DNA BacteriCIDAL |
question
| Metronidazole (pharm profile) |
answer
| Does not enter blood very well, so it enters the GI tracts and kills C. diff enters CNS as well |
question
| Metronidazole (uses) |
answer
| GET GAP at the Metro Giadia Entamoeba Trichomonas Gardernella vaginalis Anaerobes Pylori |
question
| Metronidazole (side effects) |
answer
| Disulfiram (antibuse) like side effects with alcohol NOT in pregnancy |
question
| Polymixins (drugs) |
answer
| Polymixin B Polymixin E colistin |
question
| Polymixins (MOA) |
answer
| Cationic basic proteins (detergent) that disrupts osmotic properties of the membrane. Polymixins “mix up” membranes |
question
| Polymixins (pharm profile) |
answer
| Bacteriocidal regardless of growth phase |
question
| Polymixins (uses) |
answer
| Resistant GM- infections |
question
| Polymixins (side effects) |
answer
| Neurotoxicity Acute tubular necrosis Bottom of the barrel choice |
question
| Aminoglycosides (drugs) |
answer
| Gentamycin Goes to ECF- which is larger in shock, give more to ICU patients Neomycin Amikacin Tobramycin Streptomycin |
question
| Aminoglycosides (MOA) |
answer
| bactericidal Synergistic with ?-lactam antibiotics b (must diffuse though cell wall) Inhibits 30S |
question
| Aminoglycosides (pharm profile) |
answer
| Requires O2 for uptake (NOT effective vs. anaerobes) Punch holes in cytoplasm |
question
| Aminoglycosides (uses) |
answer
| Severe GM- rod infection Resistance by aminoglycoside inactivating Neomycin for bowel surgery aminoglycoside + penicillin for enterococcal endocarditis (vanco for pen. Resistance) |
question
| Aminoglycosides (side effects) |
answer
| GNATS can NOT kill anaerobes drug accumulates in proximal tubules Nephotoxic (increases w/cephalo’s) Ototoxic (increases w/loop diuretics) Teratogenic |
question
| Tetracyclines (drugs) |
answer
| Tetracyline Doxycycline Demeclocycline Minocycline |
question
| Tetracyclines (MOA) |
answer
| bacteriostatic Inhibit 30S R. Efflux pumps+ ribosome protection proteins |
question
| Tetracyclines (pharm profile) |
answer
| Absorption inhibited by divalent cations (no milk, antacids, or iron containing compounds) |
question
| Tetracyclines (uses) |
answer
| VACuUM The BR (bedroom) Vibrio, Acne, Chlamydia, Ureaplasma, Mycoplas,a. Tularemia, H. pylori, Borrelia, Rickettsea Nocardia- minocycline Bemeclocycline in SIADH |
question
| Tetracyclines (side effects) |
answer
| Teeth/bone discoloration (chelates Ca2+) Not in pregnancy Not in renal dz (only doxy) Photosensitivity Superinfection (yeasty) |
question
| Macrolides (drugs) |
answer
| Erythromycin (g+) Azithromycin (g-, long .5) Clarithromycin (g+) |
question
| Macrolides (MOA) |
answer
| Inhibit protein synthesis by binding to the 50S subunit (or 23 srRNA) Bacteriostatic |
question
| Macrolides (pharm profile) |
answer
| Ery and clari inhibit CYP450 (higher levels of warfarin/theophilline) w/cisapride get torsades de pointes? tachycardia and DEATH |
question
| Macrolides (uses) |
answer
| Community acquired pneumonia: S. pneumo and atypical (legionella, Chlamydia and mycoplasma) GM+ cocci alternative with pen allergy STDS Chlamydia/GC + H.pylori |
question
| Macrolides (side effects) |
answer
| GI irritation (common and dose related) Not in pregnancy (cholestatic hepatitis in the mother) |
question
| Lincosamides (drugs) |
answer
| Clindamycin |
question
| Lincosamides (MOA) |
answer
| Inhibit protein synthesis by binding to the 50S subunit (or 23 srRNA) Bacteriostatic |
question
| Lincosamides (pharm profile) |
answer
| long presence in stool, altered gut flors |
question
| Lincosamides (uses) |
answer
| Anaerobic infections above diaphragm, not CNS |
question
| Lincosamides (side effects) |
answer
| Pseudomembranous colitis due to C. diff |
question
| Chloramphenicol (drugs) |
answer
| Chloramphenicol |
question
| Chloramphenicol (MOA) |
answer
| Inhibit protein synthesis by binding to the 50S subunit (or 23 srRNA) Bacteriostatic |
question
| Chloramphenicol (pharm profile) |
answer
| Conjungated in liver UDP glucuronyl transferase (absent in premature) |
question
| Chloramphenicol (uses) |
answer
| Very broad, usually meningitis or rickettsial, not really used |
question
| Chloramphenicol (side effects) |
answer
| Anemia (reversible) Aplastic anemia GREY BABY SYNDROME |
question
| Glycopeptides (drugs) |
answer
| Vancomycin |
question
| Glycopeptides (MOA) |
answer
| Inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors Bactericidal except for enterococcus |
question
| Glycopeptides (pharm profile) |
answer
| IV PO for C. diff |
question
| Glycopeptides (uses) |
answer
| Serious GM+ multidrug resistant organisms (MRSA, enterococcus, refractory C. diff) There are VRE and SRE strains (VAN genes) Use in synergy w/aminoglycosides, rifampin) |
question
| Glycopeptides (side effects) |
answer
| RED MAN NOT Red Man syndrome with rapid infusion, this is due to increased histamine release NOT Nephrotoxicity Ototoxicity Thrombophlebitis |
question
| Streptogramins (drugs) |
answer
| Quinupristin/dalphopristin |
question
| Streptogramins (MOA) |
answer
| Inhibits proteins synthesis, both bind to different sites on the 50S subunit |
question
| Streptogramins (pharm profile) |
answer
| Inhibits CYP 450 |
question
| Streptogramins (uses) |
answer
| VRE, but only e. faecium, does not work for e. facalis |
question
| Streptogramins (side effects) |
answer
| peripheral IV pain and phlebitis, arthralgias, myalgias |
question
| Cyclic lipopeptides (drugs) |
answer
| Daptomycin |
question
| Cyclic lipopeptides (MOA) |
answer
| Calcium dependent binding on plasma membrane with depolarization (K+) release and death |
question
| Cyclic lipopeptides (uses) |
answer
| Complicated skin/soft tissue and intra-abdomin MSSA, MRSA, VISA, VRSA, VRE, Pen-R pneumo |
question
| Cyclic lipopeptides (side effects) |
answer
| Rhabdomyolysis: increased CPK, muscle discomfort |
question
| Glycylcylines (drugs) |
answer
| Tigecycline |
question
| Glycylcylines (MOA) |
answer
| Inhibit protein synthesis (binds to the 30S subunit) |
question
| Glycylcylines (uses) |
answer
| Complicated skin/soft tissue and intra-abdomin MSSA, MRSA, VISA, VRSA, VRE, Pen-R pneumo |
question
| Glycylcylines (side effects) |
answer
| GI Complications Increase in liver transaminases (AST/ALT) |
question
| Oxazolidinones (drugs) |
answer
| Linezolid |
question
| Oxazolidinones (MOA) |
answer
| Inhibits protein synthesis (binds to the 50S subunit) near the 30S subunit, prevents 70S formation (unique) |
question
| Oxazolidinones (pharm profile) |
answer
| no cross resistance, 100% bioavailability PO |
question
| Oxazolidinones (uses) |
answer
| VRE and some MRSA/VRSA also RAPID growing mycobacteria Chelonae, fortuitum |
question
| Oxazolidinones (side effects) |
answer
| Bone marrow toxicity No cross reaction with other protein synthesis antibiotics Tongue discoloration |
