Abx Comlex

Front 1

Penicillin mech of action?

Back 1

Bind PBP
Block transpeptidase cross-linking of peptidoglycan
activate autolytic enzymes

Front 2

Clinical use for penicillin?

Back 2

Mostly for Gram + organisms

s. pneumo, s. pyogenes, actinomyces

Also for neisseria men in., syphillis,

Bactericidal for gram + occci, rods, gram - cocci, and spirochetes

Front 3

Toxicity for penicillin?

Back 3

hemolytic anemia, allergy

Front 4

Resistance for penicillin?

Back 4

B-lactamases cleave the beta -lactam ring

Front 5

What are the penicillinase resistant abx?

Back 5

oxacillin, nafcillin, dicloxicillin

Front 6

Mech of action for penicillinase resistant abx?

Back 6

same as enicillin.

Front 7

Clinical use for penicillinase resistant abx?

Back 7

s. aureus (except mrsa)

Front 8

toxicity for penicillinase resistant abx?

Back 8

allergy and interstitial nephritis

Front 9

What are the aminopenicillins?

Back 9

ampicillin and amoxicilin

Front 10

Mech of action of aminopenicillins?

Back 10

same as penicillin, but with a wider spectrum,

penicillinase sensitive combine with clavulinic acid to protect against beta-lactamase.

AmOxicillin has greater Oral bioavailability.

Front 11

Clinical use for aminopenicillins?

Back 11

HELPSS

haemophilus, e. coli, listeria, proteus, salmonella, shigella.

Front 12

Toxicity for aminopenicillins?

Back 12

allergy, pseudomembranous colitis

Front 13

Resistance for aminopenicillins?

Back 13

beta lactamase cleave b-lactam ring

Front 14

Antipseudomonals?

Back 14

ticarcillin and pipercillin

Front 15

Mech of action of antipseudomonals?

Back 15

same as penicillin, with extended spectrum

Front 16

Clinical use for antipseudomonals?

Back 16

pseudomonas, and gram negative rods.

susceptible to penicillinase, so use with clavulinic acid

Front 17

Toxicity with antipseudomonals?

Back 17

allergy

Front 18

What are the beta-lactamase inhibitors?

Back 18

Clavulinic Acid, Sulbactam, Tazobactam.

Front 19

Mech of action for cephalosporins?

Back 19

inhibit cell wall synthesis

Front 20

Clinical use for cephalosporins?

Back 20

1st gen - PEcK - proteus, E. coli, Klebsiella

2nd gen - HEN PEcKS - Haemophilus, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella, Serratia

3rd gen - serious gram - infections. Also good for pseudomonas

4th Gen - increased activity for gram + and pseudomonas.

Front 21

Toxicity for cephalosporins?

Back 21

allergy, vitamin K def., low cross-reactivity with other penicillins

Increased nephrotox if taken with AG's.

Front 22

What are the first gen cephalosporins?

Back 22

Cefzolin and Cephalexin.

Front 23

2nd gen cephs?

Back 23

cefoxitin, cefaclor, ceffuroxime

Front 24

3rd Gen cephs?

Back 24

ceftriaxone, cefotaxime, ceftazidime

Front 25

4th gen ceph?

Back 25

cefepime

Front 26

Mech of action for aztreonam?

Back 26

prevents peptidoglycan cross-linking by binding PBP3. Synergistic with AG's. No cross-allergy with penicillins

Front 27

Clinical use for aztrreonam?

Back 27

Gram neg rods only. No activity with gram + or anaerobes.

for penicillin-allergic pts and those with renal insuff. who can't take AG's.

Front 28

Toxicity with aztreonam?

Back 28

occasional GI upset

Front 29

Imipenem, cilastatin, meropenem mech of action?

Back 29

imipenem is a broad-spectrum. always admin'd with cilastatin (which inhibits renal dehydropeptidase 1) to lower inactivation of drug in renal tubules

Front 30

Clinical use for imipenem and meropenem?

Back 30

gram + coci, gram neg rods, and anaerbes. wide spectrum, bu significant side effecs limit use to life-threatening infections.

Front 31

Toxicity for imipenem and meropenem?

Back 31

GI distress, skin rash, CNS tox (seizures)

Front 32

Vancomycin mech ofaction?

Back 32

inhibit cell wall peptidoglycan formation by binding to D-ala D-ala portion of cell wall precursors. Bactericidal.

Front 33

Clinical use for Vanc?

Back 33

Gram + only. MRSA, enterococci, C. diff.

Front 34

Toxicity for Vanc?

Back 34

Nephrotox, ototox, thrombophlebitis

RED MAN SYNDROME

Front 35

Resistance with Vanc?

Back 35

occurs with amino acid change (D-ala D-ala to D-ala D-lac)

Front 36

What are the aminoglycosides?

Back 36

Gentamycin, neomycin, amikacin, tobramycin, streptomycin

Front 37

Mech of action for AGs?

Back 37

inhibit formation of initiation complexand cause misreading of mRNA. also block translocation. Requires O2 for uptake

Front 38

Clinical use for AG's?

Back 38

severe gram- rod infections. synergistic with b-lactam ring ABX.

Neomycin used for bowel surgery

Front 39

Toxicity with AG's?

Back 39

Nephrotox (worse when taking cephs)

neuromuscular blockade, ototox (esp. with loop diuretics)

teratogen

Front 40

Reesistance for AG's?

Back 40

transferase enzymes that inactivate the drug by acetylation, phosphorylation, or adenylation.

Front 41

Mech of action for tetracyclines?

Back 41

bind to 30s and prevent attachment of aminoacyl-tRNA.

Front 42

Clinical use for tetracyclines?

Back 42

borrelia burgdorferi, m. pneumoniae. ability for drug to accumulate intracellularly makes it good for chlamydia and rickettsia.

Front 43

Toxicity for tetracyclines?

Back 43

GI distress, discolor teeth, inhibit bone growth in kids, photosens.

NO PREGNANCY

Front 44

Resistance for tetracyclines?

Back 44

lowered uptake into cells or increased efflux from inside of cells.

Front 45

What are the Macrolides?

Back 45

Azithromycin, clarithromycin, erythromycin

Front 46

mech of action for macrolides?

Back 46

inhibit protein synthesis by blocking translocation. bind to 23s rRNA of the 50s ribosomal subunit. Bacteriostatic

Front 47

Clinical use for Macrolides?

Back 47

atypical pneumonias (mycoplasma, chlamydia, legionella), STD's, and gram + cocci

Front 48

Toxicity for macrolides?

Back 48

MACRO
motility issues, arrhythmia, acute Cholestatic hepatitis, Rash, eOsinophilia.

increased serum concentration of anticoagulants

Front 49

Resistance for macrolides?

Back 49

mehtylation of 23s rRNA binding site.

Front 50

Chloramphenicol mech of action?

Back 50

blocks peptidyltransferase at 50s riboosmal subunit. bacteriostatic

Front 51

Clinical use for chloramphenicol?

Back 51

meningitis,

Front 52

Toxicity for chloramphenicol?

Back 52

aplastic anemia, gray baby syndrome

Front 53

resistance for chloramphenicol?

Back 53

plamsa-encoded acetyltransferase that inactivates the drug

Front 54

Clindamycin mech of action?

Back 54

blocks peptide transfer at 50s subunit. bacteriostatic

Front 55

clinical use for clindamycin?

Back 55

anaerobic infection in aspiration pneumonia or lung abscesses. also oral infections with mouth anaerobes.

Front 56

Toxicity for clindamycin?

Back 56

C. diff, fever, diarrhea.

Front 57

Sulfonamides, what are they?

Back 57

suldamethoxazole, sulfasozazole, sulfadiazine

Front 58

Mech of action ofr sulfonamides?

Back 58

PABA antimentabolites ihitibit dihydropteroate syntse.

Front 59

Cllinical use for sulfonamides?

Back 59

gram +, gram -, nocardia, chlamydia. Triple sulfas or SMX for UTI's.

Front 60

Toxicity for sulfonamides?

Back 60

allergy, hemolysis if G6PD deficient, nephrotox, photosens, kernicterus

Front 61

Resistance for sulfonamides?

Back 61

alered enzyme lowered uptake, or increased PABA synthesis.

Front 62

Trimethoprim mech of action?

Back 62

inhibit bacterial DHFR.

Front 63

clinical use for trimethoprim?

Back 63

used in combo with sulfonamides, causing sequential block of folate synthesis. Combo used for UTI's, shigella, salmonella, PCP,

Front 64

toxicity for thimethoprim?

Back 64

megaloblastic anemia, leukopenia, granulocytopenia,

Front 65

FQ's mech of action?

Back 65

inhibit DNA gyrase and topoisomerase IV. cannot take with antacids

Front 66

Clinical use for FQs?

Back 66

gram neg rods of urinary and GI tracts. neisseria and some gram-pos organisms

Front 67

toxicity for FQ's?

Back 67

GI upset, superinfections, rash, HA, dizzy, tendonits, leading to tendon rupture.

NO PREGNANCY

Front 68

resistance for FQ?

Back 68

chromosome-endcoded mutation in DNA gyrase, plasma mediated resistance, efflux pumps.

Front 69

Metronidazole mech of action?

Back 69

free radical toxic metabolites in the mactera cell that dmg DNA.

Front 70

Clinical use for metro?

Back 70

GET GAP

Giardia, Entamoeba, Trichomonas, Gardnerella, anaerobes, h. Pylori.

Front 71

Toxicity with metro?

Back 71

disulfuram reaction with alcohol, HA, metallic taste.