Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
101 Cards in this Set
- Front
- Back
|
Mechanism of Action of:
Penicillin, Ampicillin, ticarcillin, piperacillin Imipenam Aztreonam Cephalosporins |
Block cell wall synthesis
Inhibit peptidoglycan cross-link |
|
|
Drugs that:
Block cell wall synthesis Inhibit peptidoglycan cross-link |
Penicillin, Ampicillin, ticarcillin, piperacillin
Imipenam Aztreonam Cephalosporins |
|
|
Mechanism of Action of:
Bacitracin Vancomycin |
Block peptidoglycan synthesis
|
|
|
Drugs that:
Block peptidoglycan synthesis |
Bacitracin
Vancomycin |
|
|
Mechanism of Action of:
Polymyxins |
Disrupt bacterial cell membrane
|
|
|
Drugs that:
Disrupt bacterial cell membrane |
Polymyxins
|
|
|
Mechanism of Action of:
Sulfonamides Trimethoprim |
Block nucleotide synthesis
|
|
|
Drugs that:
Block nucleotide synthesis |
Sulfonamides
Trimethoprim |
|
|
Mechanism of Action of:
Quinolones |
Block DNA topoisomerase and gyrase
|
|
|
Drugs that:
Block DNA topoisomerase and gyrase |
Quinolones
|
|
|
Drugs that:
Block mRNA synthesis |
Rifampin
|
|
|
Mechanism of:
Rifampin |
Block mRNA synthesis
|
|
|
Drugs that:
Block 50S subunit |
Chloramphenicol
Macrolides Clindamycin Streptogramins (quinupristin, daflopristin) Linezolid |
|
|
Mechanism of:
Chloramphenicol Macrolides Clindamycin Streptogramins (quinupristin, daflopristin) Linezolid |
Block 50S subunit
|
|
|
Drugs that:
Block 30S subunit |
Aminoglycosides
Tetracyclines |
|
|
Mechanism of:
Aminoglycosides Tetracyclines |
Block 30S subunit
|
|
|
Bacteriostatic Abx's (6)
|
"ECSTaTiC"
Erythromycin Clindamycin Sulfamethoxazole Trimethoprim Tetracyclines Chloramphenicol |
|
|
Bactericidal Abx's (6)
|
"Very Finely Proficient At Cell Murder"
Vancomycin Fluoroquinolones Penicillin Aminoglycosides Cephalosporins Metronidazole |
|
|
Penicillin Mechanism
|
prototype B-lactam Abx
G: IV, V: oral bacteriocidal 1. Binds Penicillin Binding Proteins (PBP) 2. Block transpeptidase cross-link 3. Activate autolytic enzymes |
|
|
Penicillin Clinical Use
|
Bacteriocidal
Gram + cocci, rods Gram - cocci Spirochetes |
|
|
Penicillin resistance mediated by
|
B-lactamase
|
|
|
Penicillin toxicity
|
Hypersensitivity rxns
Hemolytic anemia |
|
|
Methicillin, nafcillin, dicloxacillin
(penicllinase-resistant penicillins) Mechanism? |
Same as penicillin
Narrow spectrum Penicillin resistant b/c of bulky R group "Use naf for staph" |
|
|
Methicillin, nafcillin, dicloxacillin
(penicllinase-resitant penicillins) Clinical use? |
S. aureus
(except MRSA) |
|
|
How is MRSA resistant?
|
Altered PBP (penicillin binding protein)
|
|
|
Methicillin, nafcillin, dicloxacillin
(penicllinase-resitant penicillins) Toxicity? |
Hypersensitivity rxn
Methicillin: interstitial nephritis |
|
|
Ampicillin, amoxicillin (aminopenicillins)
Mechanism? |
Same as penicillin
Wider spectrum Combine with clavulanic acid to enhance spectrum |
|
|
Which has greater oral availability, amoxicillin or ampicillin?
|
"amOxicillin has greater Oral availability"
|
|
|
What do you combine aminopenicllins and antipseudomonals with to enhance spectrum?
|
Clavulanic acid
|
|
|
Ampicillin, amoxicillin (aminopenicillins)
Clinical use? |
Extended spectrum penicillin
certain gram + rods gram - rods "HELPS" H. influenzae E.coli Listeria monocytogenes Proteus Salmonella enterococci |
|
|
Ampicillin, amoxicillin (aminopenicillins)
Toxicity? |
Hypersensitivity rxn
Ampicillin rash Pseudomembranous colitis |
|
|
Ticarcillin, carbenicillin, piperacillin
(Anti-pseudomonals) Mechanism? |
Same as penicillin.
Extended spectrum. |
|
|
Ticarcillin, carbenicillin, piperacillin
(Anti-pseudomonals) Clinical use? |
Pseudomonas
Gram - rods Susceptible to penicillinase Use with clavulanic acid "TCP": Takes Care of Pseudomonas |
|
|
Ticarcillin, carbenicillin, piperacillin
(Anti-pseudomonals) Toxicity? |
Hypersensitivity rxn
|
|
|
Mechanisms of Cephalosporins
|
B-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases.
Bactericidal. |
|
|
Cephalosporins--1st generation uses
|
Cefazolin, cephalexin
Gram + cocci PEcK Proteus E.coli Klebsiella |
|
|
Cephalosporins--2nd generation uses
|
cefoxitin, cefaclor, cefuroxime
gram + cocci HEN PEcKS H. influenzae Enterobacter Neisseria Proteus E.coli Klebsiella Serratia |
|
|
Cephalosporins--3rd generation uses
|
ceftriaxone, cefotaxime, ceftazidime
serious gram-negative infxns resistant to other B-lactams meningitis (penetrate BBB) ex: ceftazidime for Pseudomonas ceftriaxone for Gonorrhea |
|
|
Cephalosporin Toxicities
|
Hypersensitivity rxns
Some cross-reactivity with penicillins Increases nephrotoxicity of aminoglycosides Disulfram-like rxn with ethanol |
|
|
Aztreonam Mechanism
|
Monobactam resistant to B-lactamases
Inhibits cell wall synthesis by binding to PBP3 Synergistic with aminoglycosides No cross rxn with penicillins |
|
|
Aztreonam Clinical Use
|
Gram - rods
Klebsiella Pseudomonas Serratia No activity with gram + or anaerobes |
|
|
In what circumstance would you use Aztreonam?
|
Penicillin allergic Pts
Pts with renal insufficiency who can't tolerate aminoglycosides |
|
|
4th generation Cephalosporins
|
Increased activity against Pseudomonas
Gram + |
|
|
Aztreonam Toxicity
|
Usually non-toxic
Occasional GI upset No cross reactivity with penicillins or cephalosporins |
|
|
Impenem/cilastatin, meropenem
Mechanism? |
Broad-spectrum carbapenem
B-lactamase resistant Always administered with cilastatin to decrease inactivation in renal tubules "The kill is LASTIN' with CILASTATIN" |
|
|
Aztreonam Clinical Use
|
Gram + cocci
Gram - rods Anaerobes ENTEROBACTER Significant side effects limit use to life threatening infxns or after failed drugs |
|
|
Aztreonam toxicity
|
GI distress
CNS toxicity (seizures), at high levels Skin rash |
|
|
Vancomycin Mechanism?
|
Inhibits cell wall formation by binding D-ala D-ala
Bactericidal |
|
|
Mechanism of Vancomycin resistance?
|
Amino acid change of D-ala D-ala to D-ala D-lac
|
|
|
Vancomycin clinical use?
|
Serious gram + multidrug resistant organisms
S.aureus (MRSA) C. difficile |
|
|
Vancomycin toxicity
|
"does NOT have many problems"
Nephrotoxicity Ototoxicity Thrombophlebitis "red man syndrome" (diffuse flushing) |
|
|
What is "red man syndrome" and how can you prevent it?
|
Diffuse flushing as a side effect of vancomycin use
Prevention: Pre-treatment with anti-histamines Slow infusion rate |
|
|
Protein synthesis inhibitors (7)
|
"buy AT 30, CCELL (sell) at 50"
30S: Aminoglycosides Tetracyclines 50S: Chloramphenicol, Clindamycin Erythromycin Lincomycin Linezolid |
|
|
30 S inhibitors (2)
|
Aminoglycosides
Tetracyclines "AT" |
|
|
50 S inhibitors (5)
|
Chloramphenicol
Clindamycin Erythromycin Lincomycin Linezolid "CCELL" |
|
|
Aminoglycoside Drugs (5)
|
Gentamicin
Neomycin Tobramycin Streptomycin "Mean" (amine) GNATS canNOT kill anaerobes" |
|
|
Aminoglycoside Mechanism
|
Bactericidal
Inhibition of initiation complex formation Requires O2 for uptake Ineffective for anaerobes |
|
|
Which does Aminoglycoside require for uptake and what are the implications of this?
|
Requires O2.
Makes it ineffective for anaerobes |
|
|
Aminoglycosides
Clinical Use? |
Severe gram - rod infxns
Synergistic with B-lactams. |
|
|
Aminogycoside toxicity?
|
Nephrotoxicity
Ototoxicity Teratogen |
|
|
Tetracycline Drugs (4)
|
Tetracycline
Doxycycline Demeclocycline Minocycline |
|
|
Tetracycline Mechanism?
|
Bacteriostatic
Binds 30S Limited CNS penetration |
|
|
How is Doxycycline eliminated and what are the implications of this?
|
Fecally eliminated, so can be used in Pts with renal failure.
CANNOT take with milk, antacids or Fe containing compounds--inhibits absorption |
|
|
Tetracycline Clinical Use?
|
"VACUUM THe Bed Room"
V. cholerae Acne Chlamdyia Ureaplasma Urealyticum Mycoplasma pneumonia Tularemia H. pylori Borrelia burdorferi Rickettsia |
|
|
Tetracycline Toxicity?
|
GI Distress
Discoloration of teeth Inhibition of bone growth in kids Photosensitivity Contraindicated in pregnancy |
|
|
Macrolide Drugs (3)
|
Erythromycin
Azithromycin Clarithromycin |
|
|
Macrolide mechanism
|
Bacteriostatic
Binds 50S subunit |
|
|
Macrolide clinical use
|
Gram + cocci (strep Pts allergic to Penicillin
URI Pneumonia STDs Mycoplasma Legionella Chlamdyia Neisseria |
|
|
Macrolide toxicity
|
GI discomfort
Cholestatic hepatitis Eosinophilia Skin rashes |
|
|
Chloramphenicol Mechanism
|
Bacteriostatic
Inhibit 50 S subunit |
|
|
Chloramphenicol Clinical Use
|
Meningitis (H. influenzae, N. meningitidis, S. pneumoniae)
Conservative use b/c of toxicity |
|
|
Chloramphenicol Toxicity
|
Aplastic anemia
gray baby syndrome |
|
|
Cause of gray baby syndrome?
|
Chloramphenicol
|
|
|
Clindamycin Mechanism?
|
Bacteriostatic.
Binds 50S subunit |
|
|
Clindamycin use?
|
Anaerobic infxns.
(Bacteroides, C. perfringens, etc.) |
|
|
Clindamycin toxicity
|
Pseudomembranous colitis (C. diff overgrowth)
Fever Diarrhea |
|
|
Sulfonamide Drugs (4)
|
Sulfamethaxole (SMX)
Sulfisoxazole Triple sulfas Sulfadiazine |
|
|
Sulfonamide Mechanism?
|
Bacteriostatic
PABA antimetabolites inhibit dihydropteroate synthase |
|
|
Sulfonamides clinical use?
|
Gram +
Gram - Nocardia Chlamydia Simple UTI |
|
|
Sulfonamide toxicity?
|
Hypersensitivity rxn
Hemolysis (GP6D deficient) Nephrotoxicity Photosensitivity Kernicterus in infants Displace other drugs from albumin (warfarin) |
|
|
Trimethoprim Mechanism?
|
Bacteriostatic
Inhibits folate synthesis |
|
|
Trimethoprim Clinical Use
|
Used with sulfonamides
Combination use for: recurrent UTI Shigella Salmonella PCP pneumonia |
|
|
Trimethoprim toxicity
|
Megaloblastic anemia
Leukopnia Granulocytopenia |
|
|
Fluoroquinolone Drugs
|
"Flox" drugs
Enoxacin Nadilixic acid (quinolones) |
|
|
Fluoroquinolone Mechanism?
|
Bactericidal
Inhibit DNA gyrase (topoisomerase) Must not be taken with antacids |
|
|
Fluoroquinolone Clinical Use?
|
Gram (-) rods of urinary and GI tract
Pseudomonas Neisseria Some gram + organisms |
|
|
Fluoroquinolone Toxicity
|
GI upset
Tendonits/tendon rupture Cramps/myalgia in kids Contraindicated in pregnant women "fluoroquinoLONES hurt attachments to your BONES" |
|
|
Metronidazole Mechanism
|
Bactericidal
Forms toxic metabolites that damage DNA |
|
|
Metronidazole Clinical Use
|
Antiprotozoal, anaerobes
"GET GAP on the Metro" Giardia Entamoeba Trichomonas Gardnerella Anaeroebes (Bacteroides, Clostridium) (h.)Pylori (triple therapy) |
|
|
Metronidazole Toxicity
|
Disulfiram-like toxicity with alcohol
HA Metallic taste |
|
|
Polymyxins Mechanism
|
" 'MYXins MIX up membranes"
Disrupt cell membranes. |
|
|
Polymyxins Clinical Use
|
Resistant to gram (-) infections
|
|
|
Polymyxins toxicity
|
Neurotoxicity
ATN (acute tubular necrosis) |
|
|
M. tuberculosis prophylaxis
|
Isoniazid
|
|
|
M. tuberculosis treatment
|
Isoniazid
Rifampin Ethambutol Pyrazinamide |
|
|
Isoniazid Mechanism
|
Decreases mycolic acid synthesis
|
|
|
Isoniazid clinical use
|
Solo prophylaxis for TB
|
|
|
Isoniazid toxicity
|
"INH"
Injures Neurons and Hepatocytes" |
|
|
Rifampin Mechanism
|
Inhibit RNA polymerase
|
|
|
Rifampin Clinical Use
|
M. tuberculosis
Delays dapsone resistance in leprosy Prophylaxis for contacts of Pts with H.influenzae |
|
|
Treatemnt of VRE (Vancomycin Resistant Enterococcus)
|
Linezolid and streptogramins
(quinupristin/daflopristin) |
