Antimicrobials 4-15-06

Front 1

The penicillin type drugs work by blocking ------ synthesis, specifically by inhibiting this molecule from cross-linking?

Back 1

blocks bacterial cell wall synthesis by inhibition of peptidoglycan synthesis.

Front 2

Which other drugs (aside from penicillins)block peptidoglycan cross linking?

Back 2

Imipenem, aztreonam and cephalosporins

Front 3

Bacitracin, vancomycin and cycloserine block the synthesis of this molecule, preventing cell wall synthesis

Back 3

peptidoglycans

Front 4

These drugs block the 50s ribosomal subunit

Back 4

chloramphenicol, erythromycin, cLindomycin, Lincomycin, streptogramins "Buy AT 30, CELL at 50"

Front 5

These drugs block the 30s ribosomal subunit

Back 5

Aminoglycosides and tetracyclines "Buy AT 30, CELL at 50"

Front 6

These drugs block nucleotide synthesis by interfering with the folate pathway

Back 6

Sulfonamides (e.g. Bactrim), trimethoprim

Front 7

These drugs block DNA topoisomerases

Back 7

Quinolones (e.g. Cipro)

Front 8

Which drug blocks mRNA synthesis

Back 8

rifampin

Front 9

Which are the bacteriacidal Abx

Back 9

Penicillin, cephalosporin, vancomycin, aminoglycosides, fluoroquinolones, metronidazole

Front 10

These drugs disrupt the bacterial/fungal cell membranes

Back 10

polymyxins

Front 11

These specific disrupt fungal cell membranes

Back 11

fluconazole/azoles, amphotericin B, nystatin (FAN the fungal cell membranes)

Front 12

What is the mechanism of action of Pentamidine

Back 12

Unknown (tx for pneumocistis and sleeping sickness--leishmania)

Front 13

Penicillin Which is the IV form and which is the oral form

Back 13

G = IV, V=oral

Front 14

Which of these is not a mechanism of penicillin action: (1) binds penicillin-binding protein, (2) blocks peptidoglycan synthesis, (3) blocks transpeptidase catalyzed cross-linking of cell wall and (4) activates autolytic enzymes

Back 14

Penicillin does not block peptioglycan synthesis, bacitracin, vancomycin and cycloserine do that

Front 15

T or F: penicillin is effective against gram pos and gram neg rods

Back 15

False: penicillin is used to treat common streptococci (but not staph), meningococci, gram pos bacilli and spirochetes (i.e. syphilis, treponema). Not used to treat gram neg rods.

Front 16

What should you watch out for when giving penicillin?

Back 16

Hypersensitivity rxn (urticaria,severe pruritus) and hemolytic anemia

Front 17

Methicillin, nafcillin, dicloxacillin These drugs are used mainly for what type of infection

Back 17

Staphlococcal infection (hence very narrow spectrum)

Front 18

Methicillin, nafcillin, dicloxacillin T or F: these drugs have the same mechanism of action as penicillin

Back 18

TRUE

Front 19

Methicillin, nafcillin, dicloxacillin Are these drugs penicillinase resistant? If so why?

Back 19

Bulkier R group makes these drugs resistant to penicillinase

Front 20

Methicillin, nafcillin, dicloxacillin What should you watch out for when giving these drugs?

Back 20

Hypersensitivity rxn (urticaria,severe pruritus); methicillin can cuase interstitial nephritis

Front 21

Ampicillin and amoxicillin T or F: these drugs have the same mechanism of action as penicillin

Back 21

TRUE

Front 22

Ampicillin and amoxicillin Which has greater oral bioavailability?

Back 22

amOxicillin (O for Oral)

Front 23

Ampicillin and amoxicillin What do you use these for?

Back 23

Ampicillin/amoxicillin HELPS to kill enterococci (H. influenzae, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, enterococci)

Front 24

Ampicillin and amoxicillin Can penicillinase effect these drugs efficacy?

Back 24

Yes, they are penicillinase sensitive

Front 25

Ampicillin and amoxicillin Why not give these drugs with a penicillinase inhibitor. Name one.

Back 25

clavulanic acid

Front 26

Ampicillin and amoxicillin What should you watch out for when giving these drugs?

Back 26

Hypersensitivity rxn (ampicillin rash), pseudomembranous colitis

Front 27

ticarcillin, carbenicillin, piperacillin Why are these considered to have an extended spectrum?

Back 27

Because they are effective against pseudomonas and other gram neg rods (enterobacter and some species of klebsiella) TCP: Takes Care of Pseudomonas

Front 28

Carbenicillin, piperacillin, ticarcillin What should you watch out for when giving these drugs?

Back 28

Hypersensitivity rxn

Front 29

Carbenicillin, piperacillin, ticarcillin: why administer with clavulanic acid ?

Back 29

Because they are penicillinase sensitive.

Front 30

Cephalosporins What is the mechanism of action of Cephalosporins?

Back 30

inhibit cell wall synthesis

Front 31

Cephalosporins How are they similar/different from penicillin?

Back 31

both have a beta-lactam ring structure but cephalosporins are less susceptible to penicillinases

Front 32

Cephalosporins What are the main similarities/difference between 1st and 2nd generation cephalosporins?

Back 32

2nd gen has extensive gram neg coverage but weaker gram pos coverage

Front 33

Cephalosporins 1st gen covers what bugs?

Back 33

gram positives (staph and strep), Proteus mirabilis, E. coli, Klebsiella (PEcK)

Front 34

Cephalosporins 2nd gen covers what bugs?

Back 34

gram positives (staph and strep) though less so, H. influenzae, Enterobacter aerogenes, Neisseria, Proteus mirabilis, E. coli, Klebsiella (HEN PEcK)

Front 35

Cephalosporins What can 3rd generation drugs do that 1st and 2nd generation can't?

Back 35

Cross the blood brain barrier

Front 36

Cephalosporins What are some other benefits of 3rd gen?

Back 36

better activity against gram neg bugs resistant to beta-lactam drugs. Ceftazidime for Pseudomonas and ceftriaxone for N. gonorrhea

Front 37

Cephalosporins What are the benefits of 4th gen? name a couple

Back 37

(cefepime, cefpiramide) inc activity against pseudomonas and gram positives

Front 38

Cephalosporins What drugs should you avoid taking with cephalosporins?

Back 38

Aminoglycosides (increases nephrotoxicity) and ethanol (causes a disulfiram-like rxn -- headache, nausea, flushing, hypotension)

Front 39

Aztreonam When would you use aztreonam?

Back 39

Only to treat Klebsiella, Pseudomonas and Serratia spp.

Front 40

Aztreonam Is it beta-lactamase resistant?

Back 40

Yes, this is one of the huge benefits of the drug, and it is not cross-reactive with PCN!

Front 41

Aztreonam Which population of pt. is this drug good for?

Back 41

The PCN-allergic patient that can't take aminoglycosides b/c of renal insufficiency

Front 42

Aztreonam Are there any toxicity issues with this drug?

Back 42

Not really. Generally well tolerated with occasional GI upset. Vertigo, Headache and rare hepatotoxicity have been reported.