Antimicrobials Uses Only

Front 1

What drugs Block cell wall synthesis by inhibiting peptidoglycan cross-linking.

Back 1

penicillin, ampicillin, ticarcillin, piperacillin, imipenem, aztreonam, cephalosporins

Front 2

What drugs Block peptidoglycan synthesis.

Back 2

bacitracin, vancomycin, cycloserine

Front 3

What drugs Block protein synthesis at 50S ribosomal subunit.

Back 3

chloramphenicol, erythromycin/macrolides, lincomycin, clindamycin, streptogramins (quinupristin, dalfopristin), linezolid

Front 4

What drugs Block protein synthesis at 30S ribosomal subunit.

Back 4

aminoglycosides, tetracyclines

Front 5

What drugs Block DNA topoisomerases.

Back 5

quinolones

Front 6

What drugs Block mRNA synthesis

Back 6

rifampin

Front 7

What drugs Bactericidal antibiotics.

Back 7

penicillin, cephalosporins, vancomycin, aminoglycosides, fluoroquinolones, metronidazole

Front 8

What drugs Disrupt bacterial/fungal cell membranes

Back 8

polymyxins

Front 9

What drugs Disrupt fungal cell membranes.

Back 9

amphotericin B, nystatin, fluconazole/azoles

Front 10

Penicillin (G: IV form; V: oral form): clinical use and toxicity

Back 10

C: bactericidal for gram + cocci, gram + rods, gram - cocci and spirochetes; T: hypersensitivity reactions, hemolytic anemia.

Front 11

Methicillin, nafcillin, dicloxacillin: clinical use and toxicity

Back 11

C: staphylococcus aureus; T: hypersensitivity reactions; methcillin - interstitial nephritis.

Front 12

piperacillin, ticarcillin

Back 12

C: pseudomonas spp. and gram - rods; susceptible to penicillinase; use with clavulanic acid; T: hypersensitivity.

Front 13

1st generation cephalosporins: clinical use

Back 13

PEcK: gram + cocci, Proteus mirabilis, E. coli, Klebsiella pneumoniae

mainly for surgery prophylaxis

Front 14

2nd generation cephalosporins: clinical use

Back 14

HEN PEcKS: gram + cocci, Haemophilus influenza, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. coli, Klebsiella pneumoniae, Serratia marcescens

Front 15

3rd generation cephalosporins: clinical use

Back 15

serious gram - infections resistant to other beta lactams, meningitis (most penetrate the BBB); eg.: ceftazidime for pseudomonas, ceftriaxone for gonorrhea

Front 16

4th generation cephalosporins: clinical use

Back 16

increased activity against pseudomonas and gram + organisms

Front 17

aztreonam: clinical use and toxicity

Back 17

C: gram - rods (Klebsiella spp., Pseudomonas spp., Serratia spp.), no activity agains gram + or anaerobes, for use in penicillin-allergic patients and those with renal insufficiency who can't tolerate aminoglycosides; T: usually non-toxic; occasional GI upset.

Front 18

imipenem/ cilastatin: clinical use and toxicity

Back 18

C: gram + cocci, gram - rods, and anaerobes (drug of choice for Enterobacter); T: GI distress, skin rash, and CNS toxicity (seizures) at high plasma levels

Front 19

Imipenem/cilastatin mneumonic

Back 19

with imipenem, "the kill is LASTIN' with ciLASTATIN."

Front 20

vancomycin: clinical use and toxicity

Back 20

C: used for serious gram + multi-drug resistant organisms, including Staph aureus and Clostridium difficile (pseudomembranous colitis); T: "well tolerated in general, does NOT have many problems." Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing ("red man syndrome" - can be largely prevented by pretreatment with antihistamines and slow infusion rate

Galina

Front 21

Aminoglycosides: clinical use and toxicity

Back 21

C: severe gram - rod infections, synergistic with beta lactam antibiotics, neomycin for bowel surgery; T: Nephrotoxicity (esp. when combined with cephalosporins), Ototoxicity (esp. when combined with loop diuretics) "amiNOglycosides"

Front 22

Tetracylines: clinical use and toxicity

Back 22

C: VACUUM you BedRoom: Vibrio cholerae, Acne, Chlamydia, Ureaplasma Urealyticum, Mycoplasma pneumoniae, Borrelia burgdorferi (Lyme disease), Rickettsia, tularemia; T: GI distress, discoloration of teeth and inhibition of bone growth in children, Fanconi's syndrome, photosensitivity.

Front 23

Macrolides: clinical use and toxicity

Back 23

C: URIs, pneumonias, STDs (gram + cocci; streptococcal infections in patients allergic to penicillin), Mycoplasma, Legionella, Chlamidia, Neisseria; T: GI discomfort (most common cause of noncompliance), acute cholestatic hepatitis, eosinophilia, skin rashes

Front 24

chloramphenicol: clinical use and toxicity

Back 24

C: meningits (H. influenza, N. meningitidis, S. pneumoniae);

T: use conservatively due to the toxicities - anemia (dose dependent), aplastic anemia (dose dependent), gray baby syndrome (in premature infants because they lack liver UDP-glucoronyl transferase)

Front 25

Clindamycin: clinical use and toxicity

Back 25

C: treat anaerobic infections (eg.: Bacteroides fragilis, Clostridium perfringens); T: pseudomembranous colitis (C. difficile overgrowth), fever, diarrhea

Front 26

sulfonamides: clinical use

Back 26

C: gram +, gram -, nocardia, chlamydia; triple sulfas or SMX for simple UTI T: hypersensitivity rxn, hemolysis if G6PD deficient nephrotoxicity (tubulointerstitial nephritis), kernicterus in infants, displace other drugs from albumin (eg. warfarin)

Front 27

trimethoprim: clinical use

Back 27

C: combined with sulfas to cause sequential block of folate synthesis; combo used for recurrent UTIs, Shigella, Salmonella, Pneumocystis carinii pneumonia

Front 28

trimethoprim: toxicity

Back 28

T: megaloblasticanemia, leukopenia, granulocytopenia (can alleviate with supplemental folinic acid)

Front 29

fluoroquinolones: clinical use and toxicity

Back 29

C: gram - rods of urinary and GI tracts (incl. Pseudomonas), Neisseria, some gram + organisms T: GI upset, superinfection, skin rashes, headache, dizziness; contraindicated in pregnant women and kids due to possible cartilage damage; tendonitis and tendon rupture in adults

Front 30

metronidazole:clinical use and toxicity

Back 30

C:

antiprotozoal,

Giardia,

Entamoeba,

Trichomonas,

Gardnerella vaginalis,

anaerobes (Bacteroides, Clostridium);

used with bismuth and amoxicillin (or tetracyline) for "triple therapy" against H. pylori

T: disulfram-like reaction with alcohol, headache

Front 31

polymyxins: clinical use and toxicity

Back 31

C: resistant gram - infections T: neurotoxicity, acute renal tubular necrosis

Front 32

anti-TB drugs

Back 32

RESPIre. All are hepatotoxic. Rifampin Ethanmbutol Steptomycin Pyrazinamide Isoniazid (INH) cycloserine (2nd line therapy)

Front 33

isoniazid (INH)

Back 33

INH Injures Neurons and Hepatocytes. Different INH half lives in fast vs. slow acetylators. M: - synthesis of mycolic acids

Front 34

rifampin

Back 34

Rifampin's 4 R's: RNA polymerase inhibitor Revs up microsomal P-450 Red/orange body fluids Rapid resistance if used alone

Front 35

rifampin: clinical use and toxicity

Back 35

M. tuberculosis; delays resistance to dapsone when used for leprosy; used for meningococcal prophylaxis and chemoprophylaxis in contacts with childresn with Haemophilus Influenza type B. T: minor hepatotoxicity and Drug interactions (increases p450)