Antimicrobials2 4-15-06

Front 1

Imipenem/cilastatin What is imipenem?

Back 1

broad spectrum beta-lactamase-resistant carbapenem

Front 2

Imipenem What do you always administer it with and why?

Back 2

cilastatin -- it decreases inactivation of imipenem in renal tubules

Front 3

Imipenem/cilastatin What do you use it for?

Back 3

Gram pos cocci, gram neg rods and anaerobes (broad spectrum), drug o' choice for Enterobacter

the girl from Ipanema was a Broad, y era Enterita

Front 4

Imipenem/cilastatin What bug is it the drug of choice for?

Back 4

Enterobacter

Front 5

Imipenem/cilastatin What are its side-effects

Back 5

GI distress, skin rash, seizures at high conc.

kid with skin problems getting nervous (upset stomach, shaking) when talking to girl from Ipanema

Front 6

Vancomycin Is it bactericidal or bacteriastatic and why?

Back 6

Bactericidal because it blocks cross linkage and elongation of peptidoglycan by binding D-ala D-ala protion of cell wall.

Front 7

Vancomycin How does resistance to Vanco occur?

Back 7

D-ala D-ala is replaced with D-ala D-lactate which vanco does not block

Front 8

Vancomycin What is it used for?

Back 8

Used for serious infection that is resistant to other drugs (e.g. gram pos multi-drug resistant organisms like S. aureus and C. difficile, methicillin resistant staph (MRSA))

Front 9

Vancomycin What are the important toxicities of vanco?

Back 9

generally NOT many problems except, Nephrotoxicity, Ototoxicity and Thrombophlebitis

*also red man syndrome, give with histamine to prevent

Front 10

Vancomycin What can happen with rapid infusion of vanco?

Back 10

Red man's syndrome. Diffuse flushing which can be controlled by pretreatment with anti-histamines and with slow infusion rate

Front 11

Protein Synthesis Inhibitors Which drugs target bacterial protein synthesis by blocking the 30S unit vs 50S unit?

Back 11

Buy AT 30, CELL at 50

Front 12

Protein Synthesis Inhibitors What does AT stand for?

Back 12

A = Aminoglycosides (streptomycin, gentamicin, tobramycin an damikacin. And T = Tetracyclines

Front 13

Protein Synthesis Inhibitors What does CELL stand for?

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C = Chloramphenicol, E= Erythromycin, L= Lincomycin and L= cLindamycin

Front 14

Which of the Protein Synthesis Inhibitors are bactericidal?

Back 14

Only the aminoglycosides are, the rest are bacteriostatic

Front 15

Aminoglycosides Name some aminoglycosides?

Back 15

Gentamicin, neomycin, amikacin, tobramycin and streptomycin

mean GNATS

Front 16

Aminoglycosides How do these drugs work?

Back 16

They inhibit formation of the initiation complex in mRNA translation

Front 17

Aminoglycosides Why are they ineffective against anaerobes?

Back 17

They require oxygen for uptake into bacteria

Front 18

Aminoglycosides When would you use aminoglycosides?

Back 18

against severe gram-negative rod infections

Front 19

Aminoglycosides What drugs can you use aminoglycosides with for synergy?

Back 19

the drugs that inhibit cell wall synthesis (e.g. penicillin and cephalosporins -- the beta-lactam antibiotics). Presumably this allows the drug to get in with out reliance on oxygen transport

Front 20

Aminoglycosides What drug in this class is commonly used for bowel surgery?

Back 20

Neomycin

Front 21

Aminoglycosides What are the major toxicities?

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Nephrotoxicity (esp w/ cephalosporins), Ototoxicity (esp w/ loop diuretics), Teratogen

mean GNATS canNOT kill anaerobes

Front 22

Tetracyclines Name some tetracylcines

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Tetracycline, doxycycline, demeclocycline, minocycline

Front 23

Tetracyclines How does it work?

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Blocks t-RNA attachment to 30S subunit

Front 24

Tetracyclines Which tetracycline can you use in patients with renal failure and why?

Back 24

Can use doxycycline because its elimination is fecal

Front 25

Tetracyclines Should you take these drugs with a glass of milk?

Back 25

NO, because it intereferes with absorption in the gut as does antacids and iron-containing preparations, or any divalent cations

Front 26

Tetracyclines What are tetracyclines used for?

Back 26

Toby, VACUUM THe Bed Room-- Vibrio cholerae, Acne, Chlamydia, Ureaplasma, Urealyticum, Mycoplasma pneumoniae, Tularemia, H pylori, Borrelia burgdorferi, Rickettsia

Front 27

Tetracyclines What are the common toxicities

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GI distress, teeth discoloration, inhibition of bone growth in children, Fanconi's syndrome and photosensitivity. Contraindicated in pregnancy

Front 28

Macrolides Name some macrolides?

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Erythromycin, azithromycin, Clarithromycin

EaZy was a Crip Mac

Front 29

Macrolides How do these drugs work?

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bind to 23S rRNA of 50S and inhibit translocation, bacteriostatic

Front 30

Macrolides What are they used for?

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URIs, pneumonias, STDs -- streptococcal in patients that are allergic to PNC --- Mycoplasm, Legionella, Chlamydia, Neisseria.

Eryc's Nipple's at the Mid Clavicular Line

Front 31

Macrolides Pneumonic for macrolide use?

Back 31

Eryc's Nipple is at his Mid Clavicular Line (Eryc is brand name for erythromycin, and eazy e's real name). Neisseria, Mycoplasm, Chlamydia, Legionella.

Front 32

Macrolides What are the major toxicities?

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GI discomfort, acute Cholestatic hepatitis, Eosinophilia, skin rashes
increases serum theophylines and oral anticoagulants

the Mac eazy E was a Gangsta Crip with bad Skin

Front 33

Macrolides What is the most common cause for non-compliance to macrolides?

Back 33

GI discomfort

Front 34

Chloramphenicol How does this drug work?

Back 34

inhibits 50S peptidyltransferase

Front 35

Chloramphenicol Main use?

Back 35

Meningitis (H. influenzae, N. meningitides, S. pneumo). Used conservatively b/c of toxicity

Front 36

Chloramphenicol What are the main toxicities?

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Anemia and aplastic anemia (both dose dependent), gray baby syndrome (in premes b/c they lack UDP-glucoronyl transferase)

Front 37

Clindamycin How does it work?

Back 37

blocks peptide bond formation at 50S

with CLINdamycin, the amino acids don't CLINk together

Front 38

Clindamycin When do you use it?

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Anaerobic infections (e.g. Bacteroides fragilis and C.perfringens)

Front 39

Clindamycin Toxicities?

Back 39

Pseudomembranous colitis, fever, diarrhea

Front 40

Sulfonamides Name some sulfonamides

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Sulfamethoxazole (SMX), sulfisoxazole, triple sulfa and sulfadiazine

Front 41

Sulfonamides How does it work?

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Inhibits bacterial folic acid synthesis from PABA by blocking dihydropteroate synthase.

Front 42

Sulfonamides What are its uses?

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Gram-positive, gram-negative, Nocardia, Chlamydia. Triple sulfas and SMX for simple UTIs

Front 43

Sulfonamides Toxicities?

Back 43

hypersensitivity rxn, hemolysis if G6PD deficient, nephorotoxicity (tubulointerstitial nephritis), kernicterus in infants, displace other drugs from albumin (e.g. warfarin)