Cmbm - Intro To Antibiotics

Front 1

Inhibit Transpeptidase

Cause Lysis (Bacteriocidal)

Gram +

Back 1

Penicillins/Cephalosporins

Front 2

Inactivates Penicillins/Cephalosporins

Back 2

b-lactamase

Front 3

Oral

Gm +

NOT resistant b-lactamase

Back 3

Amoxicillin / Ampicillin (2nd gen)

Front 4

Gm -

NOT resistant to b-lactamase

Back 4

Piperacillin (4th gen) (last case scenario)

Hint 4

Enhanced with Tazobactam

Front 5

IV /Parenteral

Gm + or Gm -

Pen Allergy rxn

Back 5

Imipenem - Cilastatin

Front 6

PBP

Gm -

NO Pen allergy rxn

IV / Parenteral

Back 6

Aztreonam

Front 7

Gm +

Endocarditis

IV / Parenteral

NO Pen Allergy rxn

Back 7

Vancomycin

Hint 7

MRSA

Front 8

Pen Allergy Rxn

Back 8

Cephalosporins

Hint 8

Ok for minor rxns only (like rash)

Front 9

Gm -

Gonorrhea

Pneumonia

Meningitis

Changes form in Urine

What can use in place of

Back 9

Ceftriaxone

Hint 9

Can use Cefixime in place of (oral)

Front 10

Bactericidal

Inhibits bacterial DNA Gyrase

Back 10

Quinolones / Fluoroquinolones

Hint 10

By inhibiting DNA Gyrase, it keeps DNA supercoiled preventing TS/TL

Front 11

Used infrequently in lower UTI

for common Gm - organisms (ie e Coli)

Back 11

Nalidixic Acid and Cinoxacin (older drug)

(Quinolones)

Limited Usage

Hint 11

ADR Rash

Front 12

What class is Ciprofloxacin and how is it taken

Back 12

Fluoroquinolones - Extends Gm - significantly

PO, IV

Front 13

What class is Ofloxacin and how is it taken

Back 13

Fluoroquinolones - Extends Gm - significantly

PO, IV

Front 14

Dont take Antacids with what drug class

Back 14

Fluroquinolones

Hint 14

Good PO though

Front 15

How are fluoroquinolones excreted

What is the exception?

Back 15

Urine unchanged

Exception: Moxifloxacin (biliary)

Front 16

*Inhibits CYP-450 drug metabolizing enzymes

Increases half life of other drugs

What drug class is it?

Back 16

Ciprofloxacin

(Fluoroquinolone)

Front 17

*Broad gram -

What is best against Pseudomonas, what drug?

Good against gonorrhea

Back 17

Ciprofloxacin

Front 18

Travelers Diarrhea

Neutropenic Patients

UTI in Men

Back 18

Ofloxacin

Front 19

What drug class are these from:

Levofloxacin

Moxifloxacin

What gram type are they effective against

Back 19

Fluoroquinolones

Gm +

Especially Streptococcus

Hint 19

Levofloxacin is L-isomer of Ofloxacin

Front 20

Photosensitivity

Nephrotoxicity

Crystalluria in Alkaline urine

*Cartilage erosion

Tendonitis

Contraindicated: pregnancy/nursing/children

What drug type?

Back 20

FQ

Hint 20

Levofloxacin

Moxifloxacin

Front 21

Describe difference in urine ph with FQ's vs Sulfonamides

Back 21

FQ's - Crystalluria in Alkaline urine

Sulfonamides - Crystalluria in Acidic urine

Front 22

Adjust dosage of FQ based on what? bc of nephrotoxicity

Back 22

Creatine Clearance

Front 23

*This drug type inhibits dihydropteronate synthase

What does dihydropteronate synthase do? (on hint)

No Pen Allergy rxn

Back 23

Sulfonamide

Hint 23

Dihydropteronate Synthase catalyzes PABA to folic acid required for DNA synthesis

Front 24

Sulfonamide flow chart mechanism

Back 24

Front 25

What is the main indication for systemic Sulfonamide use alone?

Back 25

Gm -: E coli

P. Mirababilis for uncomplicated UTI's

Front 26

What drug class?

Good PO

Metabolized via acetylation in liver

Excretion mainly in urine

Back 26

Sulfonamides

Hint 26

Crystallinuria in Acidic Urine

Front 27

Systemic Use of what drug for UTI's primarily?

What drug class also?

Back 27

Sulfisoxazole and Sulfamethoxazole*

Hint 27

Folic Acid

Front 28

*ADR:

Rash. Serious= Stevens Johnson syndrome

*Hemolytic Anemia, especially with G-6-PD deficiency

Contraindicated in pregnancy = Kernicterus (yellow pigment in brain)

Back 28

Sulfamethoxazole (sulfonamide)

Front 29

Yellow pigment in brain

Back 29

Kernicterus

Hint 29

Sulfamethoxazole (Sulfonamide)

Front 30

*Hemolytic Anemia, especially with G-6-PD deficiency

Back 30

Sulfamethoxazole (sulfonamide)

Front 31

*Combo of what drugs inhibits sequential steps in folic acid synthesis

*Resistance develops quickly when either drug used alone

Back 31

Trimethoprim / Sulfamethoxazole

(Sulfonamide)

Front 32

Folic Acid Deficiency

Weak Base

Back 32

Trimethoprim

NOT SULFAMETHOXAZOLE

Front 33

Gm - activity is main indication

Excludes Pseudomonas

Indications: UTI

Back 33

Trimethoprim / Sulfamethoxazole

(Sulfonamide)

Front 34

Increased ADR's in AIDS patients with TMP/SMX: Fever, rash, decreased blood cells, folate deficiency may cause macrocytic anemia

Back 34

Trimethoprim

(Sulfonamide)

Front 35

Main treatment for UTI

What is exception also?

Back 35

PO FQ

NO FQ in pregnancy, no Sulfonamides near term

Front 36

Male Prostatitis treatment?

Back 36

FQ , Ie Ofloxacin

Front 37

Summary Flow Chart

Back 37

Hint 37