David's Antibiotics Iii

Front 1

Tetracyclines spectrum?

Back 1

gram pos, gram neg, aerobes/anaerobes….also rickettsiae, chlamydiae, spirochetes, mycoplasma pneumonia

Front 2

Tetracyclines MOA? Bacteri-?

Back 2

Bind to 30S ribosome and block access to A-site. Bacteriostatic (except TGC)

Front 3

List 3 other drugs that belong with tetracyline (TC)

Back 3

Doxycycline (DC), Minocycline (MOC), Tigecycline (TGC)

Front 4

Tetracyclines resistance?

Back 4

pump out drug (plasmid pBR322), alter ribosome binding, or alter drug. Cross-resistance b/w tetracycline is NOT uniform.

Front 5

Tetracyclines absorption?

Back 5

Oral (not TGC), and depends on types of food. Absorption reduced by divalent cations (Ca, milk-Ca, Al, antacid, Mg, Fe)

Front 6

Tetracyclines distribution?

Back 6

Liver, kidney, spleen, skin, and tissues undergoing calcification. Into body fluids but poor into CSF/ocular fluids EXCEPT MOC

Front 7

Which tetracyclines can do daily dose?

Back 7

Not TC. TGC has longest t1/2 of 36 hours

Front 8

Tetracyclines excretion?

Back 8

TC/MOC through both renal and non-renal. DC/TGC do no accumulate -> do not need adjustment in renal impaired

Front 9

Tetracyclines DOC for (name 5)

Back 9

Mycoplasma pneumoniae, rickettsia, chlamydia, Vibrio cholerae, Spirochetes (LYME disease, relapsing fever) and all sorts of crap

Front 10

TGC mentioned targets/resistances/administration

Back 10

Target MRSA/VRE. Proteus and Pseudomonas resistant. IV only.

Front 11

Tetracyclines have what 3 big contraindications? 7 Adverse effects?

Back 11

RENAL DYSFUNCTION, pregnancy, children less than 8 years. Causes Hepatotoxicity (esp. pregnancy), renal toxicity, hypo-mineralization of bone, teeth/skin staining, photosensitization (DC esp), GI, and superinfections (candida -> vagina. Staphy -> GI)

Front 12

Amnioglycosides transport? MOA? Bacteri-?

Back 12

1) passive diffusion through porins of outer membrane, active transport across inner membrane (oxygen-dependent process). 2) block protein synthesis by binding to S12 protein of 30S ribosome. Blocks initation of of synthesis, misread codons, and blocks ribosome formation. 3) Bactericidal

Front 13

Amnioglycosides spectrum?

Back 13

Gram neg. enteric bacilli. Selective gram pos. depending on drug. Affects aerobes inc. Pseudomonas.

Front 14

Amnioglycosides resistance (3) and manner?

Back 14

Slow, step-wise manner. 1) Decreased uptake (R-factor). 2) Altered receptor. 3) Enzyme modification (acetylation, phosphorylation, adenyllylation on the sugar chains)

Front 15

Amnioglycosides: List the 3 IM/IV, IM, and Topical/PO agents

Back 15

IM,IV: Gentamicin, Amikacin, Tobramycin. IM: Streptomycin. Topical/PO: Neomycin

Front 16

Amnioglycosides excretion?

Back 16

mainly glomerular filtration so they will accumulate and need to be adjusted with impaired renal function

Front 17

Why is daily dosing preferred with aminoglycosides aside from convenience?

Back 17

Need to consider the concentration dependent killing and post-antibiotic prolonged side effect. Remember the graphs and that you will have less side effects and greater potency.

Front 18

Amnioglycosides side effects (3)

Back 18

1) Ototoxicity affecting vestibular (Gentamicin) and auditory (Kanamycin). 2) Nephrotoxicity -> reversable ATN. 3) Neuromuscual blocking action that looks like curare. Watch out for that anesthesia.

Front 19

Gentamicin clinical use (5 specific)? Streptomycin? Administration with other antibiotics?

Back 19

1) serious, life threatening infections (Pseudomonas, E.coli, Klebsiella, Enterobacter, Proteus). 2) TB w/ isoniazid/refampin. 3) Often with beta-lactam to cover both gram neg and positive (aminoglycodies do gram neg)

Front 20

Ciprofloxacin is an analog of what? MOA?

Back 20

Fluoroquinolones are analogs of nalidixic acid. 2) inhibits bacterial topoisomerase II (DNA gyrase) -> inhibits DNA synthesis by preventing uncoiling of DNA

Front 21

Ciprofloxacin spectrum? Specifically what 2? Bacteri-? What's not sensitive?

Back 21

Primarily gram neg cocci/bacilli. 1) Pseudomonas and mycobacteria. 3) Bactericidal. 4) Anaerobes are not sensitive…except to Trovafloxacin

Front 22

Ciprofloxacin absorption/excretion/dosing?

Back 22

Well absorbed after oral but inhibited by divalent cations like in antacids. 2) urine and bile. 3) daily dosing available

Front 23

Ciprofloxacin DOC for what? Also effective for?

Back 23

Anthrax. Pseudomonas

Front 24

Ciprofloxacin 2 contraindications. 2) 3 adverse effects? 3) drug interactions (3)

Back 24

1) Pregnancy and <18 years. 2) GI, CNS, convulsions in epilepsy. 3) Inhibits CYP1A2 -> theophyllin, caffeine, and warfarin

Front 25

Trovafloxin has what 3 improvements?

Back 25

1) Broader spectrum: some anaerobes (B. fragilis). 2) longer t1/2. 3) NON-RENAL excretion.

Front 26

Trimethoprim-sulonamide MOA?

Back 26

Sulfonamide is an analog of PABA and competes with it. TMP targets dihydrofolate reductase. Blocks folic acid synthesis….and eventually blocks DNA/RNA/protein

Front 27

TMP-SMX other name?

Back 27

Co-trimoxazole

Front 28

TMP-SMX spectrum

Back 28

positive (including MRSA) and negative: Chlyamydia , Hemophilus, Enterobacteriaceae, P. jeroveci pneumonia, nocardia

Front 29

TMP-SMX resistance (3)

Back 29

1) plasmid transfers. 2) random mutation. 3) inc PABA synthesis

Front 30

TMP-SMX absorption/metab/excretion

Back 30

well absorbed orally, metabolized by liver, excreted through kidney

Front 31

TMP-SMX 4 specific uses? Others?

Back 31

S. aureus (MRSA), P. jeroveci, shigellosis, H. influenzae (otisis media, sinusisits). UTI, prostatitis, pneumonia, topical use for burns and wounds

Front 32

Methenamine MOA? Use? Contraindicated?

Back 32

Produces formaldehyde, but decomposed at pH < 5.5. Urinary tract antiseptic. Metabolized in liver so hepatic insufficiency (or sulfonamide) contraindicated.

Front 33

Nitrofurantoin use? MOA? Side effect?

Back 33

Urinary tract antiseptic, good against resistant E. coli. 2) activated at ph < 5.5. 3) birth defect

Front 34

Metronidazole MOA? Bacteri-?

Back 34

Penetrates all bacteria but in anaerobes the nitro group is reduced -> metabolite reacts with DNA and inhibits replication. 2) Bactericidal.

Front 35

Metronidazole spectrum? 2 specifically mentioned.

Back 35

Antiprotozoal and ANAEROBIC. Bacteroides and Blostridia.

Front 36

Metronidazole absorption/distribution/excretion

Back 36

Well absorbed orally, distributed through including bone and CSF, excreted in urine and bile

Front 37

Metronidazole side effects (3)

Back 37

1) GI. 2) Candidal superinfections. 3) not with alcohol -> inhibition of aldehyde dehydrogenase