Micro Drugs

Front 1

what are the uses & clinical uses of penicillin?

Back 1

- uses: gram (+) cocci, neisseria meningitidis

- clinical uses: GAS pharyngitis, syphillis

Front 2

what are the uses & clinical uses of oxacillin/dicloxacillin? side effects?

Back 2

- uses: staph (MSSA) & strep only, not inactivated against beta-lactamases

- clinical uses: cellulitis, MSSA

- side effects: interstitial nephritis (why methicillin was taken off market!)

Front 3

what are the uses & clinical uses of ampicillin/amoxicillin?

Back 3

- uses: similar to PCN + enterococcus, gram (-) rods, listeria monocytogenes, H. influenza

- clinical uses: meningitis from listeria monocytogenes, enterococcus , H. influenza (check susceptibility), respiratory bacteria (NOT B PERTUSSIS)

Front 4

what are the uses & clinical uses of ampicillin + sulbactam?

Back 4

- uses: gram (+), MSSA, H. influ, more gut anaerobes (bactericides)

- clinical uses: H influ, diverticulitis (b/c lots of anaerobes, but NOT psuedomonas), diabetic foot infxn

Front 5

what are the uses & clinical uses of pipercillin + tazobactam?

Back 5

- uses: enterobacter, P aeruginosa, gram (-) rod, bowel anaerobes (Bacteriodes fragilis)

- clinical uses: bowel associated anaerobes producing beta-lactamase

Front 6

what is cefazolin? what are the uses & clinical uses?

Back 6

- 1st generation cephalosporin

- uses: gram (+) cocci, MSSA, gram (-) = PEcK

- clinical uses: surgical prophylaxis (kills strep & staph)

Front 7

what is the only cephalosporin not excreted by the kidneys?

Back 7

- ceftriaxone

Front 8

what is cefuroxime? what are the uses & clinical uses?

Back 8

- 2nd generation cephalosporin

- uses: gram (+) cocci, gram (-) HENS PEcK, other respiratory bacteria (NOT B PERTUSSIS)

- clinical uses: pneumonia (H. influ, S pneumonia), bronchitis

Front 9

what is cefoxitin? what are the uses & clinical uses?

Back 9

- 2nd generation cephalosporin

- uses: less activity than 1st generations against gram (+), gram (-) gram (-) HENS PEcK (Neisseria gonorrhea), ANAEROBES

- clinical uses: diverticulitis. bowel anaerobes

Front 10

what is ceftriaxone? what are the uses & clinical uses?

Back 10

- 3rd generation cephalosporin

- uses: S. pneumonia (meningitis), serious gram (-) rods, no pseudomonas

- clinical uses: neisseria meningitidis, S pneumonia & H flu meningitis, UTI b/c gram (-) activity but not psuedomonas, gonorrhea

Front 11

what is ceftazidime? what are the uses & clinical uses?

Back 11

- 3rd generation cephalosporin

- uses: poor gram (+) activity, no anaerobic activity, treats pseudomonas!

- clinical uses: P aeurginosa

Front 12

what is cefepime? what are the uses & clinical uses?

Back 12

- 4th generation cephalosporin

- uses: broad spectrum, gram (+) & gram (-) including P aeurginosa, NO ANAEROBIC ACTIVITY

- clinical uses: pseudomonal meningitis

Front 13

what is ceftaroline? what are the uses & clinical uses?

Back 13

- 5th generation cephalosporin

- uses: gram (+) --> MRSA!!!, gram (-) EXCEPT P. aeurginosa or anaerobes

- clinical uses: MRSA, pneumonia

Front 14

what is the only beta lactam used to treat MRSA?

Back 14

- ceftaroline

Front 15

what is aztreon? what are the uses & clinical uses?

Back 15

- monobactam

- uses: gram (-) only, no gram (+) or anaerobic activity

- clinical uses: PCN allergic pts w/ GNR infxn & cannot use amino glycosides b/c of renal insufficiency

Front 16

what is imipenem/cilastatin? what are the uses & clinical uses?

Back 16

- carbapenem

- uses: widest spectrum of all drugs ever developed, good for extended spectrum beta-lactamases

- clinical uses: resistant GNR

- side effects: lowers seizure threshold

Front 17

what are the uses & clinical uses of vancomycin? side effects?

Back 17

- uses: gram (+) bacteria (including MRSA & MRSE)

- clinical uses: po for C. diff, MRSA & MRSE

- side effects: Red Man Syndrome & NOT (nephrotoxicity, ototoxicity, thrombophlebitis)

Front 18

what are the uses & clinical uses of daptomycin? side effects?

Back 18

- uses: gram (+), MRSA, VRE

- clinical uses: NOT pneumonia b/c surfactant, endocarditis, IV only

- side effects: rhabdomyolysis

Front 19

what is liezolid? what are the uses & clinical uses? side effects?

Back 19

- oxazolidinone, works on 50s

- uses: gram (+) = MRSA, VRE

- clinical uses: resistant gram (+) infxns

- cytopenias

Front 20

what are the tetracyclines? which one can you not use in renal failure? what are the uses & clinical uses? side effects?

Back 20

- 30s, tetracycline, doxycycline, minocycline

- cannot use tetracycline in renal failure

- uses: broadest of all protein synthesis inhibitors, gram (+) not S aureus, gram (-) not pseudomonas, tick borne pathogens

- clinical uses: chlamydia, gonorrhea, rickettsial diseases (rocky mountain spotted fever), mycoplasma pneumoniae, malaria

- side effects: teeth + bones, photosensitivity, do not take w/ food b/c binds divalent cations in the gut

Front 21

what are the aminoglycosides? what are the uses & clinical uses? side effects?

Back 21

- 30s, gentamicin, netilmicin, tobramycin, amikacin, streptomycin (mycobacterium Tb), [ ] dependent killing

- uses: gram (-), NO ACTIVITY AGAINST ANAEROBES B/C NEED O2 TO BE TAKEN UP, Tb (streptomycin), MAC, P aeruginosa

- clinical uses: synergy w/ beta-lactams for gram (-) infxns (enterococcal endocarditis infxn), Tb (streptomycin)

- side effects: NNOT (nephrotoxicity, NMJ blockade, ototoxicity, teratogen)

Front 22

what is chloramphenicol? what are the uses & clinical uses? side effects?

Back 22

- 50s ribosome

- uses: broad spectrum

- clinical uses: meningitis (H influenza, neisseria meningitidis, strep pneumoniae)

- side effects: aplastic anemia, gray baby syndrome

Front 23

what are the macrolides? which one inhibits p450? what are the uses & clinical uses? side effects?

Back 23

- azithromycin, clarithromycin (inhibits p450), erythromycin (inhibits p450), 50s

- uses: gram (+), atypical pneumonia, pertussis

- clinical uses: atypical pneumonias

- side effects: QT prolongation, drug interactions p450 (erythromycin + clarithromycin)

Front 24

what are quinupristin/dalopristin uses? clinical uses?

Back 24

- uses: gram (+), not enterococcus

- clinical uses: gram (+)

Front 25

what are the uses of clindamycin? clinical uses?

Back 25

- 50s

- uses: anaerobes (not C diff)

- clinical uses: oral & intraabdominal anaerobic infxn

Front 26

what are the fluoroquinolones? who has activity against pseudomonas? what is the MOA? what are the uses & clinical uses? side effects?

Back 26

- ciprofloxacin (most activity against pseudomonas), levofloxacin, moxifloxacin (no activity against pseudomonas)

- MOA: against DNA gyrase

- uses: gram (-) rods, gram (+)

- clinical uses: prostatitis, UTI (not motifloxin b/c not excreted renal)

- sid effects: QT prolongation, cartilage & achilles tendon rupture, not in children <10

Front 27

what is the MOA of metronidazole? what are the uses & clinical uses? side effects?

Back 27

- MOA: direct damage to DNA

- uses: gram (-) anaerobes (B fragilis, gram (+) anaerobes (C. diff)

- clinical uses: mixed infxn, C diff

Front 28

what are the uses of nitrofurantoin? clinical uses?

Back 28

- uses: gram (-) rods

- clinical uses: first line agent for UTI

Front 29

what is the MOA of sulfonamides? what are the uses & clinical uses? side effects?

Back 29

- sulfonamides: inhibits dihydropteroate synthase, trimethoprim: inhibits DHFR

- uses: gram (+) cocci = MRSA, gram (-) rods = NOT PSEUDOMONAS

- clinical uses: PCP in HIV pts

- side effects: kernicterus, stephens johnsons syndrome

Front 30

how are penicillins excreted? which one do you not need to dose adjust in renal failure?

Back 30

- kidneys

- oxacillin/dicloxacillin don't need to dose adjust in renal failure

Front 31

which antibiotic do you use for listeria monocytogenes?

Back 31

- ampicillin/amoxicillin

Front 32

how is pipercillin-tazobactam combo different than ceftazidime?

Back 32

- both treat pseudomonas but ceftazidime has NO anaerobic activity

Front 33

what is the main mechanism of resistance of the protein synthesis inhibitors? what is the exception?

Back 33

- target site alterations

- exception = aminoglycosides (enzyme degradation) - also bactericidal (unique)

Front 34

what is the mechanism of tetracyclines? which one can you not use in renal failure?

Back 34

- bind 30s subunit & stop binding of amino-acyl t-RNA

- cannot use tetracycline in renal failure, but doxycycline & minocycline fine b/c excreted fecally

Front 35

what is the broadest drug of all the protein inhibitors?

Back 35

- tetracyclines

Front 36

how do macrolides work?

Back 36

- bind 50s stop translocation = macro"slides"

Front 37

how does clindamycin work?

Back 37

- binds 50s & stops peptide bond formation

Front 38

which drug treats prostatitis?

Back 38

- fluoroquinolones (only drug that penetrates prostate)

Front 39

what is the mechanism of resistance to fluoroquinolones?

Back 39

- efflux & altering target site (DNA gyrase)