Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
250 Cards in this Set
- Front
- Back
|
Penicillin mechanism
|
block cell wall synthesis by inhibiting peptidoglycan cross-linking
|
|
|
Bacitracin mechanism
|
Block peptidoglycan synth
|
|
|
Sulfonamides mechanism
|
block nucleotide synth
|
|
|
Imipenem mechanism
|
blocks cell wall synthesis by inhibiting peptidoglycan cross-linking
|
|
|
Polymyxins mechanism
|
disrupt bacterial cell membrane
|
|
|
Aztreonam mechanism
|
blocks cell wall synthesis by inhibiting peptidoglycan cross-linking
|
|
|
Vancomycin mechanism
|
block peptidoglycan synth
|
|
|
Trimethoprim mech
|
block nucleotide synth
|
|
|
Cephalosporin mech
|
blocks cell wall synthesis by inhibiting peptidoglycan cross-linking
|
|
|
Quinolones mech
|
block DNA topo
|
|
|
Rifampin mech
|
block mRNA synth
|
|
|
Chloramphenicol mech
|
blocks protein synth at 50S
|
|
|
Aminoglycosides mech
|
block protein synth at 30S
|
|
|
Macrolides mech
|
block protein synth at 50S
|
|
|
Clindamycin mech
|
block protein synth at 50S
|
|
|
Streptogramins mech
|
block protein synth at 50S
|
|
|
tetracyclines mech
|
block protein synth at 30S
|
|
|
Linezolid mech
|
block protein synth at 50S
|
|
|
Erythromycin
bacteriostatic or bactericidal |
bacteriostatic
|
|
|
Vancomycin
bacteriostatic or bactericidal |
bactericidal
|
|
|
Clindamycin
bacteriostatic or bactericidal |
bacteriostatic
|
|
|
Sulfamethoxazole
bacteriostatic or bactericidal |
bacteriostatic
|
|
|
Fluoroquinolones
bacteriostatic or bactericidal |
bactericidal
|
|
|
Penicillin
bacteriostatic or bactericidal |
bactericidal
|
|
|
Trimethoprim
bacteriostatic or bactericidal |
bacteriostatic
|
|
|
Aminoglycosides
bacteriostatic or bactericidal |
bactericidal
|
|
|
Cephalosporins
bacteriostatic or bactericidal |
bactericidal
|
|
|
Tetracyclines
bacteriostatic or bactericidal |
bacteriostatic
|
|
|
Metronidazole
bacteriostatic or bactericidal |
bactericidal
|
|
|
Chloramphenicol
bacteriostatic or bactericidal |
bacteriostatic
|
|
|
Bacteriostatic
what drugs: ECSTaTiC!! |
Erythro
Clinda Sulfa Trimeth Tetra Chloram |
|
|
Bactericidal:
what drugs Very Finely Proficient At Cell Murder |
Vanco
Fluoro Pen Amino Ceph Metro |
|
|
Bacteriostatic
|
inhibits growth and reproduction without killing
|
|
|
bactericidal
|
kills bacteria
|
|
|
Penicillin mechanism:
3 |
1. bind penicillin binding proteins
2. block transpeptidase cross linking of cell wall 3. activate autolytic enzymes |
|
|
Penicillin uses
|
Gram pos cocci
gram pos rods gram neg cocci spirochetes |
|
|
Penicillin toxicity
|
hypersensitivity reaction
hemolytic anemia |
|
|
Penicillinase resistant penicillins
|
methicillin
nafcillin dicloxacillin |
|
|
IV form of Penicillin
|
Penicillin G
|
|
|
Oral Penicillin
|
Penicillin V
|
|
|
Penicillinase resistant penicillins
clinical use |
staph aureas
(use naf for staph) NOT MRSA |
|
|
Methicillin toxicity
|
insterstitial nephritis
|
|
|
aminopenicillins
|
ampicillin
amoxicillin |
|
|
combine with clavulanic acid (penicillinase inhibitor) to enhance spectrum.
|
aminopenicillins mechanism
|
|
|
Amoxicillin vs ampicillin
|
amoxicillin has greater Oral bioavailability
|
|
|
aminopenicillins
clinical use: HELPS kill Enterococci |
extended spectrum penicillins
certain gram pos bacteria and gram neg rods: H. Inf, E Coli, Listeria, Proteus, Salm, enterococci |
|
|
For staph use
|
naficillin
|
|
|
For H. influenza use
|
ampicillin/amoxicillin
2nd gen cephalosporin |
|
|
For enterococci use
|
ampicillin/amoxicillin
|
|
|
For E coli use
|
ampicillin/amoxicillin
1st or 2nd gen cephalosporin |
|
|
For Listeria use
|
ampicillin/amoxicillin
|
|
|
For Proteus use
|
ampicillin/amoxicillin
aztreonam |
|
|
For Salmonella use
|
ampicillin/amoxicillin
TMP SMX |
|
|
ampicillin/amoxicillin toxicity
|
hypersensitivity
ampicillin rash pseudomembranous colitis |
|
|
antipseudomonals:
Takes Care of Pseudomonas |
ticarcillin
Carbenicillin Piperacillin |
|
|
Use what with antipseudomonals and why?
|
clavulanic acid because they're susceptible to penicillinase
|
|
|
what is clavulanic acid?
|
a beta lactamase inhibitor
|
|
|
antipseudomonals toxicity
|
hypersensitivity
|
|
|
beta lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases
bactericidal |
Cephalosporins mechanism
|
|
|
1st gen Cephalosporins:
PEcK |
Proteus
E coli Klebsiella gram positive cocci |
|
|
Ist gen cephalosporins = 2
|
cefazolin
cephalexin |
|
|
2nd gen cephalosporins = 3
|
cefoxitin
cefaclor cefuroxime |
|
|
2nd gen cephalosporins:
HEN PEcKS |
Haem infl
Enterobacter Neisseria Proteus E Coli Klebsiella Serratia |
|
|
3rd gen cephalosporins = 3
|
ceftriaxone
cefotaxime ceftazidime |
|
|
3rd gen ceph use
|
serious gram neg infections
meningitis |
|
|
Cephalosporin for pseudomonas
|
3rd gen- ceftazidime
4th- cefapime |
|
|
cephalosporin for gonorrhea
|
ceftriaxone
|
|
|
4th gen Cephalosporin
|
cefapime
|
|
|
4th gen Cephalosporin uses
|
pseudomonas
gram pos |
|
|
what drug increases nephrotoxicity of aminoglycosides?
|
cephalosporins
|
|
|
what drug causes disulfiram like reaction with ethanol
|
cephalosporins
|
|
|
Klebsiella drugs
|
1st of 2nd gen cephalosporin
aztreonam |
|
|
Proteus drugs
|
1st or 2nd gen cephalosporin
|
|
|
Enterobacter drugs
|
Carbapenems (imipenem, meropenem)
2nd gen cephalosporin |
|
|
Neisseria drugs
|
2nd gen cephalosporin
macrolides chloramphenicol |
|
|
Serratia drugs
|
2nd gen cephalosporin
aztreonam |
|
|
monobactam resistant to beta lactamases. Inhibits cell wall synthesis by binding to PBP3
|
aztreonam mechanism
|
|
|
Aztreonam is synergistic with what?
|
aminoglycosides
|
|
|
Aztreonam uses
|
gram neg rods:
klebsiella pseudomonas serratia NO GRAM POS |
|
|
If allergic to penicillin use
|
aztreonam
|
|
|
If renal insufficiency and can't tolerate aminoglycosides, use
|
aztreonam
|
|
|
aztreonam toxicity
|
GI upset, otherwise none
|
|
|
Imipenem/cilastatin
Meropenem mechanism |
broad spectrum beta lactamase resistant
administer with cilastatin to decrease inactivation in renal tubules |
|
|
administer cilastatin with what?
|
imipenem
|
|
|
carbapenems
|
imipenem
meropenem |
|
|
Carbapenems use
|
**only if life threatening due to side effects***
gram pos cocci gram neg rods anaerobes Enterobacter |
|
|
carbapenem toxicity
|
very toxic
only use for life threatening infections GI, skin, CNS (seizures) |
|
|
Inhibits cell wall mucopeptide formation by binding d-ala d-ala portion of cell wall.
|
Vancomycin
|
|
|
Vancomycin resistance mechanism
|
amino acid change of D-ala D-ala to D-ala D-lac
|
|
|
Vancomycin clinical use
|
serious gram pos
multidrug resistant Staph C diff |
|
|
C diff drug
|
Vancomycin
|
|
|
MRSA drug
|
Vancomycin
|
|
|
Vancomycin toxicity
|
nephrotoxic
ototoxic thrombophlebitis red man syndrome- flushing |
|
|
30S inhibitors:
buy AT 30, CCELL at 50 |
Aminoglycosides
Tetracyclines |
|
|
50S inhibitors
buy AT 30, CCELL at 50 |
Chloram
Clinda Erythr Lincomycin Linezolid |
|
|
aminoglycosides
Mean GNATS canNOT kill anearobes |
gentamicin
neomycin amikacin tobramycin streptomycin bactericidal |
|
|
inhibit formation of initiation complex and causes misreading of mRNA
|
aminoglycosides
|
|
|
requires O2 for uptake so ineffective against anaerobes
|
aminoglycosides
|
|
|
aminoglycosides use
|
severe gram negative
|
|
|
antibiotic used for bowel surgery
|
neomycin
|
|
|
what is synergistic with beta lactam antibiotics
|
aminoglycosides
|
|
|
aminoglycosides toxicity
|
nephro (esp with cephalosporins)
oto (with loops diuretics) teratogen |
|
|
tetracyclines
|
tetracycline
doxycycline demeclocycline minocycline |
|
|
ADH antagonist antibiotic
|
demeclocycline
|
|
|
antibiotic that acts as a diuretic in SIADH
|
demeclocycline
|
|
|
Binds to 30S and prevents attachment of aminoacyl tRNA,
limited CNS penetration |
tetracyclines
|
|
|
Tetracycline that is ok to use with renal failure due to fecal elimination
|
doxycycline
|
|
|
Antibiotic that should not be taken with milk, iron, antacids (inhibit its absorption in gut)
|
tetracyclines
|
|
|
Tetracycline uses:
VACUUM THe BR (bedroom) |
Vibrio
Acne Chlamydia Ureaplasma Urealyticum Mycoplasma Tularemia H pylori Borrelia (lyme) Rickettsia |
|
|
Vibrio drug
|
tetracycline
|
|
|
rickettsia drug
|
tetracycline
|
|
|
chlamydia drug
|
tetracycline
macrolides sulfonamides |
|
|
mycoplasma drug
|
tetracycline
macrolides |
|
|
ureaplasma drug
|
tetracycline
|
|
|
urealyticum drug
|
tetracycline
|
|
|
Tularemia drug
|
tetracycline
|
|
|
H pylori drugs
|
tetracycline
|
|
|
Borrelia drug
|
tetracycline
|
|
|
Tetracycline toxicity
|
GI
teeth discoloration bone growth probs kids photosensitivity DO NOT USE IN PREG |
|
|
Macrolides
|
erythromycin
azithromycin clarithromycin |
|
|
inhibits protein synthesis by blocking translocation, binds to 23S rRNA of the 50S rib subunit
|
macrolides
|
|
|
Macrolides use
|
URIs
typical pneumonias and weird pneumonias STDs mycoplasma legionella chlamydia neisseria gram pos cocci |
|
|
Legionella- use what?
|
Macrolides
|
|
|
use in patients with strep infection who are allergic to penicillin
|
macrolides
(erythromycin) |
|
|
Macrolides toxicity
|
GI
acute cholestatic hepatitis esoinophilia rash |
|
|
antibiotic that increases serum concentration of oral anticoagulants
|
macrolides
|
|
|
Inhibits 50S peptidyltransferase
|
Chloramphenicol
|
|
|
Chloramphenicol uses
|
meningitis (H. infl, neisseria men, strep pn)
|
|
|
Strep pneumo meningitis drug
|
chloramphenicol
|
|
|
H. influenza meningitis drug
|
chloramphenicol
|
|
|
Chloramphenicol toxicity
|
anemia
aplastic anemia gray baby syndrome (babies lack UDP glucuronyl transferase) |
|
|
blocks peptide bond formation at 50S ribosomal subunit
|
clindamycin
|
|
|
clindamycin uses
|
anaerobes
(clostridium, bacteroides) |
|
|
Clindamycin toxicity
|
C diff overgrowth
(pseudomembranous colitis) fever diarrhea |
|
|
bacteroides drug
|
clindamycin
|
|
|
clostridium perfringens drug
|
clindamycin
|
|
|
sulfonamides
|
sulfamethoxazole
sulfisoxazole sulfadiazine |
|
|
PABA antimetabolites inhibit dihydropteroate synthetase
|
Sulfonamides
|
|
|
Sulfonamides use
|
gram pos
gram neg nocardia chlamydia |
|
|
UTI drugs
|
Triple sulfas of SMX
|
|
|
Sulfonamides toxicity
|
hypersensitivity
hemolysis if G6PD deficient nephrotoxicity photosensitivity kernicterus in infants warfarin interaction |
|
|
inhibits bacterial dihydrofolate reductase, blocks folate synthesis
|
Trimethoprim
(Treats Marrow Poorly) |
|
|
Trimethoprim toxicity
|
megaloblastic anemia
leukopenia granulocytopenia |
|
|
TMP SMX use
|
recurrent UTIs
Shigella Salmonella Pneumocystis jiroveci |
|
|
Sulfa drug allergies:
avoid what drugs |
sulfonamides
thiazide diuretics acetazolamide furosemide |
|
|
shigella drugs
|
TMP SMX
|
|
|
Fluoroquinolones
|
ciprofloxacin
norfloxacin ofloxacin sparfloxacin moxifloxacin gatifloxacin enoxacin nalidixic acid |
|
|
inhibits DNA gyrase
|
fluoroquinolones
|
|
|
fluoroquinolones use
|
gram neg rods of urinary or GI tracts
pseudomonas neisseria some gram pos |
|
|
Fluoroquinolones toxicity
|
cartilage
Tendon rupture in adults cramps, myalgias in kids DONT USE WHEN PREG |
|
|
forms toxic metabolites in bacterial cell that damages DNA
|
metronidazole
|
|
|
Metronidazole uses:
GET GAP on the Metro! |
Giardia
Entamoeba Trichomonas Gardnerella Anaerobes Pylori |
|
|
Polymyxins
|
B and E
|
|
|
Bind to cell membranes of bacteria and disrupt their osmotic properties
|
polymyxins
|
|
|
polymyxin use
|
resistant gram negative
|
|
|
polymyxin toxicity
|
neuro
ATN |
|
|
M tuberculosis treatment drugs:
RIPE for treatment |
isoniazid
rifampin pyrazinamide ethambutol |
|
|
M TB prophylaxis
|
isoniazid
|
|
|
M avium intracellulare drugs
|
azithromycin
rifampin ethambutol streptomycin |
|
|
M leprae drugs
|
dapsone
rifampin clofazimine |
|
|
Anti-TB drugs:
INH-SPIRE (inspire) |
Streptomycin
Pyrazinamide isoniazid Rifampin ethambutol |
|
|
2nd line therapy for TB
|
cycloserine
|
|
|
ethambutol side effect
|
optic neuropathy (red green color blindness)
|
|
|
decreases synthesis of mycolic acids
|
isoniazid
|
|
|
INH toxicity:
|
INH Injures Neurons and Hepatocytes
|
|
|
Give what with isoniazid to prevent neurotoxicity
|
pyridoxine (B6)
|
|
|
inhibits DNA dependent RNA polymerase
|
Rifampin
|
|
|
Rifampin
4Rs |
RNA polymerase inhibitor
Revs up P450 Red body fluids Rapid resistance if used alone |
|
|
Rifampin toxicity
|
hepato
drug interactions P450 red/orange body fluids |
|
|
Penicillin/cephalosporin drug resistance mech
|
beta lactamase cleavage of beta lactam ring
|
|
|
MRSA mechanism of resistance
|
altered penicillin binding proteins
|
|
|
aminoglycoside resistance mechanism
|
modification via:
acetylation adenylation phosphorylation |
|
|
vancomycin resistance mechanism
|
termina d-ala becomes d- lac
|
|
|
chloramphenicol resistance mechanism
|
modification via acetylation
|
|
|
macrolides resistance mechanism
|
methylation of rRNA near erythromycins ribosome binding site
|
|
|
Tetracycline resistance mechanism
|
decreased uptake or increased transport outside of cell
|
|
|
Sulfonamides resistance mechanism
|
altered enzyme
decreased uptake increased PABA synthesis |
|
|
Quinolones resistance mechanism
|
altered gyrase
reduced uptake |
|
|
meningitis prophylaxis
|
rifampin
|
|
|
gonorrhea prophylaxis
|
ceftriaxone
|
|
|
syphilis prophylaxis
|
Penicillin G
|
|
|
UTI prophylaxis
|
TMP SMX
|
|
|
PCP prophylaxis
|
TMP SMX
|
|
|
endocarditis prophylaxis (for surgical or dental)
|
penicillins
|
|
|
VRE drugs
|
use linezolid or streptogramins
|
|
|
Antifungals that form artificial pores, disrupting membrane
|
amph B
Nystatin |
|
|
Amphotericin B mechanism
|
binds ergosterol
forms pores electrolytes leak |
|
|
Amphotericin B uses
|
systemic mycoses:
crypto blasto coccid asp histo candida mucor |
|
|
Amphotericin B toxicity
|
fever/chills
hypotension nephro arrhyth anemia |
|
|
Nystatin mechanism
|
binds ergosterol, disrupts membrane
|
|
|
Nystatin uses
|
too toxic for systemic
oral candida (thrush) topical for diaper or vaginal |
|
|
azoles
|
fluconazole
ketoconazole clotrimazole miconazole itraconazole voriconazole |
|
|
azoles mechanism
|
inhibits ergosterol synthesis (fungal sterols)
|
|
|
azoles uses
|
systemic mycoses
|
|
|
fluconazole uses
|
crypto meningitis in AIDS (crosses bbb)
all candida |
|
|
crypto meningitis in AIDS drug
|
fluconazole
|
|
|
candida drug
|
fluconazole
|
|
|
ketoconazole uses
|
blasto
coccido histo candida |
|
|
topical fungal infections drugs
|
clotrimazole
miconazole |
|
|
azoles toxicity
|
liver -disrupts P450
inhibits hormone synth (gynecomastia) fever, chills |
|
|
flucytosine mechanism
|
inhibits dna synth by conversion to 5 fluorouracil
|
|
|
flucytosine use
|
systemic fungal in combination wth amph B
|
|
|
use with in comb with Amphotericin B
|
flucytosine
|
|
|
flucytosine toxicity
|
nausea, vomit
BM suppression |
|
|
caspofungin mechanism
|
inhibits cell wall synthesis by inhibiting beta glucan
|
|
|
Caspofungin uses
|
invasive aspergillosis
|
|
|
Caspofungin toxicity
|
GI
flushing |
|
|
Terbinafine mechanism
|
inhibits fungal enzyme squalene epoxidase
|
|
|
Terbinafine uses
|
dermatophytoses (esp onchomycosis)
|
|
|
Griseofulvin mechanism
|
interferes with microtubules
disrupts mitosis deposits in keratin containing tissues |
|
|
Griseofulvin use
|
dermatophytes (tinea)
|
|
|
Griseofulvin toxicity
|
teratogen
carcinogen confusion increased P450 and warfarin metab |
|
|
amantadine mechanism
|
blocks viral uncoating (M2 protein)
"a man to dine takes off his coat" |
|
|
amantadine use
|
Influenza A
rubellA Parkinsons (releases dop at nerve terminals) |
|
|
amantadine toxicity
|
ataxia
dizzy slurred speech |
|
|
Zanamivir
Oseltamivir |
inhibits influenza neuraminidase
blocks release of progeny virus |
|
|
Zanamivir
Oseltamivir |
Influenza A and B
|
|
|
Ribavirin mechanism
|
inhibits synth of guanine nucleotides by inhibiting IMP dehydrogenase
|
|
|
Ribavirin uses
|
Hep C
RSV |
|
|
Ribavirin toxicity
|
hemolytic anemia
teratogen |
|
|
Acyclovir mechanism
|
monophosphorylated by HSV/VZV thymidine kinase. Guanosine analogue. Inhibits viral dna polymerase by chain termination.
|
|
|
Acyclovir uses
|
HSV
VZV EBV *no effect on latent form* |
|
|
Acyclovir toxicity
|
generally well tolerated
|
|
|
Acyclovir mechanism of resistance
|
lack of thymidine kinase
|
|
|
Ganciclovir mechanism
|
5'monophosphate formed by CMV viral kinase or HSV/VZV thymidine kinase.
Inhibits DNA pol |
|
|
Ganciclovir use
|
CMV
|
|
|
Ganciclovir toxicity
|
leukopenia, neutropenia
renal |
|
|
Ganciclovir mech of resistance
|
mutated DNA pol or lack of viral kinase
|
|
|
foscarnet mechanism
|
viral dna pol inhibitor that binds pyrophosphate binding site of enzyme. does not require viral kinase
FOScarnet = pyroPHOS analogue |
|
|
foscarnet use
|
CMV retinitis
acyclovir resistant HSV |
|
|
Foscarnet toxicity
|
nephro
|
|
|
Foscarnet mech of resistance
|
mutated dna pol
|
|
|
Protease inhibitors for HIV
|
Saquinavir
Ritonavir indinavir nelfinavir amprenavir (NAVIR tease a protease!) |
|
|
Protease inhibitor mechanism
|
blocks protease in progeny so virus can't mature
|
|
|
Protease inhibitor toxicity
|
GI
lipodystrophy |
|
|
Reverse transcriptase inhibitors
two kinds |
nucleosides
non nucleosides |
|
|
nucleoside reverse transcriptase inhibitors
|
zidovudine (used to be AZT, now ZDV)
didanosine zalcitabine stavudine lamivudine abacavir |
|
|
non nucleoside RT inhibitors
|
Never Ever Deliver nucleosides:
Nevirapine Efavirenz Delavirdine |
|
|
RT inhibitors mechanism
|
inhibit RT of HIV, can't incorporate dna copy of viral genome into host
|
|
|
RT inhibitors toxicity
|
BM suppression
lactic acidosis rash periph neuropathy |
|
|
HAART
|
highly active antiretroviral therapy
protease inhib + RT inhib < 500 CD4 or high viral load |
|
|
use for HIV prophylaxis and during pregnancy
|
ZDV
|
|
|
fusion inhibitors
|
enfuvirtide
|
|
|
fusion inhibitor mechanism
|
binds viral gp41 subunit
inhibits conformation change required for fusion with CD4 cells blocks entry into cell! |
|
|
fusion inhibitor toxicity
|
hypersens
bacterial infection |
|
|
interferons
|
glycoproteins from human leukocytes that block viral rna and dna synthesis
induce ribonuclease that degrades mRNA |
|
|
IFN alpha uses
|
hep b and c
kaposis |
|
|
IFN beta uses
|
MS
|
|
|
IFN gamma uses
|
NADPH oxidase deficiency
|
|
|
avoid these in preg:
SAFE Moms Take Really Good Care |
sulfa
aminoglycosides fluoroquinolones erythromycin metronidazole tetracyclines Ribavirin Griseofulvin Chloramphenicol |
