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250 Cards in this Set

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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