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85 Cards in this Set

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What is difference between bactericidal vs bacteriostatic?
Bactericidal: kills bacteria so dont need immune system.

Bacteriostatic: prevents bacterial replication, so keeps it static and allows immune system to kill it.
What is mechanism of action of penicillins and cephalosporins?
Block cell wall synthesis by inhibition of peptidoglycan CROSS-LINKING.
What is mechanism of action of bacitracin?
Blocks peptidoglycan synthesis
What is MOA of vancomycin?
Blocks peptidoglycan synthesis
What is MOA of cycloserine?
Blocks peptidoglycan synthesis
This drug disrupts bacterial AND fungal cell membranes.
Polymyxins.
This drug disrupts fungal cell membranes.
Amphotericin B

Nystatin

Fluconazole/Azoles
This drug blocks nucleotide synthesis
Sulfonamides

TMP
This drug blocks DNA topoisomerases?
Quinolones
This drug blocks mRNA synthesis.
Rifampin.
This drug blocks synthesis at 50 S ribosomal subunit?
Chloramphenicol

Erythromycin/Macrolides

Lincomycin

Clindamycin

Streptogramins

Linezolid.
What is drug that blocks protein synthesis at 30 S subunit?
Aminoglycosides and tetracyclines.
Which drugs are bactericidal?
Aminoglycosides (only protein synthesis inhibitor with this function)

Fluoroquinolones

Metronidazole.
What is Penicillin G?
IV form
What is penicillin V?
Oral form.
How are penicillins excreted?
By the kidney, so a patient with renal failure the dose should be decreased.
Which drugs can take care of anaerobes in the mouth, gut, and take care of Bacteroides?
Azithromycin

Clindamycin (above diaphragm)
These drugs are used to treat H. influenzae, E. coli, Listeria, Proteus, and Serratus, and enterococci!
ampicillin/Amoxicillin.
What drug is used before dental procedueres for px at risk for bacterial endocarditis?
Amoxicillin.
What is amoxicillin/ampicillin used to treat?
Sinusitis

Bronchitis

Ear infections (otitis media)
This drug can cause pseudomembranous colitis.
Ampicillin!
This drug can cause rash and pseudomembranous colitis?
Ampicillin (rash most likely in treatment patients with mononucleosis).
These drugs are used to treat pseudomonas?
1) Ticarcillin/clavulanic acid
2) Carbenicillin/clavulanic acid
3) Piperacillin/Clavulanic acid

Takes Care of Pseudomonas.
What are the Beta-lactamase inhibitors?
Clavulanic acid

Sulbactam

Tazobactam.
What is MOA of clavulanic acid?
Blocks beta lactamase at their catalytic sites. Cannto be used alone!!! Usually used with ampicillin and anti-pseudomonals.
What is difference between cephalosporins and penicillins?
Cephalosporins are LESS susceptible to penicillinases (Beta-lactamases).
What is drug of choice for enterococci?
Ampicillin.
1st generation penicillin
Cefazolin

Caphalexin

Proteus, E. coli, Klebsiella
2nd generation penicillin
HEN PEcKs

H. Influenza, Enterobacter, Proteus, E. coli, Klebsiella.
3rd generation penicillin?
Tri to Tax Taz

Ceftriaxone
Cefotaxime
Ceftazidime
What is best penicillin to use for Pseudomonas?
Ceftazidime!!
What is best penicillin to use for gonorrhea?
Ceftriaxone (but must combine with azithromycin! b/cc to cover Chlamydia as well).
Whats best way to treat Listeria?
Ampicillin/Penicillin!!
what are the only penicillins that can attack Pseudomonas?
Ceftazidime

Cefepime.
What is a 4th generation penicillin?
Cefepime: treat penicillin.

Cefpiramide
What cephalosporins can be used to treat meningitis?
3rd generation:
Ceftriaxone
Cefotaxime
Ceftazidime.

Penetrate BBB!!!!
What are side effects of cephalosporins?
5-10% have cross reactivity hypersensitivity.

Disulfuram like reaction with ethanol with those cephalosporins with methylthiotetrazole group.
This drug can cause gallstones?
Ceftriaxone!!!
This drug is monobactam resistant to beta-lactamases?
Aztreonam.
Aztreonam high yield facts:
1) Beta-lactamase resistant
2) Only work vs aerobic gram (-)
3) Use in penicillin allergy px
4) Use in renal patients
This drug is a broad spectrum for serious polymicrobial infection with aerobic and anaerobic involved.
Imipinem.
What drug must imipinem be given with?
Cilastatin: because this cilastatin inhibits renal dihydropeptidase I preventing inactivation in renal tubules.

BETA-LACTAMASE RESISTANT.
Important facts about imipinem?
1) Beta-lactamase resistant
2) Polymicrobial infection use
3) must administer with cilastatin
4) Drug of choice for enterobacter!!!
Meropenem
Like imipinem!!!
Vancomycin high yield facts?
1) Binds to D-ala D-ala preventing even formation of cell wall!!
What is a main side effect of vancomycin?
Can cause diffuse flushing: red man syndrome if infused too quickly.
Which drugs are 30 S inhibitors?
Amiglycosides (Gentamycin, Neomycin, Amikacin, Tobramycin, Streptomycin).
Tetracyclines (doxycycline, minocycline, tetracycline)
Which drugs are 50 S inhibitors?
Chloramphenicol.

Erythromycin (Macrolides0

Lincomycin

Clindamycin.
Of all the protein inhibitors, which one is bactericidal?
Aminoglycosides!!!!!
MOA of aminoglycosides
1) Block initiation complex of 30S!!!

2) Bactericidal.

3) Require oxygen, so not good vs anerobic infection.
What organis is gentamicin not effective against?
Anerobic.

Aminoglycosides require oxygen for uptake!!!!
What drug can be used for bowel surgery?
Neomycin.
What is the toxicity of gentamicin, amikacin?
First: AMINOGLYCOSIDES

NEPHROTOXICITY!!!!

OTOTOXICITY (ESPECIALLY WITH FUROSEMIDE).

TERATOGEN!!!!!! CAN CAUSE OTOTOXICITY IN FETUS.
What is MOA of tetracyclines?
Block 30 S inhibitor. Actually inhibits binding of aminoacyl tRNA!!!!!!!
What are the drugs of tetracyclines?
Tetracycline

Doxycycline

Minocycline.
What drug is tetracycline/doxycycline used for?
Vibrio cholerae
Acne
Chlamydia
Ureaplama Urealytic
Mycoplasma Pneumoniae.
Borrelia
Rickettsia.
What antibiotic can be used in renal patients?
Doxycyline: b/c eliminated through the feces.
What are some high yield facts for tetracyclines?
1) Prevent aminoacyl tRNA binding
2) NOT to be taken with milk, antacids, or iron preparations b/c divalent ions block its absorption.

3) Vibrio, Chlamydia, Ureaplasmia, Mycoplasma, Legionella, Rickettsia, Lyme
What is MOA of demeclocycline?
Used in SIADH.

Blocks ADH!!!!!

Type of tetracycline.
This drug shouldnt be taken with dairy products, multivitamins, and antacis?
Tetracyclines!!!!!!
What are the macrolides?
Erythryomycin,

Azithromycin,

Clarithromycin.
What is MOA of macrolides?
Blocks the translocation by binding to 23s rRNA of 50 S ribosomes?
A patient has a streptococcal infection but is allergic to penicillin. What drug should you treat this patient with?
Erythromycin!!!!!!!
What is erythromycin used for?
Mycoplasma
Legionella
Chlamydia
Neisseria.
What are the side effects of tetracyclines?
1) Photosensitivity
2) Gi discomfort
3) Teeth discoloration
4) In children --> prevents bone growth!!!!
What are the side effects of erythromyci, azithromycin?
Gi discomfort! (activates motilin)

Acute cholestatic hepatitis!!!
What is major side effect of erythromycin?
Inhibits p450!!!!!!!! So can increase concentratiosn of theophylline and warfarin!!!!!
Which class of antibiotics can cause ventricular tachycardia, QT prolongation, and torsades?
Macrolides.
What is MOA of chloramphenicol?
Binds to 50S peptidyltransferase!!!!
What is chloramphenicol used to treat?
Meningits (H. influenzae, N meningitis, S. pneumoniae)
What is toxicity of chloramphenicol?
Anemia (dose dependent)

Aplastic anemia (dose independent)

Gray baby synsdrome because infants lack liver UDP-glucuronyl transferase!!
This drug treats anaerobic infections (abscesses) above the diaphragm?
Clindamycin!!!!
This drug treats anaerobic infections below diaphragm?
Metronidazole.
What is clindamycin used for?
To treat anerobic infections!!!

1) Bacteroides fragilis
2) Clostridium perfringens!!!!
What drug can be used to treat C. perfringens?
Clindamycin.
This drug can cause P. colitis?
Clindamycin

Ampicillin.
Sulfonamides. Examples
Sulfamethaxazole

Sulfisoaxole

Triple sulfas

Sulfadiazine
What is MOA of sulfonamides?
PABA antimetabolite

Inhibits dihydropteroate synthase.
What are sulfonamides used for?
REcurrent UTIs.
What is the toxicity of sulfonamides?
Sulfa allergy

Hemolysis if G6PD deficient

Nephrotoxicity

Kernicterus in infants.
Sulfonamides facts:
1) inhibits dihydropteroate synthase

2) G6PD hemolysis
3) Kernicterus in infants
4) Interstitial nephritis!!!!
What is MOA of trimetoprim?
Inhibits dihydrofolate reductase!!!!
What is trimpethoprim used for?
PCP punemonia
Shigella/Salmonella
Recurrent UTIs.


Treats Marrow Poorly!!!
What are side effects of trimethroprim?
Megaloblastic anemia, Leukopenia, Granulocytopenia.
This antibiotic can cause the urine to turn a brownish color?
Nitrofurantoin. Used for UTIs.