• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/52

Click to flip

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;

52 Cards in this Set

  • Front
  • Back

Bacteriostatic drugs?
Erythromycin, Clindamycin, Sulfmethoxazole, Trimethoprim, Tetracycline, Chloramphenicol (We're ECSTaTiC about bacteriostatics)
Bacteriocidial drugs?
Vancomycin, Floroquinolone, PCN, Aminoglycosides, Cephalosporin, Metronidazole (Very Finely Proficient At Cell Murder)
- Blocks Cell Wall Synthesis by Cross-linking?
- Blocks Peptidogylcan synthesis?
- Disrupt Bacterial Cell Membranes?
- Blocks Nucleotide Synthesis?
Cell Wall - PCN, Ampicillin, Tiracillin, Peperacillin, Imipenem, Aztreonam, Cephalosporin
Peptidoglycan - Bactracin, Vancomycin
Cell Membranes - Polymyxins
Nucleotide Synthesis - Sulfa/TMP
- Blocks DNA Topoisomerases?
- Block mRNA synthesis?
- Block protein synthesis at 50S ribosome?
- Block protein synthesis at 30S ribosome?
DNA - Floroquinolone
mRNA - Rifampcin
50S Chloramphenicol, Macrolide, Clindamycin, Streptogramin (Quinupristi, Dalfopristin), Linezolid
PCN? Types? Penicillinase-Sensitive?
- Mechanism?
- Clinical Use?
- Toxicity?
PCN G - IV, PCN V - Oral
M - Binds PCN-Binding Protein, Blocks transpeptidase cross-linking of cell wall, Activate autolytic enzymes, Penicillinase-Sensitive
C - Bactericidal for gram positive cocci & rods, gram negative cocci, spirochetes
T - Hypersensitivity Rxn, Hemolytic Anemia
Methicillin, Nafcillin, Dicloxacillin?
Penicillinase-Sensitive?
- Mechanism?
- Clinical Use?
- Toxicity? Methicillin Specifically?
Penicillinase-Resistant PCN (bulkier R-group)
M - Same as PCN
C - S. Aureus (except MRSA - altered PBP target site) - USE NAF FOR STAPH!
T - Hypersensitivity Rxn, Methicillin - Interstitial nephritis
Ampicillin, Amoxicillin? Type of Drugs? Penicillinase-Sensitive? With Clavulanic Acid?
- Mechanism?
- Clinical Use?
- Toxicity?
Aminopenicillins
M - Same as PCN, Penicillinase Resistant
With Clavulanic Acid to enhance spectrum

AMPed up PCN
C - Extended-spectrum PCN - gram positive and gram negative rods (H. influenze, E. Coli, L. monocytogenes, P. Mirabilis, Salmonella, Enterococci)
Aminopenicillins HELPS kill enterococci
T - Hypersensitivity rxn, Ampicillin rash, Pseudomembraneous Colitis
Ticarcillin, Carbenicillin, Piperacillin? Penicillinase-Sensitive? With Clavulanic Acid?
- Mechanism?
- Clinical Use?
- Toxicity?
M - Same as PCN, extended spectrum
C - Pseudomonas and gram negative rods, Penicillinase susceptible, use with Clavulanic Acid (Beta-Lactamase Inhibitor)

TCP - Takes Care of Pseudomonas

T - Hypersensitivity Rxn
Cephalosporin?
- Mechanism?
- Clinical Use? 1st Generation? 2nd Generation? 3rd Generation? 4th Generation?
- Toxicity? With Ethanol? With Aminoglycosides?
M - Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases, bactericidal
1st Gen - Cefazolin, Cephalexin - gram positive cocci (Proteus mirabilis, E. Coli, K. Pneumoniae) - PEcK
2nd Gen - Cefoxitin, Cefaclor, Cefuroxime - Gram-positive cocci (H. Influenze, Enterobacter aerogenes, Neisseria, Proteus mirabilis, E. Coli, Klebsiella pneumoniae, Serratia marcescens) HEN PEcKS
3rd Gen - Ceftriaxone, Cefoxamine, Ceftazidime - serious gram negative infections resistant to Beta-lactams, meningitis
4th Gen - Cefepime - Pseudomonas & gram-positive organisms
T - Hypersenstivity Rxn (PCN)
With Ethanol - Disulfram
With Aminoglycosides - Nephrotoxic
Aztreonam? Synergistic with What?
- Mechanism?
- Clinical Use?
- Use in who?
- Toxicity?
M - monobactam resistant to B-lactamases, inhibits cell wall synthesis (binds PBP), Synergistic with Aminoglycosides
C - Gram Negative Rods (Klebsiella, Pseudomonas, Serratia), NOT for gram positives or anaerobes
U - PCN-allergic patients, renal insufficient patients
T - occasional upset stomach
Imipenem/Cilastatin, Meropenem? Resistant to what? Cilastatin Importance?
- Mechanism?
- Clinical Use?
- Toxicity?
M - Broad spectrum, B-lactamase-resistant Carbapenem, Imipenem - give with Cilastatin (inhibits renal dihydropeptidase I - decreases inactivation in renal tubules) - Meropenem is resistant to inactivation

The kill is LASTIN with ciLASTIN

C - Gram positive cocci, gram negative rods, anaerobes ... USE IN ENTEROBACTER
T - GI Distress, skin rash, CNS (seizures) - fewer seizures in Meropenem
Vancomycin?
- Mechanism?
- Resistance?
- Clinical Use?
- Toxicity?
M - inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors, bactericidal
Resistance - with amino acid change of D-ala, D-ala to D-ala, D-lac
U - serious, gram positive, multi-resistant organisms, including S. Aureus & C. Difficle (Pseudomembraneous coilitis)
T - Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse Flushing (Red Man Syndrome - avoid with antihistamine)

Does NOT have many problems
Protein Synthesis Inhibitors?
30S?
50S?
30S - Aminoglycosides (Streptomycin, Gentamicin, Tobramycin, Amikacin - BACTERICIDAL)), Tetracycline (BACTERIOSTATIC)
50S - Chloramphenicol, Clindamycin (BACTERIOSTATIC), Erythromycin (BACERTIOSTATIC), Lincomycin (BACTERIOSTATIC), Linezolid (VARIABLE)

Buy AT 30, CCELL (sell) at 50
Aminogycosides?
Which Drugs?
- Mechanism?
- Clinical Use? Not useful against what? Synergistic with what? Which for bowel surgery?
- Toxicity? With what?
Gentamicin, Neomycin, Anikacin, Tobramycin, Streptomycin (Mean GNATS canNOT kill anaerobes)
M - Bactericidal, inhibits formation of initiation complex and cause misreading of mRNA - requires O2 (NO ANAEROBES)
C - Severe gram negative rod infections - synergistic for beta-lactam antibiotics, Neomycin for bowel surgery
T - nephrotoxic (esp with Cephalosporin), ototoxic (esp with Loop Diuretics), tetratogen
Tetracycline, Doxycycline, Demeclocycline, Minocycline?
Which can be used in Renal Patients? Don't take with what?
- Mechanism?
- Clinical Use?
- Toxicity? Not safe in what? Don't use in children why?
M - BACTERIOSTATIC - binds to 30S and prevent attatachment of aminoacyl-tRNA
* Can use Doxycycline in Renal patients (eliminated in feces)
* Can't take with milk, antacids, iron-containing preparations (divalent cations inhibit absorption in gut)
C - V. Cholera, Acne, Chlamydia, Ureaplasma Urealyticum, M. Pneumoniae, Tulermia, H. Pylori, B. Burgdorferi (Lyme Disease), Rickettsia
VACUUM THe BedRoom

T - GI Distress, discoloration of teeth and bone growth inhibition in children, photosensitivity, DON'T USE IN PREGNANCY
Macrolides? What are they?
- Mechanism?
- Clinical Use? In PCN-allergic patients?
- Toxicity? Which has the greatest effect on heart?
Interaction with what drugs?
Erythromycin, Azithromycin, Clarithromycin
M - Inhibits protein synthesis by blocking translocation (binds 23S rRNA of 50S subuntil) BACTERIOSTATIC
C - URIs, Pneumonia, STDs, Streptococcal infections (when patient allergic it PCN), Mycoplasma, Legionella, Chlamydia, Neisseria
T - Prolonged QT interval (esp Erythromycin), GI Discomfort, Acute Cholestatic Hepatitis, Eosionphilia, Skin Rashes
* Increases serum concentration of theophyllines, oral anticoagulants
Chloramphenicol?
- Mechanism?
- Clinical Use?
- Toxicity? In babies?
M - Inhibits 50S peptidyltransferase activity BACTERIOSTATIC
C - Meningitis (H. Influenze, N. Meningitis, S. Pneumnoia)
T - Anemia (dose-dependant), aplastic anemia (dose-dependant), gray baby syndrome (babies lack UDP-glucoronyl transferase)
Clindamycin?
- Mechanism?
- Clinical Use?
- Toxicity?
M - Blocks peptide bond formation at 50S ribosomal subunit BACTERIOSTATIC
C - anaerboic infections
T - pseudomembraneous coilitis, fever, diarrhea
Sulfonamides?
- Mechanism?
- Clinical Use? For UTI?
- Toxicity? In babies? Hemolysis when?
- Effect on other drugs?
M - PABA Antimetabolites - inhibit Dihydropteroate Synthetase (BACTERIOSTATIC)
C - Gram Positive, Gram Negative, Nocardia, Chlamydia, SMX (Triple Sulfa) for UTI
T - Hypersensivity rxn, hemolysis with G6PD deficiency, nephrotoxic (tubulointerstitial nephritis), photosensitivity, kernicterus (babies)
* Displaces other drugs from albumin (Warfarin, etc.)
Trimethoprim?
- Mechanism?
- Clinical Use?
- Toxicity? Decrease how?
M - inhibits bacterial dihydrofolate reductase (BACTERIOSTATIC)
C - With Sulfa (TMP-SMX) for UTIs, Shigella, Salmonella, Pneumocystis jiroveci pneumonia
T - Megablastic anemia, leukopenia, granulocytopenia (can give Folate to decrease)
What are examples of Sulfa drugs?
Sulfa - Sulfasalazine, Sulfonyureas, Thiazide, Acetazolamide, Furosemide
Floroquinolones? Which is a Quinolone?
- Mechanism? Don't take with what?
- Clinical use?
- Toxicity?
- floxacin drugs & Enoxacin (Floroquinolones), Nalidixic Acid (Quinolone)
M - Inhibits DNA Gyrase (topoisomerase II) BACTERIOCIDAL, Don't take with antacids
C - Gram negative rods of GU and GI infections, Neisseria, some gram positives
T - GI upset, superinfections, skin rashes, headache, dizziness, NOT in pregnant women & children, tendonitis, tendon rupture, leg cramps, myalgia

floroquinoLONES hurt attachments to your BONES
Metronidazole?
- Mechanism?
- Clinical Use? With what for H. Pylori?
- Toxicity?
M - Forms toxic metabolites in the bacterial wall that damage DNA (BACTERICIDAL, ANTIPROTOZAL)
C - Treats Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (below diaphragm),
*Use with Bismuth, Amoxicillin or Tetracycline for "triple therapy" for H. Pylori
T - Disulfram-like rxn with alcohol, headache, metallic taste

GET GAP on the Metro
Polymyxins?
- Mechanism?
- Clinical Use?
- Toxicity?
M - Binds to cell membranes of bacteria (disrupts osmotic properties), cationic, basic proteins that act like detergents

MYXins MIX up Membranes

C - Resistant gram-negative infections
T - Neurotoxicity, acute renal tubular necrosis
Prophylaxis for M. tuberculosis? Treatment?
P - Isoniazid
T - Rifampin, Isoniazid, Pyrazinamide, Ethambutol (RIPE for treatment)
Prophylaxis for M. avium?
Treatment?
P - Azithromycin
T - Azithromycin, Rifampin, Ethambutol, Streptomycin
Prophylaxis for M. leprae?
Treatment?
P - NONE
T - Dapson, Rifampin, Clofazimine
What are the ant-TB drugs? Second line therapy?
Side effects of all drugs? Of Ethambutol?
Streptomycin, Pyrazinamide, Isoniazid (INH), Rifampin, Ethambutol -
* INH-SPIRE (Inspire)

Cycloserine (2nd line therapy)
ALL hepatoxic
Ethambutol causes optic neuropathy (red-green color blindness)
Isoniazid?
- Mechanism?
- Clinical Use?
- Toxicity?
M - decreased synthesis of mycolic acids
C - M. tuberculosis (treatment & prophylaxis)
T - Neurotoxicity, hepatotoxicity, (Pyridoxine - Vit B6 can decrease neurotoxicity)
Rifampcin
- Mechanism?
- Clinical Use?
- Toxicity?
M - Inhibits DNA-dependant RNA polymerase
C - M. tuberculosis, delays resistance to Dapson when treating Leprosy, Meningococcal prophylaxis in children after H. Influenze exposure

4 R's - RNA Polymerase Inhibitor, Revs up microsomal p450, Red/orange body fluids, rapid resistance if used alone
Treatment for MRSA? VRE?
M - Vancomycin
V - Linezolid, Streptogamin
Prophylaxis of Meningococcal infection? Gonorrhea? Syphilis? Recurrent UTIs? P. jiroveci pneumonia? Endocarditis (after surgery or dental procedures)?
M - Rifampin, Minocycline (second line)
G - Ceftriaxone
S - Benzarhine PCN G
UTI - TMP/SMX
PCP - TMP/SMX, Pentamidine (aerosol)
Endocarditis - PCN
Antibiotic Resistance for...
PCN/Cephalosporin? in MRSA & PCN-Resitant S. Pneumoniae?
Amingoglycosides?
Vancomycin?
Chloramphenicol?
Macrolides?
P - B-lactamase cleavage of B-lactam ring
MRSA & SA - altered PBP
A - acetylation, adenylation, phosphorylation
V - terminal D-ala replaced with D-lac, decreased affinity
C - acetylation
M - methylation of mRNA near erythromycin's ribosome binding site
Antibiotic Resistance for...
Tetracycline?
Sulfonamides?
Quinolones?
T - decreased uptake or increased transport out of cell
S - alterated enzyme (bacertial dihydropteroate synthetase), decreased uptake or increased PABA synthesis
Q - altered gyrase or reduced uptake
Amphotericin B?
- Mechanism?
- Clinical Use? Effect on brain?
- Toxicity? Decrease effects how?
M - binds ergosterol, forming membrane holes that allow electrolyte leakage (ampohTERICIN TEARS holes in fungal membranes)
U - wide spectrum fungi - Cryptococcus, Blastomyces, Coccidioides, Aspergillus, Histoplasma, Candida, Mucor, fungal meningitis (DOES NOT CROSS BBB)
T - fever, chills ("shake & bake"), hypotension, nephrotoxicity (decrease with hydration), arrythmia, anemia, IV phlebitis ("amphoterrible"), DECREASED TOXICITY WITH LIPOSOMAL AMPHOTERICIN
Nystatin?
- Mechanism?
- Clinical Use?
M - binds ergosterol disrupting fungal membrane, TOO TOXIC FOR SYSTEMIC USE
C - "Swish & Swallow" for oral candidiasis, topical for diaper rash or vaginal candidias
-Azoles?
- Mechanism?
- Clinical Use? Fluconazole, Ketoconazole, Clotrimazole & Miconazole?
- Toxicity?
Fluconazole, Ketoconazole, Clotrimazole, Miconazole, Itraconazole, Voriconazole
M - inhibits fungal sterol synthesis
C - systemic mycoses, Fluconazole for cryptococcal meningitis (AIDS - crosses BBB) and candidal infections, Ketoconazole for Blastomyces, Coccidioides, Histoplasma, Candida albicans, hypercortisolism, Clotrimazole & Miconazole for topical fungal infections
T - hormone synthesis inhibition (gynecomastia), liver dysfunction (inhibits p450), fever, chills
Flucytosine?
- Mechanism?
- Clinical Use? With what?
- Toxicity?
M - inhibits DNA synthesis by conversion to 5-florouracil
C - systemic fungal infections (used with Amphotericin B)
T - nausea, vomitting, diarrhea, bone marrow suppression
Capsofungin?
- Mechnanism?
- Clinical Use?
- Toxicity?
M - inhibits cell wall synthesis by inhibiting synthesis of B-glucan
C - invasive aspergillosis
T - GI upset, flushing
Terbinafine?
- Mechanism?
- Clinical Use?
M - inhibits the fungal enzyme squalene epoxidase
C - used to treat dermatophytes (esp onchomycosis)
Griseofulvin?
- Mechanism?
- Clinical Use?
- Toxicity?
M - interferes with microtubule function, disrupts mitosis, deposits in keratin-containing tissues
C - oral treatment of superficial infectins, inhibits growth of dermatophytes
T - tetrogenic, carcinogenic, confusion, headaches, increases p450 and warfarin metabolism
Amatadine?
- Mechanism?
- Clinical Use?
- Toxicity?
- Mechanism of Resistance?
- Derivative?
M - blocks viral penetration/uncoating (M2 protein), may buffer pH of endosome & increases dopamine release from nerve terminals
" A man to dine" takes off his coat

C - prophylaxis and treatment for Influenza A, Parkinson's disease

"Amantadine blocks influenze A and rubellA and causes problems with carebellA"

T - ataxia, dizziness, slurred speech
R - mutated M2 protein (90% of influenza A so often not useful)
D - Rimantidine is a derivative with CNS side effects (doesn't cross BBB)
Zanamivir, Oseltamivir?
- Mechanism?
- Clinical Use?
M - inhibit influenza neuraminidase, decreases release of progency virus
C - both influenza A & B
Ribavirin?
- Mechanism?
- Clinical Use?
- Toxicity?
M - inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase
C - RSV, Chronic HCV
T - Hemolytic anemia, severe teratogen
Acyclovir?
- Famciclovir?
- Mechanism?
- Clinical Use? Not effective for what?
- Toxicity?
- Mechanism of Resistance?
M - monophosphorylated by HSV/VZV thymidine kinase, inhibits viral DNA polymerase by chain termination, Guanosine analogue,
Triphosphate formed by cellular enzymes
Famciclovir - for Herpes Zoster
C - HSV (mucocutaneous & genital lesions, encephalitis), VZV, EBV, Prophylaxis in immunocompromised, NO EFFECT ON LATENT HSV & VZV!
T - well tolerated
R - lack of thymidine kinase
Ganciclovir?
- Mechanism?
- Clinical Use?
- Toxicity? More that what?
M - 5' monophosphate formed by CMV viral kinase or HSV/VZV thymidine kinase, Guanosine analog, Triphosphate formed by cellular enzymes, Preferably inhibits viral DNA polymerase
C - CMV, esp in immunocompromised
T - leukopenia, neutropenia, thrombocytopenia, renal toxicity (more toxic than acyclovir)
R - mutated CMV DNA polymerase of lack of viral kinase
Foscarnet?
- Mechanism? Doesn't require what?
- Clinical Use?
- Toxicity?
- Mechanism of Resistance?
M - Viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme, does NOT require activation by viral kinase
* FOScarnet - pyroFOSphate analog
C - CMV retinitis in immunocompromised patients when ganciclovir fails, acyclovir-resistant HSV
T - nephrotoxicity
R - mutated DNA polymerase
HIV Therapy? Protease inhibitors?
- Mechanism?
- Toxicity?
Saquinavir, Ritonavir, Indinavir, Nelfinavir, Amprenavir (ALL protease inhibits end in -navir)

NAVIR (never) TEASE a proTEASE

M - inhibits maturation of new virus by blocking protease in progeny virions
T - GI intolerance (nausea, diarrhea), hyperglycemia, lipodystrophy, thrombocytopenia (indinavir)
HIV Therapy? Reverse Transcriptase Inhibitors?
- Nucleosides vs Non-Nucleosides?
- Mechanism?
- Clinical Use? ZDV specifically?
- Toxicity?
Nucleosides - Zidovudine (ZDV, formerly AZT), Didanosine (ddI), Zalcitabine (ddC), Stavudine (d4T), Lamivudine (3TC), Abacavir
"Have you dined (vudine) with my nuclear (nucleosides) family?"
Non-Nucleosides - Nevirapine, Efavirenz, Delavirdine (Never Ever Deliver nucleosides)
M - preferentially inhibits reverse transcriptase of HIV, prevent incorporation of DNA copy of viral genome into host DNA
C - highly active antiretroviral therapy (HAART) with protease inhibitors & reverse transcriptase inhibitors - give when patients have low CD4 counts (<500) or high viral load * ZDV is used for general prophylaxis and during pregnancy to reduce risk of fetal transmission
T - bone marrow suppression (neutropenia, anemia - decrease with GM-CSF and erythropoietin), peripheral neuropathy, lactic acidosis (nucleosides), rash (non-nucleosides), megaloblastic anemia (ZDV)
HIV Therapy? Fusion Inhibitor?
- Mechanism?
- Clinical Use?
- Toxicity? Increased risk of what?
Enfuvirtide?
M - binds viral gp41 subunit; inhibits conformational change required for fusion with CD4 cells, therefore block entry and subsequent replication
C - in patients with persistent viral replication in spite of anti-retroviral therapy
T - hypersensitivity rxn, rxn at subcutaneous injection site, increased risk of bacterial pneumonia
Interferons?
- Mechanism?
- Clinical Use? Alpha? Beta? Gamma?
- Toxicity?
M - glycoprotein from human leukocytes that block various stages of viral RNA and DNA synthesis
C - IFN-alpha for chronic HBV, HCV, Kaposi's sarcoma, IFN-beta for MS, IFN-gama for NADPH Oxidase Deficiency
T - neutropenia
Antibiotics to avoid in pregnancy?
What do they cause?
Sulfanomides - kernicterus
Amingoglycosides - ototoxicity
Floroquinolones - cartilage damage
Erythromycin - acute cholestatic hepatitis in mom (Clarithromycin - embryotoxic)
Metronidazole - mutagenesis
Tetracycline - discolored teeth, inhibition of bone growth
Ribavirin - teratogenic
Griseofulvin - teratogenic
Chloramphenicol - gray baby
"SAFE Moms Take Really Good Care"