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63 Cards in this Set
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block cell wall synthesis by inhibiting PGN cross liking
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penicillin, ampicillin, ticarcillin, piperacillin, imipenem, aztreonam, cephalosporins
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block PGN synthesis
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bacitracin, vancomycin
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block nucleotide synthesis
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sulfonamides, trimethoprim
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block DNA topoisomerases
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fluroquinolone
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block mRNA synthesis
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rifampin
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block protein synthesis at 50S ribosomal subunit
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chloramphenicol, macrolides, clindamycin, streptogramins (quinupristin and dalfopristin), linezolid
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block protein synthesis at 30S ribosomal subunit
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aminoglycosides, tetracyclines
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bacteriostatic antibiotics
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erythromycin, clindamycin, sulfamethoxazole, trimethoprim, tetracyclines, chloramphenicol
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ECSTaTiC
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bacteriocidal
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vancomycin, fluoroquinolones, penicillin, aminoglycosides, cephalosporins, metronidazole
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Very Finely Proficient At Cell Murder
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Penicillin
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binds penicillin binding proteins, blocks transpeptidase cross-linking of cell wall, activate autolytic enzymes
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Use: gram + like strep penumo, strep pyogenes, and actinomyces; syphilis
Toxicity: hypersensitivity, hemolytic anemia Resistance: beta-lactamases |
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Methicillin
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penicillinase resistant penicillins, same as penicillin with narrow spectrum because of bulkier R group
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Use: staph aureus (except MRSA)
Toxicity: hypersensitivy reaction, interstitial nephritis |
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Nafcillin
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penicillinase resistant penicillins, same as penicillin with narrow spectrum because of bulkier R group
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Use: staph aureus (except MRSA)
Toxicity: hypersensitivy reaction |
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dicloxacillin
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penicillinase resistant penicillins, same as penicillin with narrow spectrum because of bulkier R group
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Use: staph aureus (except MRSA)
Toxicity: hypersensitivy reaction |
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Ampicillin
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same as penicillin with wider spectrum; penicillinase sensitive
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Use: gram postive bacteria and gram negative rods - [HELPSS] H flu, E coli, listeria monocytogenes, proteus, salmonella, shigella, enterococci
Toxicity: hypersensitivity reaction, ampicillin rash, pseudo memrbanous colitis |
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Amoxicillin
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same as penicillin with wider spectrum; penicillinase sensitive
amoxicillin has great oral bioavailability |
Use: gram postive bacteria and gram negative rods - [HELPSS] H flu, E coli, listeria monocytogenes, proteus, salmonella, shigella, enterococci
Toxicity: hypersensitivity reaction, ampicillin rash, pseudo memrbanous colitis |
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ticarcillin
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same as penicillin, extended spectrum, antipseudomonals
susceptible to penicillinase, use with clavulanic acid |
Use: Pseudomonas and gram negative rods
toxicity: hypersensitivity reaction |
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carbenicillin
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same as penicillin, extended spectrum, antipseudomonals
susceptible to penicillinase, use with clavulanic acid |
Use: Pseudomonas and gram negative rods
toxicity: hypersensitivity reaction |
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piperacillin
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same as penicillin, extended spectrum, antipseudomonals
susceptible to penicillinase, use with clavulanic acid |
Use: Pseudomonas and gram negative rods
toxicity: hypersensitivity reaction |
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clavulanic acid, sulbactam, tazobactam
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beta-lacatamase inhibitors
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added to penicillin antiobiotcs to protect from destruction
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Cefazolin
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first gen cephalosporin, beta lactam drug that inhibits cell wall synthesis but is less suceptible to penicillinases. bactericidal
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gram+ cocci, PEcK
Proteus, E. coli, Klebsiella |
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cephalexin
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first gen cephalosporin, beta lactam drug that inhibits cell wall synthesis but is less suceptible to penicillinases. bactericidal
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gram+ cocci, PEcK
Proteus, E. coli, Klebsiella |
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cefoxitin
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2nd gen cephalosporin
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gram+ cocci, HENS PEcK
H. flu, Enterobacter aerogenes, Neisseria spp., Serratia marcescens Proteus mirabalis, E. coli, Klebsiella pneumoniae |
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cefaclor
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2nd gen cephalosporin
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gram+ cocci, HENS PEcK
H. flu, Enterobacter aerogenes, Neisseria spp., Serratia marcescens Proteus mirabalis, E. coli, Klebsiella pneumoniae |
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cefuroxime
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2nd gen cephalosporin
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gram+ cocci, HENS PEcK
H. flu, Enterobacter aerogenes, Neisseria spp., Serratia marcescens Proteus mirabalis, E. coli, Klebsiella pneumoniae |
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ceftriaxone
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3rd gen cephalosporin
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serious gram negative infections that are resistant to other beta lactams, MENINGITIS AND GONORRHEA
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cefotaxime
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3rd gen cephalosporin
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serious gram negative infections that are resistant to other beta lactams,
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ceftazidime
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3rd gen cephalosporin
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serious gram negative infections that are resistant to other beta lactams, PSEUDOMONAS
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cephalosporin toxicity
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hypersensitivity reactions, vitamin K deficiency, cross reactivity with penicillin. nephrotoxicity, disulfiram like reaction with ethanol
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aztreonam
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monobactam resistant to beta-lactamases, inhibits cell wall synthesis (binds PBP3)
synergistic with aminoglycosides |
use: only gram negative rods with no activity against gram positives or anaerobes; for penicillin allergies, renal insufficiency who can't have aminoglycosides
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impinem/cilastatin
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broad spectrum beta lactamase resistant carbapenem.
cilastatin decrease inactivation of drug in renal tubules |
gram + cocci, gram - rods, and anaerobes. life threatening conditions
toxicity: GI distress, skin rash, and CNS toxicity- seizures at high levels |
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meropenem
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broad spectrum beta lactamase resistant carbapenem. is resistant to renal dihydropeptidase
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gram + cocci, gram - rods, and anaerobes. life threatening conditions
toxicity: GI distress and skin rash but has less risk of seizure |
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vancomycin
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inhibits cell wall mucopeptide formation by binding d-ala d-ala part of cell wall, bactericidal
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Use: gram positives ONLY - serious multidrug resistant organisms including S aureus, enterococci and clostridium difficile
Toxicity: nephrotoxicity, ototoxicity, thrombophlebitis, diffuse flushing "red man syndrome" (can prevent with antihistamines and slow infusion rate) Resistance: Dala-Dala to Dala-Dlac |
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gentamycin
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amioglycoside, bactericidal, inhibits foramtion of initiation complex and causes misreading of mRNA, requires O2 for uptake*** (ineffective against anaerobes)
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Use: severe gram negative rod infections, synergism with beta lactams
Toxicity: nephrotoxicity (especially with cephalosporins), ototoxicity (esp with loop diuretics), teratogen Resistance: transferase enzymes that can inactivate drug by acetylation, p-lation, or adenylation |
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neomycin
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amioglycoside, bactericidal, inhibits foramtion of initiation complex and causes misreading of mRNA, requires O2 for uptake*** (ineffective against anaerobes)
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Use: severe gram negative rod infections, synergism with beta lactams, for BOWEL SURGERY
Toxicity: nephrotoxicity (especially with cephalosporins), ototoxicity (esp with loop diuretics), teratogen Resistance: transferase enzymes that can inactivate drug by acetylation, p-lation, or adenylation |
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amikacin
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amioglycoside, bactericidal, inhibits foramtion of initiation complex and causes misreading of mRNA, requires O2 for uptake*** (ineffective against anaerobes)
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Use: severe gram negative rod infections, synergism with beta lactams
Toxicity: nephrotoxicity (especially with cephalosporins), ototoxicity (esp with loop diuretics), teratogen Resistance: transferase enzymes that can inactivate drug by acetylation, p-lation, or adenylation |
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tobramycin
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amioglycoside, bactericidal, inhibits foramtion of initiation complex and causes misreading of mRNA, requires O2 for uptake*** (ineffective against anaerobes)
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Use: severe gram negative rod infections, synergism with beta lactams
Toxicity: nephrotoxicity (especially with cephalosporins), ototoxicity (esp with loop diuretics), teratogen Resistance: transferase enzymes that can inactivate drug by acetylation, p-lation, or adenylation |
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streptomycin
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amioglycoside, bactericidal, inhibits foramtion of initiation complex and causes misreading of mRNA, requires O2 for uptake*** (ineffective against anaerobes)
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Use: severe gram negative rod infections, synergism with beta lactams
Toxicity: nephrotoxicity (especially with cephalosporins), ototoxicity (esp with loop diuretics), teratogen Resistance: transferase enzymes that can inactivate drug by acetylation, p-lation, or adenylation |
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tetracycline
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bacteriostatic, bind to 30S and prevent tRNA attachment,
limited CNS penetration, fecally eliminated, cannot be used in patients with renal failure divalent cations can inhibit absorption (don't take with milk, antacids, or iron) |
Use: Borrelia burgdorferi, H. Pylori, M. pneumonia, rickettsiae and chlamydia (because it can accumulate intracellularly)
Toxicity: GI distress, discoloration of teeth and inhibition of bone growth in kids, photosensitivity transport pumps can decrease uptake or increase efflux |
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doxycycline
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bacteriostatic, bind to 30S and prevent tRNA attachment,
limited CNS penetration, fecally eliminated, cannot be used in patients with renal failure divalent cations can inhibit absorption (don't take with milk, antacids, or iron) |
Use: Borrelia burgdorferi, H. Pylori, M. pneumonia, rickettsiae and chlamydia (because it can accumulate intracellularly)
Toxicity: GI distress, discoloration of teeth and inhibition of bone growth in kids, photosensitivity transport pumps can decrease uptake or increase efflux |
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demeclocycline
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bacteriostatic, bind to 30S and prevent tRNA attachment,
limited CNS penetration, fecally eliminated, cannot be used in patients with renal failure divalent cations can inhibit absorption (don't take with milk, antacids, or iron) |
Use: Borrelia burgdorferi, H. Pylori, M. pneumonia, rickettsiae and chlamydia (because it can accumulate intracellularly)
Toxicity: GI distress, discoloration of teeth and inhibition of bone growth in kids, photosensitivity transport pumps can decrease uptake or increase efflux |
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minocycline
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bacteriostatic, bind to 30S and prevent tRNA attachment,
limited CNS penetration, fecally eliminated, cannot be used in patients with renal failure divalent cations can inhibit absorption (don't take with milk, antacids, or iron) |
Use: Borrelia burgdorferi, H. Pylori, M. pneumonia, rickettsiae and chlamydia (because it can accumulate intracellularly)
Toxicity: GI distress, discoloration of teeth and inhibition of bone growth in kids, photosensitivity transport pumps can decrease uptake or increase efflux |
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erythromycin
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macrolide, inhibits synthesis by blocking translocation; binds to 23rRNA of the 50S subunit, bacteriostatic
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Use: Atypical pneumonias (mycoplasma, chlamydia, legionella), URIs, STDs, gram positive cocci (strep infections in pts allergic to penicillin) and Neisseria
Toxicity: prolonged QT interval, GI discomfort, acute cholestatic hepatitis, eosionophilia, skin rashes, increases serum levels of theophylline and oral anticoagulants Resistance: methylation of 23S rRNA binding site |
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azithryomycin
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macrolide, inhibits synthesis by blocking translocation; binds to 23rRNA of the 50S subunit, bacteriostatic
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Use: Atypical pneumonias (mycoplasma, chlamydia, legionella), URIs, STDs, gram positive cocci (strep infections in pts allergic to penicillin) and Neisseria
Toxicity: prolonged QT interval, GI discomfort, acute cholestatic hepatitis, eosionophilia, skin rashes, increases serum levels of theophylline and oral anticoagulants Resistance: methylation of 23S rRNA binding site |
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clarithromycin
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macrolide, inhibits synthesis by blocking translocation; binds to 23rRNA of the 50S subunit, bacteriostatic
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Use: Atypical pneumonias (mycoplasma, chlamydia, legionella), URIs, STDs, gram positive cocci (strep infections in pts allergic to penicillin) and Neisseria
Toxicity: prolonged QT interval, GI discomfort, acute cholestatic hepatitis, eosionophilia, skin rashes, increases serum levels of theophylline and oral anticoagulants Resistance: methylation of 23S rRNA binding site |
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chloramphenicol
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blocks peptide bond formation at 50S ribosomal subunit. bacteriostatic
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MENINGITIS (H flu, neisseria, strep pneumo), still used in developing countries because of low cost
Toxicity: anemia, aplastic anemia (dose independent), gray baby syndome (premature infants who lack UDP glucuronyl transferase Resistance: acetyltransferase that inactivates drug |
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Clindamycin
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blocks peptide bond formation at 50S ribsomal subunit, bacteriostatic
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Use: anaerobic infections (bacteroides and clostridium) in aspiration pneumonia or lung abscesses
ANAEROBES ABOVE THE DIAPHRAGM Toxicity: pseduomembranous colitis (C. diff overgrowth), fever diarrhea |
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sulfamethoxazole (SMX)
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PABA anti-metabolites that inhibit dihydropteroate synthetase (increase PABA and Pteridine)
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Gram-positive, gram negatie, nocardia, chlamydia, triple sulfa for reccurent UTIs
Toxicity: hypersensitivity, hemolysis in G 6 PD patients, tublointerstitial nephritis, photosensitivity, kernicterus in infants (displace bilirubin from albumin), displace warfarin from albumin |
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sulfasoxazole
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PABA anti-metabolites that inhibit dihydropteroate synthetase (increase PABA and Pteridine)
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Gram-positive, gram negatie, nocardia, chlamydia, triple sulfa for reccurent UTIs
Toxicity: hypersensitivity, hemolysis in G 6 PD patients, tublointerstitial nephritis, photosensitivity, kernicterus in infants (displace bilirubin from albumin), displace warfarin from albumin |
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sulfadiazine
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PABA anti-metabolites that inhibit dihydropteroate synthetase (increase PABA and Pteridine)
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Gram-positive, gram negatie, nocardia, chlamydia, triple sulfa for reccurent UTIs; TOXO!
Toxicity: hypersensitivity, hemolysis in G 6 PD patients, tublointerstitial nephritis, photosensitivity, kernicterus in infants (displace bilirubin from albumin), displace warfarin from albumin |
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Trimethoprim
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inhibits bacterial dihydrofolate reductase
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Use: in combination with sulfonamides (TMP-SMX) causing sequential block of folate synthesis, used for recurrent UTIs, shigella, salmonella, pneumocystis jiroveci
Toxicity: megaloblastic anemia, leukopenia, granulocytopenia (can rescue with leucovorin) |
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ciprofloxacin
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fluoroquinolone, inhibits DNA gyrase (topoisomerase II), do not take with antacids
resistance: chromosome encoded mutation in DNA gyrase |
Use: gram negative rods of urinary and GI tracts (including Pseudomonas), neisseria, some gram positives
Toxicity: GI upset, superinfections, skin rashes, headache, dizziness, not for pregnant women because it damages cartilage; tendonitis and and tendon rupture in adults; myalgias and leg cramps in kids |
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norfloxacin
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fluoroquinolone, inhibits DNA gyrase (topoisomerase II), do not take with antacids
resistance: chromosome encoded mutation in DNA gyrase |
Use: gram negative rods of urinary and GI tracts (including Pseudomonas), neisseria, some gram positives
Toxicity: GI upset, superinfections, skin rashes, headache, dizziness, not for pregnant women because it damages cartilage; tendonitis and and tendon rupture in adults; myalgias and leg cramps in kids |
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ofloxacin
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fluoroquinolone, inhibits DNA gyrase (topoisomerase II), do not take with antacids
resistance: chromosome encoded mutation in DNA gyrase |
Use: gram negative rods of urinary and GI tracts (including Pseudomonas), neisseria, some gram positives
Toxicity: GI upset, superinfections, skin rashes, headache, dizziness, not for pregnant women because it damages cartilage; tendonitis and and tendon rupture in adults; myalgias and leg cramps in kids |
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levofloxacin
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fluoroquinolone, inhibits DNA gyrase (topoisomerase II), do not take with antacids
resistance: chromosome encoded mutation in DNA gyrase |
Use: gram negative rods of urinary and GI tracts (including Pseudomonas), neisseria, some gram positives
Toxicity: GI upset, superinfections, skin rashes, headache, dizziness, not for pregnant women because it damages cartilage; tendonitis and and tendon rupture in adults; myalgias and leg cramps in kids |
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sparfloxacin
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fluoroquinolone, inhibits DNA gyrase (topoisomerase II), do not take with antacids
resistance: chromosome encoded mutation in DNA gyrase |
Use: gram negative rods of urinary and GI tracts (including Pseudomonas), neisseria, some gram positives
Toxicity: GI upset, superinfections, skin rashes, headache, dizziness, not for pregnant women because it damages cartilage; tendonitis and and tendon rupture in adults; myalgias and leg cramps in kids |
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moxifloxacin
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fluoroquinolone, inhibits DNA gyrase (topoisomerase II), do not take with antacids
resistance: chromosome encoded mutation in DNA gyrase |
Use: gram negative rods of urinary and GI tracts (including Pseudomonas), neisseria, some gram positives
Toxicity: GI upset, superinfections, skin rashes, headache, dizziness, not for pregnant women because it damages cartilage; tendonitis and and tendon rupture in adults; myalgias and leg cramps in kids |
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gatifloxacin
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fluoroquinolone, inhibits DNA gyrase (topoisomerase II), do not take with antacids
resistance: chromosome encoded mutation in DNA gyrase |
Use: gram negative rods of urinary and GI tracts (including Pseudomonas), neisseria, some gram positives
Toxicity: GI upset, superinfections, skin rashes, headache, dizziness, not for pregnant women because it damages cartilage; tendonitis and and tendon rupture in adults; myalgias and leg cramps in kids |
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enoxacin
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fluoroquinolone, inhibits DNA gyrase (topoisomerase II), do not take with antacids
resistance: chromosome encoded mutation in DNA gyrase |
Use: gram negative rods of urinary and GI tracts (including Pseudomonas), neisseria, some gram positives
Toxicity: GI upset, superinfections, skin rashes, headache, dizziness, not for pregnant women because it damages cartilage; tendonitis and and tendon rupture in adults; myalgias and leg cramps in kids |
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nalidixic acid
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quinolone, inhibits DNA gyrase (topoisomerase II), do not take with antacids
resistance: chromosome encoded mutation in DNA gyrase |
Use: gram negative rods of urinary and GI tracts (including Pseudomonas), neisseria, some gram positives
Toxicity: GI upset, superinfections, skin rashes, headache, dizziness, not for pregnant women because it damages cartilage; tendonitis and and tendon rupture in adults; myalgias and leg cramps in kids |
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Metronidazole
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forms free radical toxic metabolites in bacterial cell that damage DNA
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Use: Giardia, Entamoeba, Trichomonas,
Gardnerella, anaerobes (bacteroides and clostridium); with bismuth and amoxicillin for H Pylori Toxicity: disulfram like reaction with alcohol, H/A, metallic taste |
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TB prophylaxis and treatment
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prophylaxis: isoniazid
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Rx: Rifampin, Isoniazid, Pyrazinamide, Ethambutol
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MAC prophylaxis and treatment
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prophylaxis: azithromycin
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Rx: rifampin, AZITHROMYCIN, STREPTOMYCIN, ethambutol
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M. leprae
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rx: dapsone, rifampin, clofazimine
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