Pharmacology: Block 3: Antimicrobial Agents

Front 1

Block cell wall synthesis by inhibition of peptidoglycan cross-linking.

Back 1

Penicillin
Ampicillin
Ticarcillin
Piperacillin
Imipenem
Aztreonam
Cephalosporins

Front 2

Block peptidoglycan synthesis.

Back 2

Bacitracian
Vancomycin

Front 3

Disrupt bacterial cell membranes

Back 3

Polymyxins

Front 4

Block nucleotide synthesis

Back 4

Sulfonamides
Trimethoprim

Front 5

Block DNA topoisomerases

Back 5

Quinolones

Front 6

Block mRNA synthesis

Back 6

Rifampin

Front 7

Block protein synthesis at the 50S ribosomal subunit

Back 7

Chloramphenicol
Macrolides
Clindamycin
Streptogramins (quinupristin, dalfopristin)
Linezolid

Front 8

Block protein synthesis at the 30S ribosomal subunit.

Back 8

Aminoglycosides
Tetracyclines

Front 9

Pus, empyema, abscess

Back 9

S. aureus

Front 10

Pediatric infection

Back 10

Haemophilus influenza (including epiglottitis)

Front 11

Pneumonia in cystic fibrosis, burn infection

Back 11

Pseudomonas aeruginosa

Front 12

Branching rods in oral infection

Back 12

Actinomyces israelii

Front 13

Traumatic open wound

Back 13

Clostridium perfringens

Front 14

Surgical wound

Back 14

S. aureus

Front 15

Dog or cat bite

Back 15

Pasteurella multocida

Front 16

Currant jelly sputum

Back 16

Klebsiella

Front 17

Sepsis/meningitis in newborns

Back 17

Group B strep

Front 18

List the bacteriostatic antibiotics

Back 18

"we're ECSTaTiC about bacteriostatics."

Erythromycin
Clindamycin
Sulfamethoxazole
Trimethoprim
Tetracyclines
Chloramphenicol

Front 19

List the bacteriocidal antibiotics

Back 19

"Very Finely Proficient At Cell Murder"

Vancomycin
Fluoroquinolones
Penicillin
Aminoglycosides
Cephalosporins
Metronidazole

Front 20

Penicillin G: route of administration

Back 20

IV

Front 21

Penicillin V: route of administration

Back 21

Oral

Front 22

Penicillins: mechanism of action

Back 22

1. Bind penicillin-binding proteins
2. Block transpeptidase cross-linking of cell wall
3. Activate autolytic enzymes

Front 23

Penicillin: clinical use

Back 23

Bacteriocidal for gram-positive cocci, gram positive rods, gram negative cocci, and spirochete. Not penicillinase resistant.

Front 24

Penicillin: toxicity

Back 24

Hypersensitivity reactions, hemolytic anemia

Front 25

Dicloxacillin

Back 25

Penicillinase-resistant penicillin

Front 26

Methicillin, nafcillin, dicloxacillin: mechanism

Back 26

Same as penicillin. Narrow spectrum. Penicillinase resistant because of bulkier R-group.

Front 27

Methicillin, nafcillin, dicloxacillin: clinical use

Back 27

S. aureus (except MRSA, resistance because of altered penicillin-binding protein target site).

Front 28

"Use naf for ____"

Back 28

"Use naf for STAPH"

Front 29

Methicillin, nafcillin, dicloxacillin: toxicity

Back 29

Hypersensitivity reactions. Methicillin - interstitial nephritis

Front 30

Ampicillin, amoxicillin (aminopenicillins): mechanisms

Back 30

Same as penicillin. Wider spectrum, penicillinase sensitive. Also combine with clavulanic acid (penicillinase inhibitor) to enhance spectrum. AmOxicillin has greater Oral bioavailability than ampicillin.

AMPed up penicillin

Front 31

Ampicillin, amoxicillin (aminopenicillins): clinical use

Back 31

Extended-spectrum penicillin - certain gram positive bacteria and gram negative rods (H. flu, E. coli, L. monocytogenes, Proteus mirabilis, Salmonella, enterococci

Coverage: ampicillin/amoxicillin HELPS kill enterococci

Front 32

Ampicillin, amoxicillin (aminopenicillins): toxicity

Back 32

Hypersensitivity reactions, ampicillin rash, pseudomembranous colitis

Front 33

Ticarcillin, carbenicillin, pipeacillin (antipseudomonals): mechanism

Back 33

Same as penicillin. Extended spectrum.

Front 34

Ticarcillin, carbenicillin, pipeacillin (antipseudomonals): clinical use

Back 34

Pseudomonas spp. and gram negative rods. Susceptible to penicillinase. Use with clavulanic acid (b-lactamase inhibitor).

TCP: Takes Care of Pseudomonas

Front 35

Ticarcillin, carbenicillin, pipeacillin (antipseudomonals): toxicity

Back 35

Hypersensitivity reactions.

Front 36

Cephalosporins: mechanisms

Back 36

b-lactamase drugs that inhibit cell wall synthesis but are less susceptible to penicillinases. Bacteriocidal.

Front 37

Cephalosporins, 1st generation: clinical use

Back 37

Cefazolin, cephalexin

1st generation - PEcK

Gram positive cocci
Proteus mirabilis
E. coli
Klebsiella pneumoniae

Front 38

Cephalosporins, 2nd generation: clinical use

Back 38

Cefoxitin, cefacor, cerfuroxime

2nd generation - HEN PEcKS

H. flu
Enterobacter aerogenes
Neisseria spp.
Proteus mirabilis
E. coli
Klebsiella pneumoniae
Serratia marcescens

Front 39

Cephalosporins, 3rd generation: clinical use

Back 39

Ceftriaxone, cefotaxime, ceftazidime

Serious gram negative infections resistant to other b-lactams. Meningitis (most penetrate the blood brain barrier).

Example: ceftazidime for Pseudomonas, ceftriaxone for gonorrhea.

Front 40

Cephalosporins, 4th generation: clinical use

Back 40

Cefepime

Increased activity against Pseudomonas and gram positive organisms.

Front 41

Cephalosporins: toxicity

Back 41

Hypersensitivity reactions. Cross hypersensitivity with penicillins ocurrs in 5-10% of patients. Increase nephrotoxicity of aminoglycosides, disulfram-like reactions with ethanol (in cephalosporins with a methylthiotetrazole group, e.g. cefamandole)