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158 Cards in this Set

  • Front
  • Back
What chronic condtion might the following microbes cause:
1. Helicobacter Pylori
2. Human papillomavirus
3. Hepatitis B/C virus
4. Eptein-Barr virus
5. Human T lymphotropic virus type I
6. Human herpes virus 8
7. Borrelia burgdoferi
8. Trophopyra whippelii
1. peptic ulcer, gastric cancer
2. cervical, anal, vulvar cancer
3. hepatocellular cancer
4. Burkitt's lymphoma, nasopharyngral cancer, PTLD
5. adult T cell leukemia
6. Kaposi's sarcoma
7. Lyme arthritis
8. Whipple's disease
Give some examples of bacteria that lack fully formed cell wall.(4)
1. Chlamydia
2. Rikettsia
3. Mycoplasma
4. small colony variants
Properties of small colony variants.(4)
1. defect in cell wall,slow growth, lack morphology
2. may be induced by antibiotics or enzymes active in cell wall
3. can revert back to parent form
4. produces extracellular products
What is an example of small colony variants?
Staphylococcus aureus
Why do some antifungal drug cause side effects?
Antifungal drugs that taget sterols in the fungal cell wall may also act on sterols in human cell membranes.
What are the three mechanisms of action of antibiotics?
1. cell wall inhibition
2. inhibition of protein synthesis
3. inhibition of nucleic acid sythesis
What two antibiotic classes target bacterial cell wall synthesis?
1. β-lactams
2. vancomycin
What are the two classes of antibiotics that target 30s bacterial ribosomes?
1. aminoglucoside: misread mRNA
2. tetracyclin: blocks attachment to tRNA, prevent elongation
What are the five classes of antibiotics that target 50s bacterial ribosomes?
1. Chloramphenicol: inhibit peptidyl transferase, block elongation
2. Macrolides: block elongation
3. Clinsamycin: block elongation
4. Pristinamycin: block elongation
5. Linezoid: prevent 70s intiation complex to form
What drugs blocks elongation of protein synthesis? (5)
1. Tetracyclin: 30s
2. Chloramphenicol: 50s, peptidyl transferase
3. Clinsamycin: 50s
4. Macrolides: 50s
5. Pristinamucin: 50s
Which of the following is bacteriocidal?
1. Aminoglucoside
2. Chloramphenicol
3. Clinsamycin
4. Macrolides
5. Pristinamucin
6. Tetracyclin
1.
All the rest are bacterostatic
Which of the following prevent the formation of 70s of bacterial ribosomes?
A. Aminoglucoside
B. Tetracyclin
C. Macrolides
D. Linezoid
E. Pristinamycin
F. Clinsamycin
D.
What are the five classes of antibiotics that inhibit nucleic acid synthesis?
1. Rifamycin: bind to DNA dependent RNA polymerase
2. Quinolone: block DNA gyrase
3. Trimethoprim and Pyrimethamine: inhibit DHF reductase
4. Sulfonamides: antimetabolite during protein synthesis
5. Metronidazole: interfere with DNA replication
Which of the following inhibit DNA synthesis by blocking gyrase?
1. Rifamycin
2. Quinolone
3. Trimethoprim and Pyrimethamine
4. Sulfonamides
5. Metronidazole
2.
Which of the following inhibit DNA synthesis by binding to DNA dependent RNA polymerase?
1. Rifamycin
2. Quinolone
3. Trimethoprim and Pyrimethamine
4. Sulfonamides
5. Metronidazole
1.
Which of the following inhibit DNA synthesis by interfering with DNA replication?
1. Rifamycin
2. Quinolone
3. Trimethoprim and Pyrimethamine
4. Sulfonamides
5. Metronidazole
5. Metronidazole
Which of the following inhibit DNA synthesis by blocking dihydrofolate reductase?
1. Rifamycin
2. Quinolone
3. Trimethoprim and Pyrimethamine
4. Sulfonamides
5. Metronidazole
3. Trimethoprim and Pyrimethamine
Which of the following inhibit DNA synthesis by sythesizing antimetabolite during protein synthesis?
1. Rifamycin
2. Quinolone
3. Trimethoprim and Pyrimethamine
4. Sulfonamides
5. Metronidazole
4. Sulfonamide
List some mechanisms of aquired antibiotic resistance. (4)
1. transformation
2. transduction
3. conjugation
4. transposition
What makes some GN bacteria to resistant antibiotic β-lactam?
β-lactamase in periplasm
Some factors involved with antibacterial activity. (4)
1. concentration
2. diffusion through outer cell membrane
3. resist attack by inactivating enzymes
4. affinity to the target enzyme
What are the 4 routes of antibiotic administration.
1. oral (PO/enteral)
2. intravenous (IV)
3. intramuscular (IM)
4. topical
Six pharmacokinetic principles.
1. serum level: MIC
2. 1/2 life
3. protein binding
4. distribution
5. metabolism
6. excretion
What is MIC?
Minimal inhibitory concentration.
What's the relation between usual dose and MIC?
usual dose should be above MIC by 4-10 fold.
List five β-lactam antibiotics families.
1. Penam: penicillin
2. Clavan: clavulanic acid->β-lactamase inhibitor
3. Ceph: cephalosporin
4. Carbapenems: thienamycin, imipenem
5. monobactam: aztreonam
Properties of penicillin:
1. targets
2. resistance
3. excretion
4. adminstration
1. cell wall synthesis
2. β-lactamase, alteration in PBP, decreased permeability
3. renal
4. oral and parenteral
What properties in bacteria contribute to penicillin resistance? (3)
1. β-lactamase
2. change PBP structure
3. decrease perpeability: block porins
Which of the following is not a deravative of penicillin?
A. oxacillin
B. nafcillin
C. ampicillin
D. piperacillin
E. sulbactam
E.
Penicillin works on what bacterial infection? (2)
Strep
Syphilis
Staph can be treated by which of the folowing:
A. oxacillin
B. nafcillin
C. ampicillin
D. piperacillin
A
Enterococcus, Listeria can be treated by ____:
A. oxacillin
B. nafcillin
C. ampicillin
D. piperacillin
C.
Pseudomonas, GNR can be treated by_____
A. oxacillin
B. nafcillin
C. ampicillin
D. piperacillin
D.
Ampicillin works on what bacteria?
enterococcus
Listeria
Piperacillin works on what bacteria?
pseudomonas
GNR
Oxacillin/Nifcillin works on what bacteria?
Staph
What kinds of side effects can penicillin cause? (4)
1. Allergy: anaphylaxis, hypersensitivity, delayed sensitivity
2. bone marrow effects: low WBC, RBC, platlets
3. interstitial nephritis
4. seizures
T/F: Penicillin can cause decreased blood counts.
T.
Can penicillin be administered to patients with renal problems at normal dosage?
No. Penicillin is excreted through kidney.
What are some β-lactamase inhibitors?
Clavulanic acid
Sulbactam
Tazobactams
Clavulanic acid,sulbactam, and tazobactams are examples of____.
A. Carbopenems
B. Conobactams
C. β-lactamase inbitors
D. Cephems
C.
What kind of bacteria does β-lactamase inbitors work against?
Anaerobes
GNR
What bacteria does the 1st generation of Ceph work against? (3)
Staph (GP)
Steph (GP)
E. Coli (GN)
What bacteria does the 2nd generation of Ceph work against?
Staph (GP)
Steph (GP)
GN
What bacteria does the 3rd and 4th generation of Ceph work against?
Strep
GN
pseudomonas
bacterial menigitis
Which bacterium that penicillin act on but Ceph does not?
enterococcus
List four groups of carbopenems.
1. imipenem
2. meropenem
3. doripenem
4. ertapenem
What is the special feature about carbopenem that other families of β-lactams don't have?
Carbopenem is β-lactamase stable, but is susceptible to carbopenamase.
T/F: Carbopenems can be administered both orally and perenterally.
No. Only perenteral: IM, IV.
What bacteria do carbopenems target?
GP
GN
anaerobes.
Which of the following has the broadest spectrum of taget bacteria:
A. penems
B. cephs
C. carbopenems
D. monopenems
C.
Which drug is best suited for complex infections with multiple pathogens or highly resistant microbes?
carbopenems
What condition may patients develop if antibiotics are given to treat organisms that are resistant to it?
superinfection
What's the name of a monobactam?
aztreonam
Aztreonam is a _____.
A. penem
B. ceph
C. carbopenem
D. monobactam
D.
Is monobactam adminstered orally?
No. IV only.
Monobactam is active against what organisms?
GNs.
What is a alternative β-lactam to give to patients who are allergic to penicillin?
monobactam
What are some groups of aminoglucosides? (4)
1. streptomycin
2. gentamycin
3. tobramycin
4. amikacin (synthetic)
How does aminoglucoside kill bacteria?
bind to 30s to cause misreading of mRNA
Describe aminoglucoside:
1. target
2. resistance
3. excretion
4. administration
5. post antibiotic effect
1. 30s
2. enzyme degradation, decreased uptake
3. renal
4. parenteral
5. still working at some degree afterwards.
What antibiotic works synergistically with β-lactams?
aminoglucoside
What bacteria do aminoglucosides work against?
GN
some mycobacteria
What are some adverse effect of aminoglucoside? (3)
1. nephrotoxicity
2. ototoxicity
2. neuromuscular blockage
Which drug may cause nephrotoxicity, ototoxicity, and neuromuscular blockage?
A. β-lactams
B. aminoglucosides
C. tetracyclin
D. chloramphenicol
B.
Doxycyclin, minocyclin, and tigecyclin beling to____ family.
tetracyclin.
Describe tetracyclin:
1. target
2. resistance
3. excretion
4. administration
1. 30s
2. decreased uptake, active efflux
3. renal
4. oral and parenteral
Tetracyclin is good for infection cause by what specific bacteria?
Ones that lack a intact cell wall: mycoplasma, chlamydia, legionella.

In general: GP and GN
Which antibiotic is good for legionella, mycoplasma, and chlamydia?
tetracyclin
T/F: Tetracyclin has a broad spectrum of taget organisms including GP, GN, and those lacking cell walls.
T.
What are some adverse effect of tetracyclin? (4)
1. GI upset, diarrhea
2. hypersensitivity/photosensitivity
3. depressed bone growth
4. discolored teeth.
Which antibiotic might cause discoloration of teeth and photosensitivity?
Tetracyclin
Which antibiotic can be used to treat Chlamydia?
Tetracyclin, chloramphenicol
Which antibiotic can be used to treat arthropod-borne diseases?
Tetracyclin
Describe tetracyclin:
1. target
2. resistance
3. excretion
4. administration
1. 50s
2. inactivating enzyme, decreased permeability
3. renal
4. IV and oral
What bacteria does chloramphenicol target?
GP, GN
Rickettsia,chlamydia,mycoplasma,spirochete
Which antibiotic can be used to treat Rickettsia and spirochete?
tetracyclin
What are some adverse effects of chloramphenicol? (4)
1. aplastic anemia
2. reversible bone marrow toxicity
3. "gray baby" syndrome (if missing an enzyme in the liver)
4. optic neuritis
Which antibiotic might cause aplastic anemia, "gray baby" syndrome, and optic neuritis?
chloramphenicol
If a patient is allergic to β-lactams, which alternative drug can be used to treat meningitis?
chloramphenicol, or macrolide
Chloramphenicol can be used as alternatives in what infections? (3)
1. meningitis
2. RMSF(rocky mountain spotted fever)
3. typhoid fever
Which antibiotic is good for mycoplasma, and chlamydia?
tetracyclin, chloramphenoicol
Describe macrolides:
1. target
2. resistance
3. excretion
4. administration
1. 50s
2. decreased permeability, altered binding site on ribosome
3. biliray
4. oral, IV
What are three families of macrolides?
1. erythromycin
2. azithromycin
3. clarithromycin
Which two of the following belong to macrolides:
A. rifamycin
B. gentamycin
C. clarithromycin
D. tobramycin
E. amikacin
F. erythromycin
C. F.
Macrolides can be used to treat____.
Legionella,mycoplasma
campylobacter gastroenteritis
STD's
Diptheria/pertussis carriers

GP, GN
pneumonia(atypical)
Rickettsia,treponemes
What antibiotic can be used to treat rickettsia and treponemes?
macrolides
What antibiotic can be used to treat rickettsia?
tetracyclin,chloramphenicol,macrolides
What are some adverse effects of macrolides? (3)
1. GI upset
2. gout exacerbation
3. rash
Which antibiotic might cause gout?
macrolide
What is the drug to use in case patients are allergic to penicillin?
macrolides
What antibiotic can be used to treat people with STD or people who are carriers of diptheria/pertussis?
macrolide
Which antibiotic is similar to macrolide, but antagonistic to erythromycin?
quinuprisin/dalfopristin
Describe uinuprisin/dalfopristin:
1. target
2. resistance
3. metabolism
4. excretion
5. administration
1. 50s
2. no cross resistance
3. hepatic: drug interactions
4. biliary
5. central vein
What drug interations might quinuprisin/dalfopristin cause? (3)
1. Cycloporine
2. midazolam
3. Nifedipin
Which antibioc would cause drug interaction with cycloporine, midazolam, and Nifedipin?
quinuprisin/dalfopristin
Why must quinuprisin/dalfopristin be adminstered through central vein?
It's sclerotic to veins, need bigger pathway.
What bacteria do quinuprisin/dalfopristin work against?
VRE faecium
MRSA infections
What are some adverse effects of quinuprisin/dalfopristin ? (3)
1. arthralgias, myalgias
2. hyperbilirubinemia
3. sclerotic to veins
Describe linezoid:
1. target
2. resistance
3. excretion
4. administration
1. 50s
2. no cross resistance
3. 35%renal, dose post-dialysis
4. IV and oral
T/F: There is no dose adjustment of linezoid for patients with hepatic failure.
T.
Which antibiotic might need dose post-dialysis?
linezoid
What are some drug interactions of linezolid? (2)
1. MAO inhibitor
2. interact with adrenergic and serotonergic agents
What food should be avoided for patients taking linezoid?
tyramine
(cheese, dried meats, sauerkraut, soy sauce, tap beers, red wines)
Describe linezoid:
1. target
2. resistance
3. excretion
4. administration
1. 50s
2. no cross resistance
3. 35%renal, dose post-dialysis
4. IV and oral
T/F: There is no dose adjustment of linezoid for patients with hepatic failure.
T.
Which antibiotic might need dose post-dialysis?
linezoid
What are some drug interactions of linexoid? (2)
1. MAO inhibitor
2. interact with adrenergic and serotonergic agents
What food should be avoided for patients taking linezoid?
tyramine
(cheese, dried meats, sauerkraut, soy sauce, tap beers, red wines)
What symptoms mights patients have if having tyramine containing food while taking linezoid?
diarrhea
headache
nausea
Why should we monitor patients on SSRI antidepressant who are also taking linezoid?
Linezoid inhibits MAO which degrade serotonin.
What are some adverse effect of linezoid? (3)
1. peudomembranous colitis (colon)
2. thrombocytopenia(low platelets)
3. serotonin syndrome
What is the spectrum of activity of linezoid? (5)
1. E faecium (including VRE)
2. S aureus (including MRSA)
3. S agalactiae
4. S pneumoniae
5. S pyogenes
What drugs work on VRE faecium?
What drugs work on E faecium?
What drugs work on both?
What drugs work on VRE of both E faecium and E faecalis?
Quinupristin
Linezoid
Linezoid
daptomycin
Describe daptomycin:
1. target
2. resistance
3. excretion
4. administration
1. cyclic lipopeptide,caues efflux if K+
2. no
3. mostly renal (80%)
4. IV
Is dactomycin bacteriostatic or bactericidal?
bactericidal
T/F: Daptomycin is highly lipophilic, bound by proteins, and dosage need to be adjusted for people whose creatine clearance is less than 30ml/min.
T.
What is daptomycin active against?
streptococci- PCN resistant pneumococci
enterococci-VRE of E faecalis and E faecium
staphylococci-MRSA, vancomycin resistant staph
Which antibiotic are bacteria least reistant to?
daptomycin
What are some adverse effect of daptomycin? (2)
1. muscle discomfort and weakness
2. asymptomatic elevation of CPK(creatine phosphokinase)
Why can't dactomycin treat pneumonia?
It binds to lung surfactant.
T/F: Dactomycin is approved for treating complicated skin and soft tissue infection only.
T.
Describe trimethoprim:
1. target
2. resistance
3. excretion
4. administration
1. inhibit dihydrofolate reductase
2. decreased permeability, alters enzyme affinity
3. renal
4. IV and Oral
Trimethoprim would inhibit synthesis of:
A. dihydrofolic acid
B. tetrahydrofolic acid
B.
Trimethoprim is used for treating what conditions? (3)
1. UTI
2. pneumonia
3. SSTI
4. meningitis
What's the name of the GN bacteria that makes carbapenamase?
stenotrophononas maltophilia
Since stenotrophononas maltophilia is resistant to carbopenem, what antibiotic should be considered to use?
trimethoprim
Why is stenotrophononas maltophilia resistant to carbopenem?
It makes carbopenemase
Which antibiotic is good for treating nicardia?
trimethoprim
Which antibiotic is good for treating PCP?
trimethoprim
What is trimethoprim's range of action?
anaerobes
P. aeruginosa
not enterococcus
What are adverse effects of trimethoprim? (5)
1. dermatologic hypersensitivity: erythema nodosum
2. crystalluria
3. renal dysfunction
4. bone marrow suppression
Which antibiotic would cause side effects such as Stevens_Johnson syndrome?
Trimethoprim
What are the symptoms of Stevens_Johnson syndrome caused by trimethiprim? (2)
1. mucositis
2. erythema nodosum
Mucositis and erythema nodosum are symptoms of _____ syndrom.
Stevens_Johnson syndrome: caused by trimethoprim
What are the four families of quinolones?
1. ciprofloxacin: lots of GP
2. levofloxacin: lots of GN
3. gatifloxacin
4. moxifloxacin: both GP and GN
Describe quinolones:
1. target
2. resistance
3. excretion
4. administration
1. DNA gyrase
2. altered binding sites, active efflux
3. varied
4. IV and oral
What bacterial do quinolones work on?
GN
GP
anaerobes
What are the adverse effects of quinolones?
1. rash
2. CNS toxicity
3. GI ditress
4. disglycemia
5. cartilage damage
6. bound by metals, cations
Why do we need to watch out for diabetic patients taking quinolones?
Side effects include disruption of glucose metabolism.
T/F: Quinolones are has broad usefulness whenever there is GN infection.
T
Describe vancomycin:
1. target
2. resistance
3. excretion
4. administration
1. bind to D-ALA-D-ALA
2. alteration in binding site
3. renal
4. oral
Vancomycin is good for treating ____ bacteria.
GP only
PRSP (meningitis)
MRSA, MRSE
What is the main problem with using vancomycin?
overuse and resistance
What are the adverse effect of vancomycin?
1. ototoxicity
2. redman syndrom (infusion problem)
Which two antibiotics we learned so fat had ototoxicity?
1. aminoglucoside
2. vancomycin
What drug might cause redman syndrome?
vancomycin
If you infuse vancomycin too rapidly, patients may develope ____ syndrome.
redman sybdrome
Describe Clindamycin:
1. target
2. resistance
3. excretion
4. administration
1. 50s: elongation
2. alteration of binding sites
3. varies
4. IV and oral
Clindamycin has good activity toward what bacteria?
anaerobes
GP (not enterococcus)
What are the adverse effect of clindamycin?
1. rash
2. GI distress
3. psudomembranous colitis
Which 2 antibiotics may cause psudomembranous colitis?
1. linezoid
2. clindamycin
Infection of which area(s) can clindamycin treat?
A. Head and neck
B. Intraabdominal
C. Pelvic
D. Lung (aspiration pneumonia)
E. all the above
D.
Describe metronidazole:
1. target
2. resistance
3. excretion
4. administration
1. interupt DNA replication
2. ?
3. biliary
4. IV and oral
Metronidazole in only good for which type of bacteria?
anaerobes
some parasites
What are the adverse effects of metronidazole?
1. metallic tastes
2. disulfiram-like reaction: bound to alcohol
3. peripheral neuropathy
4. pancreatitis
Which drug would give you a metallic taste?
metronidazole
Which drug has a disulfiram-like reaction?
metronidazole