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158 Cards in this Set
- Front
- Back
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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 |
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Give some examples of bacteria that lack fully formed cell wall.(4)
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1. Chlamydia
2. Rikettsia 3. Mycoplasma 4. small colony variants |
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Properties of small colony variants.(4)
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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 |
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What is an example of small colony variants?
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Staphylococcus aureus
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Why do some antifungal drug cause side effects?
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Antifungal drugs that taget sterols in the fungal cell wall may also act on sterols in human cell membranes.
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What are the three mechanisms of action of antibiotics?
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1. cell wall inhibition
2. inhibition of protein synthesis 3. inhibition of nucleic acid sythesis |
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What two antibiotic classes target bacterial cell wall synthesis?
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1. β-lactams
2. vancomycin |
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What are the two classes of antibiotics that target 30s bacterial ribosomes?
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1. aminoglucoside: misread mRNA
2. tetracyclin: blocks attachment to tRNA, prevent elongation |
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What are the five classes of antibiotics that target 50s bacterial ribosomes?
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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 |
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What drugs blocks elongation of protein synthesis? (5)
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1. Tetracyclin: 30s
2. Chloramphenicol: 50s, peptidyl transferase 3. Clinsamycin: 50s 4. Macrolides: 50s 5. Pristinamucin: 50s |
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Which of the following is bacteriocidal?
1. Aminoglucoside 2. Chloramphenicol 3. Clinsamycin 4. Macrolides 5. Pristinamucin 6. Tetracyclin |
1.
All the rest are bacterostatic |
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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.
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What are the five classes of antibiotics that inhibit nucleic acid synthesis?
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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 |
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Which of the following inhibit DNA synthesis by blocking gyrase?
1. Rifamycin 2. Quinolone 3. Trimethoprim and Pyrimethamine 4. Sulfonamides 5. Metronidazole |
2.
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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.
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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
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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
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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
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List some mechanisms of aquired antibiotic resistance. (4)
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1. transformation
2. transduction 3. conjugation 4. transposition |
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What makes some GN bacteria to resistant antibiotic β-lactam?
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β-lactamase in periplasm
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Some factors involved with antibacterial activity. (4)
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1. concentration
2. diffusion through outer cell membrane 3. resist attack by inactivating enzymes 4. affinity to the target enzyme |
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What are the 4 routes of antibiotic administration.
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1. oral (PO/enteral)
2. intravenous (IV) 3. intramuscular (IM) 4. topical |
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Six pharmacokinetic principles.
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1. serum level: MIC
2. 1/2 life 3. protein binding 4. distribution 5. metabolism 6. excretion |
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What is MIC?
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Minimal inhibitory concentration.
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What's the relation between usual dose and MIC?
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usual dose should be above MIC by 4-10 fold.
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List five β-lactam antibiotics families.
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1. Penam: penicillin
2. Clavan: clavulanic acid->β-lactamase inhibitor 3. Ceph: cephalosporin 4. Carbapenems: thienamycin, imipenem 5. monobactam: aztreonam |
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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 |
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What properties in bacteria contribute to penicillin resistance? (3)
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1. β-lactamase
2. change PBP structure 3. decrease perpeability: block porins |
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Which of the following is not a deravative of penicillin?
A. oxacillin B. nafcillin C. ampicillin D. piperacillin E. sulbactam |
E.
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Penicillin works on what bacterial infection? (2)
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Strep
Syphilis |
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Staph can be treated by which of the folowing:
A. oxacillin B. nafcillin C. ampicillin D. piperacillin |
A
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Enterococcus, Listeria can be treated by ____:
A. oxacillin B. nafcillin C. ampicillin D. piperacillin |
C.
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Pseudomonas, GNR can be treated by_____
A. oxacillin B. nafcillin C. ampicillin D. piperacillin |
D.
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Ampicillin works on what bacteria?
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enterococcus
Listeria |
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Piperacillin works on what bacteria?
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pseudomonas
GNR |
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Oxacillin/Nifcillin works on what bacteria?
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Staph
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What kinds of side effects can penicillin cause? (4)
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1. Allergy: anaphylaxis, hypersensitivity, delayed sensitivity
2. bone marrow effects: low WBC, RBC, platlets 3. interstitial nephritis 4. seizures |
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T/F: Penicillin can cause decreased blood counts.
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T.
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Can penicillin be administered to patients with renal problems at normal dosage?
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No. Penicillin is excreted through kidney.
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What are some β-lactamase inhibitors?
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Clavulanic acid
Sulbactam Tazobactams |
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Clavulanic acid,sulbactam, and tazobactams are examples of____.
A. Carbopenems B. Conobactams C. β-lactamase inbitors D. Cephems |
C.
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What kind of bacteria does β-lactamase inbitors work against?
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Anaerobes
GNR |
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What bacteria does the 1st generation of Ceph work against? (3)
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Staph (GP)
Steph (GP) E. Coli (GN) |
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What bacteria does the 2nd generation of Ceph work against?
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Staph (GP)
Steph (GP) GN |
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What bacteria does the 3rd and 4th generation of Ceph work against?
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Strep
GN pseudomonas bacterial menigitis |
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Which bacterium that penicillin act on but Ceph does not?
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enterococcus
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List four groups of carbopenems.
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1. imipenem
2. meropenem 3. doripenem 4. ertapenem |
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What is the special feature about carbopenem that other families of β-lactams don't have?
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Carbopenem is β-lactamase stable, but is susceptible to carbopenamase.
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T/F: Carbopenems can be administered both orally and perenterally.
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No. Only perenteral: IM, IV.
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What bacteria do carbopenems target?
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GP
GN anaerobes. |
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Which of the following has the broadest spectrum of taget bacteria:
A. penems B. cephs C. carbopenems D. monopenems |
C.
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Which drug is best suited for complex infections with multiple pathogens or highly resistant microbes?
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carbopenems
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What condition may patients develop if antibiotics are given to treat organisms that are resistant to it?
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superinfection
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What's the name of a monobactam?
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aztreonam
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Aztreonam is a _____.
A. penem B. ceph C. carbopenem D. monobactam |
D.
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Is monobactam adminstered orally?
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No. IV only.
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Monobactam is active against what organisms?
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GNs.
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What is a alternative β-lactam to give to patients who are allergic to penicillin?
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monobactam
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What are some groups of aminoglucosides? (4)
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1. streptomycin
2. gentamycin 3. tobramycin 4. amikacin (synthetic) |
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How does aminoglucoside kill bacteria?
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bind to 30s to cause misreading of mRNA
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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. |
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What antibiotic works synergistically with β-lactams?
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aminoglucoside
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What bacteria do aminoglucosides work against?
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GN
some mycobacteria |
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What are some adverse effect of aminoglucoside? (3)
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1. nephrotoxicity
2. ototoxicity 2. neuromuscular blockage |
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Which drug may cause nephrotoxicity, ototoxicity, and neuromuscular blockage?
A. β-lactams B. aminoglucosides C. tetracyclin D. chloramphenicol |
B.
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Doxycyclin, minocyclin, and tigecyclin beling to____ family.
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tetracyclin.
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Describe tetracyclin:
1. target 2. resistance 3. excretion 4. administration |
1. 30s
2. decreased uptake, active efflux 3. renal 4. oral and parenteral |
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Tetracyclin is good for infection cause by what specific bacteria?
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Ones that lack a intact cell wall: mycoplasma, chlamydia, legionella.
In general: GP and GN |
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Which antibiotic is good for legionella, mycoplasma, and chlamydia?
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tetracyclin
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T/F: Tetracyclin has a broad spectrum of taget organisms including GP, GN, and those lacking cell walls.
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T.
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What are some adverse effect of tetracyclin? (4)
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1. GI upset, diarrhea
2. hypersensitivity/photosensitivity 3. depressed bone growth 4. discolored teeth. |
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Which antibiotic might cause discoloration of teeth and photosensitivity?
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Tetracyclin
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Which antibiotic can be used to treat Chlamydia?
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Tetracyclin, chloramphenicol
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Which antibiotic can be used to treat arthropod-borne diseases?
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Tetracyclin
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Describe tetracyclin:
1. target 2. resistance 3. excretion 4. administration |
1. 50s
2. inactivating enzyme, decreased permeability 3. renal 4. IV and oral |
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What bacteria does chloramphenicol target?
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GP, GN
Rickettsia,chlamydia,mycoplasma,spirochete |
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Which antibiotic can be used to treat Rickettsia and spirochete?
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tetracyclin
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What are some adverse effects of chloramphenicol? (4)
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1. aplastic anemia
2. reversible bone marrow toxicity 3. "gray baby" syndrome (if missing an enzyme in the liver) 4. optic neuritis |
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Which antibiotic might cause aplastic anemia, "gray baby" syndrome, and optic neuritis?
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chloramphenicol
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If a patient is allergic to β-lactams, which alternative drug can be used to treat meningitis?
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chloramphenicol, or macrolide
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Chloramphenicol can be used as alternatives in what infections? (3)
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1. meningitis
2. RMSF(rocky mountain spotted fever) 3. typhoid fever |
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Which antibiotic is good for mycoplasma, and chlamydia?
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tetracyclin, chloramphenoicol
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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 |
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What are three families of macrolides?
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1. erythromycin
2. azithromycin 3. clarithromycin |
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Which two of the following belong to macrolides:
A. rifamycin B. gentamycin C. clarithromycin D. tobramycin E. amikacin F. erythromycin |
C. F.
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Macrolides can be used to treat____.
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Legionella,mycoplasma
campylobacter gastroenteritis STD's Diptheria/pertussis carriers GP, GN pneumonia(atypical) Rickettsia,treponemes |
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What antibiotic can be used to treat rickettsia and treponemes?
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macrolides
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What antibiotic can be used to treat rickettsia?
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tetracyclin,chloramphenicol,macrolides
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What are some adverse effects of macrolides? (3)
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1. GI upset
2. gout exacerbation 3. rash |
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Which antibiotic might cause gout?
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macrolide
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What is the drug to use in case patients are allergic to penicillin?
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macrolides
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What antibiotic can be used to treat people with STD or people who are carriers of diptheria/pertussis?
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macrolide
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Which antibiotic is similar to macrolide, but antagonistic to erythromycin?
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quinuprisin/dalfopristin
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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 |
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What drug interations might quinuprisin/dalfopristin cause? (3)
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1. Cycloporine
2. midazolam 3. Nifedipin |
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Which antibioc would cause drug interaction with cycloporine, midazolam, and Nifedipin?
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quinuprisin/dalfopristin
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Why must quinuprisin/dalfopristin be adminstered through central vein?
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It's sclerotic to veins, need bigger pathway.
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What bacteria do quinuprisin/dalfopristin work against?
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VRE faecium
MRSA infections |
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What are some adverse effects of quinuprisin/dalfopristin ? (3)
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1. arthralgias, myalgias
2. hyperbilirubinemia 3. sclerotic to veins |
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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 |
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T/F: There is no dose adjustment of linezoid for patients with hepatic failure.
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T.
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Which antibiotic might need dose post-dialysis?
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linezoid
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What are some drug interactions of linezolid? (2)
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1. MAO inhibitor
2. interact with adrenergic and serotonergic agents |
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What food should be avoided for patients taking linezoid?
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tyramine
(cheese, dried meats, sauerkraut, soy sauce, tap beers, red wines) |
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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 |
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T/F: There is no dose adjustment of linezoid for patients with hepatic failure.
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T.
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Which antibiotic might need dose post-dialysis?
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linezoid
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What are some drug interactions of linexoid? (2)
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1. MAO inhibitor
2. interact with adrenergic and serotonergic agents |
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What food should be avoided for patients taking linezoid?
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tyramine
(cheese, dried meats, sauerkraut, soy sauce, tap beers, red wines) |
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What symptoms mights patients have if having tyramine containing food while taking linezoid?
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diarrhea
headache nausea |
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Why should we monitor patients on SSRI antidepressant who are also taking linezoid?
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Linezoid inhibits MAO which degrade serotonin.
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What are some adverse effect of linezoid? (3)
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1. peudomembranous colitis (colon)
2. thrombocytopenia(low platelets) 3. serotonin syndrome |
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What is the spectrum of activity of linezoid? (5)
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1. E faecium (including VRE)
2. S aureus (including MRSA) 3. S agalactiae 4. S pneumoniae 5. S pyogenes |
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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 |
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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 |
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Is dactomycin bacteriostatic or bactericidal?
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bactericidal
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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.
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T.
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What is daptomycin active against?
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streptococci- PCN resistant pneumococci
enterococci-VRE of E faecalis and E faecium staphylococci-MRSA, vancomycin resistant staph |
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Which antibiotic are bacteria least reistant to?
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daptomycin
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What are some adverse effect of daptomycin? (2)
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1. muscle discomfort and weakness
2. asymptomatic elevation of CPK(creatine phosphokinase) |
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Why can't dactomycin treat pneumonia?
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It binds to lung surfactant.
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T/F: Dactomycin is approved for treating complicated skin and soft tissue infection only.
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T.
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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 |
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Trimethoprim would inhibit synthesis of:
A. dihydrofolic acid B. tetrahydrofolic acid |
B.
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Trimethoprim is used for treating what conditions? (3)
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1. UTI
2. pneumonia 3. SSTI 4. meningitis |
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What's the name of the GN bacteria that makes carbapenamase?
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stenotrophononas maltophilia
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Since stenotrophononas maltophilia is resistant to carbopenem, what antibiotic should be considered to use?
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trimethoprim
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Why is stenotrophononas maltophilia resistant to carbopenem?
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It makes carbopenemase
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Which antibiotic is good for treating nicardia?
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trimethoprim
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Which antibiotic is good for treating PCP?
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trimethoprim
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What is trimethoprim's range of action?
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anaerobes
P. aeruginosa not enterococcus |
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What are adverse effects of trimethoprim? (5)
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1. dermatologic hypersensitivity: erythema nodosum
2. crystalluria 3. renal dysfunction 4. bone marrow suppression |
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Which antibiotic would cause side effects such as Stevens_Johnson syndrome?
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Trimethoprim
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What are the symptoms of Stevens_Johnson syndrome caused by trimethiprim? (2)
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1. mucositis
2. erythema nodosum |
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Mucositis and erythema nodosum are symptoms of _____ syndrom.
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Stevens_Johnson syndrome: caused by trimethoprim
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What are the four families of quinolones?
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1. ciprofloxacin: lots of GP
2. levofloxacin: lots of GN 3. gatifloxacin 4. moxifloxacin: both GP and GN |
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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 |
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What bacterial do quinolones work on?
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GN
GP anaerobes |
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What are the adverse effects of quinolones?
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1. rash
2. CNS toxicity 3. GI ditress 4. disglycemia 5. cartilage damage 6. bound by metals, cations |
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Why do we need to watch out for diabetic patients taking quinolones?
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Side effects include disruption of glucose metabolism.
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T/F: Quinolones are has broad usefulness whenever there is GN infection.
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T
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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 |
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Vancomycin is good for treating ____ bacteria.
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GP only
PRSP (meningitis) MRSA, MRSE |
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What is the main problem with using vancomycin?
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overuse and resistance
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What are the adverse effect of vancomycin?
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1. ototoxicity
2. redman syndrom (infusion problem) |
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Which two antibiotics we learned so fat had ototoxicity?
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1. aminoglucoside
2. vancomycin |
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What drug might cause redman syndrome?
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vancomycin
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If you infuse vancomycin too rapidly, patients may develope ____ syndrome.
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redman sybdrome
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Describe Clindamycin:
1. target 2. resistance 3. excretion 4. administration |
1. 50s: elongation
2. alteration of binding sites 3. varies 4. IV and oral |
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Clindamycin has good activity toward what bacteria?
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anaerobes
GP (not enterococcus) |
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What are the adverse effect of clindamycin?
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1. rash
2. GI distress 3. psudomembranous colitis |
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Which 2 antibiotics may cause psudomembranous colitis?
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1. linezoid
2. clindamycin |
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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.
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Describe metronidazole:
1. target 2. resistance 3. excretion 4. administration |
1. interupt DNA replication
2. ? 3. biliary 4. IV and oral |
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Metronidazole in only good for which type of bacteria?
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anaerobes
some parasites |
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What are the adverse effects of metronidazole?
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1. metallic tastes
2. disulfiram-like reaction: bound to alcohol 3. peripheral neuropathy 4. pancreatitis |
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Which drug would give you a metallic taste?
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metronidazole
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Which drug has a disulfiram-like reaction?
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metronidazole
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