Usmle: Anti-Microbials

Front 1

beta lactams: MOA

Back 1

block cell wall synthesis by inhibiting peptidoglycan cross-linking

Front 2

bacitracin: MOA

Back 2

blocks peptidoglycan synthesis

Front 3

vancomycin: MOA

Back 3

blocks peptidoglycan synthesis by binding to D-ala

Front 4

polymyxins: MOA

Back 4

disrupt cell membrane

Front 5

TMP & SMX: MOA

Back 5

block nucleotide synthesis (folate synthesis). supplement with folic acid!

Front 6

FQs: MOA

Back 6

block DNA topoisomerase II (DNA gyrase)

Front 7

rifampin: MOA

Back 7

blocks mRNA synthesis

Front 8

aminoglycosides: MOA

Back 8

block 30s ribosome unit. causes misreading of codon, inhibits translocation

Front 9

TCNs: MOA

Back 9

block 30s ribosome unit. prevents tRNA binding to ribosome

Front 10

macrolides: MOA

Back 10

block 50s ribosome unit. inhibits translocation

Front 11

chloramphenicol, clindamycin: MOA

Back 11

block 50s ribosome unit

Front 12

anti-pseudomonals

Back 12

Ticarcillin, carbenicillin, piperacillin. Use with clavulanic acid. Also works against gram- rods

Front 13

B-lactamase inhibitor. Use with anti-pseudomonals, aminopenicillins

Back 13

clavulanic acid

Front 14

works on gram+ cocci, gram- cocci, gram+ rods, spirochetes. SE is hemolytic anemia

Back 14

PCN

Front 15

works on S. aureus (not MRSA). penicillinase resistant. SE: interstitial nephritis

Back 15

methicillin. others in same group: nafcillin, dicloxacillin

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extended spectrum, includes: HiB, E coli, Listeria*, Proteus, Salmonella*, enteroccus. not penicillinase resistant. SE: pseudomembranous colitis

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aminopenicillins: ampicillin, amoxicillin. use with clavulanic acid. ampicillin may give rash. mnemonic: aminopenicillins HELPS kill enterococci

Front 17

no activity for gram+ or anaerobes*. works against Klebsiella, pseudomonas, Serratia.

Back 17

aztreonam

Front 18

monobactam, for PCN allergies and those who cannot tolerate aminoglycosides (renal insufficiency)

Back 18

aztreonam

Front 19

drug of choice for enterobacter. works on gram+ cocci, gram - rods, anaerobes. significant side effects (seizures)

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meropenem, imipenem. always administer imipenem with cilastatin

Front 20

administered with imipenem to decrease inactivation in renal tubules

Back 20

cilastatin

Front 21

works on gram + cocci, Proteus, E coli, Klebsiella

Back 21

1st gen cephalosporins (cefazolin, cephalexin)

Front 22

works on gram + cocci, HiB, enterobacter, neisseria, proteus, E coli, Klebsiella, serratia

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2nd gen cephalosporins (cefoxitin, cefaclor, cefuroxime)

Front 23

for serious gram - infections resistant to other B-lactams, and meningitis*

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3rd gen cephalosporins (ceftriaxone, cefotaxime, ceftazidine). tip: all have "f_t's" in their name

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for pseudomonas* and other gram + organisms

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4th gen cephalosporin (cefepime). mnemonic: P for pseudomonas

Front 25

used for serious gram+ drug resistant organisms, including S aureus and C. difficile

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vancomycin

Front 26

SE: red man syndrome, nphrotoxicity, ototoxocity, thrombophlebitis

Back 26

vancomycin

Front 27

ineffective against anaerobes (requires O2 for uptake)

Back 27

aminoglycosides (gentamycin, neomycin, amikacin, tobramycin, streptomycin)

Front 28

for severe gram- rod infections. SE: nephrotoxicity, ototoxicity*, teratogen

Back 28

aminoglycosides (gentamycin, neomycin, amikacin, tobramycin, streptomycin)

Front 29

avoid taking with milk, antacids, or iron-containing preparations (decreases absorption)

Back 29

TCNs (TCN, doxycycline, demeclocycline, minocycline)

Front 30

SE: causes GI distress, discoloration of teeth and inhibition of bone growth in kids, photosensitivity. contraindicated in pregnancy

Back 30

TCNs (TCN in particular has teeth/bone problems. mino has CNS and ototoxicity)

Front 31

used for vibrio, acne, chlamydia, ureaplasma, M pneumoniae, tularemia, H pylori, Lyme disease, rickettsia

Back 31

TCNs

Front 32

for URI/pneumonia, STDs, mycoplasma, legionella, chlamydia, neisseria

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macrolides (erythromycin, azithromycin, clarithomycin)

Front 33

SE: acute cholestatic hepatitis in pregnancy

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erythromycin

Front 34

used for meningitis (Hib, neisseria, s. pneumoniae). causes apastic anemia and gray baby syndrome in premature infants (no UDPGT)

Back 34

chloramphenicol

Front 35

for anaerobic infections. SE: pseudomembranous colitis, fever, diarrhea

Back 35

clindamycin

Front 36

for strep infections in PCN allergies

Back 36

macrolides (erythromycin, azithromycin, clarithomycin)

Front 37

for recurrent UTIs, shigella, salmonella, PCP*

Back 37

TMP-SMX

Front 38

SE: hemolysis (if G6PD deficiency), kernicterus*, nephrotoxicity, displaces drugs from albumin (warfarin, etc)

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sulfonamides

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anti-PABA

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sulfonamides

Front 40

must not take with antacids

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FQs

Front 41

for gram - rods, usually of urinary and respiratory tracts. contraindicated in pregnancy and in kids d/t cartilage damage*

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FQs

Front 42

for resistant gram- infxn. SE: ATN, neurotoxicity

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polymyxins

Front 43

anti-TB drug, causes red-green color blindness.

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ethambutol

Front 44

treats M. leprae

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dapsone, rifampin (decreases resistance to dapsone)

Front 45

prophylaxis against M. avium intracellulare

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azithromycin

Front 46

used with bismuth and amoxicillin against H. pylori; disulfiram-like reaction with EtoH. HA, metallic taste. causes mutagenesis in pregnancy*

Back 46

metronidazole

Front 47

treats giardia, entamoeba, trichomonas, gardnerella, anaerobes (bacteroides, c difficile*)

Back 47

metronidazole

Front 48

inhibits synthesis of mycolic acid. administer with vit B6 to prevent neurotoxicity

Back 48

INH. can be used solo for prophylaxis against TB

Front 49

anti-TB drug, inhibits RNA polymerase. turns body fluids orange.

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rifampin

Front 50

prophylaxis for endocarditis (surgical/dental procedures)

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PCN

Front 51

prophylaxis against n. meningitis, HiB

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rifampin

Front 52

prophylaxis for gonorrhea

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ceftriaxone

Front 53

embryotoxic TCN

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clarithromycin