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36 Cards in this Set

  • Front
  • Back
most common mechanism of R in Enterococcus?
chromosome-mediated alteration of ribosome function
chromosome mediated decrease uptake thru outer membrane is major mechanism of drug R for?
Pseudomonas, anaerobes
mech of drug R most often expressed agaisnt tetracyclines and sulfonamides?
plasmid-mediated exportation
mech by which linear pieces of exogenous DNA incorporated into bacterial chromosome using RecA?
homologous recombination
mech by which temperate phage can accidentally transfer genetic material from 1 bacterium to another, following error or excision?
specialized transduction
mechanism by which lytic phage can accidentally transfr genetic material from 1 bacterium to another?
generalized transduction
resistance to pyrazinamide due to?
(inhibits fatty acide synthetase); mutaitons in gene that encodes amidase--responsible for converting PZA to active form
resistance to ethambutol due to?
(inhibits synthesis of arabinogalactin); mutations in gene that encodes arabinosyl transferase. this enzyme synthesizes arabinoglactin in TB cell wall
resistance to isoniazid due to?
(inhibits mycolic acid synthesis); mutations in catalase-peroxidase gene--required for synthesis of active metabolite
resistance to quinolones due to?
(inhibit DNA gyrase); chromosomal mutations-->modify DNA gyrase OR change in bacteria outer membrane proteins-->reduced uptake
resistance to rifampin due to?
(blocks RNA polymerase); chromosomal mutaiton in gene for beta subunit of bact.RNA polymerase
resistance to trimethoprim due to?
(inhibit DHFR); mutations in csomal gene encoding DHFR
resistance to sulfonamides due to?
(PABA analog, inhibits synth of THF); 1) R factor--encodes transport system that actively exports drug; 2) csomal mutation--reduces binding affinity for dihydropteroate synthetase
resistance to erythromycin due to?
(macrolide, binds 50S, blocks translocation); R factor--enzyme methylates 23S rRNA thereby blocking binding of drug
resitance to cholamphenicol due to?
(binds 50S, blocks axn of peptidyltransferase); R factor--acetyltransferase acetylates and inactivates drug
resitance to tetracyclines due to?
(bind 30S, block tRNA from entering acceptor site); R factor--dec'd uptake or inc'd export out
resistance to aminoglycosides due to?
(bind 30S, inhibit initiation complex, misread mRNA); 1) R factor--phosphorylation, acetylation, adenylylation; 2) csomal mutations; 3) dec'd permeability to drug
resistance to vancomycin due to?
D-ala-D-ala --> D-ala-D-lactate. VanA locus on plasmid transposon
6 bacteriCIDal abx
penicillin, cephalosporins, vancomycin, aminoglycosides, fluoroquinolones, metronidazole
1st gen cephalosporins--names and activity
cefazolin, cephalexin; G+ cocci, Proteus, E.coli, Klebsiella
2nd gen cephalosporins--names and activity
cefoxitin, cefaclor, cefuroxime; G+cocci, H.flu, Enterobacter, Neisseria, Proteus, E.coli, Klebsiella, Serratia
3rd gen cephalosporins--names and activity
ceftriaxone, cefotaxime, ceftazidime; cross BBB!!
4th gen cephalosporins--names and activity
cefepime, cefpiramide; increased pseudomonas and G+ activity
why use aztreonam?
for pen-allergics or renal pts who can't tolerate aminoglycosides
drug of choice for enterobacter
imipenem w/cilastatin
vancomycin toxicity
nephrotoxicity, ototoxicity, thrombophlebitis, diffuse flushing (red man syndrome)
aminoglycosides--which toxicities enhanced by which drugs?
nephrotoxicity--cephalosporin; ototoxicity--loop diuretics
which tetracycline ok with renal pts?
which abx should not be given to COPD pts (on theophylline)?
macrolides b/c increase sr [theophylline] (also oral coag)
which abx may cause kernicterus in infants?
toxicities of trimethoprim
megaloblastic anemia, leukopenia, granulocytosis
toxicities of polymyxins
neurotoxic, acute renal tubular necrosis
IFN alpha clinical use?
chronic hep B and C, Kaposi sarcoma
IFN gamma clinical use?
NADPH oxidase def
IFN beta clinical use?
9 abx to avoid in preggers
(SAFE Moms Take Really Good Care); sulfonamides (kernicterus); aminoglycosides (ototoxicity); fluoroquinolones; erythromycin; metronidazole; tetracyclines ; ribavarin; griseofulvin; chloramphenicol