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97 Cards in this Set

  • Front
  • Back
block cell wall synthesis by inhibition of peptidoglycan cross-linking
penicillin, ampicillin, ticarcillin, piperacillin, imipenem, aztreonam, cephalosporins
block peptidoglycan synthesis
bacitracin, vancomycin, cycloserine
disrupt bacterial/fungal cell membranes
disrupt fungal cell membranes
amphotericin B, nystatin, fluconazole/azoles
block nucleotide synthesis
sulfonamides, trimethoprim
block DNA topoisomerases
block mRNA synthesis
block protein synthesis at 50S ribosomal subunit
chloramphenicol, erythromycin/macrolides, lincomycin, clindamycin, streptogramins (quinupristin, dalfopristin), linezolid
block protein synthesis at 30S ribosomal subunit
aminoglycosides, tetracyclines
bacteriacidal antibiotics (6)
penicilin, cephalosporins, vancomycin, aminoglycosides, fluoroquinolones, metronidazole
penicillin mechanism
bind PBPs, block transpeptidase cross-linking of cell wall; activate autolytic enzymes
penicillin toxicity
hypersensitivity reactions, hemolytic anemia
mechanism of methicillin, nafcillin, dicloxacillin
bind PBPs, block transpeptidase cross-linking of cell wall - penicillinase resistant because of bulkier R group
methicillin toxicity
interstitial nephritis
ampicillin, amoxicillin toxicity
hypersensitvity, ampicillin rash (esp. in pts. w/ mono), pseudomembranous colitis
ticarcillin, carbenicillin, piperacillin usage
pseudomonas (Takes Care of Pseudomonas)
mechanism of cephalosporins
beta-lactam drugs that inhibit cell wall synthesis - less susceptible to penicillinases
antibiotic for penicillin-allergic patients and patients w/ renal toxicity who can't tolerate aminoglycosides
aztreonam (synergistic w/ aminoglycosides)
drug of choice for enterobacter
antibiotic that can cause seizures at high plasma levels
mechanism of vancomycin
inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors
mechanism of resistance to vancomycin
amino acid change of D-ala D-ala to D-ala D-lac
vancomycin toxicity
well tolerated in general - does NOT have many problems: nephrotoxicity, ototoxicity, thrombophlebitis
streptomycin, gentamicin, tobramycin, amikacin - bacteriacidal
mechanism of action of aminoglycosides
inhibit 30S subunit - inhibit formation of initiation complex and cause misreading of mRNA
are aminoglycosides effective agains anaerobes?
no! require O2 or uptake
aminoglycosides cause nephrotoxicity especially when used in combination with _________
aminoglycosides cause ototoxicity especially when used with_________
loop diuretics
are aminoglycosides safe to use in pregnancy?
no! teratogenic
which tetracycline can be used in patients with renal failure?
doxycycline because it is fecally eliminated
can you take tetracyclines with milk?
no! nor atacids or iron-containing preparations because divalent cations inhibit its absorption in the gut
tetracycline toxicity
discoloration of teeth and inhibition of bone growth in children, photosensitivity
mechanism of action of macrolides
inhibit protein synthesis by blocking translocation - bind to 23S rRNA of the 50S subunit
name 3 macrolides
erythromycin, azithromycin, clarithromycin
when can sulfonamides cause hemolysis?
G6PD deficiency
most common cause of noncompliance with macrolides
GI discomfort
macrolides increase the serum concentration of what drugs?
theophyllines, oral anticoagulants
acute cholestatic hepatitis & eosinophilia are toxicities of which class of antibiotics?
clinical use of chloramphenicol
meningitis - H. flu, neisseria, strep pneumo
why does chloramphenicol cause gray baby syndrome?
because infants lack liver UDP-glucoronyl transferase
is the aplastic anemia seen with chloramphenicol dose dependent?
no! the anemia is, however
mechanism of action of chloramphenicol
inhibits 50S peptidyltransferase
what is the clinical use of clindamycin?
treatment of anaerobic infections - B. frag, C. perfringfens
clindamycin toxicity
pseudomembranous colitis - destroys normal GI flora
mechanism of action of sulfonamides (sulfamethoxazole, sulfisoxazole, triple sulfas, etc.)
PABA antimetabolites inhibit dihydropteroate synthase
what side effect can sulfonamides cause in infants?
mechanism of action of trimethoprim
inhibits bacterial dihydrofolate reductase
trimethoprim toxicity
megaloblastic anemia, leukopenia, granulocytopenia (may alleviate with supplemental folinic acid)
mechanism of action of fluoroquinolones
inhibit DNA gyrase (topoisomerase II)
what class of antibiotics can cause cartilage damage in kids?
what drug is associated with a disulfiram-like reaction with alcohol and a metallic taste
what can prevent the neurotoxicity associated with INH?
pyridoxine (vitamin B6)
INH toxicity
hemolysis if G6PD deficient, neurotoxicity, hepatotoxicity, SLE-like syndrome
mechanism of action of rifampin
inhibits DNA-dependent RNA polymerase
what drug delays resistance to dapsone when used for leprosy?
resistance mechanism for penicillins/cephalosporins
beta-lactamase cleavage of beta lactam ring
resistance mechanism for aminoglycosides
modification via acetylation, adenylation, or phosphorylation
resistance mechanism for chloramphenicol
modification via acetylation
resistance mechanism for macrolides
methylation of rRNA near erythromycin's ribosome binding site
resistance mechanism for tetracycline
decreased uptake or increased transport out of cell
resistance mechanism for sulfonamides
altered enzyme (bacterial dihydropteroate synthetase), decreased uptake, or increased PABA synthesis
mechanism of action of amphotericin B
binds ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes and disrupt homeostasis
drug of choice for systemic mycoses
amphotericin B
amphotericin B toxicity
fever/chills, hypotension, nephrotoxicity, arrhythmias, hypochromic normocytic anemia
do ketoconazole and ampho B act synergistically?
no - they antagonize each other's actions, so should never be used together
which has greater oral availability - amoxicillin or ampicillin?
spectrum of ampicillin, amoxicillin
HELPS kill enterococci:
h. flu, e. coli, listeria, proteus, salmonella, enterococci
cefazolin and cephalexin are what generation cephalosporins?
coverage of cefazolin and cephalexin?
proteus, e. coli, klebsiella
(and gram-positives)
cefoxitin, cefaclor, cefuroxamine are what generation?
coverage of cefoxitin, cefaclor, cefuroxamine?
h. flu, enterobacter, neisseria, proteus, e. coli, klebsiella
ceftriaxone, cefotaxime, and ceftazidime are what generation?
use of ceftriaxone, cefotaxime, and ceftazidime?
serious gram-negative infections resistant to other beta lactams; meningitis; ex. ceftazidime for pseudomonas, ceftriaxone for gonorrhea
cefepime, cefpiramide belong to what generation?
use of cefepime, cefpiramide?
increased activity against pseudomonas and gram-positive organisms
serum-like sickness in infants and kids can be seen with what cephalosporin?
ceflacor (2nd generation)
this is an inhibitor of renal dihydropeptidase I
cilastin - decreases inactivation of imipenem in renal tubules
why are aminoglycosides ineffective against anaerobes?
require O2 for uptake
drug used for bowel surgery?
this tetracycline is an ADH antagonist - acts as a diuretic in SIADH
clinical use of tetracyclines?
VACUUM THe BedRoom: vibrio cholerae, acne, chlamydia, ureaplasma urealyticum, mycoplasma, tularemia, h. pylori, borrelia burgdorferi, rickettsia
this drug treats anaerobes above the diaphragm
these drugs can cause leg cramps and myalgias in kids
used for anaerobes below the diaphragm
how does nystatin work?
binds to ergosterol, disrupting fungal membranes (too toxic for systemic use)
mechanism of the -azoles?
inhibit fungal steriod (ergosterol) synthesis
toxicities of -azoles?
hormone synthesis inhibition (gynecomastia), liver dysfunction (inhibition of P450), fever, chills
this antifungal inhibits DNA synthesis by conversion to fluorouracil, which competes with uracil
toxicity of flucytosine
nausea, vomiting, diarrhea, bone marrow suppression
mechanism of caspofungin?
inhibits cell wall syntehsis
use of caspofungin?
invasive aspergillosis
toxicity of caspofungin?
GI upset, flushing
this antifungal inhibits the fungal enzyme squalene epoxidase
use of terbinafene?
used to treat dermatophytoses (especially onychomycosis)
mechanism of griseofulvin?
interferes with microtubule function; disrupts mitosis; depostis in keratin-containing tissues (e.g. nails)
clinical use of griseofulvin?
oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm)
toxicity of griseofulvin?
teratogenic, carcinogenic, confusion, headaches, increases warfarin metabolism