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antimicrobial test1
| Question | Answer |
|---|---|
| Penicillinase resistant | Dicloxacillin |
| PCNase resistant | Nafcillin |
| PCNase resistant | Oxacillin |
| PCNase resistant | Methicillin |
| Anti-pseudo PCN | carboxyPCNs |
| CarboxyPCNs | Ticarcillin, Carbenecillin |
| Anti-pseudo PCN | ticarcillin |
| Anti-pseduo PCN | carbenecillin |
| Anti-pseudo PCN | UreidoPCN |
| UreidoPCN | piperacillin, mexlocillin |
| Anti-pseudo PCN | piperacillin |
| Anti-pseudo PCN | mexlocillin |
| Augmentin | Ampicillin & clavulonic acid |
| Zosyn | Piperacillin & taxobactam |
| 2nd gen Cephs | Cefaclor, Cefotoxin, Loracarbef |
| 3rd gen Cephs | Ceftriaxone, Ceftazidime, Cefixime |
| 4th gen Ceph | Cefepime |
| 5th gen Ceph | Ceftaroline |
| Imipenem | combined w/cilastin |
| 50s | Chloramphenicol |
| 50S | clindamycin |
| 50s | linezolid |
| 50s | macrolides |
| 50s | quinupristin |
| 50s | dalfopristin |
| macrolide | erthromycin |
| macrolide | azithromycin |
| macrolide | clarithromycin |
| 30s | tetracycline |
| 30s | tigecycline |
| 30s | spectinomycin |
| 30s | aminoglycosides |
| aminoglycoside | streptomycin |
| aminoglycoside | gentamycin |
| aminoglycoside | tobramycin |
| aminoglycoside | amikacin |
| aminoglycoside | neomycin |
| fluroquinolones | naladixic acid |
| fluroquinolones | 'floxins' - Ciprofloxin, Levofloxin, Trovafloxacin |
| Lipoglycopeptide | dalbavancin |
| lipoglycopeptide | telavancin |
| cyclic lipopeptide | daptomycin |
| tefibazumab | staph antibody |
| anti-Tb | Isoniazid |
| anti-TB | rifampin |
| anti-TB | pyrazinamide |
| anti-TB | ethambutol |
| anti-TB | rifabutin |
| anti-TB | streptomycin |
| Rifapentine | latent TB |
| isoniazid | latent TB |
| mixed amebicide | metronidazole |
| mixed amebicide | tinadazole |
| anti-leprosy | sulfones (dapson/sulfoxone) |
| anti-leprosy | rifampin |
| MOA PCNs | inhibit transpeptidases, bind PCN-binding proteins, alter configuration of PG layer |
| PCN drug of choice for | GAS, GBS, T.pallidum |
| Natural PCN | broad spectrum |
| Aminopencillins | better Gm-; Gm+ enterococci increasing resistance |
| causes interstitial nephritis | Methicillin |
| increases Na overload, platelet dysfunction, hypokalemia | carbenecillin |
| Beta Lactamase inhibitors | clavulonic acid, sulbactam, taxobactam |
| uses for beta lactamase inhibitors | hosp acquired pneumo, anaerobes |
| used for MRSA | vancomycin |
| not absorbed in GI so good for Cdiff | vancomycin |
| CNS penetration | vancomycin |
| causes red man syndrome when used IV | vancomycin |
| red man syndrome | nonimmunologic histamine release |
| MOA vancomycin | inhibits prostaglandin biosynthesis a step earlier than PCN and inhibits transpeptidases |
| uses of vancomycin | ALL G+ |
| MOA cephalosporins | competitive inhibitor of transpeptidase |
| PCNs | cidal |
| cephalosporins | cidal |
| vancomycin | cidal |
| monobactams | cidal |
| carbapenems | cidal |
| 1st generation Ceph is more blank than blank | more Gm+ than Gm- |
| 3rd generation ceph is more blank than blank | more Gm- than Gm+ |
| adverse effect of interfering with Vit K dependant clotting | 2nd gen ceph (cefaclor, cefoxitin, Loracarbef) |
| might be good for pseudomonas | 3rd gen ceph |
| good CNS penetration | 3rd gen ceph |
| tx meningitis | 3rd gen cep |
| tx meningitis | vancomycin |
| Cefepime | good Gm+ & Gm- coverage |
| nosocomial pneumonias (pseudomonas) | cefepime |
| empiric tx for febrile neutropenia | cefepime |
| ceftaroline | good for community acquired pneumonia |
| good for MRSA | ceftaroline |
| 1st ceph w/activity against MRSA | ceftaroline |
| 1st drug for CAP since 1998 | ceftaroline |
| broad spectrum & highly resistant to B lactamases | carbapenems |
| combined with cilastin | imipenem |
| cilastin | inhibits kidney enzyme that metabolizes the drug its combined with and protects from toxicity |
| good for MRSA | ertapenem |
| good for ESBL organisms | ertapenem |
| only Gm- | monobactams |
| used to tx septicemia | monobactams |
| single B lactam ring not fused with another | aztreonam |
| all 50s static except for | quinupristin/dalfopristin |
| chloramphenicol causes | bone marrow depression w/aplastic anemia |
| chloramphenicol causes | grey baby syndrome |
| used in Rickettsia | chloramphenicol |
| used in meningtitis when allergic to PCN, ceph | chloramphenicol |
| side effect of clindamycin | pseudomembranous c.diff |
| used when allergic to PCN & ceph | clindamycin |
| MOA clindamycin | inhibits toxin production by blocking protein synthesis |
| used in strep pyogenes & staph TSS | clindamycin |
| Gm+ | clindamycin |
| side effects of linezolid | bone marrow suppression (thrombocytopenia, anemia & leukopenia) |
| mostly Gm+ | linezolid |
| used for HAP, CAP, staph, MRSA, VRE | linezolid |
| metabolized cyp450 | macrolides |
| metabolized cyp450 | erythromyc & clarithromycin |
| causes QT prolongation | macrolides |
| interaction with anti-epileptics, warfarin, birth control | macrolides |
| have anti-inflammatory properties | macrolides |
| inhibit mononuclear cells, reduce superoxide by PMNs, modify release of cytokines, inhibit biofilms | macrolides |
| binds to 2 separate sites on protein - irreversible | quinupristin/dalfopristin |
| multi-drug resistant Gm+ cocci | quinupristin/dalfopristin |
| VRE | static quinupristin/dalfopristin |
| MSSA, MRSA, S.pyogenes | cidal quinupristin/dalfopristin |
| metabolized cyp450 | quinupristin/dalfopristin |
| side effects of quinupristin/dalfopristin | venous irritation |
| 30s | all static |
| tetracycline | also includes doxycycline |
| take this 1 hr before or 3hrs after eating | tetracycline |
| causes photosensitivity, teeth discoloration | tetracycline |
| monocycline side effects | lupus like reaction, vertigo, arthritis |
| tigecycline | slow IV infusion |
| used for MRSA, VRE, ESBL, MDR acinetobacter | tigecycline |
| NO activity against pseudomonas | tigecycline |
| spectinomycin | aminocyclitol abx, closely related to aminoglycosides |
| often used with PCN to facilitate crossing bacterial Cell wall | aminoglycosides |
| crosses CNS only with meningeal inflammation | aminoglycosides |
| oldest aminoglycoside | streptomycin |
| M/C used aminoglycoside | gentamycin |
| aminoglycoside used for pseudomonas | tobramycin |
| aminoglycoside with broadest spectrum | amikacin |
| topical, toxic aminoglycoside | neomycin |
| aminoglycoside side effects | vestibular, auditory & nephrotoxicity; neuromuscular blockade |
| Gm- enteric, Tularemia, tersinia pestis | aminoglycosides |
| Cidal | fluroquinolones |
| safe high blood levels with oral absorption and good tissue penetration | fluroquinolones |
| MOA fluorquinolones | inhibit DNA gyrase |
| good Gm- coverage | fluroquinolones |
| resistance is developind due to mutation in bacterial DNA | fluroquinolones |
| Naladixic acid | 1st generation fluroquinolones |
| side effect fluoroquinilones | tendon rupture & tendinitis |
| causes c.diff | fluroquinolones |
| side effects of ciprofloxin | inhibits GABA- and causes seizures in pt with renal insufficiency |
| used for chronic bone infxns | fluroquinolones |
| moxofloxacin | empiric coverage intra-ab infxn & broad spectrum & anaerobes |
| novel second generation lipoglycopeptide that belongs to same class as Vancomycin | dalbavancin |
| not yet FDA approved | dalbavancin |
| for hospital pt with difficult to tx MRSA | dalbavancin |
| telavancin | also a lipoglycopeptide |
| MOA telavancin | dual action - inhibits cell wall synthesis & dissipates cell membrane potential |
| qualified infectious disease product | used @ instutions with a specialist - telavancin |
| tefibazumab | monoclonal antibody that binds to the surface-expressed adhesion protein clumping factor A |
| daptomycin | newer class of cyclic lipopeptide |
| causes rapid depolarization Gm+ cell membrane potential inhibiting bacterial DNA, RNA & protein synthesis | daptomycin |
| side effect of daptomycin | constipation |
| potential for myopathy | daptomycin |
| monitor CPK when on this | daptomycin |
| broad Gm+ coverage of org resistant to methicillin & vancomycin | daptomycin |
| used in complicated skin & soft tissue infxn: MRSA, VRE, s.agalactiae | daptomycin |
| isoniazid MOA | interferes with biosyn of mycolic acid component of cell wall |
| isoniazid side effects | hepatotoxicity |
| can induce pyridoxine deficiency (Vit B6), causing pellagra manifested by peripheral neuritis, rash & anemia | isoniazid |
| rifampin MOA | inhibits DNA-dependent RNA polymerase |
| rifampin side effects | jaundice, red/orange sweat, urine, tears |
| used for TB & leprosy | rifampin |
| prophylaxis for exposure to N. meningitides | rifampin |
| induces p450 | rifampin |
| pyrazinamide | causes hepatotoxic, gout |
| ethambutol | crosses BBB |
| visual disturbance side effects | ethambutol |
| only 1st line TB that is bacterostatic | ethambutol |
| rifabutin MOA | inhibits DNA-dependent RNA polymerase |
| side effects rifabutin | uveitis, orange urine, sweat, tears |
| used in combo for prevention & tx M. avium or M. intracellulare | rifabutin |
| increases drug interactions with heart therapy | rifapentine & inh (drugs for latent TB) |
| take for 3 months | rifapentine & INH |
| take for 9 months | INH only |
| sulfonamides MOA | competitive inhibition DHPS which converts PABA in folate synthesis (important for DNA synthesis) therfore bacteriostatic |
| sulfonamides | no toxicity |
| diuretics, sulfonlylureas & acetazolamide | sulfa moity also present so beware sulfa allergy |
| sulfonamides side effects | steven-johnson syndrome, severe sun burn |
| used to treat UTIs, otitis media, sinusitis, bronchitis, MRSA | sulfonamides |
| topical silver sulfadiazine | tx burns |
| sulfadiazine | protect ppl w/RF from infx; tx toxoplasmosis |
| sulfasalazine | anti-inflammatory agent |
| metronidazole MOA | binds proteins & DNA - cell death |
| severe GI side effects | metronidazole |
| severe CNS depression in elderly side effects | metronidazole |
| drug of choice for psudomembranous colitis caused by Gm+ cdiff | metronidazole |
| tinidazole | shorter course of tx than the other amebicide |
| Leprosy | hansens disease |
| lepromatous leprosy | low cell-mediated immunity |
| lepromatous leprosy | organisms everywhere, skin, nevers, eyes, testes |
| lepromatous leprosy | leonine facies, saddle nose, peripheral neuropathy, digit absorption, blindness, infertility in men |
| tuberculoid leprosy | intact cell-mediated immunity |
| tuberculoid leprosy | difficult to isolate from skin or blood |
| tuberculoid leprosy | skin & nerves involved (1-2 superficial unilateral lesions) |
| most common cause of neuropathy worldwide | leprosy |
| Daptomycin | no activity against Gm- |
| becomes inactivated by pulmonary surfactant therefore not appropriate for pneumonia | daptomycin |
| methods to figure out MIC | dilution method & disc diffusion method |
| Bacteriocidal | have MBC similar to MIC |
| bacteriostatic | have MBC higher than MIC |
| stronger ABX | have very low MICs |
| MIC of resistant org | >2 |
| four pharmacokinetic processes | absorption, distribution, metabolism, excretion |
| pharmacokinetics | how much of drug arrives at destination to have an effect |
| pharmacokinetics | determines time course of drug response & appropriate dosing strategies |
| pharmacodynamics | drug receptor interaction, pt functional status, placebo |
| pharmacodynamics | determines the nature & intensity of the response |
| pharmacodynamic/pharmacokinetic drug activity ration | PD/PK: takes into account the peak drug CONCENTRATION & length of TIME of drug exposure at site of infection - it is time/concentration!! |
| who produces beta lactamase | H. flu, M.catarrhalis, anaerobic bacteria, gonorrhea also now |
| B-lactamase production | binding is irreversible & cannot be overcome with higher dosing but CAN BE OVERCOME WITH B-LACTAMASE INHIBITORS |
Created by:
jjohrden16
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