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USMLE

Pharm 2

QuestionAnswer
Name antibiotics that block protein synthesis at 50S ribosomal unit Chloramphenicol, Erythromycin/macrolides, Lincomycin, Clindamycin, Streptogramins (quinupristin, dalfopristin), Linezolid
Name antibiotics that block protein synthesis at 30S ribosomal unit Aminoglycosides, Tetracyclines
Name antibiotics that block nucleotide synthesis Sulfonamides, Trimethoprim
Name antibiotics that block DNA topoisomerase Quinolones
Name antibiotic that blocks mRNA synthesis Rifampin
Name bactericidal antibiotics Penicillin, Cephalosporins, Vancomycin, Aminoglycosides, Fluoroquinolones, Metronidazole
Name drugs that disrupt bacterial/fungal cell membrane Polymyxins
Name drugs that disrupt fungal cell membranes Amphotericin B, Nystatin, Flucoconazole/azoles
Oral form of penicillin is called _ IV form? Penicillin V, Penicillin G
Mechanism of penicillin - Binds penicillin binding proteins - Blocks transpeptidase cross linking of cell walls - Activates autolytic enzymes
This antibiotic is bactericidal for gram positive cocci, gram positive rods, gram negative cocci and spirochetes. Not penicillinase resistant PENICILLIN
Toxicity of penicillin Hypersensitivity reactions Hemolytic anemia
Methicillin, nafcillin, dicloxacillin - mechanism of action? Narrow or broad action? Penicillinase resistant or not? Same as penicillin. Narrow action. Penicillinase resistant because of bulkier R groups
Methcillin, nafcillin and dicloxacillin are clinically used for treatment of what bug? S. aureus
Methicillin toxicity Interstitial nephritis
Methcillin, nafcillin, dicloxacillin toxicity Hypersensitivity reactions
Ampicillin, Amoxicillin- mechanism of action Penicillinase sensitive or resistant? Spectrum narrow or wide? SAME AS PENICILLIN Wide spectrum Penicillinase sensitive
Ampicillin, amoxicillin can be combined with _ to enhance spectrum Clavulinic acid
Which has greater oral bioavailibility - amoxicillin or ampicillin AmOxicillin has greater Oral bioavailibility
Name antibiotics that are extended-spectrum penicillins - against certain gram positive and gram negative rods Name rods HELPS kill enterococci - H influenzae, E.coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, enterococci Ampicillin, amoxicillin
Toxicity for ampicillin and amoxicillin Hypersensitivity reactions, ampicillin rash, pseudomembranous colitis
Mechanism for carbenicillin, pipercillin, ticarcillin Spectrum? Same as penicillin, extended spectrum
Name penicillins used for treatment of Pseudomonas, and gram negative rods Is it penicillinase resistant or sensitive Can it be used with clavulinic acid Carbencillin, Piperacillin, Ticarcillin. Penicillinase sensitive. Use with clavulinic acid
Toxicity for carbencillin, piperacillin, ticarcillin Hypersensitivity reactions
Beta lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases, bactericidal CEPHALOSPORINS
Which cephalosporins target gram positive cocci + Proteus , E. coli,Klebsiella 1st generation
Which cephalosporins target gram positive cocci + H. flu, Enterobacter, Neisseria, Proteus, E coli Klebsiella, Serratia 2nd generation
Which cephalosporins target serious gram negative infections resitant to other beta lactams, meningitis (most penetrate BBB) - give examples 3d generation - ceftazidime, ceftriaxone
3d generation cephalosporin used for treatment of Pseudomonas Ceftazidime
3d generation cephalosporin used for treatment of gonorrhea Ceftriaxone
Which cephalosporins have increased activity agains Psedudomonas and gram positive organisms 4th generation
Is there cross hypersensitivity between cephalosporins and penicillin Yes, 5-10%
Toxicity for cephalosporins Hypersensitivity reactions Increase nephrotoxicity of aminoglycosides Disulfiram like reaction with ethanol (in cephalosporins with methylthiotetrazole group) - cefamandole
A monobactam resistant to beta lactamases. Inhibits cell wall synthesis (binds to PBP3), synergistic with aminoglycosides, no cross allerginicity with penicillins AZTREONAM
This antibiotic is used for Gram negative rods (Klebsiella, Pseudomonas, Serratia), no activity agains gram positives or anaerobes, for penicillin allergic patients and those with renal insufficiency who cannot tolerate aminoglycosides AZTREONAM
Is there any toxicity associated with AZTREONAM Usually nontoxic, occasional GI upset
Broad spectrum beta lactamase resistant carbapenem Imipenem
Imipenem is ALWAYS administered with _ WHY? CILASTATIN Inhibitor of renal dihydropeptidase I - to decrease inactivation of the drug in renal tubules
Drug of choice for Enterobacter, also active against gram positive cocci, gram negative rods and anaerobes Imipenem + cilastatin
Toxicity associated with Imipenem/cilastatin GI distress, skin rash, CNS toxicity (seizures) at high plasma levels
Inhibits cell wall mucopeptide formation by binding D ala D ala portion of cell wall precursors. Resistance occurs with amino acid change of D ala D ala to D ala D lac VANCOMYCIN
This antibiotic is used for serious gram positive multi drug resistant organisms, including S aureus, and Clostridium difficile (pseudomembranous colitis) VANCOMYCIN
Diffuse flushing ("red man syndrome") associated with vancomycin can be largely prevented by? Pretreatment with antihistamines and slow infusion rate
Toxicity for Vancomycin Nephrotoxicity Ototoxicity Thrombophlebitis Well tolerated in general - does NOT have many problems
Created by: Asclepius