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10.17 Antibiotics I
9 by Dr. Figuroa
108
Pharmacology
Professional
10/17/2011

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Cards

Term
Who discovered penicillin?
Definition
alexander flemming
Term
Which classes of antibiotics target the bacterial cell wall?
Definition
beta-lactams and glycopeptides
Term
Name the beta-lactams.
Definition
penicillin, cephalosporin, carbepenems, and monolactams
Term
Name the glycopeptides.
Definition
vancomycin (investigational= vancomycin, ramoplanin, dalbavancin, oritavancin, telavancin)
Term
Bacitracin, fosfomycin and D-cycloserine all affect what part of the bacteria?
Definition
cytoplasmic proceses
Term
Daptomycin and polymyxins target what part of the bacteria?
Definition
cell membrane
Term
Which classes of drugs affect protein synthesis by inhibiting ribosomes?
Definition
amnoglycosides, oxazolidnones, tetracycline/glycycline, chloramphenicol, macrolide/azalide/ketolide, lincosamide, and streptogramin
Term
Name the aminoglycosides.
Definition
streptomycin, gentamicin, tobramycin, and amikacin
Term
Name an oxazolidinone.
Definition
linezolid
Term
Name some tetracyclines/glycyclines.
Definition
tetracycline, doxycycline, minocycline, and tigecycline
Term
Name examples of macrolide/azalide/ketolide.
Definition
erythromycin, clarithromycin, azithromycin, telithromycin
Term
Name an example of an lincosamide.
Definition
clindamycin
Term
Name an example of a streptogramin.
Definition
quinopristin-Dalpopristin
Term
Which groups of antibacterials target DNA/RNA synthesis?
Definition
quinolones, folate antagonists, nitroimidazole, rifamycin
Term
Name examples of quinolones.
Definition
ciprofloxacin, levofloxacin, gatifloxacin, moxifloxacin {whatever}floxacin
Term
Name an example of a folate antagonist.
Definition
trimethoprim-sulfamethaxozole
Term
Name examples of nitroimidazole.
Definition
metronidazole, nitrofurantoin
Term
Name examples of rifamycin.
Definition
rifampin, rifabutin, and rifapentine
Term
What antibiotic targets the P-FOR enzyme?
Definition
nitazoxanide
Term
Cell wall synthesis inhibitors work best when tehre is...
Definition
active growth
Term
Penicillin works by imitating ____.
Definition
D-alanyl-D-alanine, only penicilin has a beta lactam ring on it
Term
What are the penicillin binding proteins?
Definition
transpeptidases
Term
What determines the different specificity, resistance, and side effects of different beta-lactams?
Definition
side rings and groups
Term
Which penicillin is given IV? PO?
Definition
IV= penicillin G; PO= penicillin V
Term
What is the spectrum of penicillin G and V?
Definition
streptococci, treponema, and oral anaerobes
Term
What are the side effects of penicillin G and V?
Definition
immunologic, seizures
Term
How are ampicillin and amoxicillin given?
Definition
amp= IV, amo= PO
Term
What is the spectrum of ampicillin and amoxicillin?
Definition
penicillin spectrum (streptococci, treponema, oral anaerobes) + haemophilus and listeria
Term
What are the side effects of ampicillin and amoxicillin?
Definition
penicillin side effects (immunologic and seizures), rash
Term
How do you give nafcillin? oxacillin? dicloxacillin?
Definition
nafcillin= IV, oxacillin= IV, dicloxacillin= PO
Term
What is the spectrum of nafcillin, oxacillin and dicloxacillin?
Definition
staphylococci
Term
What are the side effects of nafcillin, oxacilin, and dicloxacillin?
Definition
penicillin (immunologic, seizures) and nephritis
Term
How is ticarcillin given? piperacillin?
Definition
IV
Term
What is the spectrum of ticarcillin and piperacillin?
Definition
amp + (streptococci, treponema, oral anaerobes) enteric GNR, pseudomonas
Term
What are the side effects of ticarcillin and piperacillin?
Definition
immunologic seizures
Term
How do you give cefazolin?
Definition
IV
Term
How do you give cephalexin?
Definition
PO
Term
What is the spectrum of cefazolin and cephalexin?
Definition
strep/staph and enteric GNR
Term
What are the side effects of cefazolin and cephalexin?
Definition
immunologic, seizures
Term
How do you give cefuroxime?
Definition
IV/PO
Term
What is the spectrum of cefuroxime?
Definition
strep/staph, enteric GNR, haemophilus
Term
What are the side effects of cefuroxime?
Definition
immunologic, seizures
Term
How do you give ceftriazone?
Definition
IV
Term
How do you give cefotaxime?
Definition
IV
Term
How do you give cefixime?
Definition
PO
Term
What is the spectrum of ceftriaxone, cefotaxime, and cefixime?
Definition
streptococci, enteric GNR,(CSF OK),
Term
What are the side effects of ceftriaxone, cefotaxime, and cefixime?
Definition
biliary effects, immunologic seizures
Term
How do you give ceftazidime?
Definition
IV
Term
How do you give cefepime?
Definition
IV
Term
What is the spectrum of ceftazidime and cefepime?
Definition
enteric GNR, pseudomonas, (CSF OK)
Term
What are the side effects of ceftazidime and cefepime?
Definition
immunologic, seizures
Term
How do you give cefoxitin?
Definition
IV
Term
How do you give cefotetan?
Definition
IV
Term
What is the spectrum of cefoxitin and cefotetan?
Definition
strep/staph, enteric GNR, anaerobes
Term
What are the side effects of cefoxitin and cefotetan?
Definition
immunologic, seizures
Term
How do you give imipenem?
Definition
IV
Term
How do you give meropenem?
Definition
IV
Term
How do you give doripenem?
Definition
IV
Term
What is the spectrum of imipenem, meropenem, doripenem?
Definition
streptococci, staphylococci, enteric GNR, acinetobacter, pseudomonas, anaerobes (CSF OK)
Term
What are the side effects of imipenem, meropenem, and doripenem?
Definition
immunologic seizures
Term
How do you give ertapenem?
Definition
IV
Term
What is the spectrum of ertapenem?
Definition
streptococci, staphylococci, enteric GNR, anaerobes (CSF OK)
Term
What are the side effects of ertapenem?
Definition
immunologic seizures
Term
What are the side effects of aztreonam?
Definition
immunologic, seizures
Term
How do you give aztreonam?
Definition
IV
Term
What is the spectrum of aztreoname?
Definition
aerobic GNR, enteric GNR, NOT anaerobes, NOT gram positive
Term
How do gram positive organisms become resistent to beta-lactams?
Definition
beta lactamase +, altered PBP, increase PBP
Term
How do gram negative organisms become resistent to beta-lactams?
Definition
beta-lactamase + (TEM, SHV, ESBL, carbapenemase), porin changes, efflux pumps, altered PBPs
Term
What is the spectrum of amp/sulbactam and amox/clavulanate?
Definition
amp+, beta-lactamase +, anaerobes
Term
What are the side effects of amp/sulbactam and amox/clavulanate?
Definition
immunologic seizures
Term
What is the spectrumo f ticar/clavulanate?
Definition
amp/Sulbactam +, enteric GNR, pseudomonas, not enterococcus
Term
What are the side effects of ticar/clavulanate?
Definition
immunologic, seizures
Term
What is the spectrum of pip/tazobactam?
Definition
about the same as carbepenems
Term
What are the side effects of pip/tazobactam?
Definition
immunologic, seizures, salt load
Term
What special considerations must you take into account when giving vancomycin?
Definition
slower killing, gram + spectrum, resistance, increasing, follow drug levels, watch for specific reactions
Term
What is the trough?
Definition
level just before you give the next vancomycin dose
Term
What are possible reactions to vancomycin?
Definition
red man syndrome (not immunologic), ototoxicity, nephrotoxicity with other nephrotoxins, true allergy
Term
What is the mechanism of vancomycin action?
Definition
has D-ala, D-ala surrounded by bulky molecule to protect it
Term
What is vancomycin intermediate MRSA?
Definition
MRSA with abnormal cell wall that retains many d-ala-d-ala sites that bind vancomycin
Term
What is the vancomycin resistance mechanism?
Definition
plasma-encoded van H converts pyruvate to D-lactate; plasma-encoded van A links D-ala to D-lac; normal pathway incorporates D-ala-D-lac into cell wall precursor and into cell wall
Term
Which bacteria have vancomycin resistance genes?
Definition
enterococci (50+% of E. faecium, other species with intermediate to full resistance); several VR-MRSA strains described (push for new drugs)
Term
How do you give vancomycin?
Definition
IV or PO
Term
What is the spectrum of vancomycin?
Definition
gram positive, C diff
Term
In what situations do you use vancomycin?
Definition
beta-lactam R, pen allergy
Term
How do you give ramoplanin?
Definition
PO
Term
What is the spectrum of ramoplanin?
Definition
C diff, vanco R enterococcus
Term
How do you give telavancin?
Definition
IV
Term
How do you give Dalbavancin?
Definition
IV
Term
How do you give oritavancin?
Definition
IV
Term
What is the spectrum of telavancin, dalbavancin, and oritavancin?
Definition
vanco R gram +
Term
What is an important consideration when you use telavancin, dalbavancin, and oritavancin?
Definition
once weekly dosing
Term
Beta-lactams inhibit what bacterial enzyme?
Definition
transpeptidase
Term
Glycopeptides act on what bacterial enzyme?
Definition
transpeptidase
Term
What is the spectrum of fosfomycin?
Definition
broad spectrum, both gram + and -; possible use in the treatment of certain E coli infection; possible use in combo with daptomycin for gram positive endocarditis
Term
How do you treat drug resistant TB or for retreatment of TB?
Definition
cycloserine
Term
What considerations must you take into account when using cycloserine?
Definition
ALWAYS USE WITH OTHER DRUGS TO PREVENT EMERGENCE OF RESISTANT MUTANTS
Term
How do you administer cylcoserine? What is the commercial name?
Definition
PO, seromycin
Term
What are the side effects of cycloserine?
Definition
CNS (headache/confusion/etc)
Term
What is the spectrum of bacitracin?
Definition
transiently reduces the number of staphylococcus aureus organisms in staph carriers
Term
How do you administer bacitracin?
Definition
topical ointment with neomycin (bacitracin + neomycin for gram+), or polymyxin (polymyxin + neomycin for gram-)
Term
What type of molecule is daptomycin?
Definition
lipopeptide
Term
How does daptomycin work?
Definition
binds cell membrane and creates ion channel for depolarization (calcium dependent)
Term
What is the spectrum of daptomycin?
Definition
resistant gram + (not lungs/urine)
Term
What are the side effects of daptomycin?
Definition
myopathy
Term
What type of antibiotic is colistin?
Definition
polymyxin
Term
What is the mechanism of polymyxins?
Definition
binds LPS and creates ionophore (binds our membranes as well)
Term
What special considerations must be taken into consideration when using polymyxins such as colistin?
Definition
will bind bacterial membranes AS WELL AS OUR OWN and create ionophore; drug of last resort
Term
What is the spectrum of polymyxins?
Definition
gram -
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