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Anti-microbials
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06/09/2008

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Cards

Term
Name 7 antibiotics that block cell wall synthesis by inhibition of peptidoglycan cross-linking
Definition

1. Penicillin

2. Nafcillin

3. Amoxicillin

4. Ticarcillin

5. Cephalosporin

6. Aztreonam

7. Imipenem

Term
What is the mechanism of resistance of MRSA?
Definition
Structural change in PBP site
Term
Which beta lactams are penicillinase resistant?
Definition

Nafcillin/oxacillin because of R group

(used for S. aureus)

 

Aztreonam

 

Imipenem

Term
Why is cilastin administered with imipenem?
Definition
Otherwise renal dihydropeptidase I in PT will degrade the antibiotic
Term
Which antibiotics have cross-allergenicity with penicillin?
Definition

5-10% cephalosporins

 

Imipenem

 

 

NOT Aztreonam

Term

What are the non-beta lactam cell wall inhibitors?

 

 

Definition

1. Bacitracin

2. Cycloserine

3. Vancomycin

Term

What is vancomycin's mechanism of action?

 

What is a common mechanism of resistance against vanco?

Definition

MOA: bind D-ala D-ala cell wall

 

Resistance: mutate cell wall to be D-ala D-lac

Term
What are the side effects of vancomycin?
Definition

Nephrotoxicity

Ototoxicity

Thrombophlebitis

 

 

 

Term
What is red man syndrome and what antibiotic is it associated with?
Definition

Due to vancomycin

 

Facial flushing and hypotension which can be avoided by pretreatment with anti-histamines and slow infusion rate

Term
What antibiotics work at the 30s subunit?
Definition

1. Aminoglycosides (streptomycin)

 

2. Tetracyclines

Term
What antibiotics work at the 50s subunit?
Definition

1. Chloramphenicol

 

2. Erythromycin (Macrolides)

 

3. Clindamycin

 

5. Lincomycin

Term
What antibiotic inhibits the formation of the initiation complex and causes misreading of mRNA?
Definition

Aminoglycosides such as gentamicin

 

Requires O2 for uptake

 

Nephrotoxicity with cephs

Ototoxicity with loop diuretics

Teratogen

Term
What anti-biotic binds to 30s and prevents attachment of aminoacyl-tRNA?
Definition
Tetracyclines such as doxycycline
Term
What antibiotic works by inhibiting the 50s peptidyltransferase?
Definition
Chloramphenicol
Term
Name 3 serious side effects of chloramphenicol.
Definition

1. Anemia

2. Aplastic anemia

3. Gray baby syndrome in premature infants

Term
What two antibiotics inhibit translocation?
Definition

1. Erythromycin (macrolides)

 

2. Clindamycin

Term
What diuretics should be avoid in a sulfa allergy?
Definition
Thiazide, loops, acetazolimide
Term
What antibiotics work by inhibiting DNA gyrase (topoisomerase II which relieves supercoils)?
Definition
Fluoroquinolones (ciproxfloxacin)
Term
What antibiotics are associated with tendonitis and tendon rupture in kids?
Definition
Fluoroquinolones (ciprofloxacin)
Term
What antibiotics are used for anaerobes above and below the diaphragm, respectively?
Definition

Upper body - Clindamycin

 

Lower body - Metronidazole

Term
What is the triple therapy for H. pylori?
Definition

1. Bismuth

2. Amoxicillin (or tetracycline)

3. Metronidazole

Term

What are the five drugs that should be given for TB?

 

 

What is given for prophylaxis?

Definition

"INH-SPIRE"

 

Isoniazid, Streptomycin, Pyrazinamide, Rifampin, Ethambutol

 

 Isoniazid (INH) is given for TB prophylaxis

Rifamppin is given for meningitis prophylaxis

Term
Vit B6 is given with which TB drug to prevent neurotoxicity?
Definition
Isoniazid
Term
What TB drug is associated with red-green color blindness?
Definition
Ethambutol: inhibitor of arabinosyl-transferase involved in mycobacterial cell wall
Term

What is Rifampin's mechanism of action?

Definition

Inhibits RNA synthesis by inhibiting DNA-dependent RNA polymerase.

 

Induces p450 and turns body fluids red/orange

Term
What is a mechanism of resistance for macrolides and sulfonamides?
Definition

Macrolides - methylation of rRNA near erythmocyin's ribosome-binding site

 

 

Sulfanomides - altered enzyme (decrease dihydropteroate synthetase) or increased PABA synthesis

Term
What is amphotercin B and nystatin's mechanism of action?
Definition
binds ergosterol and punches holes in membrane
Term
What is the azole's mechanism of action?
Definition
blocking lanosterol --> ergosterol thereby inhibiting ergosterol synthesis
Term

What anti-fungal interferes with microtubule function and disrupts mitosis?

Definition
Griseofulvin
Term

What anti-fungal inhibits squalene --> lanosterol in ergosterol synthesis?

Definition
Terbinafine
Term
What is flucytosine's mechanism of action?
Definition
Inhibits DNA synthesis by conversion to fluoruracil which competes with uracil
Term
Which anti-fungal inhibits cell wall synthesis?
Definition

Caspofungin.

 

 

Used for invasive aspergillosis.

Term
What are important side effects of azoles?
Definition

1. p450 inhibitor

 

2. gynecomastia/hormone synthesis inhibition

Term
What anti-viral blocks uncoating via an M2 protein?
Definition

Amantadine

 

Use for influenza A, rubella and PD

 

Gives ataxia

Term

Which anti-viral inhibits influenza neuraminidase, thereby decreasing release?

Definition
Zanamivir, oseltamivir for influenza A and B
Term
Which viral DNA polymerase inhibitor does NOT require activation by thymidine kinase?
Definition

Foscarnet used for CMV retinitis

 

 

Term
Which anti-virals require are phosphorylated by viral kinase and inhibit DNA polymerase?
Definition

Acyclovir for HSV, VZV, EBV

 

Ganciclovir for CMV

Term
What anti-viral can be used for RSV, hep C and others?
Definition
Ribavirin: inhibits synthesis of guanine nucleotides by inhibiting IMP dehydrogenase
Term
What is the MOA of protease inhibitors?
Definition

Inhibit assembly of new virus by blocking protease in progeny virions

 

Ending in -navir such as ritonavir

Term
What is the MOA of reverse transcriptase inhibitors?
Definition
Prevent incorporation of viral genome into host DNA
Term

What is enfuvirtide?

Definition
Fusion inhibitor tht binds gp41
Term
Which interferon can be given for chronic hep B or C?
Definition
IFN-alpha
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