Term
| Name 2 alternative antibiotics to oxacillin and vancomycin |
|
Definition
– Linezolid
– Quinupristin/dalfopristin |
|
|
Term
| Name 2 older antibiotics that may still work on CA-MRSA |
|
Definition
– Tetracycline
– Clindamycin |
|
|
Term
| Name four beta lactam antibiotics |
|
Definition
Penicillium
Cephalosporium
Monobactam
Carbapenem |
|
|
Term
| The core of penicillin is ________. For PCN it's called the _______ ring. For cephalosporin it's called __________ ring . |
|
Definition
6-aminopenicillianic acid
Beta lactam ring
thiazolidine ring |
|
|
Term
| Semisynthetic penicillins contain ____________ which differentiate them from natural PCNs |
|
Definition
|
|
Term
| Penicillin G is __________, _______, and has (narrow/wide) spectrum. Penicillin V is ___________, ______, and has (narrow/wide) spectrum. |
|
Definition
acid labile, high potency, narrow spectrum
acid stable, low potency, narrow spectrum |
|
|
Term
| Penicillin G/V works against what? |
|
Definition
Gram + bacilli and cocci
Gram - cocci
spirochetes (syphilis) |
|
|
Term
| Semisynthetic PCNs are used because they have increased stability to __________, increased __________, and resistance to _________. |
|
Definition
stomach acid
increased spectrum of activity
resistance to B-lactamase |
|
|
Term
How does Penicillin work?
Overall effect is _______________ |
|
Definition
Interferes with peptidoglycan synthesis and activates autolytic enzymes
bactericidal |
|
|
Term
| What are two side effects of penicillin and why? |
|
Definition
Hypersensitivity due to allergic rxn by host
GI issues due to disruption of normal flora |
|
|
Term
| What enzymes can the bacteria produce to become penicillin resistance? |
|
Definition
|
|
Term
| What is extended-spectrum B-lactamases (ESBLs) |
|
Definition
| B-lactamase that can break down all B-lactam rings |
|
|
Term
| PCN resistance can come from altered __________ and ___________ which will slow the influx of PCN into cells |
|
Definition
altered cell wall formation
efflux pumps |
|
|
Term
| PCN resistance can come from mutation of _______ |
|
Definition
| Penicillin binding proteins |
|
|
Term
| PCN resistance can come from tolerance. Explain tolerance. |
|
Definition
| Low MIC, High MBC (easily stopped from replicating, hard to kill bacteria) |
|
|
Term
| The nucleus of cephalosporins are __________ composed of a ________ ring |
|
Definition
7-aminocephalosporanic acid
dihydrothiazine ring |
|
|
Term
| Cephalosporins will work against what bacteria? |
|
Definition
| Gram + and Gram - (broad spectrum) |
|
|
Term
___% of patients allergic to PCN are also sensitive to cephalosporins
Also, GI stress occurs because _______ |
|
Definition
10%
disruption of normal flora |
|
|
Term
| What enzyme can bacteria produce to become resistant to cephalosporins |
|
Definition
| cephalosporinase - breaks down dihydrothiazine ring |
|
|
Term
| Name 3 B-lactamase inhibitors |
|
Definition
Clavulanic acid
Sulbactam
Tazobactam |
|
|
Term
Clavulanic acid + amoxicillin = _____________
Sulbactam + Ampicillin = _____________
Tazobactam + Piperacillin = ___________ |
|
Definition
|
|
Term
| 2 other Beta lactam antibiotics __________ which is (narrow/broad) and __________ which is (narrow/broad) |
|
Definition
Carbapenems (broad)
Monobactam (narrow) |
|
|
Term
| Give the carbapenems (DIEM) |
|
Definition
doripenem
imipenem
ertapenem
meropenem |
|
|
Term
|
Definition
|
|
Term
| What is the mechanism of action of vancomycin |
|
Definition
| Inhibits linking of polypeptide and is bactericidal |
|
|
Term
| Vancomycin works against ________ and is (narrow/broad)-spectrum because ______. |
|
Definition
gram + bacteria
narrow
Vancomycin is too large to cross outer cell membrane of gram-neg |
|
|
Term
| Bacitracin mechanism of action? |
|
Definition
| Inhibits transfer of peptidoglycan precursors and is bactericidal |
|
|
Term
Bacitracin is (narrow/broad)
It is applied by ______ application and _____ admin
side effect? |
|
Definition
narrow
topical and oral
nephrotoxic |
|
|
Term
| Mycobacterial infections are treated with what? These are always used ________ to prevent ___________. |
|
Definition
isoniazid, ethionamid, ethambutol, cyclserine
combo
microbial resistance |
|
|
Term
| Mammalian cells have ______ ( _____ + ______) ribosomes. Bacterial cells have _______ (_______+________) ribosomes |
|
Definition
80S = 60S + 40S
70S = 50S + 30S |
|
|
Term
30S ribosomal subunit contains ____________
50S ribosomal subunit contains _________________ |
|
Definition
amino-acyl transfer RNA
linking of amino acids |
|
|
Term
| What is the mechanism of action of aminoglycosides? |
|
Definition
| irreversible binding to 30S ribosome subunit and bactericidal |
|
|
Term
| Aminoglycosides are not active under _______ conditions bc ________________. |
|
Definition
anaerobic conditions
uptake of aminoglycosides is O2 dependent |
|
|
Term
| Aminoglycosides leads to what 3 things |
|
Definition
Failure to initiate protein synthesis
failure to elongate proteins
deformed proteins |
|
|
Term
| Aminoglycosides are ______ absorbed and must be given ________. |
|
Definition
poorly absorbed
intravenously |
|
|
Term
| Aminoglycosides are (narrow/broad) spectrum and function against ...? |
|
Definition
narrow
Gram-neg bacteria but no anaerobic |
|
|
Term
| Two side effects of aminoglycosides |
|
Definition
ototoxicity (CNVIII)
nephrotoxicity |
|
|
Term
| Resistance of aminoglycosides can occur through enzyme modification of ...? |
|
Definition
Acetyltransferase
phosphotransferase
nucleotidyltransferase |
|
|
Term
| Resistance to aminoglycosides can occur by decreased __________, increased ____________ or mutation of _________ |
|
Definition
uptake
expulsion
binding site |
|
|
Term
| What is the mechanism of action for tetracyclines |
|
Definition
| reversible binding to 30S ribosomal subunit and bacteriostatic |
|
|
Term
| Tetracyclines are (narrow/broad)-spectrum and can kill .... |
|
Definition
VERY broad
Gram + or neg., aerobes and anaerobes |
|
|
Term
What are the side effects of tetracycline
Should NOT be used in ___________ or ___________ |
|
Definition
Discoloration and abnormal growth of teeth and bone
GI discomfort
not to be used in pregnant women or children |
|
|
Term
| What are 4 mechanisms of resistance to tetracycline |
|
Definition
Less permeable
active efflux of tetracycline
alteration of ribosomal binding site
enzymatic modification |
|
|
Term
| What is the MOA of Chloramphenicol |
|
Definition
| Reversible binding of 50S ribosomal subunit and bacteriostatic |
|
|
Term
Side effects of chloramphenicol
Which is dose-related |
|
Definition
Reversible bone marrow depression (anemia, leukopenia, thrombocytopenia) - dose related
Aplastic anemia --> fatal |
|
|
Term
| What is the mechanism of resistance for chloramphenicol |
|
Definition
Acetyltransferase
mutations to alter outer membrane porins |
|
|
Term
| Name the two types of macrolides |
|
Definition
erythromycin derivatives
ketolide derivatives |
|
|
Term
| Name erythromycin derivatives of macrolides |
|
Definition
| Clarithromycin, Azithromycin, & Roxithromycin |
|
|
Term
| Name ketolide derivatives of macrolides |
|
Definition
|
|
Term
| What is the MOA of macrolides |
|
Definition
| binds to 50S ribosomal subunit and bacteriostatic |
|
|
Term
| Most ______ bacteria are resistant to _____________ |
|
Definition
|
|
Term
| Erythromycin is (narrow/broad) |
|
Definition
|
|
Term
| Side effect to erythromycin is... |
|
Definition
|
|
Term
| Name two mechanisms of resistance to erythromycin |
|
Definition
Alteration of 50S subunit
Esterase |
|
|
Term
|
Definition
|
|
Term
MOA of lincosamides.
They kill _________ bacteria |
|
Definition
Binding 50S ribosomal subunit and bacteriostatic
anaerobic |
|
|
Term
| Lincosamides are notorious for what side effect? |
|
Definition
|
|
Term
| Mechanism of resistance for lincosamides? |
|
Definition
|
|
Term
| _________ is a streptogramin antibiotic that combines ______ and _____ |
|
Definition
| Synercid = Quinupristin + Dalfopristin |
|
|
Term
|
Definition
Inhibits protein synthesis
Dalfopristin - inhibits 50S subunit
Quinupristin - premature release of peptide |
|
|
Term
| Streptogramins work on __________ bacteria. What is the recommended use? |
|
Definition
Gram+
Use on Vancomycin-resistance Enterococcus faecium (VREF) |
|
|
Term
| Side effect of Streptogramins |
|
Definition
|
|
Term
| Oxazolidinones are also called _____________ |
|
Definition
|
|
Term
|
Definition
| Inhibits protein synthesis at 30S ribosome and bacteriostatic |
|
|
Term
| What do you use Oxazolidinones for (2)? |
|
Definition
| Vancomycin resistant Enterococcus faecium (VREF) Methicillin resistant Staphylococcus aureus (MRSA) |
|
|
Term
| Oxazolidinones have an interaction with ____________ |
|
Definition
|
|
Term
| Name the MOA of sulfonamides |
|
Definition
| inhibits folic acid synthesis (aka DNA synthesis) by inhibiting PABA --> Dihydrofolic acid enzyme = tetrahydropteric acid synthetase |
|
|
Term
| Sulfonamides are (narrow/broad) spectrum and (bacteriostatic/bacteriocidal) |
|
Definition
|
|
Term
| Sulfonamides are used ________ for _______ infections |
|
Definition
topically
urinary tract infections and GI tract infections |
|
|
Term
| Name 3 side effects of sulfonamides |
|
Definition
hypersensitivity (skin rash)
anemia
thrombocytopenia |
|
|
Term
| Name 4 mechanisms of resistance for sulfonamides |
|
Definition
decreased permeability (drug cant get into cell)
bacteria get folate from the environment
alteration of tetrahydropteric acid synthetase
overproduce PABA |
|
|
Term
| Dapsone and Para-Aminosalicylic Acid have a structure similar to ____________ with a MOA similar to |
|
Definition
|
|
Term
| Dapsone and Para-Aminosalicylic Acid are (narrow/broad) spectrum and are used for what? |
|
Definition
narrow
mycobacterium (M. leprae) |
|
|
Term
| What is the structure of trimethoprim? |
|
Definition
|
|
Term
|
Definition
inhibits dihydrofolate reductase and bacteriostatic
(inhibits dihydrofolic acid --> tetrahydrofolic acid) |
|
|
Term
| trimethoprim are (narrow/broad) spectrum and (bacteriocidal/bacteriostatic) |
|
Definition
|
|
Term
| Name two uses of trimethoprim |
|
Definition
|
|
Term
| Coltrimoxazole is ________ and ________ together (_____ dilution). Coltrimoxazole is (bacteriocidal/bacteriostatic) |
|
Definition
trimethoprim and sulfamethoxazole
(1:5)
bacteriocidal |
|
|
Term
| Name 2 side effects to trimethoprim |
|
Definition
hypersensitivity
blood abnormalities |
|
|
Term
| 4 mechanisms of resistance for trimethoprim |
|
Definition
• Overproduction of Dihydrofolic acid
• Alteration of Dihydrofolic Reductase
• Development of Folic Acid Dependency
• Decreased Permeability |
|
|
Term
|
Definition
| produces short-lived intermediates that break down bacterial DNA |
|
|
Term
| Metronidazole is (broad/narrow) spectrum and (bactericidal/bacteriostatic) |
|
Definition
|
|
Term
| Metronidazole has an interaction with what? |
|
Definition
|
|
Term
| Rifampin is made from _________ |
|
Definition
|
|
Term
| Rifabutin is active against ________________ |
|
Definition
|
|
Term
| What is the MOA of Rifampin |
|
Definition
| Inhibits DNA-dependent RNA polymerase |
|
|
Term
| Rifampin is (broad/narrow) |
|
Definition
|
|
Term
| Rifampin works against _____________ |
|
Definition
| Mycobacterium tuberculosis |
|
|
Term
| Side effects of rifampin are ? |
|
Definition
skin rashes
thrombocytopenia |
|
|
Term
| What is a mechanism of resistance for rifampin |
|
Definition
| alteration of RNA polymerase |
|
|
Term
|
Definition
| inhibits bacterial DNA gyrases and topoisomerases |
|
|
Term
| Nalidixic acid is (narrow/broad) and kills _______ bacteria. it's primarily used for __________ |
|
Definition
|
|
Term
| Quinolones are derivatives of _______________ |
|
Definition
|
|
Term
| Give 3 names of quinolones |
|
Definition
| •Gatifloxacin, Levofloxacin, & Ciprofloxacin |
|
|
Term
|
Definition
| Inhibits bacterial DNA dependent gyrase and topoisomerases |
|
|
Term
| Quinolones are (broad/narrow) and kill __________ bacteria. They are administered ________. |
|
Definition
broad
gram + and gram-neg bacteria
orally |
|
|
Term
| What are the side effects of quinolones |
|
Definition
|
|
Term
| Mechanisms of resistance to quinolones can occur by altering __________ enzymes, altering ________, or increasing __________. |
|
Definition
Bacterial DNA gyrase/topoisomerases
OMPs
export of antimicrobial agent through efflux pumps |
|
|
Term
| What is the structure of polymixin |
|
Definition
|
|
Term
| What are 2 names of polymixin |
|
Definition
| polymixin B and E (colistin) |
|
|
Term
|
Definition
cationic detergent disrupts cell membrane
bactericidal |
|
|
Term
| Polymixin is (narrow/broad) and kills ___________. |
|
Definition
|
|
Term
| Topical polymixins are ___________ and _______ |
|
Definition
|
|
Term
| Polymixins are not __________ by the _________ which means they are used in _________________. |
|
Definition
absorbed
GI tract
guy "sterilization" |
|
|
Term
| Polymixins are used as a last resort to treat systemic infections of ___________ and __________. |
|
Definition
| Acetinobacter and pseudomonas |
|
|
Term
| 2 side effects of polymixins |
|
Definition
|
|
Term
| Mechanism of resistance for polymixins |
|
Definition
| alteration of lipopolysaccharide (cell membrane) |
|
|
Term
|
Definition
| membrane depolarization and disruption of ionic gradients |
|
|
Term
| Daptomycin is (narrow/broad) spectrum and kills ______ bacteria |
|
Definition
|
|
Term
|
Definition
| lipophilic antibiotic that binds to DNA |
|
|
Term
| Clofazimine is used to treat |
|
Definition
|
|
Term
| Pyrazinamide (PZA) is used to treat what? |
|
Definition
| Mycobacterium tuberculosis |
|
|
Term
| Agar dilution is a ________ procedure that determines _____ value. What is done? |
|
Definition
quanitative procedure
MIC
Plating several different bacterial colonies and several antimicrobial concentrations |
|
|
Term
| Tube broth dilutions uses the same principle as __________ except in broth culture tubes |
|
Definition
|
|
Term
In Tube broth dilution the first culture exhibiting no growth is the ....
How do you find MBC? |
|
Definition
MIC - lowest concentration of antimicrobial that will inhibit growth.
3 cultures can then be plated onto agar with no antibiotic. The cultures that don't grow can be tracked back to antibiotic concentration that kills bacteria |
|
|
Term
| In a beta lactamase test, if the bacteria turns ________ it is producing beta lactamase |
|
Definition
|
|
