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Antibiotic drug classes only

What is the MOA of Isoniazide?

(1) MOA: inhibits synthesis of mycolic acids (essential components of the mycobacterial cell wall)
(2) Active form of INH forms a covalent complex with an acyl carrier protein (AcpM) and a beta-ketoacyl carrier protein synthetase (KasA), which blocks mycolic acid synthesis and kills the cell

What is the most common adverse reaction to isoniazide?
What is nervous system side effect is common, and how can you treat it?

INH-induced hepatitis
Peripheral neuropathy is due to a pyridoxine deficiency: INH promotes the excretion of pyridoxine; pyridoxine supplementation reverses neuropathy

What is the key advantage of Rifampin?

Readily penetrates most tissues, penetrates into phagocytic cells, and can kill organisms that are poorly accessible to other agents (e.g., intracellular organisms and those sequestered in abscesses and lung cavities)

What is the MOA of Rifampin?

binds to the β-subunit of bacterial DNA-dependent RNA polymerase and inhibits RNA synthesis

What are the adverse reactions to Rifampin?

(1) Strong P450 inducer (1A2, 2C9, 2C19, 2D6, 3A4)
(a) Rifampin is contraindicated in patients with HIV who are taking protease and nonnucleoside reverse transcriptase inhibitors (NNRTIs)
(b) Half-lives of agents metabolized by CYP450s are reduced (e.g., digoxin, propranolol, ketoconazole, metoprolol, verapamil, methadone, corticosteroids, oral contraceptives)

2) Harmless orange color to urine, sweat, tears, contact lenses

(3) Rashes, thrombocytopenia, nephritis

(4) Cholestatic jaundice and hepatitis are more rare<br /><br

(5) Light-chain proteinuria is common

(6) If administered less than 2x/week, rifampin causes a flu-like syndrome (fever, chills, myalgias, anemia, thrombocytopenia)

Patient being treated for TB develops gouty arthritis. What drug were tehy treated with?

Pyrazinamide

What drug is inactive at neutral pH but inhibits tubercle bacilli and other mycobacteria at pH 5.5

Pyrazinamide

Why is pyrazinamide used with INH and rifampin in treating TB?

It helps to eliminate residual intracellular organisms that may cause relapse

When can ethambutolol cross the blood brain barrier?

When the meningies are inflamed. bad news because it can cause retrobulbar neuritis, resulting in loss of visual acuity and red-green color blindness,

Why is ethambutol contraindicated in small childern?

They are too young to asses visual acuity and red green color blondness. Both of which can be damaged by ethambutolol in a dose depedant fashion.

When would you use streptomycin in treatment of TB?

(1) Used when an injectable drug is needed or desirable - patients with severe or life-threatening forms of TB (e.g., meningitis and disseminated disease) and in the treatment of infections resistant to other drugs

What is the most common side effect of streptomycin?

Ototoxicity. (vertigo and hearing loss)

What is the mechanism of macrolides?

Macrolides - Bind to 50S ribosomal subunit, inhibits translocation<br />

What is the mechanism of tetracyclines?

Binds to 30S, block access of acyl-tRNA<br />

What is the mechanism of aminoglycosides?

Aminoglycosides<br /> Binds to 30S , interferes with assembly of functional ribosome &/or misreading<br />

What is the mechanism of Chloramphenicol?

Binds 50S, inhibits peptidyl transferase reaction<br />

What is the mechanism of clindamycin?

Bind to 50S ribosomal subunit, inhibits translocation

Are Macrolides bacteriostatic or bacteriocidal?

Mainly bacteriostatic. <br /><br />bacteriaocidal at high concentrations

Do macrolides distribute to CSF?

NO

Are macrolides best for gram + or - organisms?<br /><br />3 organisms macrolides are most useful for?

Gram + (although effective on a ton of G-)<br /><br />Chlamydia (Chlamydophila) , Mycoplasma, Legionella<br />

What is the most common adverse effect of macrolides?

Epigastric distress (stimulates GI motility)

Is doxycycline static or cidal?

Doxycycline is bacteriostatic

What group of people should you never give doxycycline to?

Children<br /><br />readily binds to calcium deposited in newly formed teeth and bones; can cause discoloration and enamel dysplasia; can cause deformity and growth inhibition<br /><br />

What is the most common side effect of doxycycline?

superinfection with C. Difficile

What age group should you never use fluoroquinolones in?

Not approved for use in children < 16 yo (damage growing cartilage and cause arthropathy)<br />

What are the 2 extended spectrum penecillins?

ampicillin, amoxicillin

What is the spectrum of penecillin G, what 3 organisms are most sensative?

Spectrum = mainly G+ (G- LPS membrane is a barrier to water soluable penecillins)<br /><br />S. aureus, Strep. pneumoniae, Strep. pyrogenes,

How does the spectrum of Carbenicillin, piperacillin, and ticarcillin differ from penecillin<br />

Spectrum same as penicillin, except extended spectrum versus Pseudomonas spp. and gram (-) rods<br />

What generation of cephalosporin is Cefuroxime?

2nd gen

What generation of cephalosporin is Ceftriaxone?

3rd gen

What generation of cephalosporin is Ceftaxime?

3rd gen

What generation of cephalosporin is Cefpodoxime?

3rd gen

What generation of cephalosporin is Ceftazidime?

4th gen

Is Ceftriaxone stable to Beta-lactamase?

yes

What is Augmentin?

Amoxicillin + Clavulanic acid

What is Piperacillin + tazobactam called?

Zosyn

What is Ampicillin + sulbactam called?

Unasyn

How does amphotericin B work?

Binds ergosterol in fungal cells, increases membrane permeability<br />

What is the mechanism of Zanamivir?

viral neuraminidase inhibitors<br /><br />(Influenza viral neuraminidase is essential for release of the virus from infected cells and for its subsequent spread throughout the respiratory tract of the infected host. The enzyme cleaves terminal sialic acid residues, thus destroying the cellular receptors recognized by the viral hemagglutinin.)

What kind of viruses are Amantadine & Rimantadine used for?

RNA viruses

What class of antibiotic is Azithromycin?

Macrolides

What class of antibiotic is Clarithromycin?

Macrolides

What class of antibiotic is Erythromycin?

Macrolides

What class of antibiotic is Doxycycline?

Tetracyclines

What class of antibiotic is Clindamycin?

Protein Synthesis Inhibitors

What class of antibiotic is Linezolid?

Protein Synthesis Inhibitors

What class of antibiotic is Levofloxacin?

Fluoroquinolones

What class of antibiotic is Moxifloxacin?

Fluoroquinolones

What class of antibiotic is Gemifloxacin?

Fluoroquinolones

What class of antibiotic is Amoxicillin?

PO Penicillin based Beta-lactam & Cell wall synthesis inhibitor

What class of antibiotic is Penicillin G?

IV Penicillin based Beta-lactam & Cell wall synthesis inhibitor

What class of antibiotic is Ampicillin?

IV Penicillin based Beta-lactam & Cell wall synthesis inhibitor

What class of antibiotic is Ampicillin/Sulbactam?

IV Penicillin based Beta-lactam & Cell wall synthesis inhibitor

What class of antibiotic is Amoxicillin/Clavulanate?

PO Penicillin based Beta-lactam & Cell wall synthesis inhibitor

What class of antibiotic is Cefpodoxime proxetil?

PO Cephalosporin based Beta-lactam & Cell wall synthesis inhibitor

What class of antibiotic is Cefuroxime axetil?

PO Cephalosporin based Beta-lactam & Cell wall synthesis inhibitor

What class of antibiotic is Cefotaxime?

IV Cephalosporin based Beta-lactam & Cell wall synthesis inhibitor

What class of antibiotic is Ceftriaxone?

IV Cephalosporin based Beta-lactam & Cell wall synthesis inhibitor

What class of antibiotic is Carbapenems?

Cell wall synthesis inhibitor

What class of antibiotic is Vancomycin?

Cell wall synthesis inhibitor

What class of antibiotic is TMP-SMZ (Trimethoprim/sulfamethoxazole)?

Sulfonamides (also antifungal)

What class of antibiotic is Gentamicin?

Aminoglycosides

What class of antibiotic is Streptomycin?

Aminoglycosides

What class of antibiotic is Rifampin?

Transcription inhibitor

What class of antibiotic is Bactrim?

Antifungal

What class of antibiotic is Amphotericin B?

Antifungal

What class of antibiotic is Itraconazole?

Antifungal

What class of antibiotic is Fluconazole?

Antifungal

What class of antibiotic is Oseltamivir?

Antiviral Agents

What class of antibiotic is Zanamivir?

Antiviral Agents

What class of antibiotic is Amantadine?

Antiviral Agents

What class of antibiotic is Rimantadine?

Antiviral Agents

What class of antibiotic is Ribavirin?

Antiviral Agents

What class of antibiotic is Acyclovir?

Antiviral Agents

What class of antibiotic is Ganciclovir?

Antiviral Agents

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