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Antimicrobial Drugs- ID domain
Block II ID domain
101
Medical
Graduate
10/03/2009

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Term
Narrow spectrum penicillin for Strep. pneumoniae. Destroyed by stomach acid
Definition
Pen G (phenoxy-methyl penicillin)
Term
Broad spectrum penicillin given with a beta-lactamase inhibitor. Good for S. pneumo, H. influenza, E. coli
Definition
Augmentin (amoxicillin + clavulanic acid).
Term
Anti-staph penicillin. Risk of hepatitis
Definition
Nafcillin
Term
Extended spectrum, good for P. aeruginosa. (BLI's not effective vs. P. aeuruginosa)
Definition
Piperacillin
Term
Three side effects of penicillins
Definition
Side effects include seizures at high levels, C. difficile overgrowth, and hypersensitivity
Term
Drug of choice for Syphillis
Definition
Penicillin is the drug of choice for this STI
Term
Generation of cephalosporins uses for anaerobic infections?
Definition
2nd generation cephalosporins
Term
Third generation cephalosporin, good against P. aeruginosa
Definition
Ceftazadime
Term
This class may cause bleeding- should be given with vitamin K
Definition
Cephalosporins should be given with this supplement
Term
Which generation of cephalosporins can cross the Blood Brain Barrier? Also, very broad spectrum
Definition
3rd generation cephalosporins
Term
These inhibit protein synthesis by binding the 50s subunit, and are effective against mycoplasma. Resistance is usually due to efflux pumps or changes to binding site.
Definition
Macrolides/Ketolides
Term
Macrolide that is good for Strep. pneumo, and has risk of hepato-toxicity
Definition
Telithromycin
Term
Can cause skeletal muscle damage when combined with a statin
Definition
Side effect of Clarithromycin + statin
Term
These macrolides are good against Chlamydia
Definition
Azithromycin and erythromycin are good against this STI
Term
All macrolides are metabolized in the liver except:
Definition
Azithromycin is the only macrolide not metabolized here
Term
These drugs bind the 30s ribosomal subunit and should not be taken with divalent cations (ex. calcium), which inhibit their absorption
Definition
Tetracyclines
Term
Side effects or contraindications of Tetracycline
Definition
Photosensitivity, teeth discoloration, and steatosis in pregnant women
Term
This drug, which binds the 30s subunit, should not be given with a penicillin (antagonistic effect)
Definition
Tetracylin should not be given with this antagonistic antimicrobial
Term
Name two drugs which are good for chlamidya
Definition
Tetracyclines and Macrolides are good for this STI
Term
Resistance to tetracyclines is due to:
Definition
Resistance due to efflux and alteration of porins for this 30s subunit binding antimicrobial
Term
This glycopeptide binds to cell wall proteins, and is good against G + cocci (S. aureus, streptococci, enterococci). It is also active against C. difficile.
Definition
Vancomycin
Term
Side effects of Vancomycin? (a parenteral only drug)
Definition
Side effects include ototoxicity, nephrotoxicity, thrombocytopenia, neutropenia, and Red Man syndrome (flushing, pruritis, due to histamine release)
Term
This drug inhibits protein synthesis by blocking tRNA binding. Good for G+ cocci and anaerobes. Can inhibit toxin formation by group A strep.
Definition
Clindamycin
Term
Clindamycin can lead to diarrhea due to:
Definition
C. difficile overgrowth is a problem with this antimicrobial, which also inhibits toxin formation by S. pyogenes
Term
This drug inhibits protein synthesis and is good against G+ cocci, including MRSA and VRE (vancomycin resistant enterococcus). It is a weak MAO inhibitor and should not be given w/ anti-depressants.
Definition
Linezolid
Term
Side effects of Linezolid?
Definition
Side effects include thrombocytopenia and peripheral neuropathy with long term use. Good against MRSA.
Term
This drug is a lipopeptide. Good against G+ cocci, MRSA, VRE. Given IV only. May cause muscle pain/weakness.
Definition
Daptomycin
Term
This drug has high affinity for PBP's, and is resistant to many beta-lactamases. Can cause seizures at high doses (like penicillins). Dose should be decreased w/ renal insufficiency
Definition
Carbapenems
Term
This drug is given with cilastatin to prevent breakdown by the body
Definition
Imipenem is always given with this
Term
Good against anaerobic bacteria and protozoa. Goes to CSF. Can cause pancreatitis, and reacts badly with alcohol, warfarin and phenytoin (due to hepatic metabolism)
Definition
Metronidazole (flagyl)
Term
Systemic azole good for yeasts (C. albicans) but not molds (aspergillus). Goes to CSF. Can cause rashes and hepatitis.
Definition
Fluconazole, an ergosterol synthesis inhibitor
Term
Echinocandin that inhibits B-glucan synthesis. Good against aspergillus and even fluconazole resistant C. albicans
Definition
Caspofungin
Term
Rifampin, phenytoin and efavirenze can reduce levels of this anti-fungal drug by increasing its metabolism
Definition
Caspofungin metabolism is enhanced by these drugs
Term
This antifungal can cause phlebitis (venous inflammation), rash, fever and hepatitis
Definition
Caspofungin has these adverse effects
Term
Binds ergosterol in fungal cell membrane. Very broad spectrum (less active against Aspergillus). Extensive hepatic metabolism, and causes nephrotoxicity, hypokalemia.
Definition
Amphotericin B deoxycholate (given IV only)
Term
This systemic azole, good against C. albicans and aspergillus, is almost entirely metabolized by the liver. It reacts w/ warfarin and phenytoin, and can caused blurred vision and photophobia
Definition
Voriconazole (some risk of hepatotoxicity)
Term
The lipid formulation of this drug increases its broad spectrum anti-fungal activity to include invasive aspergillosis, and decreases its nephrotoxicity. Still has liver toxicity.
Definition
Amphotericin B lipid formulations
Term
This systemic azole does not enter the CSF, is good against aspergillosis and C. albicans, is only taken orally and has significant drug-drug interactions. May cause hepatitis, hypokalemia and hypertension.
Definition
Itraconazole
Term
Inhibits replication of influenza A (not B) by blocking M2 ion channel function. Renally excreted and teratogenic.
Definition
Amantadine
Term
Neuraminidase inhibitor (prevents virus release from infected cells) good against influenza A & B. Resistance from mutations in viral neuraminidase is common.
Definition
Oseltamivir
Term
Guanosine analog that is phosphorylated by viral Thymidine Kinase (TK). Changes to TK confer resistance. For HSV and VZV. Safe in pregnancy, can cause renal insufficiency
Definition
Acyclovir
Term
Given with chloroquine or quinine, this antibiotic is very effective against malaria, especially in children or pregnant women. Side effects include membranous colitis due to C. difficile overgrowth.
Definition
Clindamycin can be used for this tropical parasite
Term
Rifampin, Ethambutol, Streptomycin, Pyrazinamide, Isoniazid --> treatments for which disease?
Definition
What are the RESPIre drugs used for tuberculosis
Term
Clindamycin above the diaphragm and Metronidazole below the diaphragm for this type of bacteria
Definition
Anaerobic infections above the diaphragm are treated with one drug, and below the diaphragm are treated with another
Term
This drug can cause kernicterus (bilirubin poisoning) in neonates when given to pregnant mothers, and it can cause hemolytic anemia in people with G6PD deficiency
Definition
Sulfamethoxazole is contraindicated in these two populations
Term
A PABA analog, used to treat UTI's and unusual organisms like toxoplasmosis, Nocardia and Pneumocystis jirovecii
Definition
Sulfamethoxazole (given with trimethoprim for synergistic action)
Term
Inhibits dihydrofolate reductase (DHFR). Can cause megaloblastic anemia (supplement with folinic acid to prevent this). For UTI's
Definition
Trimethoprim (given with Sulfamethoxazole)
Term
This drug is only approved for E. coli and Staph saprophyticus UTIs.
Definition
Nitrofurantoin is only approved for UTIs caused by these two organisms
Term
This drug is metabolized and activated by bacteria. It alters DNA so that it cannot be used for replication. Bacteriocidal for G- bacilli.
Definition
Mechanism and spectrum of Nitrofurantoin
Term
Contraindicated in neonates. Can cause pulmonary fibrosis and turns urine brown.
Definition
Contraindications and side effects of Nitrofurantoin
Term
Blocks bacterial gyrases/ topoisomerases. Good for G- bacilli (not anaerobes though), including mycobacteria, H. infleunza, S. pneumo and Chlamydia (i.e. respiratory and UTI uses)
Definition
Mechanism and spectrum of Fluoroquinolones (Ciprofloxacin and Levofloxacin)
Term
Can damage cartilage (don't give to kids) and cause CNS excitement. Risk of tendon rupture, and may cause nausea if taken with coffee. Inactivated by divalent metal cations (ex. iron, calcium)
Definition
Side effects of Fluoroquinolones
Term
Good for UTIs and aerobic G- bacilli. Inhibit protein synthesis by binding 30s subunit.
Definition
Mechanism and spectrum of the Aminoglycosides (gentamycin, Tobramycin)
Term
Nephrotoxic, ototoxic, compounds effects of curare (blocks NMJ). Maintain hydration to limit toxicity. Can incite biofilms at low doses.
Definition
Side effects of Aminoglycosides (gentamycin, tobramycin)
Term
Treat this G+ cocci with Vancomycin or Linezolid. Maybe Clindomycin.
Definition
Use these to treat Staphylococcus aureus
Term
Treat this G+ cocci with penicillin (otherwise you risk post-infection sequelae). Macrolides or tetracycline may also be used.
Definition
Treat Strep. pyogenes (GAS) with penicillin
Term
Treat this oxidase negative G+ cocci with Pen G, or erythromycin/ vancomycin if resistant.
Definition
Use these to treat Pneumococcus
Term
This intracellular pathogen must be treated with macrolides or fluoroquinolones, NOT penicillin
Definition
Treatment for Legionella pneumophila
Term
Treatment for this spirochete includes Tetracyclines or Cephalosporins (macrolides for pregnant women)
Definition
Treatments for Borrelia burgdorferi
Term
Treatment of this spirochete, which crosses the placenta at 4 months, is penicillin. Treatment can result in an acute hypersensitivity reaction.
Definition
Treatment for syphillis
Term
This obligate intracellular pathogen must be treated with Tetracyclines (or macrolides/fluoroquinolones), and NOT with penicillin
Definition
Treatment for Chlamydia trachomatis
Term
The 2nd leading STI in the USA can be treated with Amoxicillin, Cephalosporins or Flouroquinolones
Definition
Treatment for Neisseria gonorrhea
Term
Treat this G- rod with Piperacillin or Ceftazidime
Definition
Treatment for P. aeurinosa
Term
This pleiomorphic G- rod, which grows on chocolate agar, can be treated with Cephalosporins or fluoroquinolones, but not penicillins.
Definition
Treatment for H. influenzae
Term
This bacteria, which causes woolsorter's disease, should be treated with IV penicillin or other B-lactams
Definition
Treatment for Bacillus anthracis
Term
Lamivudine
Definition
Nucleoside reverse transcriptase inhibitor (NRTI) for HIV. Cytidine analog
Term
Zidovudine
Definition
Nucleoside reverse transcriptase inhibitor for HIV, thymidine analog
Term
Emtricitabine
Definition
Cytidine analog, nucleoside reverse transcriptase inhibitor for HIV
Term
Efavirenz
Definition
Non-nucleoside reverse transcriptase inhibitor. Binds the non-active site of the Reverse Transcriptase enzyme
Term
Gtravirine
Definition
Non-nucleoside reverse transcriptase inhibitor. Binds the non-active site of the Reverse Transcriptase enzyme
Term
Tenofovir
Definition
Nucleotide reverse transcriptase inhibitor
Term
Nelfinavir
Definition
HIV protease inhibitor. Risk of drug-drug interactions, lipid abnormalities
Term
Ritonavir/Lopinavir
Definition
HIV protease inhibitor. Risk of drug-drug interactions, lipid abnormalities
Term
Enfuvirtide
Definition
HIV fusion inhibitor (blocks binding to CD4 cells). Can cause eosinophelia
Term
Maravioroc
Definition
HIV fusion inhibitor. Works on CCR5 receptor but not CXCR4 receptor. May cause hepatitis
Term
Raltegravir
Definition
HIV integrase inhibitor (blocks integration of HIV genes into host genome). Combine with NRTI's.
Term
This is the drug of choice for gonococcal urethritis
Definition
Ceftriaxone or Cefotaxime (3rd Gen. cephalosporin) is the drug of choice for this disease
Term
This is the drug of choice for non-gonococcal urethritis
Definition
Azithromycin (a macrolide) is the drug of choice for this disease
Term
These are the drugs of choice for Pelvic Inflammatory Disease
Definition
Cefoxitin with Doxycycline are the drugs of choice for this disease
Term
Oxacillin
Definition
A penicillinase resistant penicillin
Term
This cephalosporin is commonly used for anaerobic infections
Definition
Cefoxitin (also commonly used with Doxycycline for PID).
Term
Bacteriocidal effect of this antibiotic is enhanced if used with an aminoglycoside
Definition
Penicillin (e.g. amoxicillin) efficacy is enhanced when used with this class of antibiotic
Term
Staph. aureus virulence factors
Definition
Virulence factors include Protein A (bind Fc portion of Ig), exfoliating toxins, TSST-1, staphylokinase, P-V leukocidin, and B-hemolysin.
Term
Strep. pyogenes (Group A Strep)
Definition
This bacitracin sensitive organism has M protein, Proteins F & G, C5a peptidase, streptolysin O and pyrogenic exotoxins which are associated with necrotising fasciitis
Term
Strep pneumoniae
Definition
This oxidase (-), optochin sensative organism is protected by a capsule, has pneumolysin (not secreted), and sIgA protease. Treat with Pen G.
Term
Legionella pneumophila
Definition
This obligate aerobe grows on buffered charcoal yeast extract, invades macrophages, has a type IV pili and type III secretion, and is capable of organelle trafficking. Treat with macrolides or flouroquinolones, not penicillins.
Term
Mycobacterium tuberculosis
Definition
This organism binds C3b receptors on macrophages, has mycolic acid in the cell wall, and inhibits phago-lysosome fusion. Treat with RESPIre drugs.
Term
Treponema pallidum
Definition
This spirochete crosses the placenta at 4 months, causes a painless lesion at site of entry, loves vasculature, and has no known toxins. Treatment with penicillin can result in systemic reaction.
Term
Borrelia burgdorferi
Definition
This organism can cause Bell's palsy, arthritis, cardiac block and erythema migrans. Is iron abstinent and does not perform the TCA cycle. Treat with tetracycline/cephalosporin
Term
Chlamydia trachomatis
Definition
This obligate intracellular pathogen does not have LPS and is insensitive to penicillin. No reliable immunity is formed to this pathogen.
Term
Neisseria gonorrhoeae
Definition
This pathogen targets epithelial cells and PMNs, grows on Thayer-Martin agar and has LOS. Can be treated with penicillins.
Term
E. coli (UPEC = uropathogenic E. coli)
Definition
This pathogen causes many UTI's and can ascend to the kidneys using a type I pili for adhesion. Contains hemolysin toxin and cytotoxic necrotizing factor.
Term
Pseudomonas aeruginosa
Definition
This G- aerobe has 3 main virulence factors, exotoxin A (an ADP-ribose transferase), exoenzyme S and elastase. It should be treated with ceftazidime or Piperacillin
Term
Staphylococcus epidermidis
Definition
This G+ pathogen likes prosthetic heart valves and can cause endocarditis. It is a normal human flora and has a slime layer and forms biofilms.
Term
Haemophilus influenzae
Definition
This G- pleomorphic rod grows in chocolate agar (it needs factors X and V). It colonizes the URT and must have a capsule to cause disease. It has IgA protease and can be treated with cephalosporins or flouroquinolones
Term
Bacillus anthracis
Definition
This spore forming G+ rod is aerobic and has a polypeptide capsule. It's tirpartite exotoxins are made of PF, EF and LF. Causes widening of the mediastinum. Treat it with IV penicillins.
Term
Varicella Zoster Virus
Definition
This virus causes both chickenpox and shingles, and should be treated with acyclovir.
Term
Candida albicans
Definition
This yeast grows hyphae when pathogenic and is common in the mucosa of AIDS patients. It can also cause endocarditis, or cerebromeningeal infections. Treat with topical fluconazole.
Term
Aspergillus fumigatus
Definition
This fungi grows septate hyphae with dichotomous branches at acute angles. Often occurs during sever neutropenia, in leukemia or transplant patients. Aflatoxin from stored nuts/grains can be a problem too. There is often an IgE mediated immune reaction.
Term
Plasmodium falciparum
Definition
This organism reproduces in RBCs and the liver, and causes paroxsysms, anemia, and may cause cerebral infarcts. Treat with quinine or malarone.
Term
Variola virus
Definition
This virus is extinct in the wild, but caused a vesicular rash that spread to the palms and soles.
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