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Flashcards in Multi-Systems: ABX Deck (133)
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1

(3) Mechanisms of ABX that inhibit Cell Wall Biosynthesis?

  • Inhibit Peptidoglycan Cross-linking
  • Inhibit Peptidoglycan Polymerization
  • Inhibit Cell wall Synthesis by Binding PBP3

2

ABX that inhibit Membrane Potential?

  • Lipopeptides
    • Daptomycin

3

(1) ABX that cause Cell Membrane Disruption?

  • Polymyxins
    • ​Polymyxin A
    • Polymyxin B

4

(10) ABX that inhibit Protein Synthesis?

  • Oxazoladinones
  • Tetracyclines
  • Aminoglycosides
  • Glycylcycline
  • Chloramphenicol
  • Clindamycin
  • Lincosamines
  • Macrolides
  • Streptogramins
  • Trimethoprim

5

(2) ABX that inhibit Folic Acid Synthesis?

(DNA Methylation)

  • Sulfonamides
  • Trimethoprim

6

(3) ABX that inhibit DNA Replication or Transplatation?

  • Fluoroquinolones (DNA Topoisomerase)
    • Ciprofloxacin
    • Levofloxacin
  • Nitroimidazole
  • Rifamycin (mRNA synthesis - RNA Polymerization)

7

(2) ABX that acts on the Transglycosylase enzyme
of the Cell Wall Biosynthesis?

  • Vancomycin
    • D-ala D-ala portion of cell wall precursor
  • Teicoplanin

8

(5) Sub-types of ABX that acts on the Transpeptidase
of the Cell Wall Biosynthesis?

(Inhibiting Peptidoglycan Cross-linking)

  • Beta-Lactams
    • Penicillins (Sensitive, Resistant)
    • Cephalosporins (I, II, III, IV)
    • Carbecephams
    • Carbepenems
    • Monobactams

9

(5) Penicillinase-Resistant Penicillins?

"MEt NAsty OX -OX -OX"

  • Methicillin
  • Nafcillin
  • Oxacillin
  • Cloxacillin
  • Dicloxacillin

10

(2) Extended Range Penicillins?

"AM extended"

  • Ampicillin
  • Amoxicillin
     
  • Penicillinase Sensitive
  • Combine w/ Clavulanic Acid 
    --> protect against β-lactamase
  • "AMinoPenicillins are AMPed-up Penicillin"

11

Anti-Pseudomonal Penicillins?

"Pseudo-cars (2x), Never are more popular"

  • Carboxylated derivatives extend range of Ampicillin to 
    P. aeruginosa; Indole-positive Proteus and Enterobacter
    • Carbenicillin
    • Ticarcillin
  • N-acyl derivatives
    • Azlocillin
    • Mezlocillin
    • Piperacillin

12

(3) Prophylaxis during intra-abdominal surgery?

  • Cefotetan (2nd)
  • Cefoxitin (2nd)
  • Neomycin (Bowel surgery) (Aminoglycoside)

13

(4) Surgery prophylaxis?

  • First Generation
    • Cephalexin
    • Cephadrine
    • Cefadroxil
    • Cefazolin

14

(1) Used to treat Community-acquired Pneumonia?

(H. influenzae and K. pneumoniae)

  • Cefuroxime

15

(1) Used to treat Diabetic Foot Infections?

  • Cephalexin

16

Drugs of choice for treating?

(1) N. gonorrhea

(2) Meningitis (Adult, Children)

(1) B. burgdorferi

  • N. gonorrhea
    • ​Ceftriaxone
  • Meningitis
    • ​Ciprofloxacin (1st)
    • Rifampin (children)
  • B. burgdorferi
    • ​Tetracyclines

17

(2) ABX for Multidrug-resistant Gram-negative Infections, especially those caused by P. aeruginosa?

  • Ceftazidime
  • Cefoperazone

18

First β-lactam approved for MRSA?

Better drug Rx for MRSA?

  • Ceftaroline fosamil (IV) (1st)
  • Vancomycin (Better)

19

(3) Glycopeptide ABX?

(Inhibits Peptidoglycan Syn. --> Cell Wall Synthesis)

  • Vancomycin
  • Bacitracin
  • Teicoplanin

20

Pathogenic spectrum of Vancomycin?

  • G+ only
  • Bacteriostatic against Gram-positive Cocci
  • Bactericidal for Gram-positive Rods
    • Serious Penicillinase producers
    • MRSA
    • Enterococci
  • NOT Effective against Gram negatives
  • Last Resort for Pseudomembranous colitis cause by 
    C. difficile (Oral Vancomycin)

21

Where does Vancomycin work?

  • Binds to D-Ala-D-Ala terminus of Murein Monomer
    --> D-Ala-D-Lactate.  Same mode of VRE
  • Inhibits Murein Polymer synthesis
    --> Inhibits Peptidoglycan formation
  • Blocks attachment of Disaccharide subunits to pre-existing Cell Wall

22

SE of Vancomycin?

"NOT"

  • Hypersensitivity Rxn - Skin flushing or Rash
    • "Red man syndrome" - rapid infusion due to Histamine release (slow infusion and pretreatment w/ antihistamines)
  • Nephrotoxicity
  • Ototoxicity
  • Thrombophlebitis
  • Neutropenia
  • Tissue necrosis if given IM

23

Pathogen spectrum of Lipopeptide ABX?

  • Gram positive Aerobic organisms
    • Complicated skin infections
    • Endocarditis
  • Bactericidal against VRE?
  • Bacteriostatic against
    • S. pneumoniae
    • S. aureus
  • Retains activity against Gram-positive bacteria
  • Synergizes w/ Oxacillin against MRSA

24

Where does Lipopeptide ABX work?

  • Binds to Bacterial Membranes
  • Forms membrane channels in a Calcium-dependent manner leading to a rapid membrane depolarization thus inhibiting protein
  • DNA and RNA synthesis

25

SE of Lipopeptide ABX?

  • Irritation at site of Injection
  • Skeletal muscle Pain and Weakness (Myopathy)
  • Increase in CPK (creatine phosphokinase)
  • Renal Failure

26

Where does Polymyxins ABX work?

  • Cationic detergents (positive potential) disrupt the membranes of Gram-negative Bacteria

27

Pathogen spectrum of Polymyxins?

  • Topical: OTC ointments
  • IV: Last resort for Gram-negative infections
  • Ophthalmic drops
  • Otic drops

28

SE of Polymyxins?

  • (IV) EXTREME Nephrotoxicity and Neurotoxic
  • Sometimes used Internally for Multidrug resistant Strains
    • Acinetobactor from the Middle East

29

(2) ABX that Inhibit Peptidoglycan Polymerization Synthesis?

(Glycopeptides)

 

  • Bactericidal
    • Vancomycin
    • Bacitracin

30

(1) ABX that Inhibits Cell Wall Synthesis by Binding PBP-3?

(Monbactam - monocyclic β-lactam)

  • Bactericidal
    • Aztreonam
  • Penicillin-binding-protein 3 (PBP-3)