2-5: Microbiology/infectious Diseases: 4/28 - Antibiotics Review

Front 1

Where does erythromycin bind?

What other drug classes bind this?

Back 1

Binds ribosome (50S?); erythro = MARCOLIDE

Lincosamides
Streptogramins

Front 2

Name 4 drug classes that bind to ribosomes.

Back 2

-tetracyclines
-ketolides
-chloramphenicol
-macrolides

Front 3

Name 4 classes of beta-lactams.

Back 3

-penicillins
-carbapenems
-monobactams
-cephalosporins

Front 4

Aztreonam is not active against which 2 classes of bacteria?

Back 4

Gram poz
Anaerobes

Front 5

Aminoglycosides are cidal or static?

Back 5

CIDAL

Front 6

Compared to erythromycin, newer _______ are (less/more) acid stable.

Back 6

newer marcolides, more stable

Front 7

The enzyme responsible for cross-linking peptigoglycans in bacterial cell walls is _________

Back 7

Transpeptidase

Front 8

In a patient with inflamed meninges, penicillin concentrations are (higher/lower) in the CSF than serum.

Back 8

HIGHER IN SERUM!

BBB (meningitis does allow some penetration)

Front 9

The side chains of beta-lactam drugs affect _______ (4)

Back 9

half life
metabolism
spectrum of activity
bioavailability

Front 10

PCN-G half-life is ______

Back 10

30 minutes

Front 11

Ceftriaxone half-life is ____

Back 11

8 hours

Front 12

Ertapenem half-life is ______

Back 12

4 hours

Front 13

__________ is a urinary antiseptic that produces formaldehyde in the bladder (sterilizing effect).

Back 13

Methanamine

Front 14

4 adverse events to PCN.

Back 14

Anaphylaxis
Hypersensitivity (Urticaria)
Thrombocytopenia
Seizures (increase with dose)

Front 15

Name 3 categories of beta-lactam resistance.

Back 15

-β-lactamase (drug inactivation)
-Efflux pumps (pseudomonas)
-Changing target (changing up the penicillin binding proteins)
-Porins (drug uptake)

Front 16

What does SPA stand for?

Back 16

-Source pathogen antibiotic – meaning, when possible use the targeted AB, NOT broad spectrum

Front 17

Name 3 aminoglycosides.

Back 17

-streptomycin
-tobramycin
-amikacin
-gentamycin
-topical neomycin B (topical because it's nephrotoxic)

Front 18

Name one oral and one intravenous first generation cephalosporin.

Back 18

-cephalexin (Keflex - oral)
-cefazoline (IV)

Front 19

Telithromycin, a ketolide, causes what unique AE?

Back 19

-blurred vision

Front 20

T/F: β-lactamase inhibitors are the broadest spectrum antibiotics because they are active against
numerous bacteria including antibiotic-resistant strains.

Back 20

FALSE

beta-lactamase inhibitors are not antibiotics; they inhibit beta-lactamases

Front 21

Give two examples of beta-lactamase inhibitors.

Back 21

Clavulanic acid
Tazobactam

Front 22

beta-lactam drugs act by __________

Back 22

inhibiting transpeptidase

Front 23

T/F: Newer macrolides are active against mycobacteria such as macrolide avium intracellulare.

Back 23

TRUE

Front 24

Class of antibiotic that binds to ribosome and is cidal.

Back 24

Aminoglycoside

Front 25

Marcolides are cidal/static.

Back 25

Static

Front 26

What drug, if used after expiration, causes Fanconi syndrome.

Back 26

Tetracycline

Fanconi Syndrome -disorder of the kidney tubes in which certain substances normally absorbed into the bloodstream by the kidneys are released into the urine instead.

Front 27

What drug must be co-administered with imipenem? Why?

Back 27

Dihydropeptidase degrades imipenem!

Need to administer cilastatin to inhibit dihydropeptidase

Front 28

The classes of β-lactams are classified by their ___________

Back 28

side rings

Front 29

Penicillins NOT hydrolyzed by staph aureus penicillinase are ___________

Back 29

Methicillin (IV)
Nafcillin (V)
Clox (IV)
Ox
Diclox (PO)

Front 30

Which penicillin is hepatically cleared (biliary excretion)?

Back 30

nafcillin

Front 31

What drugs have a disulfram-like effect?

Back 31

Cephalosporins with MTT side chain Metronizadole

Front 32

Which penicillins are effective agtainst pseudomonas?

Back 32

Pipercillin
Carbercillin
Ticercillin

Front 33

What third generation cephalosporins are NOT effective against p. aeruginosa?

Back 33

Cefotaxime
Ceftriaxome

Front 34

What third generation cephalosporin is effective against p. aeruginosa?

Back 34

Ceftaxidine
Cefoperazone

Front 35

What fourth generation cephalosporin is active against p. aeruginosa?

Back 35

Cefepime (only fourth generation!)

Front 36

Which gram positive organisms are NOT inhibited by cephalosporins?

Back 36

Listeria
Enterococci
MRSA

Front 37

Which has the longest half-life:
Imipenem
Meropenem
Ertapenem

Back 37

Ertapenem (4 hours)
Imipenem (1 hour)
Ertapenem (1 hour)

Front 38

Ertapenem is not active against which common nosocomial gram-negative rod?

Back 38

PSEUDOMONA aeruginosa (gram neg rod)

Front 39

What drugs are effective against pseudomona aeruginosa?

Back 39

Meropenem
Imipenem

Front 40

Which antibiotic is deposited in teeth and bone in children under 7, resulting in permanent discoloration?

Back 40

Tetracycline

Front 41

Which antibiotic causes red man syndrome by stimulating release of histamine from mast cells?

Back 41

Vancomycin

Front 42

Sulfonamides are similar in structure to __________

Back 42

para amino benzoic acid (PABA)

Front 43

Which antibacterial agent is also a cationic detergent?

Back 43

Polymyxin

Front 44

Daptomycin is NOT indicated for the treatment of ______.

Back 44

Pneumonia

(Depolarizes cell membrane, active in test tubes, but not clinical studies)

Front 45

What is the target of echinocandin anti-fungals?

Back 45

beta-glucan (inhibit synthesis in cell walls)

Front 46

What are the toxicities of aminoglycosides?

Back 46

Ototoxic (hearing/dizziness)
Nephrotoxic
Neuromuscular blockade

Front 47

Which class of antibiotics is synergistic against enterococci with beta-lactams?

Back 47

Aminoglycosides

Front 48

What 3 drugs are active agaisnt aspergillus?

Back 48

Caspofungin
Ampho B
Voriconazole

Front 49

T/F: P. aeruginosa is universally susceptible to ciprofloxacin.

Back 49

False:
1/4 resistant to cipro (used to be totally susceptible)

Front 50

Which tetracycline causes vertigo?

Back 50

Minocycline

Front 51

Which antibiotics are a derivative of nalidixic acid?

Back 51

Quinolones:
Ciprofloxacin
Levofloxacin
Monifloxacin
Norfloxacin
Ofloxacin

Front 52

Which antibiotic classes exhibit decreased bioavailability when administered with calcium?

Back 52

Tetracyclines
Quinolones

Front 53

Which aminoglycoside exhibits activity against mycobacterium tuberculosis?

Back 53

Streptomycin

Front 54

What is the mechanism of action of oxazolidonones?

Back 54

Inhibition of protein synthesis (oxazolidonones are a purely SYNTHETIC compound)

Front 55

Which antibiotic antagonizes penicillin?

Back 55

Tetracycline

Front 56

Which cephalosporin has the longest half-life?

Back 56

Ceftriaxone

Front 57

Which antibiotic is active against bacteroides fragilis, amoebas, and trichomonas?

Back 57

Metronixadole

Front 58

Which antibiotic is used to treat lower pole UTI but NOT pyelonephritis?

Back 58

Nitrofurantoin

Front 59

Which antibiotic has good prostate penetration?

Back 59

Trimethoprim (BACTRIM)
Quinolones for extra credit

Front 60

Gray baby syndrome is caused by ________

Back 60

Chloramphenicol

Must be conjugated and infants don't do that well

Front 61

What is the target of polyene antifungals?

Back 61

Ergosterol

Front 62

What is the target of azole antifungals?

Back 62

Ergosterol synthesis pathway

Front 63

Which polyene is given systemically?

Back 63

Ampho B

Front 64

Which polyene is given topically?

Back 64

Nystatin

Front 65

Caspofungin, micafungin, and anidulofungin are _______

Back 65

Echinocandins

Front 66

A common side effect of clavulanate is _________

Back 66

DIARRHEAAAAAA

Front 67

TMP/SMX should not be used for pharyngitis because ______

Back 67

IT WON'T DO SHIT TO GROUP A STREP

Front 68

Which quinolones exhibit activity against streptococcus pneumoniae?

Back 68

MOXIfloxacin
LEVOfloxaxin