Term
| What drug class inhibits DNA gyrase and Topoisomerase IV? |
|
Definition
|
|
Term
| The quinolones that target the gram negatives are using which arm of their mechanism of action? |
|
Definition
|
|
Term
| The quinolones that are targeting the gram positive are using which aspect of thier MOA? |
|
Definition
| inhibiting topoisomerase IV |
|
|
Term
| Are the quinolones bactericidal or static? |
|
Definition
|
|
Term
| What is the mechanism of resistant to quinolones? |
|
Definition
| it is a two step process in which the binding to DNA gyrase and topo IV is altered |
|
|
Term
| In pneumococcus what quinolone mutation is present in the background thus making it easy for a second hit to occur? |
|
Definition
|
|
Term
| In general what do the quinolones have activity against? |
|
Definition
gram negtive including pseudomonas
|
|
|
Term
| What is a first generation quinolone? |
|
Definition
|
|
Term
| What are the second generation quinolones? (4) |
|
Definition
levofloxacin
moxifloxacin
gemifloxacin
gatifloxacin |
|
|
Term
| What quinolone has activity against gram negatives, pseudomonas, and antrax? |
|
Definition
|
|
Term
| What quinolone has activity against gram positive and gram negative including the atypicals? |
|
Definition
|
|
Term
| What quinolone should not be given to a diabetic? |
|
Definition
|
|
Term
| What is the major toxicity unique to the second generation quinolones? |
|
Definition
| QT prolongation-->Torsade |
|
|
Term
| What are the four main toxicities of the quinolones? |
|
Definition
tendonitis
cartilage damage
raises theophylline levels
siezures |
|
|
Term
| You have a 10 year old patient with a history of seizures and acid reflux who comes in with mycoplasma pneumonia (atypical). What drug would you have considered to give this child to treat an atypical pneumonia if it weren't for his medical history and age? |
|
Definition
| you do not want to give him quinolones because they cause seizures, are contraindicated for children, and with acid reflux, he probably is on antacids and you do not want to give quinolones to someone on antacids because it would delay its absorption |
|
|
Term
| What is happening with regards to pneumococcal resistant and second generation quinolones? |
|
Definition
|
|
Term
| In general what is the use of second generation of quinolones? (3) |
|
Definition
gram negative
pneumococcal
atypical |
|
|
Term
| What generation cephalosporin is cefuroxime? |
|
Definition
|
|
Term
What does cefuroxime cover?
include the two specific bacteria it covers |
|
Definition
| gram negative including haemophilus and moraxella |
|
|
Term
| What drug is a third generation cephalosporin? |
|
Definition
|
|
Term
| What is ceftriaxone's coverage? |
|
Definition
| gram negative w/o pseudomonas |
|
|
Term
| What are the third generation cephalosporins with pseudomonas activity? |
|
Definition
|
|
Term
| What do ceftazidime and cefepime cover? |
|
Definition
| gram negatives and pseuodmonas |
|
|
Term
| Which has better pneumococcal coverage ceftazadime or cefepime? |
|
Definition
|
|
Term
| What is good about ceftrizxone's administration? |
|
Definition
|
|
Term
| How is ceftriaxone administered? |
|
Definition
|
|
Term
| If you use ceftazidime or cefepime alone for treatment of pseudomonas what do you have to be concerned with? |
|
Definition
| with one agent alone you have to be concerned about resistance |
|
|
Term
| What cephalosporin would be useful in ampC containing bacteria? |
|
Definition
|
|
Term
| Are cephalosporins bacteristatic or cidal? |
|
Definition
|
|
Term
| Are macrolides cidal or bacteristatic? |
|
Definition
|
|
Term
| What is the MOA of macrolides? |
|
Definition
|
|
Term
| What are the three mechanisms of resistance for erythromycin? |
|
Definition
efflux pump (mef)
methylation of ribosome (erm)
altered 23s binding (MLSb) |
|
|
Term
| What does erthromycin have great activity against? (5) |
|
Definition
pneumococci
bordetella
atypicals
legionella
mycoplasma
chlamydia |
|
|
Term
| What is the problem with treating pneumococcus with erythromycin? |
|
Definition
|
|
Term
| What do clarithromycin and azithromycin have better activity against compared to erythromycin? |
|
Definition
| better activity against haemophilus and moraxella |
|
|
Term
| What makes azithromycin more appealing to prescribe? |
|
Definition
| only needed for 5 days 1/day (Zpack) |
|
|
Term
| What are the adverse effects of erythromycin? (3) |
|
Definition
GI
QT prolongation
thrombophliebitis |
|
|
Term
|
Definition
| a 50 s inhibitor that was suppose to replace the macrolides but has increased hepatotoxicity |
|
|
Term
| What is the adverse effect of telithromycin that may stop its use? |
|
Definition
|
|
Term
| What is the MOA of the tetracyclines? |
|
Definition
|
|
Term
| Are tetracyclines bacteriastatic or cidal? |
|
Definition
|
|
Term
What is the MOA of resistance to tetracyclines?
where are these coded for |
|
Definition
increased efflux
coded for on plasmids, transposons or on the chromosome |
|
|
Term
| If you are resistant to doxycycline, are you resistant to minocycline? |
|
Definition
| yes, resistant to one tetracycline means resistance to all |
|
|
Term
| How are most of the tetracyclines eliminated? Which one is not eliminated this way? |
|
Definition
| most are renally except for doxycycline |
|
|
Term
| What are the adverse effects of tetracyline? (3) |
|
Definition
|
|
Term
| TRUE/FALSE: Tetracyclines are often given to children? |
|
Definition
| FALSE, they are generally avoided in children |
|
|
Term
| What drug is in the lincomycin class? |
|
Definition
|
|
Term
| What is the MOA of clindomycin? |
|
Definition
|
|
Term
| Is clindamycin bacteria static or cidal? |
|
Definition
|
|
Term
| what is the mechanism of resistant of clindamycin? (2) |
|
Definition
MLSb (23s ribosome)
alter 50s ribosome |
|
|
Term
| What drugs are included in the MLSb resistance? |
|
Definition
macrolides
clindamycin
streptogramin |
|
|
Term
| What is clindamycin good for in use? |
|
Definition
| aspiration pneumonia because of broad spectrum |
|
|
Term
| What is the important side effect of clindamycin? |
|
Definition
|
|
Term
| What is the most common cause per dose for producing C diff? |
|
Definition
|
|
Term
| What activity makes clindamycin great for treating lung abscess? |
|
Definition
| gram positive anaerobic activity b/c abcsess usually comes from the mouth flora |
|
|
Term
| For gram positive infections, in what patients is clindamycin useful for? |
|
Definition
|
|
Term
| What is the mechanism of action of chloramphenicol? |
|
Definition
|
|
Term
| What drug causes aplastic anemia and is therefore not used anymore? |
|
Definition
|
|
Term
| Is chloramphenicol static or bactericidal? |
|
Definition
|
|
Term
| What drugs are great to treat staph pneumonia? |
|
Definition
anti-staph PCN
nafcillin
methacilin
oxacillin
|
|
|
Term
| What are the extended spectrum PCN? |
|
Definition
Ticarcillin, Piperacillin, Carbenicillin, Timentin
|
|
|
Term
| What are the extend spectrum PCN often combined with to increase their use? |
|
Definition
|
|
Term
| What do they extended PCNs have great use in? |
|
Definition
|
|
Term
| What are the monobactams/aztreonam useful for? |
|
Definition
ONLY Gram negatives
NOT GRAM POSTIVE OR ANAEROBES |
|
|
Term
| Why cannot daptomycin be used in repiratory infections? |
|
Definition
|
|
Term
| What drug is in the lipopeptide class? |
|
Definition
|
|
Term
| What is a side effect of daptomycin? |
|
Definition
|
|
Term
| What drug is in the class of glycylcycline? |
|
Definition
|
|
Term
| What are the two major toxicities of aminoglycosides? |
|
Definition
ototoxicity
nephrotoxidity |
|
|
Term
| In combination for example with an extended PCN, what bacteria is an aminoglycoside used against? |
|
Definition
|
|
Term
| What bacteria and fungi is TMP-SMX active against (2)? |
|
Definition
nocardia
pneumocytis jiroveci |
|
|
Term
| What are two uses of TMP-SMX? |
|
Definition
|
|
