Pharm-Micro Block 3 pt. 1

alex0624's version from 2016-07-15 23:16

Cell Wall Synthesis & Inhibitors & Protein Synthesis Inhibitors

Question Answer
Penicillins bind to and inactivate Transpeptidase (Penicillin-binding proteins)
Penicillinases secreted by bacterias such as staphylococci break theBetalactam ring
Alteration of penicillin-binding proteinsMRSA & MRSE, Penicillin resistant pneumococci, S. Aureus
Gram negative bacterias become resistance to penicillins byReducing permeability in Gram-negative cell membranes (Eg.pseudomonas)
Acts by binding to D-Ala-D-Ala terminal of the nascent peptidoglycan pentapeptide side chainVancomycin
Leads to inhibition of transglycosilation and in turn prevents the peptidoglycan chain elongationVancomycin
Replacement of the terminal D-Ala by D-LactateVancomycin resistance
Drug used to prevent endocarditis due to surgeryAmoxicillin or Ampicillin
Cephalosporin that is used in surgical prophylaxisCefazolin
Used in gram –ve infections especially in patients allergic to Penicillins/CephalosporinsAztreonam (Monobactams)
Inhibitor of renal dehydropeptidaseCilastatin
Bind to 30S ribosomal subunit.Aminoglycosides & Tetracycline (reversible)
Block the formation of initiation complex, prevent polysome (peptide) formation, misreading of mRNAAminoglycosides
Interfere with the attachment of aminoacyl tRNA to acceptor siteTetracycline
Bind to 50S ribosomal subunitChloramphenicol & Macrolides (Reversible) & Clindamycin
Inhibits the activity of peptidyltransferase..(i.e the transfer of peptide chain from site P to acceptor site)Chloramphenicol
Prevent the translocation of peptidyl tRNA from site A to site P and the formation of initiation complexesMacrolides & Clindamycin
Production of transferase enzyme by the bacteria causes resistance toAminoglycosides
Drug that works based on concentration-dependent killing, Postantibiotic effect and given once dailyAminoglycosides
Development of efflux pumps and decreased activity of the uptake systems causes resistance toTetracycline's
Gram + organisms produce methylase enzyme and the efflux pump (throws out the drug from within the cell) and causes resistance toMacroglides
Enterobacteriaceae resistance due to formation of drug metabolising esterases causes resistance toMacroglides

Drug Synergism

Question Answer
Activity of this drug is enhanced if used in combination with beta lactamase inhibitors (clavulanic acid, Sulbactum, Tazobactam)Amoxicillin & Aminoglycosides
Drug that has synergistic action with aminoglycosidesPiperacillin & Ticarcillin
Imipenem is combined with ____ to prevent hydrolysis by enzymes in the renal brush borderCilastatin
Causes sequential block of folate metabolism. Individually they are bacteriostatic. Together they are Bactericidal & SynergisticSulfamethaxazole and Trimethoprim
Synergism action caused by Sulfonamide + TrimethoprimSequential blockade
Synergism action caused by Amoxicillin + Clavulanic acidBlockade of drug inactivating enzyme
Synergism action caused by Gentamicin + penicillin can be used to treatBacterial endocarditis
Synergism action caused by Amphotericin B + flucytocine can be used to treatCryptococcal meningitis
Synergism action caused by Extended spectrum Penicillin + AG can be used to treatPseudomonal infections (increased drug uptake)

Drug A/E

Question Answer
Drug that release of histamine and causes flushing, redness of face, hypotensionRed mans syndrome (Vancomycin) & Amphotericin B
Maculopapular rash; pseudomembranous colitisAmpicillin
Drug that causes interstitial nephritisMethicillin, nafcilin
Antibiotics that contain methylthiotetrazole group (MTT group) and may cause disulfiram like reactions with ethanol. Pesents as nausea, vomiting, headache, tachycardia, CV collapseMetronidazole & Cephalosporins (Cefamandole, Cefoperazone, Cefotetan), & Chlorpropramine (Diabetic Sulfonamide) & Griseofulvin
In high doses causes seizures Imipenem, Meropenem, ertapenem, Doripenem (Carbapenems)
NephrotoxicityVancomycin, Aminoglycosides, Amphotericin B, Tetracyclines, Cidofovir, Foscarnet
OtotoxicityVancomycin, Aminoglycosides
Neuro muscular blockadeAminoglycosides
Should not be given with milk products, antacidsTetracycline & Flouroquinolones & Ketoconazole
Bind to tissues like teeth, bones which are undergoing calcificationTetracycline
Phototoxicity on exposure to UV lightTetracyclines (demeclocycline, doxycycline)
Causes Fanconi’s syndrome: A form of renal tubular acidosis is attributed to use of outdatedTetracyclines
Bone marrow suppression - dose dependent- causing Aplastic anaemiaChloramphenicol, Flucytosine, Ganciclovir
Grey baby syndrome - occurs in neonates- due to deficient hepatic glucuronosyltransferase. C/F: vomiting, abdominal distension, cyanosis, refusal to feed, CV collapse, deathChloramphenicol
Antibiotic that are CYP450 Enzyme inhibitorErythromycin, azole antifungal, HIV protease inhibitors, Streptogramins
Cause diarrhea by stimulates motilin receptorsErythromycin
Causes Pseudomembranous enterocolitisClindamycin
Drug that Should not be given to children and pregnant women. Get deposited in cartilage and damage its matrix. Danger of ruptured tendonsFluoroquinolones
Side effect causing ArthrophatyFluoroquinolones
Megaloblastic anemia, leukopenia, granulocytopeniaTrimethoprim
Hypersensitive reactions mostly rashes, which can be severe. Stevens-Johnson syndromeSulfonamides (UTI) & Nevirapine (HIV)
Hemolysis in G-6-PD deficiencySulfonamides, Isoniazid (INH), Dapsone, Quinine, Primaquine (Malaria drugs)
Drugs known to cause suprainfections in immunocompramised patientsTetracyclines, Ampicillin & Cephalosporins

Antibiotic DOC

Question Answer
DOC for Prophylaxis of endocarditis in valvular disease patients who are allergic to PenicillinClindamycin
DOC for S. pneumoniae & S. pyogenesPenicillin
DOC for Penicillin resistance S. pneumoniae & S. pyogenesErythromycin, Doxycycline, Quinolones
DOC for EnterococcusPenicillin + gentamicin
DOC for Penicillin resistance EnterococcusVancomycin+Gentamicin
DOC for Penicillinase producing Staph. aureusOxacillin, nafcillin, dicloxacillin
DOC for MRSAVancomycin
DOC for Vancomycin resistance S. AureusLinezolid & Streptogramins (Quinupristin-Dalfopristine)
DOC for Bacillus anthracisCiprofloxacin, Penicillin or Tetracycline. Alternative Erythromycin
DOC for ListeriaAmpicillin
DOC for NocardiaTMP-SMX (Cotrimoxazole)
DOC for ActinomycesPenicillin G
DOC for Anaerobic infectionsMetronidazole
DOC for Corynebacterium diphtheriaEythromycin
DOC for Clostridia perfringesPenicillin
DOC for Cl. tetaniPenicillin
DOC for Clostridia difficleMetronidazole & Vancomycin
DOC for Bacteroids fragilisMetronidazole
DOC for mycoplasma pneumoniae Erythomycin & Tetracycline (Doxycycline)
DOC for of N. GonorrhoeaCeftriaxone
DOC for N meningitidisCeftriaxone, Cefotaxime, Cefixime
DOC for E.coliTMP-SMX (Trimethoprim & Sulfamethaxazole) A.K.A Cotrimoxazole
DOC for ProteusTMP-SMX (Trimethoprim & Sulfamethaxazole), A.K.A Cotrimoxazole
DOC for KlebsiellaTMP-SMX (Trimethoprim & Sulfamethaxazole), A.K.A Cotrimoxazole
DOC for H.influenzaCefuroxime, ceftriaxone
DOC for PseudomonasPiperacillin, Ticarcillin & Aminoglycoside ("Mycin's") & Ciprofloxacin
DOC for allergies to Piperacillin to treat PseudomonasAztreonam
DOC for BrucellaDoxycycline
DOC for H.pyloriTetracycline (Clarithromycin) + Metronidazole + PPI or Metronidazole + amoxicillin + PPI
DOC for S. typhii (Typhoid Fever)Ciprofloxacin
DOC for Vibrio choleraTetracycline (Doxycycline)
DOC for Lyme disease (Borelia burgdorferi)Tetracycline (Doxycycline)
DOC for Relapsing fever (Borelia recurrentis)Tetracycline (Doxycycline)
DOC for RickettsiaTetracycline (Doxycycline)
DOC for ChlamydiaAzithromycin or Tetracycline (Doxycycline) or Ofloxacin
DOC for Syphilis (Treponema pallidum)Penicillin G
DOC for Syndrome of In appropriate secretion of ADH (SIADH)Demeclocycline (Tetracycline)
DOC for Mycobacterium aviumClarithromycin & Azithromycin
DOC for LegionellaErythromycin
DOC for Bordetella pertussisErythromycin
DOC for Campylobacter enteritisErythromycin
DOC for Pneumocystis jiroveci pneumoniaTMP-SMX (Trimethoprim & Sulfamethaxazole), A.K.A Cotrimoxazole
DOC for shigellaTMP-SMX (Trimethoprim & Sulfamethaxazole), A.K.A Cotrimoxazole
DOC for Urinary tract infection (uncomplicated-mild)SMX + TMP = Cotrimoxazole
DOC for Complicated UTICiprofloxacin
DOC for Q feverTetracyclines
DOC for anaerobeCefotetan
DOC for hepatic comaLactulose
Antibiotic for for hepatic comaNeomycin
Drug that inhibits the renal tubular secretion of penicillinProbenecid (Gout)
DOC for Monilial Diarrhoea, oral thrush , vulvonaginitis caused by Candida albicansClotrimazole
DOC prophylaxis for Gonorrhoea/SyphillisProcaine penicillin
DOC prophylaxis for pneumocystis jiroveci pneumonia in AIDS patientsCotrimoxazole
DOC prophylaxis for Rheumatic fever-streptococciBenzathine Penicillin
DOC prophylaxis given to people in contact with TuberculosisINH
DOC prophylaxis for dental extraction, upper respiratory proceduresAmoxicillin/clindamycin
DOC prophylaxis for Genitourinary/gastrointestinal procedures(prevent endocarditis)Ampicillin/Vancomycin + Gentamycin
DOC prophylaxis for SurgeriesCefazolin
Used in Tularemia, TB and bubonic plagueStreptomycin

Inhibitors of Nucleic Acid Synthesis

Question Answer
Bacteria synthesize their own folate from precursors likePara-Aminobenzoic Acid (PABA)
Competitively inhibits Dihydropteroate synthetaseSulfonamides (Sulfamethoxazole (SXT))
Inhibit Dihydrofolate ReductasePyrimethamine & Trimethoprim
Altered enzyme – bacterial dihydropteroate synthetase confers resistance toSulfonamides
Mutations in the gene that codes for the dihydrofolate reductase confers resistance toPyrimethamine & Trimethoprim (antimetabolite)
Inhibits folate synthesisPyrimethamine & Trimethoprim (antimetabolite)
Sulfamethoxazole (SXT) & trimethoprim (TMP)Cotrimoxazole
Drug Resistance to Fluoroquinolones (Ciprofloxacin) may occur byDrug efflux
Bactericidal drugs that inhibit bacterial enzymes needed for DNA replication; DNA topoisomerase II (DNA gyrase) & DNA topoisomerase IVFluoroquinolones (Ciprofloxacin)
Acts by inhibiting bacterial DNA gyrase, after binding to subunit ‘A’ interferes with strand cutting and resealing DNA strandsFluoroquinolones (Ciprofloxacin)
Sulfonamide for Ulcerative colitis & Rheumatoid arthritisSulfasalazine
Sulfonamide for ConjunctivitisSulfacetamide eye drops
Sulfonamide for MalariaSulfadoxine + Pyrimethamine
Sulfonamide for BurnsSilver sulfadiazine 1% cream
Sulfonamide for ToxoplasmosisSulfadiazine + pyrimethamine


Question Answer
Treats Giardia, Entamoeba, Trichomonas, Gardenella vaginalis, Anaerobes (Bacteroides, C.difficle). Used with a proton pump inhibitor and clarithromycin for “triple therapy” against H.pylori. “GET GAP on the Metro with metronidazole"Metronidazole (Flagyl)