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Pharmacology Medical (MD/DO) School Study Aid


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Antibiotics
38 Picmonics to Learn | 1 hr 16 mins

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Antibiotics Overview
Cell Wall Inhibitors
Cell Wall Inhibitors
Penicillins
Cephalosporins
Monobactams
Carbapenems (Imipenem & Meropenem)
Beta-Lactamase Inhibitors
Protein Synthesis Inhibitors
Protein Synthesis Inhibitors
Aminoglycosides
Macrolides
Clindamycin
Tetracyclines
Linezolid
Chloramphenicol
Other
Fluoroquinolones
Sulfonamides
3 mins
Cephalosporins Overview
Mechanism of Action
Beta lactam drug
Inhibits cell wall synthesis
Bactericidal
Side Effects
Hypersensitivity reactions
Vitamin K Deficiency
Disulfiram like reaction with Alcohol
Increased Nephrotoxicity of Aminoglycosides
1 min
1st Generation Cephalosporin
Drug Names
Cefazolin
Cephalexin
Indications (PEcK Mnemonic)
Proteus mirabilis
E. coli
Klebsiella
Gram-Positive Cocci
1 min
2nd Generation Cephalosporin
Drug Names
Cefoxitin
Cefaclor
Cefuroxime
Indications (PEcK HENS Mnemonic)
Proteus mirabilis
E. coli
Klebsiella
Gram-Positive Cocci
Haemophilus influenzae
Enterobacter
Neisseria
Serratia marcescens
1 min
3rd Generation Cephalosporin
Drug Names
Cefotaxime
Ceftriaxone
Cefdinir
Ceftazidime
Pseudomonas
Indications
Serious Gram-Negative Bacteria Resistant to Other Beta-Lactams
1 min
4th Generation Cephalosporin
Drug Name
Cefepime
Indications
Increased Activity Against Gram-Positive Infections and Pseudomonas
29 secs
5th Generation Cephalosporin
Mechanism
Beta-Lactam
Indications
Resistant Bacteria
Broad Spectrum Gram-Positive and Gram-Negative
Drugs
Ceftobiprole
Has Pseudomonas Coverage
Ceftaroline
No Pseudomonas Coverage
1 min
Protein Synthesis Inhibitors
Drug Names
30S inhibitors
Aminoglycosides
Tetracyclines
50S inhibitors
Chloramphenicol
Clindamycin
Erythromycin
Lincomycin
Linezolid
2 mins
Linezolid (Zyvox)
Mechanism Of Action
Oxazolidinone Antibiotic
Binds 23S rRNA of 50S Subunit
Inhibits Protein Synthesis
Indication
Gram-Positive Organisms
MRSA
VRE (Vancomycin Resistant Enterococci)
Side Effects
Bone Marrow Suppression
Decreased Platelet Count
Peripheral Neuropathy
Lactic Acidosis
Serotonin Syndrome
Considerations & Patient Education
Avoid Tyramine Containing Foods
3 mins
Clindamycin
Mechanism of Action
Bacteriostatic
Binds 50S Ribosomal Subunit
Blocks Translocation
Indications
Anaerobic Infections above the Diaphragm
Aspiration Pneumonia
Lung Abscess
Side Effects
Can Cause Pseudomembranous Colitis
1 min
Aminoglycosides
Drug Names
Gentamicin
Neomycin for Bowel Surgery Prep
Amikacin
Tobramycin
Streptomycin
Mechanism of Action
Bactericidal
Inhibit Formation of Initiation Complex
Cause Misreading of mRNA
Require O2 for Uptake
Resistance
Resistance by Transferase Enzymes
Acetylation
Phosphorylation
Adenylation
Indications
Gram-Negative Rod Infections
Synergistic with B-Lactam Antibiotics
Side Effects
Nephrotoxicity Especially When Used with Cephalosporins
Ototoxicity Especially When Used with Loop Diuretics
Teratogen
4 mins
Macrolides
Bacteriostatic
Erythromycin
Azithromycin
Clarithromycin
Bind to 23S rRNA of 50S subunit
Inhibit protein synthesis by blocking translocation
Gram-Positive Cocci
Atypical pneumonia
Chlamydia
Resistance by methylation of 23S rRNA binding
1 min
Macrolides Side Effects
Side Effects
Diarrhea
Prolonged QT Interval
P450 Inhibitor
Cholestatic Hepatitis
Skin Rash
Eosinophilia
2 mins
Neomycin Sulfate
Mechanism
Aminoglycoside Antibiotic
Indications
Topical Infection
Intestinal Surgery Prophylaxis
Side Effects
Ototoxicity
Nephrotoxicity
Rash
Blood Dyscrasias
Considerations
GI Superinfection
1 min
Penicillin
Gram Positive
Spirochetes
Bind PBPs
Block Transpeptidase Cross-linking of Cell Wall
Activate Autolytic Enzymes
Bactericidal
Hypersensitivity Reactions
Hemolytic Anemia
Beta-lactamase Sensitive
1 min
Aminopenicillin Mechanisms
Indications
Broader Spectrum
Drug Names
Ampicillin
Amoxicillin
Mechanism and Characteristics
Beta-Lactamase Sensitive
Combine with Clavulanic Acid
Side Effects
Hypersensitivity Reactions
Ampicillin Rash
Pseudomembranous Colitis
2 mins
Ampicillin and Amoxicillin
Mechanism
Aminopenicillin
Broad Spectrum Penicillin
Indications
Gram-Positive and Some Gram-Negative Infections
Side Effects
Rash
Diarrhea
Considerations
No Effect Against Staph Aureus
Often combined with Beta Lactamase Inhibitor
Allergic Reaction
1 min
Aminopenicillin Uses
Drug Names
Ampicillin
Amoxicillin
Indications
Shigella
Haemophilus Influenzae
Salmonella
Listeria
Enterococci
Proteus Mirabilis
E. Coli
1 min
Antipseudomonal Penicillins
Drugs
Ticarcillin
Carbenicillin
Piperacillin
Mechanism of Action
Same Mechanism as Penicillin
Indications
Extended Spectrum
Pseudomonas and Gram-Negative Rods
Considerations
Combine with Beta Lactamase Inhibitor
Clavulanic Acid
Tazobactam
Hypersensitivity Reactions
2 mins
Beta-Lactamase Inhibitors
Considerations
Often Combined with Penicillin Antibiotics
Drug Names
Clavulanic Acid
Sulbactam
Tazobactam
51 secs
Aztreonam
Monobactam
Resistant to beta lactamases
Binds to penicillin binding protein (PBP)
Inhibit cell wall synthesis
No Activity on Gram-Positives or Anaerobes
Gram-Negative Rods
Non allergenic to penicillin
Synergistic with aminoglycosides
1 min
Tetracycline Drug Names and Indications
Drug Names
Demeclocycline
Minocycline
Doxycycline
Fecally Eliminated
Can be Used in Renal Failure
Indications
Antidiuretic Hormone Antagonist
Chlamydia
Rickettsia
Borrelia burgdorferi
Helicobacter Pylori
Mycoplasma Pneumonia
3 mins
Tetracycline Mechanism
Binds to 30 S to Prevent Attachment of Aminoacyl tRNA
Limited CNS Penetration
Divalent Cations Inhibit Absorption
Must Not Take with Milk, Antacids, Iron
1 min
Tetracycline Toxicities
Photosensitivity
GI Distress
Teratogen
Discoloration of teeth
Inhibition of bone growth in children
1 min
Tigecycline (Tygacil)
Mechanism Of Action
Glycylcycline Antibiotic
Binds 30S Subunit
Inhibits Protein Synthesis
Indications
Severe Infections
Broad Spectrum Coverage
Anaerobic & Multidrug-Resistant Organisms
Deep Tissue Penetration
Side Effects
GI Distress
Severe Nausea and Vomiting
Considerations
2nd Line Agent
3 mins
Vancomycin Mechanism
Bacteriostatic and Bactericidal
Gram-Positive
Inhibits Cell Wall Mucopeptide
Binds to D-ala D-ala
Resistance with change to D-ala D-lac
Staphylococcus aureus
Orally for Clostridium difficile
Enterococci
2 mins
Vancomycin Side Effects & Toxicity
Side Effects
Thrombophlebitis
Nephrotoxicity
Ototoxicity
Diffuse Flushing Called Red Man Syndrome
Prevent with Antihistamine
Prevent with Slow Infusion
2 mins
Fluoroquinolones Antibiotics
-floxacin
Mechanism of Action
Inhibits Topoisomerase II & IV
Bactericidal
Indications
Gram-negative Rods
Pneumonia
Gastrointestinal Infections
Urinary Tract Infection
Genital Infections
Drugs
Levofloxacin
Ciprofloxacin
Has Pseudomonas Coverage
Considerations
Avoid Polyvalent Cations
2 mins
Fluoroquinolones Toxicities
Diarrhea
Skin Rash
Headache
Tendon Rupture in Adults
Myalgias in Kids
Damage to Cartilage
Teratogen
QT Prolongation
1 min
Sulfonamides Mechanisms
Bacteriostatic
Gram-Positive
Gram-Negative
Nocardia
Chlamydia
PABA antimetabolites
Inhibit dihydropteroate synthase
Sulfamethoxazole
Sulfisoxazole
Sulfadiazine
1 min
Sulfonamides Side Effects
Side Effects
Hypersensitivity
Nephrotoxicity
Photosensitivity
Kernicterus in Infants
Displaces Warfarin from Albumin
Considerations
Hemolysis with G6PD Deficiency
2 mins
Sulfa Drug Allergies
Sulfasalazine
Sulfonylureas
Thiazide Diuretics
Acetazolamide
Furosemide Diuretic
Celecoxib
Probenecid
49 secs
Trimethoprim
Mechanism of Action
Bacteriostatic
Inhibits Bacterial Dihydrofolate Reductase
Causes Sequential Block of Folate Synthesis
Used in Combination with Sulfamethoxazole
Combination Used For Recurrent Urinary Tract Infections
Indications
Shigella
Salmonella
Pneumocystis Jiroveci Pneumonia
Side Effects
Decrease in Red and White Blood Cells
Alleviated with Leucovorin Rescue
2 mins
Metronidazole
Mechanism of Action
Bactericidal
Forms Free Radical Toxic Metabolites
Damages DNA
Indications
Giardia lamblia
Entamoeba Histolytica
Trichomonas
Gardnerella
Anaerobes
Side Effects
Metallic taste
Disulfiram like Reaction with Alcohol
2 mins
Imipenem
Mechanism
Resistant to beta lactamases
Broad Spectrum
Indications
Anaerobes
Gram-Negative Rods
Gram-Positive Cocci
Must administer with cilastatin
Cilastatin is inhibitor of renal dehydropeptidase I
Side Effects
Diarrhea
Skin rash
Seizures
Considerations
Meropenem
Stable to dehydropeptidase I
Reduced risk of seizures (Non seizure causing)
2 mins
Chloramphenicol
Mechanism
Bacteriostatic
Inhibits 50S Peptidyltransferase Activity
Indications
Meningitis
Rocky Mountain Spotted Fever in Pregnant Women
Side Effects
Anemia
Aplastic Anemia
Gray Baby Syndrome due to Decreased UDP-Glucuronyl Transferase
Resistance Caused by Plasmid Encoded Acetyltransferase
1 min
Polymyxins
Mechanism of Action
Cationic
Act Like Detergents
Bind to Cell Membranes of Bacteria
Disrupt Their Osmotic Properties
Indications
Resistant Gram-Negative Infections
Side Effects
Neurotoxicity
Renal tubular necrosis
2 mins
HIV Prophylaxis Medications
CD4+ < 200
TMP-SMX
Pneumocystis Pneumonia
CD4+ < 100 Susceptible to Toxoplasma Gondii
CD4+ < 50
Mycobacterium Avium and Intracellulare
Azithromycin If Delayed Therapy
2 mins

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