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169 Cards in this Set
- Front
- Back
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the parasites treated by metronidazole
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giardia lamblia
entamoeba histolytica trichomonas vaginalis |
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giardia rx
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metronidazole
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entamoeba histolytica rx
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metronidazole and iodoquinol
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the parasites treated by iodoquinol
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entamoeba histolytica
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cryptosporidium rx
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prevention -- filtering water supplies
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toxoplasma gondii rx
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sulfadiazine + pyrimethamine
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sulfadiazine + pyrimethamine
treats what |
toxoplasma gondii
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metronidazole and iodoquinol treats what
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entamoeba histolytica
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naegleria fowleri rx
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amphotericin has been effective for a few survivors
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amphotericin has been effective for a few survivors of what parasite?
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naegleria fowleri
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trypanosoma brucei rx
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suramin for blood-borne disease
melarsoprol for CNS penetration |
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suramin and melarsoprol treat what
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trypanosoma brucei
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plasmodium rx
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chloroquine
mefloquine primaquine begin with chloroquine if resistant, use mefloquine vivax/ovale -- add primaquine for dormant hypnozoite in liver |
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babesia rx
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quinine
clindamycin |
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quinine, clindamycin can treat what
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babesia
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nifurtimox treats what
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trypanosoma cruzi
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leishmania donovani rx
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sodium stibogluconate
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sodium stibogluconate treats what
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leishmania donovani
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trypanosoma cruzi rx
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nifurtimox
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trichomonas vaginalis rx
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metronidazole
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-bendazoles treat what?
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a worm will EAT what it EATS
enterobius ascaris trichinella echinococcus ancyclostoma; necator taenia solium strongyloides |
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pyrantel pamoate treats what?
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enterobius
ascaris ancyclostoma; necator |
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"-bendazoles or pyrantel pamoate"
treat what? |
enterobius
ascaris ancyclostoma; necator |
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niridazole treats what?
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dracunculus medinensis
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dracunculus medinensis rx
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niridazole
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enterobius vermicularis rx
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-bendazoles or pyrantel pamoate
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ascaris lumbricoides rx
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-bendazoles or pyrantel pamoate
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trichinella spiralis rx
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-bendazoles
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strongyloides stercoralis rx
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-bendazoles or ivermectin
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ivermectin treats
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strongyloides stercoralis
onchocerca volvulus |
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-bendazoles or ivermectin
treats what? |
strongyloides stercoralis
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onchocerca volvulus rx
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ivermectin
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ancyclostoma duodenale
necator americanus rx |
-bendazoles or pyrantel pamoate
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diethylcarbamazine rx
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loa loa
wuchereria bancrofti toxocara canis |
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loa loa rx
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diethylcarbamazine
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wuchereria bancrofti rx
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diethylcarbamazine
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toxocara canis rx
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diethylcarbamazine
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taenia solium rx
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praziquantel
use -bendazoles for neurocysticercosis |
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diphyllobothrium latum rx
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praziquantel
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echinococcus granulosus rx
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-bendazoles
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schistosoma rx
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praziquantel
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clonorchis sinensis rx
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praziquantel
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paragonimus westermani rx
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praziquantel
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praziquantel rx
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taenia solium
echinococcus granulosus schistosoma clonorchis sinensis paragonimus westermani |
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protozoa that cause GI infections
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giardia lamblia
entamoeba histolytica cryptosporidium |
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protozoa that cause CNS infections
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toxoplasma gondii
naegleria fowleri trypanosoma brucei |
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protozoa that cause hematologic infections
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plasmodium
babesia |
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protozoa that cause visceral infections
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trypanosoma cruzi
leishmania donovani |
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protozoa that cause STDs
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trichomonas vaginalis
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intestinal nematodes
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enterobius vermicularis
ascaris lumbricoides trichinella spiralis strongyloides stercoralis ancyclostoma; necator |
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tissue nematodes
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dracunculus medinensis
onchocerca volvulus loa loa wuchereria bancrofti toxocara canis |
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cestodes
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taenia solium
diphyllobothrium latum echinococcus granulosus |
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trematodes
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schistosoma
clonorchis sinensis paragonimus westermani |
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chloroquine mechanism
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blocks plasmodium heme polymerase
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plasmodium vivax / ovale have a dormant hypnozoite form in the liver
rx? |
add primaquine
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leishmania donovani rx
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sodium stibogluconate
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trypanosoma cruzi rx
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nifurtimox
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what drugs block cell wall synthesis by inhibition of peptidoglycan cross-linking?
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pennicillin
methicillin ampicillin piperacillin cephalosporins aztreonam imipenem |
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what drugs block peptidoglycan synthesis?
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bacitracin
vancomycin |
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what drugs block nucleotide synthesis?
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sulfonamides
trimethoprim |
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what drugs block DNA topoisomerases?
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fluoroquinolones
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what drugs block mRNA synthesis?
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rifampin
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what drugs damage DNA
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metronidazole
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what drugs block protein synthesis at the 50S ribosomal subunit
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chloramphenicol
macrolides clindamycin streptogramins --quinupristin --dalfopristin linezolid |
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what drugs block protein synthesis at the 30S ribosomal subunit?
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aminoglycosides
tetracyclines |
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penicillin IV vs. oral form
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penicillin G is IV
penicilin V is oral |
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penicillin G vs. penicillin V
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G is IV
V is oral |
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penicillin moa
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bind penicillin binding proteins
block transpeptidase cross-linking of peptidoglycan activate autolytic enzymes |
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penicillin clinical use
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gram-positive organisms
-- strep pneumo -- strep pyogenes -- actinomyces and syphilis |
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penicillin is bactericidal for
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gram + rods
gram + cocci gram - cocci spirochetes |
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penicillin s/e
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hypersensitivity
hemolytic anemia |
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penicillin resistance
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beta-lactamases cleave beta-lactam ring
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the drugs on the upgraded penicillin page
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penicillinase-resistant penicillins
--methicillin --nafcillin --dicloxacillin aminopenicillins --ampicillin --amoxicillin antipseudomonals --ticarcillin --carbenicillin --piperacillin |
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penicillinase-resistant penicillins
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methicillin
nafcillin dicloxacillin |
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aminopenicillins
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ampicillin
amoxicillin |
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antipseudomonals
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ticarcillin
carbenicillin piperacillin |
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which of the "upgraded penicillins" have a narrow spectrum?
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penicillinase-resistant penicillins
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penicillinase resistant penicillins
rx |
S. aureus
except MRSA |
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mechanism of MRSA resistance against
methicillin nafcillin dicloxacillin |
altered penicilin binding protein
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which of the upgraded penicillins are penicillinase sensitive?
what do you do about that? |
ampicillin
amoxicillin ticarcillin carbenicillin piperacillin use with clavulanic acid |
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beta-lactamase inhibitors include
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clavulanic acid
sulbactam tazobactam |
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ampicillin
amoxicillin s/e |
hypersensitivity
ampicillin rash pseudomembranous colitis |
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ampicillin
amoxicillin rx |
HELPSS kill enterococci
Haemophilus influenzae E. coli Listeria monocytogenes Proteus mirabilis Salmonella Shigella enterococci |
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what drug HELPSS kill enterococci?
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ampicillin
amoxicillin |
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ampicillin
amoxicillin s/e |
hypersensitivity
ampicillin rash pseudomembranous colitis |
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ampicillin
amoxicillin resistance |
beta-lactamases cleave beta-lactam ring
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ticarcillin
carbenicillin piperacillin rx |
pseudomonas
gram - rods |
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organisms not covered by cephalosporins
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they are LAME
listeria atypicals (chlamydia, mycoplasma) MRSA enterococci |
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1st generation cephalosporins
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cefazolin
cephalexin |
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2nd generation cephalosporins
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cefoxitin
cefaclor cefuroxime |
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3rd generation cephalosporins
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cefixime
cefotaxime ceftriaxone ceftazidime |
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4th generation cephalosporins
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cephipime
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cephipime is a _ generation cephalosporin
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4th
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cefotaxime is a _ generation cephalosporin
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3rd
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ceftazidime is a _ generation cephalosporin
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3rd
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cefazolin is a _ generation cephalosporin
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1st
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cephalexin is a _ generation cephalosporin
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1sttttttttt
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1st generation cephalosporins
rx |
G+ cocci
Proteus mirabilis E coli Klebsiella pneumoniae PEcK |
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2nd generation cephalosporins
rx |
G+ cocci
Haemophilus influenzae Enterobacter aerogenes Neisseria Proteus mirabilis E coli Klebsiella pneumoniae Serratia marcescens HEN PEcKS |
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3rd generation cephalosporins
rx |
serious G - infections
that are resistant to other beta-lactams |
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ceftriaxone rx
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meningitis
gonorrhea |
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ceftazidime rx
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pseudomonas
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cephalosporins that can be used against pseudomonas
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ceftazidime
cefipime |
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4th generation cephalosporins
rx |
^ activity against
pseudomonas gram + organisms |
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cephalosporins s/e
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hypersensitivity
-- 5-10% cross-hypersensitivity with penicillins vitamin K deficiency ^ nephrotoxicity of aminoglycosides disulfiram-like rxn with EtOH |
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the page with cephalosporins on it also has _ drug
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aztreonam
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aztreonam mechanism
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inhibits cell wall synthesis
(binds to PBP 3) |
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aztreonam rx what bugs?
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G - rods only
no activity against G + or anaerobes |
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aztreonam rx what bugs and what patients?
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G - rods only
no activity against G+ or anaerobes penicillin-allergic patients those with renal insufficiency who cannot tolerate aminoglycosides |
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aztreonam s/e
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occasional GI upset
no cross-allergenicity with penicillins or cephalosporins |
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the page after cephalosporins includes what drugs?
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imipenem / cilastatin
meropenem vancomycin |
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imipenem is given with _ why? mecahnism?
|
cilastatin
to decrease inactivation of drug in renal tubules cilastatin inhibits renal dehydropeptidase I |
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imipenem/cilastatin
meropenem rx |
G+ cocci
G- rods anaerobes s/e limit use to life-threatening infections or after other drugs have failed |
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meropenem vs. imipenem/cilastatin
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meropenem:
less risk of seizures stable to dihydropeptidase I |
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imipenem/cilastatin
meropenem s/e |
GI distress, skin rash, and CNS toxicity (seizures) at high plasma levels
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vancomycin moa
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inhibits cell wall mucopeptide formation
by binding D-ala D-ala portion of cell wall precursors |
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vancomycin rx
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G+ only
serious, multidrug resistant organisms, including-- S. aureus enterococci Clostridium difficile |
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vancomycin s/e
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Nephrotoxicity
Ototoxicity Thrombophlebitis diffuse flushing -- "red man syndrome" well tolerated in general -- does NOT have many problems |
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how can you prevent red man syndrome as caused by _ drug?
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pretreatment with antihistamines
slow infusion rate |
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aminoglycosides include
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gentamycin
neomycin amikacin tobramycin streptomycin |
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which of the protein synthesis inhibitors is bactericidal?
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aminoglycosides
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mechanisms of all the protein synthesis inhibitors
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aminoglycosides
--inhibit formation of initiation complex --cause misreading of mRNA tetracyclines --bind to 30S --prevent attachment of aminoacyl-tRNA macrolides --block translocation --bind to the 23S rRNA of the 50S ribosomal subunit chloramphenicol and clindamycin -- block peptide bond formation at 50S |
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_____ antibiotics
inhibit formation of initiation complex and cause misreading of mRNA |
aminoglycosides
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_____ antibiotics
bind to 30S and prevent attachment of aminoacyl-tRNA |
tetracyclines
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______ antibiotics
block translocation bind to the 23S rRNA of the 50S |
macrolides
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_____ antibiotics
block peptide bond formation at 50S |
chloramphenicol
clindamycin |
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aminoglycosides rx
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severe G- rod infections
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aminoglycosides moa
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inhibit formation of initiation complex
cause misreading of mRNA |
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aminoglycosides s/e
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nephrotoxicity
--esp. with cephalosporins ototoxicity --esp. with loop diuretics teratogen |
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side effects of vancomycin vs. aminoglycosides
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nephrotoxicity
ototoxicity thrombophlebitis red man syndrome nephrotoxicity -- esp with cephalosporins ototoxicity -- esp with loops teratogen |
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resistance to aminoglycosides
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transferase enzymes inactivate the drug by
acetylation phosphorylation adenylation |
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tetracyclines include
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tetracycline
doxycycline demeclocycline minocycline |
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tetracyclines moa
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bind to 30S and prevent attachment of aminoacyl-tRNA
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pharmacokinetic features of tetracyclines
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limited CNS penetration
doxycycline is fecally eliminated and can be used in renal failure pts do not take with milk, antacids, or iron-containing preparations because divalent cations inhibit absorption in the gut |
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tetracyclines rx
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borrelia burgdorferi
mycoplasma pneumoniae ability to accumulate intracellularly makes it very effective against Rickettsia and Chlamydia |
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tetracyclines s/e
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GI distress
in children: --discoloration of teeth --inhibition of bone growth photosensitivity contraindicated in pregnancy |
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tetracyclines
|
v uptake or
^ efflux by plasmid-encoded pumps |
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macrolides include
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erythromycin
azithromycin clarithromycin |
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macrolides moa
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block translocation
bind to the 23S rRNA of the 50S subunit |
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macrolides rx
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*atypical pneumonias*
--mycoplasma --chlamydia --legionella URIs STDs G+ cocci --strep in pts with pcn allergy Neisseria |
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macrolides s/e
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prolonged QT interval
--esp erythromycin GI discomfort --most common cause of noncompliance acute cholestatic hepatitis eosinophilia skin rashes |
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macrolides drug interactions
|
increases serum concentration of
--theophyllines --oral anticoagulants |
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macrolides resistance
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methylation of 23S rRNA binding site
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_____ antibiotic blocks peptide bond formation at 50S
|
chloramphenicol
clindamycin |
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chloramphenicol rx
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meningitis
--haemophilus influenzae --neisseria meningitidis --strep pneumo |
|
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chloramphenicol
s/e |
anemia (dose dependent)
aplastic anemia (dose independent) gray baby syndrome (in premature infants because they lack UDP-glucuronyl transferase) conservative use b/c of s/e but often still used in developing countries due to low cost |
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chloramphenicol resistance
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plasmid-encoded acetyltransferase inactivates the drug
|
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clindamycin moa
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blocks peptide bond formation at 50S
|
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clindamycin rx
|
anaerobic infections
--bacteroides fragilis --clostridium perfringens in aspiration pneumonia or lung abscesses |
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____ treats anaerobes above the diaphragm
____ treats anaerobes below the diaphragm |
clindamycin
metronidazole |
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sulfonamides include
|
sulfamethoxazole
sulfisoxazole sulfadiazine |
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sulfonamides moa
|
PABA antimetabolites inhibit dihyropteroate synthetase
|
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sulfonamides rx
|
G+
G- Nocardia Chlamydia triple sulfas or sulfamethoxazole for simple UTI |
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sulfonamides s/e
|
hypersensitivity
hemolysis if G6PD deficient nephrotoxicity (tubulointerstitial nephritis) kernicterus in infants |
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sulfonamides drug interaction
|
displaces other drugs from albumin (e.g. warfarin)
|
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sulfonamides resistance
|
altered enzyme bacterial dihydropteroate synthetase enzyme
v uptake ^ PABA synthesis |
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folate synthesis inhibitors include...
they inhibit what enzymes specifically? |
sulfonamides
-- dihydropteroate synthetase trimethoprim pyrimethamine -- dihydrofolate reductase |
|
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TMP-SMX rx
|
UTIs
Shigella Salmonella Pneumocystis jiroveci pneumonia |
|
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trimethoprim s/e
|
megaloblastic anemia
leukopenia granulocytopenia may alleviate with supplemental folinic acid (leucovorin rescue) |
|
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two fluoroquinolones that have unusual names
|
enoxacin
nalidixic acid (a quinolone) |
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fluoroquinolones & a quinolone
(9) |
cipro
nor levo o gati moxi spar enoxacin nalidixic acid |
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fluoroquinolones moa
|
- DNA gyrase (topoisomerase II)
|
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fluoroquinolones drug interactions
|
must not be taken with antacids
|
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fluoroquinolones clinical use
|
G- rods of urinary and GI tracts
(including Pseudomonas) Neisseria some G+ organisms |
|
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fluoroquinolones s/e
|
GI upset
superinfections skin rashes headache dizziness contraindicated in pregnant women and children because of possible damage to cartilage tendonitis and tendon rupture in adults leg cramps and myalgias in kids |
|
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fluoroquinolones resistance
|
chromosome-encoded mutation in DNA gyrase
|
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metronidazole moa
|
forms free radical toxic metabolites
in the bacterial cell that damage DNA |
|
|
metronidazole rx
|
Giardia
Entamoeba Trichomonas Gardnerella vaginalis Anaerobes --bacteroides --c. difficile used in triple therapy against H pylori GET GAP on the metro |
|
|
metronidazole s/e
|
disulfiram-like reaction with alcohol
headache metallic taste |
