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49 Cards in this Set

  • Front
  • Back
What bugs do you not use a 3rd gen cephalosporin for?
LAME:
listeria
atypical (mycoplasma, chlamydia)
MRSA (use vanc)
enterococci (use penicillins w/ AGs)
What are the exceptions to the rule that penicillins are excreted renally?
nafcillin and oxacillin (through bile)
Wha are the exceptions to the rule that cephalosporins are excreted renally?
cefoperazone
ceftriaxone
(bile)
What type of drug is cefazolin?
First gen cephalosporin
they do not enter the CNS
used commonly for surgical prophylaxis
What drug do you use with gram neg rods?
aztreonam
T/F: aztreonam is beta-lactamase resistant
true
What are the 3 mechanisms of drug resistance to penicillins?
Penicillinases
Structural change in PBPs
Change in porin structure
What 3rd gen cephalosporin does not enter the CNS and has a disulfaram-like effect?
cefoperazone
What class of drugs do I use for the empiric tx of sepsis and meningitis?
3rd gen cephalosporins (not cefoperazone)
What is the primary route of elimination for impenem and meropenem?
Renal
What is the Rx for staph aureus? (not MRSA)
nafcillin, methicillin, oxacillin (penicillinase-resistant)
What type of reaction is blocked by vancomycin?
Elongation of peptidoglycan chains, blocks transglycosylation
What are the AE of vancomycin?
"Red man syndrome" (histamine release)
Ototoxicity (permanent)
nephrotoxicity
What generation is cefoperazone?
3rd, doesn't enter the CNS
How does probenecid affect blood levels of these drugs?
Increases when coadminstered with
penicillins
cephalosporins
What drug to use with VRSA and VRSE?
Linezolid (inhibits formation of initiation complex at 50s)
also
Dalfopristin and Quinupristin
What drug class can cause misreading of the genetic code leading to bacteriocidal?
aminoglycosides
What drugs mess with the attachemtn of the aminoacyl tRNA to the acceptor site?
Tetracyclines (30s) and Dalfopristin/quinupristin (50s)
What drugs inhibit the activity of peptidyltransferase? (static)
chloramphenical (50s)
What drugs inhibit the translocation of peptidyl-TRNA from acceptor to donor site?
macrolides and clindamycin
Can you use aminoglycosides on anaerobics?
No, because AGs are O2 dependent for uptake
What are 3 AGs
gentamicin
trobramycin
amikacin
streptomycin
What rx for TB, bubonic plague and tularemia?
streptomycin (an AG)
Primary AE of AGs?
nephrotoxicity
and also ototoxicity
and lower release of Ach so NM blockade
What are AGs good for?
gram neg rods, also used with penicillin G and ampicillin for enterococci
What's the deal with neomycin?
Used in triple abx ointment, an aminoglycoside
can cause contact dermatitis
Are tetracyclines bacteriostatic or cidal?
static
What are tetracyclines used for?
Chlamydia
H pylori
Rickettsia
Lyme disease (borrelia)
Brucella
Vibrio cholera
and treponema (backup)
Doxycycline indication?
chlamydia or gonorrhea (prostatitis in young person)
What tetracycline is used to treat SIADH?
demeclocycline because it blocks ADH receptor
What drug classes can cause phototoxicity?
tetracyclines
sulfonamides
quinolones
Chloramphenicol in neonates
gray-baby syndrome
displaces bilirubin so can cause kernicterus
inhibits CYP450
What are macrolides used for?
Gram positive cocci (not MRSA)
Atypical organisms (chlamydia, mycoplasma, ureaplasma)
Legionella!!!!
Campylobacter jejuni
H pylori
What macrolide does not inhibit CYP450?
azithromycin (use in pregnant)
What drug do you use in macrolide-resistant strep pneumo?
telithromycin
Staph aureus caused osteomyelitis?
use clindamycin
Does chloramphenicol and macrolides inhibit CYP450?
Yes (not azithryomycin though)
What enzyme is not in humans that is the target of sulfonamides?
Dihydropteroate synthetase
When to use TMP-SMX?
Nocardia
Listeria
prophylaxis against opportunistic infxns with AIDs
Hemolysis in G6PD deficiency reaction with what drug?
Sulfonamides
How do quinolones act?
inhibit topoisomerase II and topoisomerase IV
When to use quinolones?
UTIs
STDs
Skin, soft tissue, bone infections by gram (-) organisms
Diarrhea due to shigella, salmonella, e.coli, campylobacter
Is quinolone contraindicated in pregnancy and children?
yes
What is the DOC for protozoa?
metronidazole (think metallic taste)
Does metronidazole cause a disulfram like reaction?
Yes
What anti-TB drug requires a vitamin supplement?
Isoniazid, use B6 to prevent peripheral neuritis and sideroblastic anemia (increase serum iron)
What drug can cause red-orange metabolites in body fluids?
rifampin
What anti-TB drug can cause color blindness?
ethambutol
What anti-TB drug induces CYP450?
rifampin