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