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185 Cards in this Set
- Front
- Back
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which drugs block cell wall synthesis by inhibition of peptidoglycan cross linking?
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penicillin, methicillin, ampicillin, piperacillin, cephalosporines, aztreonam, imipenem.
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what is the enzyme responsible for peptidoglycan cross linking?
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transpeptidase
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which drugs block the peptidoglycan synthesis
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bacitracin and vancomycin
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which enzyme is responsible for peptidoglycan synthesis
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transglycosylation
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penicillin use
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gram positive organisms (s. penumoniae, s. pyogenes, actinomyces), syphilis. Works for gram positive cocci, positive rods, negative cocci, and spirochetes
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methicillin use
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penicillinase resistant because of bulkier R group. Cover staph except MRSA.
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nafcillin use
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penicillinase resistant because of bulkier R group. Cover staph except MRSA.
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dicloxacilin use
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penicillinase resistant because of bulkier R group. Cover staph except MRSA.
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oxacillin
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penicillinase resistant because of bulkier R group. Cover staph except MRSA.
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ampicillin
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aminopenicillin. HELPSS. H. influenza, e.coli, listeria, proteus, salmonella, shigella, entercocci.
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amoxicillin
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aminopenicillin. HELPSS. H. influenza, e.coli, listeria, proteus, salmonella, shigella, entercocci. Increased oral bioability.
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which set of PBP binding antibiotics has longer oral bioability
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amoxicillin.
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which PBP binding antibiotic can result in jarisch herxheimer syndrome
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aminopenicilins. While treating syphillis, can result in release of exotoxins.
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ticarcillin
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pseudomonas. Gram negative rods
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carbenicillin
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pseudomonas. Gram negative rods
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piperacillin
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pseudomonas. Gram negative rods
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which are beta lactamase inhibitors
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clavuanic acid, sulbactam and tazobactam.
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which cephalosporine protects against only proteus, e.coli, klebsiella and gram positive cocci
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cephalexin, cefazolin
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which cephalosporine protects against only h. influenzae, enterbacter, neiserria, serratia marcescens, proteus, e.coli, klebsiella and gram positive cocci
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cefoxitin, cefaclor, cefuroxime
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which cephalosporine protects against pseudomonas and serious gram negative infections resistant to other beta lactams
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ceftriaxone, cefotaxime, ceftazidime
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which cephalosporine protects against pseudomoonas and gram positive organism
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cefepime.
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which PBP binding antibiotic can result in vitamin K dficiency?
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cephalosporins.
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which PBP binding antibiotic can result in increased nephrotoxicitiy when used in conjunction with aminoglycosides
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cephalosporines
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which cephalosporine can result in disulfiram like reaction with ethanol?
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the ones with methylthiotetrazol group. Cefotetan, cefamandole, cefoperazone.
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which organisms are not covered by cephalosporines?
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listeria, atypicals (chlamydia, mycoplasma), MRSA, enterococci.
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which monobactam is resistant to beta lactamases and inhibit cell wall synthesis by binding to PBP3?
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aztreonam.
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which monobactam is synergistic with aminoglycosides?
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aztreonam
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for patients that have a gram negative rod infection and are penicillin allergic and have renal insufficiency and cannot tolerate aminoglycosides, what should you use?
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aztreonam
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what drug is always administered with cilastiatin?
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imipenem. This inhibits the renal dehyropeptidase I to decrease inactivation of drug in renal tubules.
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what is the drug used against gram positive cocci and gram negative rods and anaerobes that is used as last minute resort due to significant side effects of CNS toxicity?
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imipenem and meropenem.
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what is the drug that is used to cover gram positives only that are multidrug resistant including s. aureus, enterococci, and c.difficil?
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vancomycin
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redman syndrome
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vancomycin
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what are some side effects of vanc
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nephrotoxicity, ototoxicity, thrombophlebitis, diffuse flushing.
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which bactericidal binds to d.ala d.ala portion of the cell wall precursor.
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vanco
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what can the bacteria do to become resistant to vanc?
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convert to d ala d lac.
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what are the ribosomal units of bacteria
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30s 50s. Together make 70s. Clearly they do not know how to do ****** math
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30s
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aminoglycosides. Tetracyclin.
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50s
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chloramphenicol, clindamycin, erythromycin, linezolid.
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bactericidal protein synthesis inhibitor
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aminoglycoside.
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which protein synthesis inhibitor is ineffective against anaerobes because it needs O2 for uptake?
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aminoglycosides. (gentamicin, neomycin, amikacin, tobramycin, streptomycin)
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what are the side effects of aminoglycosides
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nephrotoxicity, ototoxicity, teratogen.
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what are the resistance against aminoglycosides?
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transferase enzymes that inactivate the drug by acetylation, phosphorylation, adenylation.
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what is the protein synthesis inhibitor that can be used in SIADH?
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demeclocycline. ADH antagonist. Act as a diuretic in SIADH.
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which protein synthesis inhibitor should no be uase dwith milk, antacids, or iron containing preparatinos?
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tetracyclins.
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whch tetracycline can be used in patients with renal faiure?
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doxycycline.
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which protein synthesis inhibitor results in discoloration of teeth and inhibition of bon growht in children? And is contraindicated In pregnancy? + photosensitivity
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tetracycline.
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which antibiotic inhibits protein sysnthesis by blocking translocation?
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macrolides. Erythromycin, clarithromycin, azithromycin.
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23s rRNA
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macrolides. Erythromycin, clarithromycin, azithromycin.
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which proteinsynthesis inhibitor is used for atypical pneumonias? mycoplasma, chlamydia, legionella, URI, STD?
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macrolides. Erythromycin, clarithromycin, azithromycin.
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patients who are allergic to penicillin should treat their streptococcal infection now?
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through macrolides.
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SE: prlonged qt interval.
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erythromycin.
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which antibiotic resultsin increased motilin persitalsis, resultingin GI discomfort.
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macrolides. Erythromycin, clarithromycin, azithromycin.
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which antibiotic is efective against rickettsia and chlamydia because its ability to accumulate intracellularly?
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tetracyclines
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which drug prevents peptide bond formation at the 50s ribosomal subunit
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chloramphenicol, clindamycin
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gray baby syndrome
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chloramphenicol
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treamtent of meningitis (h. influenzae, n. meningitidis, s. pneumoniae)
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chloramphenicol
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how is chloramphenicol inactivated
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acetyltransferase encoded by plasmid.
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treatment of anaerobic infections such as bacterioid fragilis, clostridium perfringens, in aspiration penumonia or lung abscess.
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clindamycin. Treat anaerobes above the diaphragm.
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toxicity of clindamycin?
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pseudomembranous colitis
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which drugs could result in pseudomembranous colitis
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clindamycin and ampicillin
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which protein synthesis inhibitor blocks the formation of initiation complex?
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linezolid and aminoglycosides
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which antibacterial drug works by becoming PABA antimetabolite inhibiting dihydropteroate synthetase?
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sulfonamides.
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dihydropteroate synthetase
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sulfonamide
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dihydrofolate reductase inhibition
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TMP, pyrimethamine, methotrexate.
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what drug competes with albumin, resulting in kernicterus in infants?
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sulfonamide. Displaces bilirubin.
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what antibiotic may result in megaloblastic anemia, leukopenia, granulocytopenia? Overall bonemarrow supression
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trimethoprim
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leucovorin rescue
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trimethoprim. Supplemental folinic acid.
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what is tetrahydrofolic acid used for?
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purines, thymidines, methionine, glycines.
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what can result in megaloblastic anemia, steven johnson syndrome, and toxic epidermal necrolysis
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TMP-SMX
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"-oxacin"
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fluoroquinolone
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what inhibits the DNA gyrase?
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fluoroquinolone
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what inhibits the DNA topoisomerase II
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fluoroquinolone
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what drug is known to cause damage to the cartilage, causing tendonitis nd tendon rupture in adults. Also leg cramps and myalgias in children?
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fluoroquinolone
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what should fluoroquinolone not be used with?
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antacids
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what forms free radical toxic metabolites in the bacterial wall that damages the DNA?
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metronidazole
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what can metronidazole treat
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giardia, entamoeba, trichomonas, gardnerella vaginalis, anaerobes (bacteriodes, c. difficil)
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what is the triple therapy for h. pylori infection
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metronidazole, tetracycline, amoxicillin/clarithromycin with proton pump inhibitor and/or bismuth
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treatment options for TB
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rifampin, isoniazide, pyrazinamide, ethambutol. (RIPE).
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prophylaxis for TB
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isoniazide
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treatment for m. avium intracellulare
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azithromycin, rifampin, ethambutol, streptomycin
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prophylaxis for m. avium intracellulare
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azithromycin
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m. leprae treatment
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dapsone, rifampin, clofazimine.
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what drug has significant different in fast and slow acetylators?
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isoniazid
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which drug injures neurons and hepatocytes
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isoniazid
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which drug is used to decrease synthesis of mycolic acids. Catalase peroxidase (katG) is needed to convert this to active metabolites.
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isoniazid
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how do you prevent the neurotoxicity resulting from isoniazid?
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give pyridoxine, vitamin B6.
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which drug used for TB inhibits DNA dependent RNA pol?
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rifampin.
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orange body fliuds?
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rifampin
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RNA polymerase inhibitor, revs up P450, red/orange body fluids, rapid resistance if used alone?
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rifampin
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inhibition of mycolic acid production by blocking mycobacterial fatty acid synthase I. Effective in acidic pH of phagolysosomes where TB engulfed by macrophages are found
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pyrazinamide.
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carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase
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ethambutol
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red-green color blindness.
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ethambutol
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prophylaxis for meningococcal infection
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ciprofloxacin, rifampin, minocycline
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prophylaxis for gonorrhea infection
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ceftriaxone
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prophylaxis for syphilis infection
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benzathine penicillin G
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prophylaxis for recurrent UTI infection
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TMP-SMX
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prophylaxis for endocarditis with surgical or dental procedures
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penicillin.
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if a patient cannot tolerate TMP-SMX for HIV prophylaxis what can you give him instead? and what is he vulnerable for if he doesn't take TMP-SMX
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aerosolized pentamide. He is at risk for toxoplasmosis infection.
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prophylaxis for HIV under CD4<200? What are you trying to prevent?
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TMP-SMX. Pneumocystitis pneumonia
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prophylaxis for HIV under CD4<100? What are you trying to prevent?
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TMP-SMX. Pneumocystitis pneumonia. Toxoplasmosis
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prophylaxis for HIV under CD4<50? What are you trying to prevent?
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azithromycin. m. avium complex
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treatment of MRSA
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vancomycin
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treatment of VRE
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linezolid, streptogramins (quinupristin/dalfopristin)
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outpatient setting community acquired pneumonia treatment
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macrolides
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inpatient setting community acquired pneumonia treatment
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fluoroquinolones
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ICU setting community acquired pneumonia treatment
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beta lactam and fluoroquinolones or azithromycin.
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which drug binds to ergosterol, form membrane pors that allow leakage of electrolytes?
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amphotericin B.
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how hsould amphotericin B be administered for meningitis?
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intrathecally. Does not cross BBB
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how doy ou treat serious systemic mycosis?
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with amphotericinB
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what supplement should you be giving someone who is getting amphotericin B?
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potassium and magnesium. This is due to altered renal tubule permeability.
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shake and bake
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amphotericinB.
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phlebitis from fungal treatment
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amphotericin B.
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fever, chills, hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis
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amphotericin B.
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oral candidasis (thrush) treatment, diaper rash, vaginal candidiasis
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nystatin.
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inhibition of sterol ergosterol synthesis by inhibiting p450 nezyme that converts lanosterol to ergosterol
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azoles.
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treatment of cryptococcal meningitis in AIDS
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azole
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treatment of candida infection of all types
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azoles.
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antifungal resulting in gynecomastia.
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azoles.
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inhibit DNA synthesis in fungi by conversion by cytosine deaminase.
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flucytosine.
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which antifungal requires triphosphorylation resulting in a product that inhibits thymidylate synthase?
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flucytosine.
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systemic fungal infection in combinatinon with amphotericin B
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flucytosine.
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which antifungal inhibit cell wallsynthesis by inhibiting synthesis of B-glucan?
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caspofungin.
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treatment of invasive aspergillosis and candida?
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caspofungin
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which antifungal inhibit the fungal enzyme squalene eposidase and in tern decrease the amount of ergosterol?
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terbinafine.
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treatment of dermatophytes especially onychomycosis
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terbinafine.
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which antifungal interferes with microtubule function. Distrupts mitosis, deposit in keratincontaining tissue?
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griseofulvin.
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which antifungal is used as an oral treatment of superficial infections, inhibit the growht of dermatophytes (tinea, ringworm)
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griseofulvin.
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treatment of toxoplasmosis or plasmodium falciparum
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pyrimethamine
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treatment of t. brucei
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suramin and melarsoprol
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treamtent of t. cruzi
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nifurtimox
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treatment of leishmaniasis
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sodium stibogluconate
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treatment of malaria
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chloroquine.
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what blocks plasmodium heme polymerase?
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chlorquine.
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what is used for prophylaxis of malaria
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chloroquine.
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what is used for resistant species of malaria?
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quinine, pyrimethamine and sulfonamide.
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name helminth drugs
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mebendazole, pyrantel, pamoate, ivermectin, diethylcarbamazine, praziquantel
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what drug can be used as influenza A prophylaxis and parkinson's disease
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amantadine.
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what drug block viral penetration/uncoating by M2 protein?
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amantadine
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which antiviral results in release of DOPAMINE from intat nerve terminals?
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amantadine.
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which drug is used for influenza A and has less CNS problems?
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rimantadine.
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what area of the brain is negatively affected when amantadine is used?
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cerebella.
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how much of influenza A virus is resistant to amantadine?
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about 90%.
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which drugs inhibit influenza neuraminidase, decreasing the release.
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zanamivir, oseltamivir.
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what is used to treat influenza A and b
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zanamivir, oseltamivir.
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what is used to treat RSV and chronic hepatitis C?
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ribavirin
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what inhibits the synthesis of guanine nucleotides by competitively inhibitng IMP dehydrogenase?
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ribavirin
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what antiviral is monophosphorylated by virus thymidine kinase? And is a guanocine analogue? Treat HSV, VZV and EBV
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acyclovir
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antiviral tat preferetnailly inhibits viral DNA pol by chain termination?
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acyclovir
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which antiviral is a prodrug, has better oral bioavailability, and used to treat HSV, VZV, EBV
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valacyclovir
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which drug is used to treat herpes zoster?
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famciclovir
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5' monophosphate formed by a CMV viral kinase. quanosine analogue. Preferentially inhibit viral DNA polymerase.
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ganciclovir.
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treatment of CMV
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ganciclovir.
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treamtent of CMV with better bioavaiability
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valganciclovir.
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which antiviral can result in leukopenia, neutropenia, thrombocytopenia and renal toxicity?
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ganciclovir
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what is the viral DNA pol inhibitor that binds to pyrophosphate binding site of the enzyme and does not require activation by viral kinase?
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FOSCARNET.
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treatment of CMV retinitis in immunocompromise patietns when ganciclovir fails
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foscarnet.and cidofovir.
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pyrophosphate analog
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foscarnet
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preferential inhibition of viral DNA polymerase and does not require phosphorylation by viral kinase.
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cidofovir as well as foscarnet. Treatment of CMV retinitis
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what antiviral should be coadministered with probenecid?
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cidofovir to avoid nephrotoxicity.
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what are the three that are included in the HAART?
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2 nucleoside reverse transcriptase inhibitor, 1 non nucleoside reverse transcriptase inhibitor or 1 protease inhibitor or 1 integrase inhibitor.
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navir
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protease inhibitors
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what does protease inhibitior for HIV do?
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depends on HIV-1 protease. Which cleaves the polypeptide product of HIV mRNA into their functional parts. Thus protease inhibitor prevent maturation of new viruses.
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which protease inhibitor block p450
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ritonavir
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which HIV treatment results in cushings like syndrome?
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protease inhibitor. Called lipodystrophy.
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which HIV treatment competitively inhibit nucleotide binding to reverse transcriptase and terminate the DNA chain? Must be phosphoryalted by thymdine kinase to be active
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nucleoside reverse transcriptase inhibitors.
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which HIV treatment binds to reverse transcriptase at site different form NRTI and does not require phosphorylation to b active or compete with nucleotides
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NNRTIs. Non nucleoside reverse transcriptase inhibitor.
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what drug is used in HIV patients prophylaxis during pregnancy to reduce transmission?
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AZT/ZDV
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what is the integrase inhibitor in HIV
|
raltegravir
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interferon for hepatitis b and c
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alpha
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interferon for kaposi sarcoma
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alpha
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interferon for ms
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beta
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interferon for NADPH oxidase deficiency
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gamma
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interferon toxicity
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neutropenia
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inhibit HIV genome integration into the host cell chromosome by reversibly inhibiting HIV integrase.
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raltegravir
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pregnancy affect of sulfonamides
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kernicterus
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pregnancy affect of aminoglycosides
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ototoxicity
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pregnancy affect of fluoroquinolone
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cartilage damage
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pregnancy affect of tetracycline
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discolored teeth, inhibition of bone growth
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pregnancy affect of chloramphenicol
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gray baby
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pyrimethamine
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inhibits dihydrofolate reductase.
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quinine
|
chloroquinine. Interferes with plasmodium heme polymerase
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mefloroquine
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chloroquinine. Interferes with plasmodium heme polymerase
|
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teratogenic antibiotics
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, clarithyromycine, sulfonamides, aminoglycosides, fluoroquinolone, metronidazole, tetracycline, ribavirin, griseofulvin, chloramphenicol
|
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which drug is used for the atypical pneumonias such as mycoplasma, chlamydia, legionella,
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macrolides
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which drug could result in aplastic anemia due to poor dosing?
|
cloramphenicol.
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