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209 Cards in this Set
- Front
- Back
What is the mechanism of action of PCN
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cell wall synthesis blocker by inhibition of peptidoglycan cross-linking
1.) bind PCN binding proteins 2.)block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes |
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What is the mechanism of action of ampicillin
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cell wall synthesis blocker by inhibition of peptidoglycan cross-linking
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What is the mechanism of action of ticarcillin
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cell wall synthesis blocker by inhibition of peptidoglycan cross-linking
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What is the mechanism of action of piperacillin
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cell wall synthesis blocker by inhibition of peptidoglycan cross-linking
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What is the mechanism of action of imipenem
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cell wall synthesis blocker by inhibition of peptidoglycan cross-linking
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What is the mechanism of action of aztreonam
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cell wall synthesis blocker by inhibition of peptidoglycan cross-linking
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What is the mechanism of action of cephalosporins
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cell wall synthesis blocker by inhibition of peptidoglycan cross-linking
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What is the mechanism of action of Bacitracin
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block peptidoglycan synthesis
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What is the mechanism of action of vancomycin
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block peptidoglycan synthesis
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cycloserine
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block peptidoglycan synthesis
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What is the mechanism of action of Polymyxins
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Disrupt bacterial/fungal cell membranes
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What is the mechanism of action of
ampho B |
disrupt fungal membranes
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What is the mechanism of action of nystatin
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disrupt fungal membranes
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What is the mechanism of action of fluconazole/azoles
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disrupt fungal membranes
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What is the mechanism of action of Sulfonamides
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Block nucleotide synthesis -- PABA antimetabolites inhibit dihydropterate synthesis
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What is the mechanism of action of trimethoprim
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Block nucleotide synthesis---inhibits bacterial dihydrofolate reductase
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What is the mechanism of action of Quinolones
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Block DNA topoisomerases
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What is the mechanism of action of Rifampin
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block mRNA synthesis
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What is the mechanism of action of Chloramphenicol
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block protein synthesis at the 50S ribosomal subunit
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What is the mechanism of action of erythromycin/macrolides
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block protein synthesis--at the 50S ribosomal subunit
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What is the mechanism of action of clindamycin
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block protein synthesis at 50S ribosomal subunit
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What is the mechanism of action of streptogramins (quinupristin, dalfopristin)
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block protein synthesis at 50S ribosomal subunit
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What is the mechanism of action of linezolid
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block protein synthesis at 50S ribosomal subunit
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What is the mechanism of action of Aminoglycosides
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block protein synthesis at 30S ribosomal subunit
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What is the mechanism of action of tetracyclines
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block protein synthesis at 30S ribosomal subunit
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Which antibiotics block cell wall synthesis by inhibition of peptidoglycan cross linking
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PCN, Ampicillin, ticarcillin, piperacillin, imipenems, aztreonam, cephalosporins
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Which antibiotics block peptidoglycan synthesis
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Bacitracin, Vancomycin, cycloserine
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Which antibiotics disrupt bacterial/fungal cell membranes
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Polymyxins
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Which antibiotics disrupt fungal cell membranes
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Ampho B, nystatin, fluconazole/azoles
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which antibiotics block nucleotide synthesis
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Sulfonamides, trimethroprim
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Which antibiotics block DNA topoisomerases
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Quinolones
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Which antibiotics block mRNA synthesis
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Rifampin
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Which antibiotics block protein synthesis at 50S ribosomal subunit
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Buy AT 30, CELL at 50
Chloramphenicol Erythromycin/Macrolides Lincomycin Clindamycin Streptogramins (quin/dalfo) Linezolid |
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Which antibiotics block protein synthesis at 30S ribosomal subunit
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Buy AT 30, CELL at 50
Aminglycosides Tetracyclines |
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What are the bactericidal antibiotics
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PCN, Cephalosporins, Vanco, Aminglycosides, Fluoroquinolones, Metronidazole
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What is the clinical use for PCN
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bactericidal for GPC, GPR, GNC and spriochetes but is not PCNase resistant
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what is most common toxicity with PCN
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hypersensitivity rxns
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What is the mechanism of action for methicillin, nafcillin, dicloxacillin
Clinical Use |
Block cell wall resistance--PCNase resistant b/c of bulkier R group.
Narrow Spectrum MSSA, not MRSA |
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What toxicity is assoc with Methicillin
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Interstitial Nephritis
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What is the mechanism of Ampicillin and Amoxicillin
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Wider spectru B-lactam, PCNase sensitive
can combine with clavulanic acid --> PCNase inhibitor |
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What is the clinical use of Ampicillin and Amoxicillin
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Extended spect PCN --> GPs and GN (H. flu, E.coli, Listeria, Proteus, Salmonella, enterococci)
Amp/Amox HELPS kill enterococci |
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What is the mech of Tic/Carbenicillin, Pipercillin
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extended spectrum PCN
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What is the clinical use of Tic/ Carbenicilline, piperacillin
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Takes Care of Pseudomonas
Pseudomonas, GNRs; susceptible to PCNase (use with clavulanic acid) |
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What is the mech of action of Cephalosporins
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B-lactam that are less susceptible to PCNases.
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What is the clinical use of 1st gen cephalosporins (Cephalexin, Cefazolin)
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GPC + proteus, E.coli, Klebsiella
1st Gen -PEcK |
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What is the clinical use of 2nd gen cephalosporins (cefoxitin, cefaclor, cefuroxime)?
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2nd gen -- HEN PEcKS
H. flu, Enterobacter, Neisseria, Proteus, E.coli, Klebsiella, Serratia |
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what is the clinical use of 3rd gen cephalosporins (ceftriaxone, cefotaxime, ceftazidime)
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serious GN infxns resistant to other B-lactams
meningitis -- penetrate BBB ceftazidime -- Pseudomonas Ceftriaxone -- Gonococcus |
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What is the clinical use of 4th gen cephalosporins (cefpime, ecfpiramide)
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increased Pseudomonal and GP activity
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What is the most common toxicity with cephalosporins
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Hypersensitivity rxns -- 5-10% cross reactivity w/ PCN;
disulfram like rxn with ETOH |
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What is the mech of Aztreonam
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Inhib cell wall synthesis--monobactam resistant to B-lactamases (bind PBP3)
synergistic with Aminoglycosides |
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What is the clinical use of Aztreonam
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GNR -- klebsiella, Pseudomonas, Serratia; no GP or anaerobic coverage
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What is the mechanism of action of imipenem/cilastatin, meropenem
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Imipenem is broad spectrum- B-lactamase resistsant carbapenem
Alway admin w/ cilastain to decrease inactivation in renal tubules |
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What is the clincal use of Imi and meropenem
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GPC, GNR and anaerobes, enterobacter
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What is the toxicity assoc w/ Imi and meropenem
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GI, rash, CNS (seizures)
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What is the mech of vancomycin
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inhib cell wall mucopeptide by binding D-ala -D-ala portion of cell wall. Bactericidal
resistance in AA change to D-ala --D-lac |
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What is the clinical use of Vancomycin
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MRSA and C. Diff.
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What toxicities are assoc w/ Vanc
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Nephrotoxicity, Ototoxicity, Thrombophlebitis, Red Man Syndrome
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What is the mechanism of action of Aminoglycosides (Gent, Neo, Amikacin, Tobra, Strepto)
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30S inhibitors -- inhibit formation of initiation complex and cause mRNA misreading
require O2 for uptake--> ineffective vs anaerobes |
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What is the clinical use of Aminoglycosides
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Severe GNR infxn -- synergistic with B-lactams
Increase uptake with cell wall synthesis inhibition |
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What is the primary toxicity with Aminoglycosides
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Nephrotoxicity, Ototoxicity, Teratogen
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Which antibiotics are Aminoglycosides
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GNATS
Gent, Neo, Amikacin, Tobra, Strepto |
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What abx are tetracyclines
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Tet, doxy, demeclocycline, minocycline
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What is the mechanism of action of tetracycline
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bind 30S and prevent aminoacyl-tRNA
limited CNS penetration, not to take with milk |
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What is the clinical use of tetracyclines
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VACUUM THe BedRoom
Vibrio, Acne, Chlamydia, Ureaplasam Urealyticum, Mycoplasma, Tularemia, H.pylori Borrelia (lyme), rickettsia (RMSF) |
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what is the toxicity assoc w/ tetra
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GI, teeth discoloration, inhibition of bone growth
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What are the macrolides
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Erythro, Azithro, Clarithro
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What is the mech of action of macrolides (erythro, azithro, clarithro)
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50S inhibitors-- block translocation by binding 23S rRNA of 50S subunit
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What is the clinical use of macrolides
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URI, PNA, STD
URI and PNA:GPC (tx strep in pts w/ PCN allergies)Mycoplasma, legionella, STD: Chlamydia, Neisseria |
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What is the toxicity assoc c/ macrolides
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GI, acute cholestatic hepatitis, eosinophilia,
increases serum concentrations of theophyllines and oral anticoags |
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What is the mechanism of chloramphenicol
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inhib 50S peptidyltransferase
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What is clinical use of chloramphenicol
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meningitis (H flu, Neisseria, Strep pneumo)
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What is the toxicity assoc w/ Chloramphenicol
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Anemia, aplastic anemia, gray baby syndrome b/c lack UDP-glucuronyl transferase
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What is the mech of clindamycin
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block peptide formation at 50S subunit
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What is the clinical use of clindamycin
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Anaerobic infections above the diaphragm
Bacteroides fragilis, clostridium perfringens |
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What is the toxicity assoc w/ clindamycin
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Pseudomembranous colitis (c.diff), fever, diarrhea
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What is the mech of sulfonamides
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block nucleotide synthesis -- PABA antimetab inhib DHP synthese --> decrease in THF
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what is the clinical use of sulfas
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GP, GN, Nocardia, Chlamydia
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what is the toxicity with sulfas
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hemolysis in G6PD, tubulointerstitial nephritis, kernicterus in infants, displace other albumin bound drubs (warfarin)
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What is the mech of TMP
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inhib bacterial DHF reductase --> sequential block of folate synthesis in combo with sulfa
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what is the clinical usage of SMX/TMP
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recurrent UTI -- Shigella, Salmonella,
Pneumocystis carinii PNA |
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What is the toxicity assoc w/ TMP
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megaloblastic anemia, leukopenia, can supp with folinic acid
|
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What are the fluoroquinolones
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cipro, norflox, oflox, sparflox, moxi, gati, enoxacin (FQs);
nalidixic acid (Quinolone) |
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what is the mech of FQs
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DNA Gyrase inhibitors (topo II)
|
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what is the clinical use of FQa
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GNR of UTI and GI infxns
Pseudomonas, Neisseria and some GPs |
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What is the toxicity assoc w FQs
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GI, superinfxn, rash, HA , dizziness
Contra in prego 2/2 cartilage damage Tendonitis in adults |
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What is the mech of metronidazole
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forms toxic metabolites in bacterial cells
|
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what is the clinical use of Metro
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GET GAP on the Metro
Antiprotozoal Giardia, Entamoeba, Trichomonas Garnerella, Anaerobes (Bacteroides, Clostridium), H. Pylori |
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What is the toxicity assoc w/ Metro
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disulfram-like rxn with ETOH, HA and metallic taste
|
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What is the mechanism of polymyxin
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bind to cell membranes of bacteria and disrup their osmotic properties (cationic base proteins like detergents)
|
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What is the clinical use of polymyxin
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reisistant GN infxns
|
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What is the toxicity assoc with Polymyxins
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Neurotoxicity, acute renal tubular necrosis
|
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What are the anti-TB drugs
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INH-SPIRE
INH -- Streptomycin, Pyrazinamide, INH, Rifampin, Ethambutol all hepatotoxic |
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What is the mech for INH
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decrease synth of mycolic acids
|
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what is the clinical use and toxicity
|
MTB (solo prophylaxis)
Toxicity: slow acetylators --neuro and hepatotoxic; hemolysis in G6PD, SLE-like syndrome, Pyridoxine (vit B6) can prevent neurotoxicity |
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What is the mechanism of Rifampin
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inhib DNA-dep RNA polymerase, increases microsomal p-450 system
red-orange body fluids rapid resistance if used solo |
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What is the clinical use of rifampin
|
MTB,
delays resistance to dapsone when use in leprosy meningococcus prophylaxis chemoprophylaxis in HIB in kids |
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What is the resistance mechanism to PCN/Cephalosporins
|
B-lactamase cleavage of B-lactam ring
|
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What is the resistance mechanism to Aminoglycosides
|
Modification via acetylation, adenylation, phosphorylation,
AGs are 50S inhib of initiation complex |
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What is the resistance mechanism to Vancomycin
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Terminal D-ala of cell wall replaced with D-lac --> decrease affinity
|
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What is the resistance mechanism to chloramphenicol
|
modification via acetylation
chloramphenicol inhibits 50S peptidyltransferase |
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What is the resistance mechanism to macrolides
|
methylation of rRNA near erythromycins ribosome binding site
Macrolides block translocation |
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What is the resistance mechanism to Tetracyclines
|
decreased uptake or increased transport out of cell
Tetracycline binds the 30S and prevent attachment of aminoacyl-tRNA |
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What is the resistance mechanism to Sulfonamides
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Altered enzyme (bacterial DHP synthetase), decreased uptake, or increase PABA synthesis
|
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What is prophylaxis for meningococcus
|
Rifampin or minocycline
|
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What is prophylaxis for Gonorrhea
|
Ceftriaxone
|
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What is prophylaxis for Syphilis
|
Benzathine PCN G
|
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What is prophylaxis for hx of recurrent UTI
|
TMP-SMX
|
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What is prophylaxis for Pneumocystis carinii PNA
|
TMP-SMX
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What is prophylaxis for endocarditis with surg or dental procedures
|
PCNs
|
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What is the mechanism of Ampho B
|
bind ergosterol, forms membrane pores --> leakage of electrolytes
|
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what is Ampho B used for
|
Crypto, Blasto, Coccidoides, Aspergillus, Histo, Candida, Mucor
does not cross BBB --> intrathecal |
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toxicity with Ampho B
|
fever/chills, phebitis, nephrotoxicity
|
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What is mech of nystatin
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binds ergosterol, disrupt fungal membrane
|
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use of nystatin
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oral candidiasis, diaper rash
|
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mech of azoles
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inhib fungal steroid (ergosterol) sythesis
|
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use of azole
|
systemic mycosis
fluconazole in crypto meningitis in AIDS; candidal ifxn Keto--Blasto, coccidioides, histo, candida |
|
toxicity with azoles
|
hormone synthe inhib (gynecomastia), liver dysfx (inhib cytochrom p450
|
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mech of flucytosine
|
inhib DNA synthesis by conversion to FU competing with U
|
|
use of flucytosine
|
system fungal infxn--candida, crypto
|
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mech of caspofungin
|
inhib cell wall synthesis
|
|
use of caspofungin
|
invasive aspergillosis
|
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mech of terbinafine
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inhib fungal enzyme sqalene epoxidase
|
|
use of terbinafine
|
tx dermatophytoses (onychomycosis)
|
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mech of Griseofulvin
|
interferes with microtubule function, disrupts mitosis --. deposits in keratin containing tissues (nails)
|
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use of griseofulvin
|
oral tx of superficial infxn, inhib growth of dermatophytes (tinea, ringworm)
|
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toxicity of griseofulvin
|
teratogenic, carcinogenic, HA, increse p450 and warfarin metab
|
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What are basic mechanism of antiviral therapy
|
inhib viral absorption (nonspec)
block uncoating (influ A) block early protein synthesis (CMV) Reverse transcriptase inhib block packaging and assembly (vaccinia) block viral release (influenza) |
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what is the use, mech, and mech of resistance of amantadine
|
use: Influenza A --tx and prophylaxis
parkinsons mech:blocks viral penetration (M2 protein) resistance: M2 protein (90% in FluA) |
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what is the use, mech, and mech of resistance of zanamavir/oseltamivir
|
use: influenza A and B
mech: inhib neuraminidase --> decreased viral release resistance: segments genomic shifts |
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what is the use, mech, and mech of resistance of ribavirin
|
use: RSV, hepC
mech: inhib synthesis of guanine tox: hemolytic anemia, severe teratogen |
|
what is the use, mech, and mech of resistance of acyclovir
|
Use: HSV, ZVZ, EBV, prophylaxis in IC pts
Mech: inhib viral DNA polymerase when phosphorylated by thymidine kinase Resist: lack of thymidine kinase |
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what is the use, mech, and mech of resistance of gancyclovir
|
USE: CMV, in IC pts
Mech: inhib CMV DNA polymerase after phosphorylation by viral kinase Resist: mutation in DNA polymerase or absence of thymidine kinase |
|
what is the use, mech, and mech of resistance of Foscarnet
|
USE: CMV retinitis in IC pts, when gancyclovir fails, also acyclovir resistant HSV
mech: viral DNA poly inhib, not required to be phosphorylated resist: mutated DNA polymerase |
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what are some of the protease inhibitors
|
ritonavir, indinavir, nelfinavir
|
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what is the mech of protease inhibitors
|
inhib new virus assembly by blocking protease in progeny viruses
|
|
what is the toxicity of protease inhibitros
|
GI, hyperglycemia, lipodystrophy, thrombocytopenia
|
|
what are some of the RTIs
|
Nucl: zidovudine (AZT), diadanosine (DDI), lamivudine (3TC)
NonNucl: nevirapine, efavirenz, delavirdine |
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What is the mech of NRTI, NNRTIs
|
inhib RT of HIV, prevent incorporation into host genome
|
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What is the toxicity of NRTIs
|
BM suppression, lactic acidosis, rash
|
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What is the clinical use of NRTI
|
HAART --> CD4 < 500 or high viral load
|
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what is the use, mech, and toxicity of Interferons
|
USE: IFN-a chronic hep B and C, kaposi's; IFN-b --MS, IFN-g -- NADPH oxidase deficiency
Mech: -- glycoproteins from human leukocytes that block viral RNA and DNA synthesis, induce ribonuclease that degrades viral mRNA Toxicity: neutropenia |
|
What is Ivermectin use in
|
Onchcerciasis (rIVER blindness tx w/ IVERmectin
|
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What is mebendazole/thiabendazole used in
|
Nematode/roundworm (pinworm, whipworm)
|
|
What is pyrantel pamoate used in
|
Giant roundworm (ascaris), hookworm(necator/ancylostomia)
pinworm (enterobius) |
|
waht is praziquantel used in
|
trematod/fluke (schotsome, paragonimum, clonorhci and cysticercosis
|
|
what is niclosamide used in
|
cestode/tapeworm (diphyllobothrium latum, tenia) except cysticercosis
|
|
what is pentavalent antimony used in
|
Leishmaniasis
|
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What is chloroquine, quinine, mefloquine, atovaquone used in
|
malaria
|
|
what is primaquine used in
|
latent hypnozoite (liver) forms of malaria--vivax and ovale
|
|
What is metronidazole used in
|
Giardia, amedic dysentery (entamoeba histolytica), BV (gardnerella), and trichomonas
|
|
what is TMP-SMX use in prophylactically
|
Pneucystic carinii PNA prophylaxis
|
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What is nifurtimox used in
|
Chagas dz, american trypanosomiasis (trypanosoma cruzi)
|
|
What is Suramin use in
|
African trypanosomiasis (sleeping sickness)
|
|
What antibiotics should be avoided in pregnancy
|
SAFE Mom Take Really Good Care
Sulfa (kernicterus), AG (ototoxic), FQ (cartilage), Erythro (hepatitis) Metro (mutagen), Tetracycline (discolored teeth, inhib bone growth), Ribavirin (teratogen), Griseofulvin (teratogen), Chloramphenicol (gray baby) |
|
What is the normal flora of the skin
|
staph epi
|
|
What is the normal flora of the nose
|
Staph aureus
|
|
What is the normal flora of the oropharynx
|
viridans strep
|
|
What is the normal flora of the dental plaque
|
strep mutans
|
|
What is the normal flora of the colon
|
bacteroides > e.coli
|
|
What is the normal flora of the vagina
|
lactobacillus, e.coli, GBS
|
|
What orgs cause PNA in Children (6wk-18yr)
|
Virus (RSV)
Mycoplasma, Chlam PNA, Strep Pneumo |
|
what orgs cause PNA in Adults (18-40)
|
Mycoplasma, C pneumo, S pneumo
|
|
What orgs cause PNA in Adults (40-65)
|
S. pneumo
H flu Anaerobes Viruses and Mycoplasma |
|
What orgs cause PNA in Elderly
|
S. Pneumo
Virus Anaerobes H flu GNR |
|
Org responsible in Hosp Acq PNA
|
Staph, GNR
|
|
Orgs responsible in IC PNA
|
Staph, GNR, fungi, viruses, Pneumocystis in HIV
|
|
Orgs in aspiration PNA
|
anaerobes
|
|
Orgs in Postviral PNA
|
Staph, H flu
|
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Orgs in Neonatal PNA
|
GBS, E. coli
|
|
Orgs in atypical PNA
|
Mycoplasma, Legionella, Chlamydia
|
|
Orgs in Neonatal Meningitis
|
GBS, Ecoli, Listeria
|
|
orgs in meningitis in kids (6mos-6yrs)
|
S pneumo, N. mening, H flu, Enterovirus
|
|
orgs in meningitis b/w 6yr and 60yrs
|
N. mening
Enterovirus S. pneumo HSV |
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orgs in meningitis in elderly
|
S. pneumo
GNR Listeria |
|
orgs in osteo
|
S. aureus
|
|
osteo in sexually active
|
N. gono
|
|
osteo in DM
|
Pseudomonas
|
|
Osteo in Sickle cell
|
Salmonella
|
|
Osteo in Prosthetic replacement
|
S aureus, S epi
|
|
org in Vertebral osteo
|
potts-- MTB
|
|
org in Ambulatory UTI
|
Ecoli, Klebsiella, Staph sapro (yg women)
|
|
orgs in hospital UTI
|
ecoli, proteus, klebsiella, serratia, pseudomonas
|
|
What does positive Leukocyte esterase and positive nitrite test indicate
|
Leukocyte esterase -- bacterial
nitrite test -- gram negative |
|
What STD would cause a rectal strictures
|
Lymphogranuloma venereum
|
|
What strains of HPV cause condylomata accuminata
|
HPV 6 and 11
|
|
what are the clinical feature fo chancroid and what is the org
|
painful genital ulcer, haemophilus ducreyi
|
|
What risk factor is assoc w/ CMV and RSV infxns
|
newborn nursery
|
|
what org would likely to cause infxn 2/2 urinary catheterization
|
e coli
proteus |
|
What infxn in use of respiratory equipment assoc w/
|
Pseudomonas
|
|
what infxn in assoc w/ work in a renal dialysis unit
|
HBV
|
|
what infection is assoc w/ hyperalimentation
|
candida
|
|
what infection is assoc with water aerosols
|
legionella
|
|
What are the ToRCHeS in pregos
|
dangerous infections in pregos
Toxo Rubella CMV HSV/HIV Syphilis |
|
What org?
pus, empyema, abscess |
S. aureus
|
|
what bug
Pediatric infxn, epiglottis |
H flu
|
|
what bug
PNA in CF or burn victim |
pseudomonas
|
|
what bug
branching rod in oral infxn |
Actinomyces
|
|
what bug
traumatic open wound |
clostridium perfringens
|
|
what bug
surgical wound |
s. aureus
|
|
what bug
dog or cat bite |
pasteurella
|
|
what bug
currant jelly sputum |
klebsiella
|
|
what bug
sepsis/meningitis in newborn |
GBS
|
|
OI in AIDS
Brain |
Crypto, toxo, CMV, AIDS dementia, PML (JC virus)
|
|
OI in AIDS
Eyes |
CMV retinitis
|
|
OI in AIDS
Mouth and throat |
thrush -- Candida albican, HSV, CMV, oral hairy leukoplakia (EBV)
|
|
OI in AIDS
Lungs |
PCP, TB, histo
|
|
OI in AIDS
GI |
Cryptosporidiosis, MAC, CMV colitis, NHL (EBV)
|
|
OI in AIDS
Skin |
Shingles (VZV), kaposi (hHV-8)
|
|
OI in AIDS
Genitals |
HSV, warts, cervical Ca (HPV)
|