Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
46 Cards in this Set
- Front
- Back
|
Sulfonamides & Trimethoprim MOA
|
disrupt tetrahydrofolic acid synthesis = suppressed bacterial growth
|
|
|
Sulfonamides & Trimethoprim
Spectrum? |
Broad
|
|
|
1st Systemic Antx
|
Sulfonamides
|
|
|
Sulmonamides MOA
|
Inhibits Folic Acid Synthesis
|
|
|
Sulfonamides Uses
|
Uti (E. Coli) , Chlamydia, toxoplasmosis, malaria, ulcerative colitis
|
|
|
Sulfonamides Adverse Effects
|
Hypersensitivity (e.g. Stevens-Johnson syndrome),Hematologic,
Kernicterus,Crystalluria = kidney damage |
|
|
Sulfonamides
Drug Interactions |
Metabolism-related interactions
Allergy-inducing drugs |
|
|
Trimethoprim Uses
|
Acute, uncomplicated UTIs
|
|
|
Trimethoprim
Adverse Effects |
Hematologic, Pregnancy & lactation
|
|
|
Trimethoprim-Sulfamethoxazole
|
Inhibits sequential steps in synthesis of folic acid; more powerful than either drug alone
|
|
|
Trimethoprim-Sulfamethoxazole
Uses |
UTI, otitis media, bronchitis, Shigellosis, Pneumocystis jiroveci, P. pneumoniae, GI infections
|
|
|
Trimethoprim-Sulfamethoxazole
Adverse Events |
N/V, rash, hypersensitivity (Stevens-Johnson), blood dyscrasias, kernicterus, crystalluria – renal damage
|
|
|
Most Common Infection
|
UTI
|
|
|
Acute pyelonephritis, Acute bacterial prostatitis
|
Upper UTI Infection (Kidney)
|
|
|
Acute cystitis
Acute urethral syndrome |
Lower UTI infection (bladder, urethra)
|
|
|
80% of UTIs
|
Uncomplicated, community acquired (E. Coli)
|
|
|
Klebsiella, Proteus, Enterobacter, Pseudomonas, staph, enterococci, E. coli
|
Hospital-acquired UTI
|
|
|
1. Nitrofurantoin (Furadantin, Macrodantin, Macrobid)
2. Methenamine (Mandelamine, Hiprex, Urex) 3. Nalidixic acid (NegGram) 4. Cinoxacin (Cinobac) |
Urinary Tract Antiseptics
|
|
|
Antimycobacterials treat?
|
TB, Leprosy, & M. avium Complex
|
|
|
Tx for Mycobacterial Infections
|
Slow-growing microbes = prolonged tx
Drug toxicity & patient adherence = promotes drug-resistance |
|
|
Global epidemic ~2 billion people worldwide
|
TB
|
|
|
TB transmission?
|
Person-person
Coughing & sneezing |
|
|
TB Diagnosis
|
CXR, Sputum culture (AFB)
Evaluation of drug susceptibility |
|
|
TB Treatment
|
2 or more drugs
Direct observation of drug administration is standard of care Intermittent dosing Tx effective when sputum mycobacteria-free & culture shows no colonies |
|
|
TB Drug Resistance Causes
|
Some bacilli inherently resistant
Some bacilli develop resistance during tx Infection w/resistant TB acquired through Contact w/someone who has resistant bacteria Repeated ineffectual tx |
|
|
1st Line TB Drugs
|
INH, rifampin, rifapentine, rifabutin, pyrazinamide, ethambutol
|
|
|
Injectable second-line anti-TB drugs
|
amikacin, kanamycin, or capreomycin
|
|
|
TB drug duration
|
6-24 months. Induction and Continuation phases
|
|
|
Latent TB
|
USA: 9-14 million people
|
|
|
2nd Line TB Drugs
|
Levofloxacin, moxifloxacin, kanamycin, amikacin, capreomycin, para-aminosalicylic acid, ethionamide, cycloserine
|
|
|
INH Adverse Effects
|
Peripheral neuropathy, Hepatotoxicity, Optic neuritis,Anemia
|
|
|
Rifampin (Rifadin) Uses
|
Hepatotoxicity, hepatitis; Discoloration of body fluids, GI disturbances
|
|
|
Rifampin Drug Interactions
|
Induces P450 – can increase drug metabolism
Oral contraceptives, warfarin, HIV drugs |
|
|
Pyrazinamide Adverse Effects
|
Hepatotoxicity,Hyperuricemia, GI disturbances
|
|
|
Ethambutol (Myambutol) Adverse Effects
|
Optic neuritis,Allergy, Hyperuricemia
|
|
|
Fluoroquinolones spectrum?
|
Broad. Gram - and some gram +
|
|
|
Fluoroquinolones Uses
|
Anthrax (drug of choice)
Infections – respiratory, urinary, bones, joints, skin, soft tissue |
|
|
Cipro (Fluoroquinolones) Adverse Effects
|
Mild) GI: N/V/D, abd pain; CNS: dizziness, HA, restlessness, confusion, sz (rare); Candida infections (pharynx & vagina)
Elderly pts: confusion, somnolence, psychosis, visual disturbances |
|
|
Cipro (Fluoroquinolones) Drug and Food Interactions
|
Absorption reduced by: aluminum or Mg antacids, iron or zinc salts, Sucralfate,dairy products
Elevation of drug levels |
|
|
Metronidazole (Flagyl) Uses
|
Protozoan infection, H.Pylori
|
|
|
Metronidazole (Flagyl) Adverse Events
|
Neurotoxicity
Allergy Superifections |
|
|
Systemic Mycoses causes (non-opportunistic)
|
sporotrichosis, blastomycosis, histoplasmosis, coccidiodomycosis
|
|
|
Antifungal Classes
|
1. Plyene antibx
2. Azoles 3. Echinocandins 4. Pyrimidine analogs |
|
|
Amphotericin B Uses
|
Drug of choice for system mycoses
|
|
|
Amphotericin B Adverse Effects
|
Infusion rxn, nephrotoxicity, hypokalemia (NS infusions)
|
|
|
Amphotericin B MOA
|
Binds to ergosterol Increases Cell Permeability
|
