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80 Cards in this Set
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Sulfamethoxazole (SMX)
sulfisoxizole triple sulfas sulfadiazine |
MECH: bacteriostatic, inhibits dihydropterate synthase which bac need to make folate
USE: Gm+, Gm-, Nocardia, Chlamydia, PCP, UTIs TOX: Cystalluria (tubulo-interstitial nephritis) hypersensitivity hemolytic anemia (G6PD deficiency) Kernicterus drug potentiation (warfarin; displaces other drugs from albumin) |
Sulfonamide
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Trimethoprim (TMP)
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MECH: bacteriostatic; inhibits bac dihydrofolate reductase interfering with folate production. Folate is needed for nucleic acids, cell growth.
USE: With sulfas, Gm-s are resistant TOX: folate deficiency → megaloblastic anemia, leukopenia, granulocytopenia (reversed with folinic acid - bac can't use) |
Trimethoprim
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Co-Trimoxazole
Bactrim |
MECH: inhibits two sequential steps of folate production in bac
USE: UTI (recurrent/chronic), PCP, Shigella, Salmonella, gonococcal urethritis, oropharyngeal gonorrhea TOX: derm, GI, heme (megaloblastic anemia, leukopenia, thrombocytopenia - reversed by folinic acid), HIV drug-induced fever, drug interactions (warfarin) |
TMP-SMX
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Penicillin G
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IV form
MECH: 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes USE: bateriocidal for gm+ cocci (esp. pneumococcus), gm+ rods (listeria), gm- cocci (gonococcus), spirochetes (syphillis) TOX: Hypersensitivity rxn (sometimes causing hemolytic anemia via haptens associated with RBC), diarrhea (imbalance of gut flora) |
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Penicillin V
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Oral form
MECH: 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes USE: bateriocidal for gm+ cocci (esp. pneumococcus), gm+ rods (listeria), gm- cocci (gonococcus), spirochetes (syphillis) TOX: Hypersensitivity rxn (sometimes causing hemolytic anemia via haptens associated with RBC), diarrhea (imbalance of gut flora) |
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Methicillin
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Penicillinase-resistant penicillin
MECH: 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes USE: S. aureus (except MRSA) TOX: Hypersensitivity rxn, *interstitial nephritis* |
Penicillinase-resistant penicillin
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Nafcillin
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Penicillinase-resistant penicillin
MECH: 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes USE: S. aureus (except MRSA) TOX: Hypersensitivity rxn |
Penicillinase-resistant penicillin
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Oxacillin
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Penicillinase-resistant penicillin
MECH: 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes USE: S. aureus (except MRSA) TOX: Hypersensitivity rxn |
Penicillinase-resistant penicillin
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Cloxacillin, dicloxacillin
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Penicillinase-resistant penicillin
MECH: 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes USE: S. aureus (except MRSA) TOX: Hypersensitivity rxn |
Penicillinase-resistant penicillin
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Ampicillin
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Aminopenicillin
MECH: 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes USE: penicillin + more gm- enterobac: H. flu E. coli Listeria Proteus Salmonella *combine with β-lactamase inhibitors (clavulanic acid) to extend TOX: Hypersensitivity rxn, rash, pseudomembranous colitis |
Extended-spectrum penicillin
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Amoxicillin
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Aminopenicillin (more orally bioavailable than Amp)
MECH: 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes USE: penicillin + more gm- enterobac: H. flu E. coli Listeria Proteus Salmonella *combine with β-lactamase inhibitors (clavulanic acid) to extend TOX: Hypersensitivity rxn, rash, pseudomembranous colitis |
Extended-spectrum penicillin
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Clavulanic acid
Sulbactam Tazobactam |
β-lactamase inhibitors
-Competitive inhibitor -Combine with penicillinase-sensitive penicillins |
Extended-spectrum penicillin
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Ticarcillin
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Anti-pseudomonal
MECH: 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes USE: Pseudomonas aeruginosa & gm- rods (H. flu, enterobactor, E. coli, Proteus) *combine with β-lactamase inhibitors (clavulanic acid) to extend to Klebsiella TOX: Hypersensitivity rxn |
Anti-pseudomonal
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Carbenicillin
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Anti-pseudomonal
MECH: 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes USE: Pseudomonas aeruginosa & gm- rods (H. flu, enterobactor, E. coli, Proteus) *combine with β-lactamase inhibitors (clavulanic acid) to extend to Klebsiella TOX: Hypersensitivity rxn |
Anti-pseudomonal
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Piperacillin
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Anti-pseudomonal
MECH: 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of cell wall 3. Activate autolytic enzymes USE: Pseudomonas aeruginosa & gm- rods (H. flu, enterobactor, E. coli, Proteus) *combine with β-lactamase inhibitors (clavulanic acid) to extend to Klebsiella TOX: Hypersensitivity rxn |
Anti-pseudomonal
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Cefazolin
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1st Gen Cephalosporin w/ bone penetration
MECH: β-lactam, inhibits cell wall synthesis (like penicillins) USE: gm+ cocci & Proteus E. coli Klebsiella TOX: Hypersensitivity reactions, disulfiram-like rxn |
cephalosporin
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Cephalexin
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1st Gen Cephalosporin w/oral admin
MECH: β-lactam, inhibits cell wall synthesis (like penicillins) USE: gm+ cocci & Proteus E. coli Klebsiella TOX: Hypersensitivity reactions, disulfiram-like rxn |
cephalosporin
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Cefotoxitin
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2nd Gen Cephalosporin
MECH: β-lactam, inhibits cell wall synthesis (like penicillins) USE: gm+ cocci & Bacteroides fragilis H. flu Enterobactor Neisseria Proteus E. coli Klebsiella Serratia TOX: Hypersensitivity reactions, disulfiram-like rxn |
cephalosporin
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Cefaclor
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2nd Gen Cephalosporin (oral)
MECH: β-lactam, inhibits cell wall synthesis (like penicillins) USE: gm+ cocci & H. flu Enterobactor Neisseria Proteus E. coli Klebsiella Serratia TOX: Hypersensitivity reactions, disulfiram-like rxn, *serum sickness* |
cephalosporin
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Cefuroxime
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2nd Gen Cephalosporin (oral)
MECH: β-lactam, inhibits cell wall synthesis (like penicillins) USE: gm+ cocci & H. flu Enterobactor Neisseria Proteus E. coli Klebsiella Serratia TOX: Hypersensitivity reactions, disulfiram-like rxn |
cephalosporin
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Ceftriaxone
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3rd Gen Cephalosporin w/ long t1/2 and good CSF penetration
MECH: β-lactam, inhibits cell wall synthesis (like penicillins) USE: gm- HEN PEcKS +, esp. Neisseria gonorrhea TOX: Hypersensitivity reactions, disulfiram-like rxn |
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Cefotaxime
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3rd Gen Cephalosporin w/ good CSF penetration
MECH: β-lactam, inhibits cell wall synthesis (like penicillins) USE: gm- HEN PEcKS + TOX: Hypersensitivity reactions, disulfiram-like rxn |
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Ceftazidime
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3rd Gen Cephalosporin
MECH: β-lactam, inhibits cell wall synthesis (like penicillins) USE: gm- HEN PEcKS +, esp. P. aeruginosa TOX: Hypersensitivity reactions, disulfiram-like rxn |
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Cefepime
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4th Gen Cephalosporin w/ good CSF penetration
MECH: β-lactam, inhibits cell wall synthesis (like penicillins) USE: gm+ & P. aeruginosa, E. coli, Klebsiella, Proteus TOX: Hypersensitivity reactions, disulfiram-like rxn |
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Aztreonam
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Monobactam
MECH: Inhibits cell wall synthesis; resistant to β-lactamase USE: Gm- rods: Klebsiella, Pseudomonas, Serratia *No activity against gm+ or anaerobes TOX: usually none |
β-lactam
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Imipenam/cilastatin
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Carbapenam
MECH: Inhibits cell wall synthesis; resistant to β-lactamase *cilastatin protects imapenam from cleavage which creates a nephrotoxic metabolite USE: very broad spectrum: gm+ cocci, gm- rods, anaerobes, esp. Enterobacter TOX: GI, rash, seizures (at high plasma levels) |
β-lactam
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Vancomycin
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MECH: bactericidal, inhibits cell wall formation by bindin D-ala D-ala portion of cell wall precursors
USE: gm+ MDR organisms - S. aureus, C. diff TOX: Fever, chills, phlebitis, red man syndrome (fast infusion), nephrotox, ototox |
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Tetracycline
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MECH: Bacteriostatic, binds 30S and prevents aminoacyl-tRNA attachment to inhibit protein synthesis
USE: V. cholera, Acne, Chlamydia, Ureaplasma, Mycoplasma pneumo, Tularemia, H. pylori, Borrelia burdorferi, Rickettsia TOX: GI distress, binds calcifying tissue → teeth discoloration & disrupted growth, photosensitivity Contraindicated in preg and renal failure, don't take with milk |
Protein synthesis inhibitor
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Doxycycline
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MECH: Bacteriostatic, binds 30S and prevents aminoacyl-tRNA attachment to inhibit protein synthesis
USE: V. cholera, Acne, Chlamydia, Ureaplasma, Mycoplasma pneumo, Tularemia, H. pylori, Borrelia burdorferi, Rickettsia TOX: GI distress, binds calcifying tissue → teeth discoloration & disrupted growth, photosensitivity *Can be used in pts with renal failure |
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Demeclocycline
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MECH: Bacteriostatic, binds 30S and prevents aminoacyl-tRNA attachment to inhibit protein synthesis; *antagonized ADH
USE: SIADH; V. cholera, Acne, Chlamydia, Ureaplasma, Mycoplasma pneumo, Tularemia, H. pylori, Borrelia burdorferi, Rickettsia TOX: GI distress, binds calcifying tissue → teeth discoloration & disrupted growth, photosensitivity Contraindicated in preg and renal failure, don't take with milk |
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Minocycline
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MECH: Bacteriostatic, binds 30S and prevents aminoacyl-tRNA attachment to inhibit protein synthesis
USE: V. cholera, Acne, Chlamydia, Ureaplasma, Mycoplasma pneumo, Tularemia, H. pylori, Borrelia burdorferi, Rickettsia, *can cross BBB to eradicate carrier state TOX: GI distress, binds calcifying tissue → teeth discoloration & disrupted growth, photosensitivity, *vestibular problems Contraindicated in preg and renal failure, don't take with milk |
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Gentamicin
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MECH: bactericidal, binds 30S inhibiting formation of initiation complex and causing mRNA misreading. Requires O2 for uptake.
USE: only aerobic, gm- rods TOX: Nephrotox (dose-related), Ototox, teratogen |
aminoglycoside
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Neomycin
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Topical
MECH: bactericidal, binds 30S inhibiting formation of initiation complex and causing mRNA misreading. Requires O2 for uptake. USE: only aerobic, gm- rods TOX: Nephrotox (dose-related), Ototox, teratogen |
aminoglycoside
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Amikacin
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MECH: bactericidal, binds 30S inhibiting formation of initiation complex and causing mRNA misreading. Requires O2 for uptake.
USE: only aerobic, gm- rods TOX: Nephrotox (dose-related), Ototox, teratogen |
aminoglycoside
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Tobramycin
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MECH: bactericidal, binds 30S inhibiting formation of initiation complex and causing mRNA misreading. Requires O2 for uptake.
USE: only aerobic, gm- rods TOX: Nephrotox (dose-related), Ototox, teratogen |
aminoglycoside
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Streptomycin
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MECH: bactericidal, binds 30S inhibiting formation of initiation complex and causing mRNA misreading. Requires O2 for uptake.
USE: only aerobic, gm- rods TOX: Nephrotox (dose-related), Ototox, teratogen |
aminoglycoside
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Erythromycin
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MECH: binds 50S inhibiting translocation step
USE: same as PenG (good for pts with PEN allergies), URIs, pneumonias, STDs, Mycoplasma, Legionella, Chlamydia, Neisseria TOX: GI, acute cholestatic hepatitis, eosinophila, skin rash; metabolized in liver and interferes with warfarin, theophyline leading to accumulation |
Macrolide
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Clarithromycin
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MECH: binds 50S inhibiting translocation step
USE: same as PenG (good for pts with PEN allergies), URIs, pneumonias, STDs, Mycoplasma, Legionella, Chlamydia, Neisseria TOX: GI, acute cholestatic hepatitis, eosinophila, skin rash; metabolized in liver and interferes with warfarin, theophyline leading to accumulation |
Macrolide
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Azithromycin
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MECH: binds 50S inhibiting translocation step
USE: same as PenG (good for pts with PEN allergies), URIs, pneumonias, STDs, Mycoplasma, Legionella, Chlamydia, Neisseria, H. flu, Moraxella, MAI TOX: GI, acute cholestatic hepatitis, eosinophila, skin rash; metabolized in liver and interferes with warfarin, theophyline leading to accumulation |
Macrolide
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Chloramphenicol
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MECH: bacteriostatic, inhibits 50S peptidyltransferase
USE: Broad spectrum, but nasty toxicities limit use. Enters CNS readily: H. flu, N. meningitidis, S. pneumo TOX: hemolytic anemis (G6PD deficiency), aplastic anemia, gray baby syndrome (UDP-glucuronyl transferase deficiency in newborn) |
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Clindamycin
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MECH: blocks peptide bond formation at 50S
USE: Anaerobes above the diaphragm: B. frag, C. perf TOX: pseudomembranous colitis, diarrhea, fever |
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-floxacin
Cipro-, moxi-, gati-, nor-, o-, spar-, |
MECH: bactericidal, inhibit DNA gyrase → DNA cleavage
USE: - gm- rods of GI: Klebsiella Enterobacter E. coli Proteus Serratia Shigella - gm- rods of urinary tract: KEEPSS + P. aeruginosa - Resistant respiratory infections: pneumococcus - Neisseria TOX: GI, CNS (HA, N/V, dizziness), skin rash/photosensitivity, *Tendonitis/rupture in adults, cramps and myalgias in kids |
Flouroquinolones
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Isoniazid
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MECH: inhibits synthesis of mycolic acids
USE: Mycobacterium Tuberculosis TOX: Neurotox (peripheral neuritis; B6/pyridoxine can prevent), hepatotox, hemolysis (G6PD deficient), SLE-like syndrome |
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Rifampin
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MECH: inhibits DNA dependent RNA polyerase
USE: Mycobacterium Tuberculosis, M. leprae, prophylaxis of meningococcus and H. flu contacts TOX: minor, drug interactions (↑P450), rapid resistance if used alone |
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Pyrazinamide
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USE: Mycobacterium Tuberculosis
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Ethambutol
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USE: Mycobacterium Tuberculosis
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Dapsone
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USE: M. leprae
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Amphotericin B
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Polyene antifungal
MECH: binds ergosterol which disrupts fungal membrane → leakage USE: wide spectrum for systemic infections - Blasto, Histo, Cocci, Crypto, Aspergillus, Mucor, Candida *intrathecally for meningitis (doesn't cross BBB) TOX: highly toxic - fever/chills, hypotension, nephrotox (hydration reduces), arrhythmias, anemia, phlebitis |
antifungal
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Nystatin
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Polyene antifungal
MECH: binds ergosterol which disrupts fungal membrane → leakage USE: Too toxic for systemic use - oral thrush, diaper rash, vaginal candidiasis TOX: same as amphotericin |
antifungal
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Azoles:
Floconazole, ketoconazole, itraconazle, voriconazole |
MECH: Inhibits ergosterol synthesis → disrupting membrane (don't use with ampho)
USE: Systemic mycoses - Flucon for crypto Keto for blasto, cocci, histo, candida TOX: Hormone synthesis inhibition → endocrine abnormalities, liver dysfxn (inhibits cytP-450), fever, chills |
antifungal
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Flucytosine
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MECH: inhibits DNA synthesis
USE: systemic candida, crypto *resistance develops - use with ampho TOX: N/V, dairrhea, bone marrow suppression, hepatotox |
antifungal
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Caspofungin
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MECH: inhibits cell wall synthesis
USE: invasive aspergilloss TOX: GI, flushing |
antifungal
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Terbinafine
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MECH: inhibits fungal enzyme squalene epoxidase
USE: dermatophytoses |
antifungal
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Griseofulvin
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MECH: interferes with microtubules → disrupts mitosis
USE: dermatophytosis - oral treatment of superficial infxns TOX: teratogenic, carcinogenic, HA, ↑P-450 and warfarin metabolism |
antifungal
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Metronidazole
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MECH: nitro group serves as an electron-acceptor, forming reduced cytotoxic compounds that bind proteins and DNA → cell death
USE: anaerobic protazoa: E. histolytica, Giardia, Trichomonas anaerobic bac: Bacteroides, C. difficile, Gardnerella TOX: GI, metallic taste, oral yeast infection, disulfiram-like effect, neurotox (rarely) |
amebicide
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Primaquine
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MECH: not understood - oxidants kill schizonts
USE: P. vivax and P. ovale (liver stage) TOX: Hemolytic anemia (G6PD deficient) |
Tissue schizonticide
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Chloraquine
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MECH: inhibits schizont's ability to break down heme → build up, also kills RBC; alkalinization of food vacuole; decreased DNA synthesis
USE: Plasmodium sporozites in the blood TOX: GI, pruritis, HA |
Blood schizonticide
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Quinine
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MECH: effects DNA synthesis
USE: chloraquine-resistant Plasmodium TOX: cinchonism - N/V, tinnitus, vertigo; hemolytic anemia |
Blood schizonticide
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Mefloquine
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MECH: effects DNA synthesis
USE: choraquine-resistant Plasmodium TOX: cinchonism - N/V, tinnitus, vertigo; disorientaiton |
Blood schizonticide
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Pyrimethamine
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MECH: inhibits plasmodial dihydrofolate reductase → block of DNA synthesis
USE: sporonticide, P. falciparum, with sulfonamide treats P. malariae and Toxoplasma gondii |
Blood schizonticide
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Melarsoprol
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MECH: reacts with enzymes
USE: african sleeping sickness - trypanosoma brucei TOX: CNS, hypersensitivity, GI |
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Nifurtimox
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MECH: oxygen radicals
USE: Trypanosoma cruzi (American) TOX: hypersensitivity, GI |
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Stibugluconate
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USE: Leishmania
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Albendazole, Mebendazole, Thiabendazole
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MECH: inhibits microtubules → paralysis → passing of worms in stool
USE: intestinal nematodes Ancyclostoma (hookworm) Ascaris (roundworm) Enterobius Strongyloides Trichinella TOX: GI, teratogenic |
antihelminthic
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Pyrantel pomoate
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MECH: depolarizing neuromuscular blocking agent
USE: Ancyclostoma (hookworm) Ascaris (roundworm) Enterobius TOX: N/V, HA, rash |
antihelminthic
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Diethylcarbamazine
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MECH: increased phagocytosis of fillaria
USE: Wuchereria bancrofti (elephantitis) Loa loa (skin swelling) Onchocerca volvulus (river blindness) TOX: reaction caused by death of parasites |
antihelminthic
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Ivermectin
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MECH: targets GABA → paralysis
USE: Onchocerca volvulus (river blindness) TOX: contraindicated with other GABA agonists |
antihelminthic
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Praziquantel
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MECH: ↑calcium permeability → paralysis
USE: Trematodes - Schistosoma, Clonorchis, Paragonimus westermani Cestodes - Taenia, Echinococcus |
antihelminthic
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Niclosamide
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MECH: inhibits ADP phosporylation → death of scolex (head)
USE: Cestodes - Taenia, Echinococcus |
antihelminthic
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Amantadine
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MECH: Blocks viral penetration/uncoating (M2); causes release of DA.
USE: influenza A prophylaxis and treatment; Parkinson's dz TOX: cerebellar (ataxia, dizziness, slurred speech) |
antiviral
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Rimantidine
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MECH: Blocks viral penetration/uncoating (M2)
USE: influenza A prophylaxis and treatment TOX: doesn't cross BBB (fewer side fx than amantadine) |
antiviral
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Ribavarin
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MECH: inhibits viral mRNA synthesis
USE: RSV, HepC, Influenza A & B TOX: hemolytic anemia, teratogen |
antiviral
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Acyclovir
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MECH: preferentially inhibits viral DNA polymerase when phosphorylated by viral thymidine kinase
USE: HSV (mucocutaneous and genital lesions), VZV, EBV, prophylaxis in immunocompromised TOX: delirium, tremor, nephrotox (in dehydrated) RESISTANCE: lack of thymidine kinase |
antiviral
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Gancyclovir
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MECH: preferentially inhibits CMV DNA polymerase when phosphorylated by viral thymidine kinase
USE: CMV, esp. in immunocompromised TOX: leukopenia, neutropenia, thrombocytopenia, delirium, tremor, nephrotox RESISTANCE: lack of thymidine kinase or mutated DNA pol |
antiviral
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Foscarnet
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MECH: Binds pyrophosphate site of viral DNA polymerase causing inhibition
USE: CMV retinitis in immunocompromised after gancyclovir failure (IV only) TOX: nephrotox RESISTANCE: mutated DNA pol (does not require kinase activation) |
antiviral
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Zidovudine (AZT)
didanosine (ddI) zalcitabine (ddC) stavudne(d4T) lamivudine (3TC) abacavir |
Reverse transcriptase inhibitors - nucleosides
MECH: inhibit RT, prevent viral incorporation USE: HIV with HAART, reduce maternal-to-infant transmission TOX: bone marrow suppression, peripheral neuropathy, lactic acidosis, megaloblastic anemia(AZT) |
antiviral
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Nevirapine
efavirenz delavirdine |
Reverse transcriptase inhibitors - non-nucleosides
MECH: inhibit RT, prevent viral incorporation USE: HIV with HAART, reduce maternal-to-infant transmission TOX: bone marrow suppression, rash, elev liver enzymes |
antiviral
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Saquinavir
ritonavir indinavir nelfinavir |
Protease inhibitors
MECH: block protease to inhibit assembly of new virions USE: HIV with HAART TOX: dyslipidemia, insulin resistance/hyperglycemia, lipodystrophy |
antiviral
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Enfuviritide
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MECH: binds gp41 preventing HIV fusion with target cell
USE: salvage regimen |
antiviral
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Interferons (alpha, beta, gamma)
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MECH: glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis; induce ribunuclease to degrade viral mRNA
USE: IFNα - chronic hepB and hepC, karposi's saroma IFNβ - MS IFNγ - NADPH oxidase deficiency TOX: Neutropenia |
antiviral
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