Antimicrobials

Front 1

Rifampin

Back 1

mRNA synthesis blocker - combined with isoniazid to treat Tb. orange urine and tears.

Front 2

Sulfamethoxazole

Back 2

Sulfonamide - nucleotide synthesis blocker. Inhibits dihydropteroate synthase (static), gram +/-, tx UTIs. SE gout (bad for pregnancy!) Steven Johnson's syndrome, kernicterus in infants (bilirubin brain damage)

Front 3

Trimethoprim

Back 3

Nucleotide synthesis blocker - combined with polymyxin B = polytrim. Combined with sulfonamides tx UTIs.
- Inhibits dihydrofolate reductase, static.
- toxicity: bone marrow megaloplastic anemia, leukopenia, granulocytopenia

Front 4

Fluconazole

Back 4

Fungal membrane blocker - inhibits ergosterol synthesis

Front 5

Amphotericin B

Back 5

Fungal membrane blocker - "Tears" holes by binding ergosterol and creating leaks. SE "Terr"ible for kidneys!, neurotoxicity

Front 6

Nystatin

Back 6

Fungal membrane blocker - tears holes by binding ergosterol and creating leaks - tx oral thrush.

Front 7

Bacitracin

Back 7

Peptidoglycan synthesis blocker: Cidal, gram + only
- bleph tx
- Combo w/Polymixin(gram-) =Polysporin

Front 8

Vancomycin

Back 8

Peptidoglycan synthesis blocker: Binds D-ala of cell wall, disrupts precursors
- Serious gram + infxns (esp pseudomembrane colitis, MRSA)
- Toxicity: Red man's syndrome is thrombophlebitis at IV site, ototoxicity, nephrotoxicity

Front 9

Fluoroquinolones

Back 9

DNA Topoisomerase blockers
- Very broad specturm
- inhibits DNA gyrase and topoisomerase II, cidal
- ocular infxn, UTI, GI
-3rd and 4th have better gram+ activity
- SE: LONES hurt attachment to BONES = tendonitis
- contraind pregnancy and children b/c cartilage formation damage

Front 10

Penicillin G (IV) or V (oral)

Back 10

Cell wall synthesis blocker - Primarily gram + and spirochetes (syphillis). Inhibits PG crosslinks in bacterial cell wall. Not penicillinase resistant.
Used for strep, syphilis, meningitis, pneumococcus.
Oral aborption impaired with food
Pregnancy safe

Front 11

Methicillin

Back 11

Penicillinase Resistant cell wall synthesis blocker: Inhibits PG crosslinking. narrower spectrum, targeting S. aureus.
SE interstitial nephritis
pregnancy safe

Front 12

Dicloxacillin

Back 12

Penicillinase Resistant cell wall synthesis blocker: Inhibits PG crosslinking. narrower spectrum, targeting S. aureus.
Acid stable
pregnancy safe

Front 13

Nafcillin

Back 13

Penicillinase Resistant cell wall synthesis blocker: Inhibits PG crosslinking. narrower spectrum, targeting S. aureus.
IV only
pregnancy safe

Front 14

Ampicillin

Back 14

Aminopenicillin: Increased activity against gram -. Not penicillinase resistant.

Front 15

Amoxicillin

Back 15

Aminopenicillin: Increased activity against gram -. Better oral aborption than ampicillin. Not penicillinase resistant.

Front 16

Cephalosporins

Back 16

Inhibit cell wall synthesis, cidal, less susceptible to penicillinases.
Become increasingly more gram - selective w/ increasing generation

Front 17

Rocephin

Back 17

3rd generation cephalosporin used for treatment meningitis, TOC for gonorrhea

Front 18

Keflex

Back 18

1st generation cephalosporin used tx dacryoadenitis, dacryocystitis, preseptal cellulitis

Front 19

Aminoglycosides: gentamycin, neomycin, tobramycin, streptomycin

Back 19

Block protein synthesis at 30S ribosomal subunit.
Inneffective against aenerobes
Used mainly for gram -, but some activity against mycobacteria and staph aureus.
Poor absorption through GI, often given IM
Toxicity: nephrotoxicity, ototoxicity, MAY cause keratitis

Front 20

Tetracyclines

Back 20

Bind to 30S subunit, WIDE specturm.
Impaired in GI by dairy products, excreted through kidney
Minocycline-acne
Doxycyline- meibomianitis, acne rosacea, excreted through feces

Front 21

Chloramphenicol

Back 21

Blocks protein synthesis at 50S ribosomal subunit, STATIC
Rarely used b/c SE aplastic anemia, optic neuritis, Grey baby syndrome

Front 22

Macrolides: Erythromycin, azithromycin, clarithromycin

Back 22

Blocks protein synthesis at 50S ribosomal unit
Gram + cocci and vacilli, STATIC
Erythromycin causes GI upset (noncompliance)
DOC mycoplasma pneumonia, chlamydia. blepharitis

Front 23

Lincomycin, Clindamycin

Back 23

Blocks protein synthesis at 50S subunit. Static.
Gram + cocci and bacilli. Used against methacillin resistance, anaerobic infections above diaphragm
SE stomach cramping, pseudomembranous colitis

Front 24

Metronidazole (Flagyl)

Back 24

Disrupts DNA and inhibits nucleic acid synthesis. Cidal against bacteroides fragilis.
Given orally for bacterial infections below the diaphragm, giardia, trichomoniasis (STD)
Metabolized by liver
SE GI upset w/ alcohol

Front 25

Isoniazid (INH)

Back 25

Interes with mycolic acids and disrupts cell wall, cidal.
Tx latent TB
Used for prophylaxis against TB
SE peripheral neuritis, optic neuritis

Front 26

Fluconazole

Back 26

Yeast ifections
SE GI distress, hepatotoxicity

Front 27

Griseofulvin (Grifulvin)

Back 27

Antifungal - inhibits fungal mitosis by acting on microtubules. Only active against growing cells
Used on scalp and skin

Front 28

Terbinafine (Lamisil)

Back 28

Inhibits ergesterol, for superficial dermatophyte infections

Front 29

Amantadine (symmetrel)

Back 29

Influenza virus: inhibits virus entereing cell. Activity against RNA viruses.
Used for influenza virus A and Parkinson's (crosses BBB)
Excreted in urine so must be decreased in renal failure pts

Front 30

Rimantadine (Flumadine)

Back 30

Influenza virus: inhibits virus entereing cell. Activity against RNA viruses.
Used for influenza virus A and Parkinson's (crosses BBB)

Front 31

Oseltaminivir (Tamiflu)

Back 31

Inhibitor of influenza A and B neuraminidase. Prevents spread along mucous linings of respiratory tract.
Used in prophylaxis and tx influenza and avian flu

Front 32

Trifluridine (Viroptic)

Back 32

Inhibits viral DNA synthesis
Used for HS lesions in eye

Front 33

Acyclovir

Back 33

Inhibits viral DNA synthesis by acting on DNA polymerase.
Used in oral herpes, genital herpes and zoster infections
SE renal dysfunction and neurotoxicity

Front 34

Valacyclovir (Valtrex)

Back 34

Pro-drug of acyclovir, less frequent administration
Used genital herpes, cold sores, zoster

Front 35

Ganciclovir *Cytovene)

Back 35

Inhibits DNA polymerase
Given IV for CMV infections.
SE: bone marrow suppression, renal insufficiency

Front 36

Foscarnet (Foscavir)

Back 36

"Net" for CMV retinitis (2nd choice).
Inhibits DNA polymerase of herpes virus and reverse transcriptase of AIDS virus

Front 37

Zidovudine (retrovir)(azt)

Back 37

HIV - potent inhibitor of viral reverse transcriptase, huge resistance problem.
Also used during pregnancy to prevent transfer to fetus.
Renal elimination

Front 38

Didanosine (Videx)

Back 38

Used with AZT for triple therapy, inhibits Viral reverse transcriptase

Front 39

Ivermectin

Back 39

River blindness - prevents microtubule formation in cell wall synthesis

Front 40

Chloroquine (plaquenil)

Back 40

Causes buildup of heme, toxic to parasites (malaria). Also inhibits phospholipase-A (anti-inflammatory) for lupus and RA.
Safe in pregnancy.
Often used with doxycycline b/c of resistance.
Bull's eye maculopathy: irreversible, developed in 10% pts taking 250mg/day.

Front 41

Malarone

Back 41

Oral prophylaxis treatment of malaria due to chloroquine resistant strains