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104 Cards in this Set

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What are examples of fluoroquinolones?
Ciprofloxacin

Gatifloxacin
What is example of quinolone?
Nalidixic acid.
What is mechanism of ciprofloxacin and gatifloxacin?
Inhibits DNA gyrase (topoisomerase II).
What is toxicity of ciprofloxacin gatifloxacin?
Damages cartilage!!!!!!

Cause tendonitis in aduls

Cause leg cramps/myalgias in children!!!
What is MOA of metronidazole?
Forms toxic metabolites in bacterial cell.
What can metrondiazole treat?
Giardia

Entamebola histolytica

trichomonas

Gardenella

Bacteroides/Clostridium!

Anaerobes BELOW diaphragm.
What is the triple therapy for H. pylori?
Metronidazole

Bismuth

Amoxicillin!
What is side effects of metronidazole?
Metallic taste

Disulfuram like reaction with alcohol!!!
What is MOA of polymyxins?
Binds to cell membranes of bacteria and disrupt osmotic properties.

Cationic proteins that can bind to negative protein on cell wall and destroy them.
What drug is used alone for TB prophylaxis?
Only isoniazid!!!!!
What drugs are used for TB treatment?
STreptomycin
Pyrazinamide
Isoniazid
Rifampin
Ethambutol.
What is 2nd line therapy for TB?
Cycloserine.
What is similar among all Anti-TB drugs?
All hepatotoxic!!!!!
What is MOA of isoniazid?
Decreases mycolic acid synthesis!!!!!!!
What is the agent used for solo prophylaxis of TB?
Isoniazid!!
What is side effect of isoniazid?
Peripheral neuropathy (decreases Vit B6 concentrations)

Hemolysis if G6PD deficient

Hepatotoxicity
What effect does isoniazid have on P450?
INHIBITS IT!!!
What is MOA of rifampin?
Blocks RNA polymerase!!!!!
What is a non-TB use of rifampin?
1)Used for meningococcal prophylaxis in close contacts

2) Used for prophylaxis in contact with H. influenzae B.
What is drug toxicity?
Induces Cytochrome p450!!!!

Induces Red/Orange body fluids!
Rifampin facts!
1) RNA polymerase inhibitor
2) Activates microsomal P450!
3) Rapid resistance when used alone
4) Red/Orange body fluids!!
A child is in close contact with someone who has H influenzae type B, but is not vaccinated. What to treat with?
Rifampin: used for chemoprophylaxis in contacts of children with H influenzae type B!!!!
What is the mechanism of resitance to penicillins?
Bugs have beta-lactamase which degrades the beta lactam ring of penicillin.
What is mechanis of resitance of aminoglycosides?
Bacteria modify via:
1) acetylation
2) adenlyation
3) phosphorylation
What is mechanism of resistance to vancomycin?
Dala-Dala

Replaced by Dala-D lac so decreased affinity for vancomycin
What is resistance to chloramphenicol?
Acetylation
What is mode of resistance to macrolides (erythromycin, azithromycin, clarithromycin)?
Methylation of rRNA near erythromycin ribosome binding site.
What is mode of resistance to sulfonamides?
Altered bacterial dihydropteroate synthetase or increase PABA synthesis.
How do you treat meningococcal infection for prophylaxis???
Rifampin

2nd choice: minocycline!!
Patient comes in with gonorrhea?
Ceftriaxone.
Patient has syphilis. Tx?
Benzathine Penicillin G (IV)
History of recurrent UTIs. What you treat with?
TMP-SMX.
Pneumocytis carinii pneumonia. What you treat with?
TMP-SMX

2nd: aerosolized pentamidine.
What you treat a patient with having endocarditis and surgical/dental procedures?
Penicillins (Ampicillin).
What are side effects of ethambutol?
Retrobulbar neuritis
Optic neuritis

**Regular opthalmic exams are recommended in patients taking ethambutol.
What is MOA of ethambutol?
inhibits arabinosyl transferases.
What are some side effects of streptomycin?
irreversible ototoxicity: its an aminoglycoside!!!!!!!!!!!!!
What is MOA of amphotericin B?
Binds ergosterol (unique to fungi) and forms holes in membrane!!!!!
Amphotericin B facts:
1) Puts holes in ergosterol membrane
2) Use for systemic mycoses.
3) Does NOT cross BBB!!!!!!
4) fevers/chills; arrythmias, nephrotoxicity.
What are the side effects of amphotericin B?
1) Does NOT cross BBB
2) Fevers/Chills ("Shake and Bake")
3) Hypotension!
4) Arrythmias!!
What is MoA of nystatin?
1) Same as amphotericin B!!
2) Binds ergosterol and disrupts cell membrane.
What is best way to treat oral candidiasis?
Nystatin: "swish and swallow"!!!!
what drug is used to treat diaper rash?
Nystatin: binds ergosterol and disrupts cell membrane.
What drug is used to treat vaginal candidiasis?
Nystatin: binds ergosterol and disrupts cell membrane.
What is MOA of the azoles? flucanazole, ketocanozole, miconazole, itracanazole?
INHIBITS FUNGAL STEROID (ERGOSTEROL) SYNTHESIS!
What is drug of choice to treat cryptococcal meningitis?
FLUCANOZOLE!!!!
What drug is used to treat all candidial infections?
Fluconazole.
What are the side effect of "azoles"?
Inhibits P450!!!!

Gynecomastia (Inhibits steroid hormones)!!
What is side effect of ketoconazole?
Inhibits steroid synthesis

Gynecomastia in men

Menstrual irregularities in women.
What is Flucytosine used for?
Systemic fungal infections.
What is MOA of flucytosine?
Inhibits DNA synthesis by conversion to 5-FU which competes with uracil!!!!!
What are the side effects of flucytosine?
Bone marrow suppression (neutropenia, thrombocytopenia).
What is mechanism of action of caspofungin?
Inhibits cell wall synthesis!!

Inhibits Beta-glucan formation.
What is MOA of terbinafine?
Inhibits fungal enzyme squalene epoxidase!!!!
What is the MOA of drug used to treat dermatophytes?
Terbinafine: inhibits fungal enyzme squalene epoxidase.
What is MOA of griseofulvin?
Disrupts microtubule function do disrupts mitosis!!!
What are side effects of griseofulvin?
Teratogenic

Activates cytochrome p450!!!
What is MAO of amantadine, rimantadine?
Blocks viral penetration!!!

Blocks uncoating of virus!!!

Also causes release of dopamine from nerve terminal.
What is amantadine used to treat?
Influenza A!!!

Also used to treat RubellA!!

Also causes problems with Cerebella!!!!
What is side effect of amantadine?
Ataxia, dizziness, slurred speech!!!!
What What is zanamivir used for?
Inhibits influenza neuraminidase.

Used to treat Influenza A and B.
Wat is MOA of ribavarin?
Inhibits IMP dehydrogenase so inhibits synthesis of guanine nucleotides!
What is ribavirin used to treat?
Hepatitis C

RSV
This drug inhibits influenza neuraminidase.
Zanamivir, Oseltamivir.
What is MOA of acyclovir?
Inhibits VIRAL Dna polymerase preferentially. So acyclovir is phosphorylated by viral thymidine kinase.
What is acyclovir used to treat?
Herpes
Varicella
Ebstein Barr.

Mucocutaneous and genital herpes
What is MOA of ganciglovir.
Same as acyclovir. Needs thymidine kinase!!!!! But preferentially inhibits CMV DNA polymerase.
What is drug of choice to treat CMV?
gangcyclovir.
What drug is used prophylactically in renal transplant patients to prevent CMV?
Gancyclovir.
What are side effects of ganciclovir?
Luekopenia, neutropenia, thrombocytopenia.
What is MOA of foscarnet?
Viral DNA polymerase inhibitor but binds to pyrophosphate binding site!!!! Does not require thymidine kinase!!!
What is special about foscarent?
Does NOT require viral thymidine kinase!!!!!!!!
A patient comes in with CMV retinitis that is refractory to ganciclovir. What do you treat patient with?
Foscarnet.
A patient comes in with acyclovir resistant HSV. What do you treat with?
Foscarnet!

Remember when resistant to acyclovir and ganciclovir most likely means that mutated viral thymidine kinase, so use foscarnet b/c does NOT require thymidine kianse to work!!!!!!!!!!!!!
Thsi drug is an inorganic phosphate analog used to treat viruses?
Foscarnet!!!!!!
What interferon alpha used for?
Hepatitis B or C

Kaposi's sarcoma!!
How you treat kaposi's sarcoma?
IFN-alpha
How you treat multiple sclerosis?
IFN-beta.
How you treat NADPH oxidase deficiency?
IFN-gamma.
What is MOA of interferons?
1) Inhibit viral replication
2) Increase lymphocyte function
3) Increase macrophage action.
How you treat onchocerciasis?
Ivermectin. Increases GABA so paralyzes worm.
How you treat nematode/roundworms?
mebendazole.
How you treat ascaris?
pyrantel pamoate
How you treat enterobius?
pyrantel pamoate
How you treat necator?
Pyrantel pamoate
How you treat schistosomiasis?
praziquantel.
How you treat clonorchis?
Praziquantel.
How you treat cystercercosis?
Praziquantel.
How you treat diphloobothrium lateum?
Niclosamide.
How you treat cysticercosis?
praziquantel. Just like schistosomiasis.
How you treat leishmaniasis?
pentavalent antimony.
How you treat the latent hypnozoite in the liver?
Primaquine!!
How you treat chagas disease?
nifurtimox
How you treat T. cruzi?
Nifurtimox.
How you treat african sleeping sickness?
Suramin.
What is used as prophylaxis vs malaria?
Proguanil and pyrimethamine because they are folate antagonists.
What is side effect of sulfonamide use in pregnancy?
kernicterus
What is side effect of aminoglycoside in pregnancy?
ototoxicity
What is side effect of fluoroquinolones in pregnancy?
Cartilage damage.
what is side effect of erythryomycin on mother in pregnancy?
cholestatic hepatitis!!!!!
What is side effect of metronidazole in pregnancy?
mutagenesis.
What is side effect of tetracyclines in pregnancy?
discolored teeth, and inhibition of bone growth.
What is side effect of griseofulvin in pregnancy?
teratogenic.
What is side effect of ribavrian in pregnancy?
teratogenic.