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30 Cards in this Set
- Front
- Back
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Acyclovir
Bugs MOA oral availability CNS penetration elimination |
Acyclovir
HSV-1, HSV-2, VZV phosphorylated by viral TK --> inhibition of viral replication by inhibition of viral DNA polymerase 10% bioavailability PO (valacyclovir has 50% bioavail. PO) Penetrates CNS renal elimination (can lead to renal insufficiency) |
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Fluconazole
Bugs MOA oral availability CNS penetration excretion interactions |
Fluconazole
Candida inhibits ergosterol synthesis - binds 14-a-demethylase IV = PO water-soluble --> CSF penetration long half-life (24 hrs) renal exretion INTERACTIONS!! (CYP 3A4, CYP 2C9) safe |
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Caspofungin
Bugs MOA oral availability CNS penetration metabolism & excretion interactions |
Caspofungin:
Candida & Aspergillus inhibit beta-glucan synthesis IV only half-life 10 hours CNS penetration LIMITED b/c of high protein binding liver metabolism, biliary excretion few interactions safe |
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Amphotericin B
Bugs MOA oral availability CNS penetration Adverse effects |
Amphotericin B
broad spectrum! systemic polyene - binds ergosterol I.V. only CSF levels minimal, but used for brain infections ADVERSE REACTIONS: NEPHROTOXICITY infusion reactions hypokalemia, hypomagnesemia |
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Differences between Ampho B & Ampho B lipid form
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Lipid form LESS NEPHROTOXIC
lipid form more expensive |
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Voriconazole
Bugs MOA oral availability CNS penetration excretion interactions adverse effects |
Voriconazole
Candida & Aspergillus IV = PO CNS penetration biliary excretion DRUG INTERACTIONS transient abnormal vision 50% pts |
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Itraconazole
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mostly used for fungi other than candida, aspergillus
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Bactrim
Spectrum MOA oral availability excretion Adverse effects |
Bactrim
Gram neg bacilli (E. coli, P. aeruginosa) oral availability high urine levels HSR, leukopenia, hemolytic anemia w/ G6PD deficiency |
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Nitrofurantoin
Spectrum MOA oral availability excretion adverse effects |
Nitrofurantoin
Gram neg bacilli oral availability high urine levels but need high creatinine clearance to use N/V - take with food |
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fluoroquinolones
spectrum MOA oral availability excretion adverse effects |
fluoroquinolones
Gram neg spectrum, including P. aeruginosa bind topoisomerase --> inhib DNA synthesis variable resisitance oral availability - don't take w/ IRON or CAFFEINE high levels kidney, prostate, urine urinary excretion nausea, insomnia, dizziness |
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Aminoglycosides (Gentamicin)
spectrum MOA resistance oral availability excretion dosing cautions adverse effects |
Aminoglycosides (Gentamicin)
Gram negative bacilli (like FQs) inhibiti protein synthesis (30S subunit) resistance 2* drug inactivation NOT absorbed orally excreted in urine dose with respect to Cr clearance NEPHROTOXIC OTOTOXIC |
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Penicillins:
narrow - broad - antistaph - extended - |
Penicillins:
narrow - Pen G (S. PNA, syphillis) broad - ampicillin (S. PNA) antistaph - naficillin extended - piperacillin (P. aeruginosa) |
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Macrolides
spectrum MOA oral availability resistance |
Macrolides
broad spectrum against respiratory pathogens inhibit protein synthesis (50S subunit) orally absorbed resistance b/c of ACTIVE EFFLUX and change in binding site |
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Consequences of liver metabolisms of macrolides
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clarithromycin + statins = bad
azithromycin NOT heavily metabolized in liver, can be used with statins |
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significance of telithromycin
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latest in macrolide family (actually a ketolide)
least resistance most hepatotoxicity |
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3 nephrotoxic antibiotic classes
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Aminoglycosides (Gentamicin)
3rd generation Cephalosporins Amphotericin B |
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Drugs that inhibit DNA gyrase
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Quinolones
Nalidixic acid |
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Drugs that inhibit DNA-dependent RNA polymerase
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Rifampin
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Drugs that inhibit protein synthesis by binding 50S subunit
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Macrolides
Clindamycin Chloramphenicol |
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Drugs that inhibit protein synthesis by binding 30S subunit
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Tetracycline
Aminoglycosides |
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Drugs that punch holes in cell membranes (bacteria and fungi)
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polymixin
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Drugs that inhibit folic acid metabolism
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Trimethoprim
Sulfonamides |
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Drugs that inhibit cell wall synthesis
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Vancomycin
Bacitracin Cycloserine Penicillins Cephalosporins Carbapenems |
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Drug that breaks bacterial DNA strands
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Nitrofurantoin
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Drugs with biliary excretion
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Macrolides
Doxycycline (not tetracycline) Nafcillin Clindamycin (also urine excretion) |
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Which macrolide is safe with statins?
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Azithromycin
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Interferes with synthesis of mycolic acid
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Isoniazid
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Inhibits mycolic acid synthesis
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ethambutol
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only anti-TB drug that is bacterioSTATIC
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ethambutol
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Drug of choice for P. falciparum
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Malarone (atovaquone-proguanil)
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