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59 Cards in this Set
- Front
- Back
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Tx for Legionella pnumophilia
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Erythromycin
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Tx for Pseudomonas aeruginosa
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Aminoglycoside + extended-spectrum penicillin (piperacillin, ticarcillin)
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Tx. for Helicobacter pylori
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Triple therapy:
1) metronidazole, bismuth and tetracyclin or amoxicillin 2) metronidazole, omeprazole, and clarithromycin |
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Tx. for Lyme dz
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doxycycline, ceftriaxone
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Tx. for syphilis
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penicillin G
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Tx. for Gardnerella vaginalis
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metronidazole
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Tx. for Rickettsia infxns (RMSF, Endemic typhus, Epidemic typhus, Ehrlichosis, Q fever)
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doxycycline
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Tx. for Chlamydia
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axithromycin or doxycycline
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Tx. for Mycoplasma pneumonia
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tetracycline or erythromycin
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Tx. for Giardia lamblia
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Metronizdazole
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Tx. for Entamoeba histolytica
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metronidazole + iodoquinol
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Tx. for Toxoplasma gondii
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sulfadiazine + pyrimethamine
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Tx. for Trypanosoma cruzi/Chagas' dz
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Nifurtimox
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Tx. for Leishmania donovani
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sodium stibogluconate
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Tx. for Plasmodium
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chloroquine, then mefloquine.
For P. vivax/P. ovale, add primaquine |
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Tx. for babesiosis
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quinine, clindamycin
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Tx. for Trichomonas vaginalis
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metronidazole
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What drugs block cell wall synthesis by inhibition of peptidoglycan cross-linking?
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penicillin, ampicillin, ticarcillin, piperacillin, imipenem, aztreonam, cephalosporins
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What drugs block peptidoglycan synthesis?
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bacitracin, vancomycin
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What drugs disrupt bacterial cell membranes?
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polymyxins
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What drugs block nucleotide synthesis?
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sulfonamides, trimethoprim
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What drugs block DNA topoisomerases?
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fluoroquinolones
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What drugs block mRNA synthesis?
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rifampin
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What drugs block protein synthesis at 50S ribosomal subunit?
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chloramphenicol, macrolides, clindamycin, streptogramins, linezolid
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What drugs block protein synthesis at 30S ribosomal subunit?
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aminoglycosides, tetracyclines
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What drugs are bacteriostatic?
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"we're ECSTaTiC about bacteriostatics"
Erythromycin, Clindamycin, Sulfamethoxazole, Trimethoprim, Tetracycline, Chloramphenicol |
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What drugs are bacteriocidal?
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"Very Finely Proficient At Cell Murder"
Vancomycin, Fluoroquinolones, Penicillin, Aminoglycosides, Cephalosporins, Metronidazole |
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Penicillin
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-Examples: penicillin G, penicillin V
-MOA: 1) Bind penicillin-binding proteins 2) Block transpeptidase cross-linking of cell wall 3) Activate autolytic enzymes Uses: Mostly used for G(+) organisms & syphilis. Toxicity: hypersensitivity rxns, hemolytic anemia |
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Penicillinase/beta-lactamase-resistant penicillins
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Examples: methicillin, nafcillin, dicloxacillin
MOA: Same as penicillin but narrow spectrum and resistant to beta-lactamase b/c bulkier R group Uses: Staph aureus Toxicity: hypersensitivity rxn; interstitial nephritis (methicillin) |
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Aminopenicillins
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Examples: ampicillin, amoxicillin
MOA: Same as penicillin w/ wider spectrum; beta-lactamase sensitive. Can be combined w/ clavulonate to enhance spectrum. Uses: Certain G(+) bacteria and G(-) rods (H. influenza, E. coli, Listeria, Proteus, Salmonella, enterococci) Toxicity: hypersensitivity rxn, ampicillin rash, pseudomembranous colitis |
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Antipseudomonals
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Examples: ticarcillin, carbenicillin, piperacillin
MOA: Same as penicillin w/ extended spectrum Uses: Pseudomonas and G(-) rods. Susceptible to beta-lactamase so combine w/ clavulonate Toxicity: hypersensitivity rxn |
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beta-lactamase inhibitors
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clavulanate, sulbactam, tazobactam
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Different generations of cephalosporins
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1st-cefazolin, cephalexin
2nd-cefoxitin, cefaclor, cefuroxime 3rd-ceftriaxone, cefotaxime, ceftazidime 4th-cefepime |
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Cephalosporins
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MOA: beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases
Uses: 1st gen - G(+) cocci, Proteus, E. coli, Klebsiella ("PEcK") 2nd gen - G(+) cocci, H. influenza, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella, Serratia ("HEN PEcKS") 3rd gen - serious G(-) infxns resistant to other beta-lactams 4th gen - increased activity against Pseudomonas & G(+) organisms Toxicity: hypersensitivity rxn, vit. K deficiency, disulfiram rxn |
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Aztreonam
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MOA: inhibits cell wall synthesis; resistant to beta-lactamases; synergistic w/ aminoglycosides
Uses: G(-) rods only; used in penicillin-allergic and renal insufficiency Toxicity: GI upset occasionally |
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Vancomycin
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MOA: Inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors
Uses: G(+) only; saved for serious, multidrug-resistant organisms (S. aureus, enterococci, C. diff) Toxicity: Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse flushing - "red man syndrome" |
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Protein synthesis inhibitors
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"buy AT 30, CCELL at 50"
30S inhibitors: aminoglycosides, tetracyclines 50S inhibitors: chloramphenicol, clindamycin, erythromycin, lincomycin, linezolid |
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Aminoglycosides
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Examples: gentamicin, neomycin, amikacin, tobramycin, streptomycin
MOA: inhibit formation of initiation complex; require O2 for uptake (ineffective against anaerobes) Uses: Severe G(-) rods; neomycin for bowel surgery Toxicity: nephrotixicity, ototoxicity, teratogen |
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Tetracyclines
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Examples: tetracycline, doxycycline, demeclocycline, minocycline
MOA: bind to 30S and prevent attachment of initiation complex; divalent cations (Ca, Fe, etc) inhibit absorption in gut Uses: Borrelia burgdorferi, H. pylori, M. pneumonia; effective against Rickettsia & Chlamydia Toxicity: GI distress, photosensitivity, teeth discoloration & bone growth retardation in children. C/I in pregnancy |
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Macrolides
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Examples: erythromycin, azithromycin, clarithromycin
MOA: inhibit protein synthesis by blocking translocation Uses: Atypical pneumonias (Mycoplasma, Chlamydia, Legionella), URIs, STDs, G(+) cocci, & Neisseria Toxicity: Prolonged QT interval, GI discomfort, acute cholestatic hepatitis, eosinophilia, skin rashes |
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Chloramphenicol
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MOA: inhibits 50S peptidyltransferase activity
Uses: Meningitis (H. influenza, N. meningitidis, Strep pneumo) Toxicity: anemia, aplastic anemia, gray baby syndrome |
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Clindamycin
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MOA: blocks peptid bond formation at 50S ribosomal subunit
Uses: anaerobic infxns in aspiration pneumonia or lung abscesses Toxicity: pseudomembranous colitis, fever, diarrhea |
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Sulfonamides
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Examples: sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine
MOA: PABA antimetabolites inhibit dihydropteroate synthetase Uses: G(+), G(-), Nocardia, Chlamydia; triple sulfas or SMX for simple UTI Toxicity: hypersensitivity rxn, hemolysis in G6PD deficiency, nephrotoxic, photosensitivity, kernicterus in infants, displace other drugs from albumin |
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Trimethoprim (TMP)
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MOA: inhibits bacterial dihydrofolate reductase
Uses: used in combination w/ sulfonamides, causing a sequential block of folate synthesis; used for recurrent UTIs, Shigella, Salmonella, Pneumocystis jiroveci pneumonia Toxicity: megaloblastic anemia, leukopenia, granulocytopenia |
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Fluoroquinolones
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Examples: ciprofloxacin, norfloxacin, ofloxacin, sparfloxacin, moxifloxacin, gatifloxacin, enoxacin, nalidixic acid
MOA: inhibits DNA gyrase; not to be taken w/ antacids Uses: G(-) rods of urinary & GI tracts Toxicity: GI upset, superinections, skin rashes, headache, dizziness; tendonitis & tendon rupture in adults; leg cramps & myalgias in children. C/I in pregnancy |
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Metronidazole
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MOA: forms free radical toxic metabolites that damage DNA
Uses: Giardia, Entamoeba, Trichomonas, Gardnerella, Anaerobes, H. pylori (3x therapy) Toxicity: disulfiram-like rxn, headache, metallic taste |
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Polymyxins
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Examples: polymyxin B, colistimethate (polymyxin E)
MOA: bind to cell membranes of bacteria and disrupt their osmotic properties Uses: resistant G(-) infxns Toxicity: neurotoxicity, acute renal tubular necrosis |
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Anti-TB drugs
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Rifampin, Isoniazid, Pyrazinamide, Ethambutol, Streptomycin (RIPES)
Side effects: red-green color blindness (ethambutol), hepatotoxicity |
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Isoniazid (INH)
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MOA: decreases synthesis of mycolic acids
Uses: M. tuberculosis; only agent used as solo prophylaxis against TB Toxicity: neurotoxic, hepatotoxic, lupus-like; can be prevented w/ vit. B6 |
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Rifampin
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MOA: inhibits DNA-dependent RNA polymerase
Uses: M. tuberculosis; delays resistance to dapsone when used for leprosy Toxicity: minor hepatotoxicity and drug interactions; orange body fluids |
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Nonsurgical antimicrobial prophylaxis
1) Meningococcal infection 2) Gonorrhea 3) Syphilis 4) Hx of recurrent UTIs 5) Pneumocystis jiroveci pneumonia 6) Endocarditis w/ surgical or dental procedures 7) Mycobacterium avium-intracellulare |
1) Rifampin, minocycline
2) Ceftriaxone 3) Benzathine, penicillin G 4) TMP-SMX 5) TMP-SMX (DOC), aerosolized pentamidine 6) Penicillins 7) Azithromycin |
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Caspofungin
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MOA: inhibits cell wall synthesis by inhibiting synthesis of beta-glucan
Uses: invasive aspergillosis Toxicity: GI upset, flushing |
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Amantadine
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MOA: blocks viral penetration/uncoating; also causes the release of dopamine from intact nerve terminals
Uses: prophylaxis & treatment for influenza A only; Parkinson's disease Toxicity: ataxia, dizziness, slurred speech |
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Zanamivir, oseltamivir
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MOA: inhibit inluenza neurominidase, decreasing the release of progeny virus
Uses: both influenza A & B |
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Ribavirin
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MOA: inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase
Uses: RSV, chronic hepatitis C Toxicity: hemolytic anemia, severe teratogen |
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Acyclovir
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MOA: monophosphorylated by HSV/VZV thymidine kinase; preferentially inhibits viral DNA polymerase by chain termination
Uses: HSV, VZV, EBV; prophylaxis in immunocompromised patients; use famciclovir for herpes zoster; no effect of latent forms of HSV & VZV Toxicity: well tolerated |
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Ganciclovir
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MOA: 5'-monophosphate formed by a CMV viral kinase or HSV/VZV thymidine kinase; preferentially inhibits viral DNA polymerase
Uses: CMV, especially in immunocompromised patients Toxicity: leukopenia, neutropenia, thrombocytopenia, renal toxicity |
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Foscarnet
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MOA: viral DNA polymerase inhibitor that binds to the pyrophosphate-binding site of the enzyme
Uses: CMV retinits in immunocompromised patients when ganciclovir fails; acyclovir-resistant HSV Toxicity: nephrotoxic |
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Antibiotics to avoid in pregnancy
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"SAFE Moms Take Really Good Care"
Sulfonamides - kernicterus Aminoglycosides - ototoxicity Fluoroquinolones - cartilage damage Erythromycin - acute cholestate hepatitis in mom Metronidazole - mutagenesis Tetracyclines - discolored teeth, inhibition of bone growth Ribavirin - teratogenic Griseofulvin - teratogenic Chloramphenicol - gray baby |
