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92 Cards in this Set

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Aminopenicillins
Amoxicillin, ampicillin. Not beta lactamase R.
Penicillinase R PCNs
"met a nasty ox." Methicillin, Nafcillin, Oxicillin, Dicloxacillin.
Antipseudomonal penicillins
"bond uses a tic, car, pipe bomb vs. pseudomonas." Ticarcillin, Piperacillin, Carbenicillin. Not beta lactamse R
Beta lactamase inhibitors
clavulinic acid, sulbactam, tazobactam
Cephalosporins: 1st gen
cephalexin, cefazolin
Cephalosporins: 2nd gen
"fox met a anaerobe for tea" = anaerobes =[Cefoxitin, cefotetan, Cefmetazole]. Cefaclor, Cefuroxime
None
Cephalosproins: 3+4 gen
Menigitis: Cephtriaxone. Pseudomonas: taz, fop, fep: ceftazidime, cefepime, cefoperazone
None
Monobactam
aztreonam.
Cross-hypersensitivity w/ PCN
cephalosporins
When give aztreonam
Gram negative aerobic rods only. Not GP, not anaerobes. 1) can't give PCN/ceph: allergic. 2) can't give AG: renal insufficiency
When give imipenem/cilastatin
Enterobacter. Good for: Pseudomonas, enterococcus, anaerobes.
Aminoglycosides (eg + s/e)
gentamicin, neomycin, amikacin, tobramycin, spretomycin. "Mean GANTS do NOT kill anaerobes" NOT = nephrotox, ototox, teratogen
Tobramycin
AG
Amikacin
AG
Streptomycin
AG
Neomycin
AG
AG mech
inhibit initiation complex formation + mRNA misreading
Tetracyclines (eg)
Tetracycline, Doxycycline (if renal failure), Demeclocycline (ADH antagonist), Minocycline (2nd line meningococcus prophylaxis)
None
Doxycycline
Tetracycline. OK if renal failure.
Demeclocycline
Tetracycline. ADH antagonist (give for SIADH)
Tetracycline mech
bind 30S, inhibit tRNA binding.
Don't take tetracyclines with…
Divalent cations: milk, antacids, iron. Prevent abs.
Tetracyclines are good for…
VACUUM THe BedRoom. Vibro cholera, Acne, Ureaplasma Urealyticum, Mycoplasma, Tularemia, H. pylori, Borellia burgorferi, Rickettsia
Tetracycline toxicity
Photosensitivity, tooth discoloration, bone growth (teratogen).
Macrolides eg
Erythromycin, clarythromycin, azithromycin.
Macrolide mech
bind 50s, inhibit translocation
Macrolide tox
1) acute cholestatic hepatitis (a wreath in the bile duct), 2) eosinophilia 3) GI (motilin R). 4) inc serum [] of theophylline + oral anticoagulants
Macrolide use
1) PNA: chlamydia, mycoplasma, legionella (a wreath on the grave). 2) STD: chlamydia + neisseria. 3) GP cocci if PCN allergy
Chloramphenicol mech
50S. inhibit peptidyl transferase
Chloramphenicol use
Meningitis: H. flu, meningococcus, pneumococcus
Chloramphenicol tox
1) dose dep anemia 2) aplastic anemia 3) grey baby syndrome (cyanosis): lack UDP-glucuronyl transferase.
Clindamycin mech
50S. inhibit peptidyl transferase
Clindamycin use
anaerobes above the diaphragm: Bacteroides, Clostridium perfringens
Clindamycin tox
pseudomembranous colitis
Sulfonamides mech/use/tox
PABA antimetabolite: inhibit dihydropteroate synthase => dec purine + thymidine synth, methionin, glycine. Use: UTI, nocardia, chlamydia, PCP. Tox: 1) G6PD 2) nephro 3) kernicterus 4) albumin displace (warfarin)
Trimethoprim mech/use/tox
inhibit bacterial DHFR. Use: UTIs, shigella, salmonella, PCP. Tox: bone marrow sep (megaloblastic anemia)
Fluoroquinolones m/u
_floxacin. (nalidixic acid = quinolone). Flox of sinners. Mech: inhibit DNA gyrase/topoisomerase II ("gyrate hips"). Use: GN UTI/GI (inc pseudomonas).
Fluoroquinolones tox
1) GI "sinner's hangover" 2) "dance too much:" cartilage damage (not for kids/prego), tendonitis/rupture
Metronidazole m/u/tox
mech: forms toxic metabolites. Use: TBAM + anaerobes below the diaphrgam + protozoa ("GET on the Metro:" giardia, entamoeba, trichomonas"). Tox: disulfiram, metallic taste
Polymixins
B, E. basic proteins act like detergents. Use: resistant GN. Tox: neuro + neprho (ATN)
Anti TB drugs, use
"Ihn SPIRE": Isoniazid, Streptomycin, Pyrazinamide, Rifampin, Ethambutol. "Iso a Red PYRe burning the liver". Isoniazid for prophylaxis, latent. Cycloserine =2nd line.
Isoniazid
inh mycolic acid synth. Give with B6 pyridoxine. S/e: "INH" = injures neurons (B6 def) + hepatocytes. Fast acetylators (azn) metabolize faster.
Give what with INH
B6 pyridoxine
Who metabolizes INH faster
fast acetylator (azn)
Rifampin
Inh DNA-dep RNA polymerase. 1) TB 2) w/ dapsone for leprosy 3) Meningococus prophylaxis 4) Hib prophylaxis. Tox: P450 inducer, red body fluids
4 R's of Rifampin
RNA polyermase inh. Red/orange body fluids. Revs up P450. Rapid resistance if used alone.
PCN/Cephalosporin R
ß lactamase
AG R
modification: acetylation, adenylation, phosphorylation
Vancomycin R
d-ala => d-lac
chlorampenicol R
modification: acetylation
macrolides R
methylation of rRNA
Tetracycline R
dec uptake, inc export
Sulfonamides
1) dihydropteroate synthase mutation 2) dec uptake 3) inc PABA synthesis
Meningoccus prophylaxis
rifampin (or minocycline)
Hib prophylaxis
rifampin
Gonorrhea prophyalxis
ceftraxione
Syphilis prophylaxis
benzathine pcn
Recurrent UTIs
TMP-SMX
PCP
TMP-SMX or pentamidine
Endocarditis
PCNs
Amphotericin B mech? use? tox?
bind ergosterol, disrupt membrane. systemic mycoses. doesn't cross BBB (intrathecal). tox: hypotension, nephrotox, *arrhythmias*
Nystatin m/u/t
bind ergosterol, disrupt membrane. too toxic for systemic use. Use: candidiasis. swish + swallow or topical.
Fluconazole
inhibit fungal p450, dec ergosterol synth. Cryptococcal meningitis in AIDS, candidiasis. Tox: gynecomastia
Tx for cryptococcal infection in AIDS
fluconazole
Candidiasis Tx
nystatin swish/swallow, topical nystatin, amphotericin B, fluconazole, ketoconazole.
Ketoconazole
Hist, Blast, Coccidioides, Candida. Hypercortisolism. Tox: gynecomastia
Flucytosine
flucytosine => fluorouracil => inh nucleotide synth. Use: systemic mycoces. Tox: bone marrow suppression
Caspofungin
dec synth of glucan component of cell wall. Use: aspergillosis. Tox: flushing
Terbinafine
inhibit squalene epoxidase => dec ergosterole synth. Use: dermatophytes, esp onychomycosis
Griseofulvin
deposit in keratin, disrupt fungal MT. Use: superficial fungal infections. Tox: teratogen, carcinogen, inc warfarin metabolism
Amantidine
1) influenza A uncoating 2) rubellA 3) pd. tox: cerebellA: ataxia, dizziness, slurred speech
Rimantidine
new amantidine. less s/e.
Zanamivir
influenza a+b. neuraminidase inhibitor
Oseltamavir
tamiflu. infleunza a+b. neuraminidase inhibitor
Ribavirin
compet inh IMP dehydrogenase => dec guanine. Hep C, RSV. Tox: hemolytic anemia, *teratogen*
Acyclovir
P by thymidine kinase => inh viral DNA polymerase. Use: HSV, VZV, EBV
Gancyclovir
doesn't require thymidine kinase (vs. acyclovir) => inh viral DNA polymerase. Use: CMV. Tox: worse (vs. acyclovir). pancytopenia, renal tox.
Foscarnet
"FOScarnet = pyroFOSphosphate analog". Inh viral DNA polymerase w/o kinase activation. Use: acyclovir R HSV, gancyclovir R CMV.
HIV Protease inhibitors
_navir. Saquinavir, Ritonavir, indinavir, nelfinavir, amprenavir. Tox: hyperglycemia, lipids abnormalities, thrombocytopenia (indinavir)
_ navir
hiv protease inhibitor
nucleoside RTI
zidovudine (AZT), didanosine (ddI), zalcitabine (ddC), stavudine (d4T), lamivudine (3TC), abacavir. Prevent viral genome incorp into host DNA! Use: CD4< 500. AZT during pregnancy Tox: bone marrow, lactic acidosis.
AZT tox
megaloblastic anemia
zidovudine
nucleoside RTI. azt. during pregnancy
didanosine
nucleoside RTI. ddI
zalcitabine
nucleoside RTI. ddC
stavudine
nucleoside RTI. d4T
lamivudine
nucleoside RTI. 3TC
abacavir
nucleoside RTI.
non-nucleoside RTI
nevirapine, delavirdine, efavirenz. prevent viral genome incorp. Use: CD4< 500. Tox: bone marrow, rash
Teratogenic antibiotics
SAFE Moms Take Really Good Care. Sulfonamides (kernicterus), Aminoglycosides (ototoxicity), Fluoroquinolones (cartilage), Eryhtromycin (acute cholestatic hepatitis) and clarithromycin (teratogen), Metronidazole (mutagen), Tetracycline (bone), Ribavirin (teratogen), Griseovulvin (teratogen), Chloramphenicol (grey baby syndrome)
which PCN bios are beta lactamse R
(methicillin, nafcillin, oxacillin, dicloxacillin), cephalosporins, aztreonam, impipenem, vanc
bacteriocidal abios
P-VAC-FM. penicillin, vancomycin, AG, ceph, fluoroquinolones, metronidazole