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