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95 Cards in this Set
- Front
- Back
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mechanism of penicilin?
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1. bind pcn binding protein 2. block transpeptidase cross-linking 3. activate autolytic enzymes
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why is methicilin penicillinase resistant?
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bulkier R group
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why is MRSA resitant?
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altered pcn-binding protein target site
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toxicity of methicilin
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intersitial nephritis
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use of ampicilin orally avialable amoxicillin?
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hamophilus, e. coli, listeria, proteius, slamonella, enterococci
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sfx ampicillin/amoxicillin
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pseudomembranous colitis, rash
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major use of ticarcilin, carbeicillin, piparacilin?
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TCP takes care of psuedomonase
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how do clauvanic acide, sulbactam, and tazobactam act?
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protect antibiotic from destruction by beta-lactamase
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tx nieseria?
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cetriaxone
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tx pseudomonas?
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cetrazidime; titaracillin, carbeicillin, amoxicillin
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toxicity of cephalosporins?
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vitamin K deficiency; inc nephrotoxicity of aminoglycosides; inc disulfiram rxn w/ ethanol
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use of aztreonam?
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gram negative rods only- pcn allergic, renal insufficiency (can't tolerate aminoglycosides)
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toxicity of imipenm, meropenum?
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seizures- worse w/ imipenem
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mechanism of vancomycin?
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inhibits cell wall formation by binding d-ala d-ala portion of cell wall precursors
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vancomycin is used when?
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C. diff, gram positives
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vancomycin side fx?
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nephrotoxicity, ototoxicity, thrombophelitis, red man syndrome- only when fast
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mechanism of resistance in VRE?
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amino acid change of d-ala d-ala to d-ala d-lac
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name the 30 s protein synthesis inhibitors? Which is bactericidal?
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aminoglycocides (bacteriacidal); tetracyclines
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name the 50s protein synthesis inhbitiros?
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chorlamphenicol, clindamycin, erythromycin, linezolid, licomycin)
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suffix of aminoglycosides?
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mycin/micin
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mechanism of aminoglycosides?
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At 302- inhibt formation of intiation complex so MRNA is misred
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which organism are aminoglycosides ineffective against?
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anerobes; require o2 for uptake
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sfx aminoglycosides?
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nephrotoxiicity (es/ w/ cephalosporin), ototoxicty (esp w/ loop diuretic), teratogen
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mechanism of resistance to aminoglycosides
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transferase enzymes-inactivate drug by acetylation, phosphorylation, or adenylation
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use of demeclocycline?
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diuretic in SIADH that acts as an ADH antagonist (even though it’s a tetracyclien abx!)
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mechanism of tetracyclines?
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bind ot 30s and prevent attachemtn of aminoacyl-tRNA
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t/f doxycycline can be used in renal failure?
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true- it is fecally eliminated
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what cannot be taking w/ doxycyclines?
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milk, antacids, iron-containing preparations b/c divanet cations inhibt its absorption in the gut
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why is doxycytline/tetracyclines could against rickettsia/chlamydia?
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b/c it can accumulate intracellularly
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sidefx tetracyclines?
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GI, discolored teeth/inhibition of bone growth in kids; photosensitivity
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mechanism of resistance to tetracyclines?
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dec uptake into cells; inc efflux out of cells by plasmid encoded transport pumps
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name macrolides?
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erythromycin, azithromycin, clarithromycin
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tx atypical pneumonia- mycoplasma, chlamydia, legionella?
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macrolides- erythromycin, azithromycin, clarithromycin
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toxicity of macrolides-i.e. erythromycin?
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prolonge QT interval, GI discomfort (most common), acute cholestatic hepatitis, rashes. Increased theophylines, oral anticoagulatns
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mechanism of resistance to macrolides?
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methylation of 23s rRNA binding site
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use of chloramphenicol?
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meningitis due to haemophilis, strep pneumonia, or nisseria
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mechanism of macrolides?
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inhibit protein sythesis by blocking translocation, binds to the 23 rRNA of the 50s ribosomal subunit
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which drug causes gray baby syndrome? Why?
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choloraphenicol b/c premature infants lack UDP-glycoronyl transferase
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toxicity of chloramphenicol?
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gray baby syndrome, aplastic anemia, dose dependent anemia
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resistance to choramphenicol?
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acetyltransferase that inactivates it
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use of clindamycin?
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anaerobic infections like apsiration pneumonia, lung abcess, b. fragiles, clostridium perfringes
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toxicity of clindamycin
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pseudomembranous colitis, fever, diarrhea
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mechanism of sulfonamines?
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PABA antimetabolites that inhibit dihydropteroate synthase (eventually makes THF)
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toxicity of sulfonamides?
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hemolysis in g6pd deficient, tubulinterstiital nephritis, kernicterus, photosensitivity, displaces other drugs from albumin (i.e. warfarin)
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resistance to symphademides?
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dec uptake, inc paba synthethesis,altere dihyrdopteroate synthase
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side fx trimetophrim?
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granulocytopenia, megaloblastic anemia, leukopenia
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mechanism of trimetophrim?
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inhibits bacterial dihydrofolate reductase
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what drugs besides sulfas are included in sulfa drug allergies?
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thiazide diuretics, acetazolamide, furosemide, celecoxicb, probenecid
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suffix of floroqunilones?
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floxacin +enoxacin and nalidixic acid
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mechanism of fluoroquinolones?
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inhibit DNA gyrase (topoisomerase II)
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what can not be taking w/ flouroquinolnes?
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antacids
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toxicity of floroquinolones?
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tendonitis and tendon rupture in adults-contraindicated in pregnancy; leg cramps in kids
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mechanism of metronidazole?
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forms free radical toxic metabolites in the bacterial cells that damage DNA (also anti protzoal)
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use of metronidazole?
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GET GAP= Giardia, Entamoeabe; Tricomonas; Gardenella; Anaerobes; h. Pylori triple therapy
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toxicity of metronidazole
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disulfram like rxn w/ alcohol; headache; metalic taste
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mechanism of polymixins?
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detergents of cell membranes
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toxicity of polymyxins?
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neurotoxicity, acute renal tubular necrosis
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drugs for m. avium prophylaxis?
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azithromycin (rifamin, ethambutom, streptomycin for treatment)
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drugs for m. leprae treatment?
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dapsone, rifampin, clofazimine
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sfx of ethambutol?
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optic -neuropathy, red-green clorblindess
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anti-tb drug toxicity?
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hepatotoxicity- color blindness of ethambutol
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why does pyrazinamide work?
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effective in acidic pH of phagolysomes, where TB ingested by macrophages is found
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mechanism of ethambutol?
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Tb- dec carbohydrate polymeraziation of mycobacterium cell wall by blocking arabinosyltransferase
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sfx of INH? How to prevent
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neurotoxicity, lupus (prevented w/ pyridoxine- B6), + hepatotoxicity
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mechanism of INH
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dec synthesis of mycolic acids, but hast o be activated by bacteria catalase peroxidase
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how is the 1/2 life of INH different in certain people?
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fast/slow acetylators
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mechanism of rifampin?
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inhibts DNA dependnt RNA polymerase
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what drug can be used to delay resistance to dapsone in leprosy?
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riframpin
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toxicity of rifamping?
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inc p-450; orange body fluids
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drug for pneumocytis jiroveci?
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tmp-smx
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drug for endocarditis?
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pcn
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mechanism of amphotericin b?
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amphoTERicin TEARS holes in membrane after binding to ergosterol
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f/f amphotericin crosses blood-brain barrier?
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fase
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drug for serious systemic fungal infections?
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amphotericin B
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toxicity of amphotericin b?
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shake and bake, hypothension, nephrotoxicity, arrhythmias, anemia, IV phlebitis,
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how to reduce toxicity of amphotericin b?
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liposomal preparation; hydration to reduce nephrotoxicity
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use of nystatin?
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topical (teras holes in membranes by binding to ergosterol)
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mechanism of azoles?
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inhibit ergosterol synthesis by inhibting the p450 enzyme that converts lanosterol to ergosterol
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drug for cryptococal mieningitis in AIDS?
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azoles
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t/f azoles can cross the blood brain barrier?
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true
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drug for candidal infections?
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zoles
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toxicity of azoles?
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hormone synthesis inhibition, gynecomastia, inhibits cyp, fever, chils
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mechanism of flucostyine?
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inhibits DNA synthesis by coversion to 5-FU
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toxicity of flucytosine?
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bone marrow suppresion, diarrhea, vomiting, nausea
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use of flucytosine
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systemic fungal infections-candida, cryptococcus in combination w/ amphotericin b
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tx invasive aspergillosis?
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capsofungin
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sfx capsofungin?
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gi upset, flushing
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mechanism of capsofungin?
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inhibits cell wall synthesis by inhibiting syntheis of b-glucan
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tx of onchymycosis?
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terbinafine- inhibits epoxidase
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tx of tineae/dermatophytes? Mechanism
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griseofulvin; interferes w/ microtubule fxn and disrupts mitosis. Depositis on keratin containing tissue
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toxicity of griseofulvin?
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teratogenic, carcinogenic, confusion, headache, inc p-450, inc warfarin metabolism
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mechanism of pyrimethamine?
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inhibits plasmodial dihydrofolate resistnace
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tx p. falciprium?
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pyrimethamine
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what drug inhibits glycolysis at the PFK rxn?
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sodium stibogluconate
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mechanism of cholroquine?
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blocks plasmodium heme polymerase> accumulation of toxic hgb break down products> organism destroyed
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