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95 Cards in this Set

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