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144 Cards in this Set
- Front
- Back
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Mechanism of action of Penicillins
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B-lactam antibiotics
Bind penicillin binding proteins to block transpeptidase cross-linking of cell wall |
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Penicillin
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Prototype B-lactam antiobiotic
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Methicillin
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B-lactam antibiotic
Penicillinase-resistant penicillin b/c bulky R group |
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Naficillin
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B-lactam antibiotic
Penicillinase-resistant penicillin b/c bulky R group |
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Dicloxicillin
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B-lactam antibiotic
Penicillinase-resistant penicillin b/c bulky R group |
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Ampicillin
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B-lactam antibiotic
Wider spectrum than penicillin |
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Amoxicillin
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B-lactam antibiotic
Wider spectrum than penicillin |
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Ticarcillin
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B-lactam antibiotic
Antipseudomonal |
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Carbenicillin
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B-lactam antibiotic
Antipseudomonal |
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Piperacillin
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B-lactam antibiotic
Antipseudomonal |
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Mechanism of penicillinases (B-lactamases)
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Cleave B-lactam ring and inactivate drug, leading to resistance
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Clavulonic Acid
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Prevents destruction of B-lactam antiobiotics sensitive to penicillinase (B-lactamase)
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Mechanism of action of Cephalosporins
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B-lactam antibiotics
Block transpeptidase cross-linking of cell wall |
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Cefazolin
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1st generation cephalosporin
B-lactam antibiotic Less susceptable to penicillinases |
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Cephalexin
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1st generation cephalosporin
B-lactam antibiotic Less susceptable to penicillinases |
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Cefoxitin
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2nd generation cephalosporin
B-lactam antibiotic Less susceptible to penicillinases than penicillin |
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Cefaclor
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2nd generation cephalosporin
B-lactam antibiotic Less susceptible to penicillinases than penicillin |
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Cefuroxime
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2nd generation cephalosporin
B-lactam antibiotic Less susceptible to penicillinases than penicillin |
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Ceftriaxone
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3rd generation cephalosporin
B-lactam antibiotic Less susceptible to penicillinases than penicillin Treats gonorrhea |
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Cefotaxime
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3rd generation cephalosporin
B-lactam antibiotic Less susceptible to penicillinases than penicillin |
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Cefazidime
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3rd generation cephalosporin
B-lactam antibiotic Less susceptible to penicillinases than penicillin Treats pseudomonas |
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Cefepime
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4th generation cephalosporin
B-lactam antibiotic Less susceptible to penicillinases than penicillin Treats pseudomonas |
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Cephalosporins with a methylthiotetraxole group (cefamandole) have this toxicity
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Disulfram-like reaction w/ethanol
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1st Generation Cephalosporins treat
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Gram +
Proteus E. coli Klebsiella |
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2nd Generation Cephalosporins treat
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Gram + (but less than 1st gen)
H. influenzae Enterobacter aerogenes Neisseria Proteus E. coli Klebsiella |
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3rd Generation Cephalosporins treat
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Serious gram negative infections
Meningitis (penetrate BBB) |
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Aztreonam is used for
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B-lactam antibiotic
Resistant to B-lactamases Treats Grm - only No cross allerginicity with penicillins or cephalosporins |
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Cephalosporins sometimes have cross allerginicity with
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Penicillins
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Mechanism of B-lactam antibiotics
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Inhibit transpeptidase cross linking of cell-wall, thus inhibiting cell-wall formation
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Imipenem type, uses, toxicities
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Carbapenem
B-lactam antibiotic B-lactamase resistant Broad-spectrum but many toxicities Toxicities include seizures, GI distress, rash Always administer with cilastatin to block renal metabolism (prevents inactivation in renal tubules) |
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Meropenem
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Carbapenem
B-lactam antibiotic B-lactamase resistant Broad-spectrum but many toxicities Toxicities include seizures, GI distress, rash |
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Vancomycin
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Prevents polymerization of peptidoglycans by binding D-ala D-ala portion of cell wall precursors
Used for MRSA and C. diff Toxicities include red man syndrome (diffuse flushing), nephrotoxic, ototoxic, thrombophlebitis, but well tolerated in general |
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Mechanism of action of Aminoglycosides
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Bind to 30S
Inhibit formation of initiation complex and cause misreading of mRNA Requires O2 for uptake and is ineffective against anaerobes |
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This class of drugs requires O2 for uptake and is ineffective against anaerobes
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Aminoglycosides
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Gentamicin
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Aminoglycoside
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Neomicin
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Aminoglycoside
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Amikacin
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Aminoglycoside
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Tobramycin
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Aminoglycoside
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-mycin or -micin or -cin
(BUT NOT -thromycin, clindamycin, or vancomycin) |
Aminoglycosides
(-thromycin is Macrolides) |
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This class of drug is synergistic with B-lactam antibiotics
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Aminoglycosides
B-lactam breaks cell wall and allows aminoglycosides inside Especially useful for enterococci |
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Resistance to vancomycin occurs by
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D-ala D-ala is replaced by D-ala D-lac, so vancomycin can't bind
Common in enterococci |
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Toxicities of Aminoglycosides
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Nephrotoxic (especially if used with cephalosporins), Ototoxic (especially if used with loop diuretics), Teratogen
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Mechanism of action of tetracyclines
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Binds 30S
Prevents attachment of tRNA Bacteriostatic |
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Doxycyclin CAN be used in patients with
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Renal failure (b/c fecally eliminated)
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Milk, antacids, divalent cations inhibit the absorption of this antibiotic in the gut
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Doxycyclin
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Uses of tetracyclines
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V. cholerae, Acne, Chlamydia, Ureaplasma urealyticum, Mycoplasma pneumoniae, Tularemia, H. pylori, Borrelia burgdorfery, Rickettsia
Gets intracellular organisms |
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Toxicities of tetracyclines
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Discolored teeth, inhibited bone growth in children
Photosensitivity GI distress Contraindicated in pregnancy |
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Tetracyclin
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Tetracyclin
Treats acne |
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Doxycyclin
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Tetracyclin
Absorbed in gut, can be used in renal failure Milk, antacids, iron, divalent cations prevent absorption |
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Demeclocycline
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Tetracyclin
ADH antagonist used in SIADH as a diuretic |
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Minocycline
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Tetracyclin
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-cyclin or -cycline
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Tetracyclines
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Mechanism of action of macrolides
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Binds 50S (23S part)
Blocks translocation in protein synthesis |
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Erythromycin
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Macrolide
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Azithromycin
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Macrolide
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Clarithromycin
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Macrolide
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-thromycin
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Macrolides
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Uses of macrolides
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URIs
STDs Community acquired pneumonias (mycoplasma, legionella, chlamydia, neisseria) Steptoccocal infections in those allergic to penicillin |
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Can be used in streptococcal infections in those allergic to penicillin
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Macrolides (Erythromycin)
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Toxicity includes increased serum concentration of theophyllines, oral anticoagulants
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Macrolides
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Toxicities of Macrolides
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GI discomfort (most common cause of noncompliance)
Acute cholestatic hepatitis Eosinophilia Rash Increased serum concentration of theophyllines, oral anticoagulants |
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Chloramphenicol
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Binds 50S
Inhibits 50S peptidyltransferase activity, inhibiting transpeptidation of protein synthesis Toxicities include aplastic anemia, gray baby syndrome (b/c lack liver UDP-glucuronyl transferase and can't metabolize drug) |
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Antibiotic that can cause aplastic anemia (pancytopenia) and gray baby syndrome
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Chloramphenicol
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Clindamycin
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Binds 50S
Blocks peptide bond formation Treats anaerobic infections above the diaphragm Toxicity is pseudomembranous colitis |
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Toxicity is pseudomembranous colitis
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Clindamycin
Also possibly ampicillin |
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Mechanism of action of sulfonamides
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PABA antimetabolites that inhibit dihydropteroate synthetase
Blocks folate synthesis |
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Sulfamethoxazole (SMX)
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Sulfonamide
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Sulfisoxazole
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Sulfonamide
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Triple Sulfas
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Sulfonamide
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Sulfadiazine
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Sulfonamide
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Sulf-
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Sulfonamides
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Class of antibiotics that causes hemolysis in G6PD deficient patients
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Sulfonamides
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Toxicities of sulfonamides
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Hypersensitivity
Hemolysis if G6PD deficient Nephrotoxic Kernicterus in infants Displacement of drugs from albumin (ex. warfarin) |
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Trimethoprim (TMP) mechanism of action
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Inhibits bacterial dihydrofolate reductase
Blocks folate synthesis |
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Pyrimethamine mechanism of action
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Inhibits bacterial dihydrofolate reducatase
Blocks folate synthesis |
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Mechanism of action of fluoroquinolones
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Inhibit DNA gyrase (topoisomerase II)
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TPM-SMX uses
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(Trimethoprim-Sulfamethoxazole)
Recurrent UTIs Shigella Salmonella PCP (Pneumocystic jiroveci) pneumonia |
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Megaloblastic anemia, leukopenia, granulocytopenia are toxicities of which antibiotic
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Trimethoprim
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Cannot take this class of drugs with antacids
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Fluoroquinolones
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Sulfa drugs (for those with sulfa drug allergies) include
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Sulfonamides, sulfasalazine, sulfonylureas, thiazide diuretics, acetazolamide, furosemide
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Metronidazole mechanism of action
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Forms toxic metabolites in the cell wall that damage DNA
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Side effects of fluoroquinolones
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Damage to cartilage in fetus and children
Tendonitis and tendon rupture in adults Leg cramps and myalgias in kids Inhibits GABA --> seizures GI upset, superinfections, skin rash, headache, dizziness |
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This type of antibiotic/antiprotozoal produces a disulfram-like type of reaction with alcohol and gives you a metallic taste in your mouth
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Metronidazole
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Used for anaerobic infections below the diagphragm
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Metronidazole
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Used for anaerobic infections above the diaphragm
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Clindamycin
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Mechanism of action of polymixins
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Binds cell membrane of bacteria and disrupts osmotic properties
Acts like detergents (cationic, basic) |
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Toxicities of polymixins
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Neurotoxic
ATN |
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TB prophylaxis
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Isoniazid (INH)
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TB treatment
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Isoniazid (INH), Rifampin, Ethambutol, Pyrazinamide
Also streptomycin? |
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M. avium-intracellulare prophylaxis
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Azithromycin
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M. avium-intracellulare treatment
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Azithromycin, rifampin, ethambutol, streptomycin
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M. leprae treatment
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Dapsone, rifampin, elofazimine
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This drug used to treat TB can kill TB protected in macrophages because it requires an acidic environment to work
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Pyrazinamide
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Optic neuropathy (red-green color blindness) is a side effect of this drug used to treat TB
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Ethambutol
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Mechanism of action of Isoniazid (INH)
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Decreases synthesis of mycolic acids (part of mycobacterial cell wall) by inhibiting KatG enzyme
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This drug used to treat TB is hepatotoxic, neurotoxic, has SLE-like syndrome, and causes hemolysis if G6PD deficient
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INH (Isoniazid)
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This drug used to treat TB has different half-lives if slow-vs-fast acetylators
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INH (Isoniazid)
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Giving vitamin B6 can prevent neurotoxicity associated with this drug used to treat TB
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INH (Isoniazid)
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Mechanism of action of Rifampin
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Inhibits DNA-dependent RNA polymerase, suppressing initiation of RNA chain synthesis
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This drug used to treat TB causes orange body fluids
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Rifampin
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This drug delays resistance for dapsone when used for leprosy
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Rifampin
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This drug can be used for meningococcal propylaxis and chemoprophylaxis in contacts of children with H. influenzae type B
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Rifampin
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Treat MRSA with
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Vancomycin
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Treat VRE with
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Linezolid and streptogramins (quinupristin/dalfopristin)
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BLANK DIVIDER CARD
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BLANK DIVIDER CARD
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Mechanism of Amantadine
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Blocks viral uncoating (M2 protein) in host cell
Influenza A only Also causes the release of dopamine from intact nerve terminals |
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Antiviral that can be used to treat Parkinsons
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Amantidine
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Amantadine toxicities
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Ataxia, dizziness, slurred speech
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Mechanism of resistance to Amantidine
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Mutated M2 protein
90% of influenza A strains are resistant, so not used anymore |
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Why is rimantidine safer for the elderly than amantadine
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Fewer CNS side effects because does not cross BBB
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Zanamivir mechanism of action
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Inhibits influenza neuraminidase, which prevents cleavage of progeny virus from surface
Influenza A and B |
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Oseltamivir mechanism of action
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Inhibits influenza neuraminidase, which prevents cleavage of progeny virus from surface
Influenza A and B |
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-mivir drugs work by
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Inhibits influenza neuraminidase, which prevents cleavage of progeny virus from surface
Influenza A and B |
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Ribavirin mechanism of action, use, toxicities
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Inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase
Used for RSV, Hep C Toxicities include: Hemolytic Anemia, Severe Teratogen |
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Acyclovir mechanism, use
-cyclovir (NOT Ganciclovir) |
Guanine nucleotide analog
Monophosphorylated by viral thymadine kinase, triphosphate formed by cellular enzymes Inhibits viral DNA polymerase by chain termination Used for HSV, VZV, EBV NOT USEFUL FOR CMV |
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Mechanism of resistance to acyclovir
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Lack of thymidine kinase
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Used on a daily basis to prevent HSV-2 outbreak
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Famciclovir
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Guanine nucleotide analog that does not require viral thymidine kinase for activation and therefore is useful for CMV
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Ganciclovir
Inhibits viral DNA polymerase |
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Gancyclovir toxicities
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Myelosuppression
Renal toxicity More toxic to host than acyclovir |
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Foscarnet mechanism of action
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Viral DNA polymerase inhibitor that binds to the pyrophosphate binding site of the enzyme
Pyrophosphate analog Does NOT require activation by viral kinase |
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-navir
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Protease inhibitors used for HIV therapy
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Saquinavir
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Protease inhibitor used for HIV therapy
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Ritonavir
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Protease inhibitors used for HIV therapy
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Indinavir
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Protease inhibitors used for HIV therapy
Toxicity is thrombocytopenia |
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Nelfinavir
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Protease inhibitors used for HIV therapy
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Amprenavir
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Protease inhibitors used for HIV therapy
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Mechanism of action of protease inhibitors
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Inhibit assembly of new virus by blocking protease in progeny virions
Used to treat HIV |
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Lipodystrophy is a toxicity of what type of HIV therapy
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Protease Inhibitors
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Nucleoside Reverse Transcriptase Inhibitors mechanism of action
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Compete with nucleosides and inhibit reverse transcriptase causing chain termination
Used to treat HIV |
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Non-nucleoside Reverse Transcriptase Inhibitors mechanism of action
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Allosterically binds reverse transcriptase and prevents it from interacting with nucleosides
Used to treat HIV |
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Zidovudine (ZDV or AZT)
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NRTI
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Didanosine (ddI)
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NRTI
Can cause pancreatitis |
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Zalcitabine (ddC)
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NRTI
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Stavudine (d4T)
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NRTI
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Lamivudine (3TC)
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NRTI
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Abacavir
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NRTI
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Treatment of HIV that can cause lactic acidosis
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NRTIs
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Drug used to treat HIV that can cause megaloblastic anemia
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Zidovudine
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Drug used to prevent mother to child transmission of HIV
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Zidovudine
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Toxicities of Reverse Transcriptase Inhibitors
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Bone marrow suppression
Peripheral Neuropathy Etc. depending on specific drug |
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Enfuviritide mechanism and use
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Fusion inhibitor
Binds viral gp41 subunit, inhibits conformational change required for fusion with CD4 cells Used to treat HIV as last resort |
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Toxicities of Enfuviritide
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Hypersensitivity at injection site
Increased risk of bacterial pneumonia |
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Mechanism, uses, toxicity of Interferons
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Glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis
Induce ribonuclease that degrades viral mRNA INF-a used for chronic Hep B and C, Kaposi's sarcoma INF-B used for MS INF-y used for NADPH oxidase deficiency Toxicity is neutropenia |
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BLANK DIVIDER CARD
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BLANK DIVIDER CARD
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