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70 Cards in this Set
- Front
- Back
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What is the route for Chloramphenicol?
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IV
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What can Chloramphenicol be used to treat?
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Resistant and serious aerobic/anaerobic G+/G- infections
Meningitis |
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What fatal side effect is associated with Chloramphenicol?
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Fatal Blood Dyscrasias
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What is the mechanism of Chloramphenicol?
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Same as tetracycline
Inhibits binding of aminoacyl-tRNA to acceptor site |
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How does Chloramphenicol affect our erythropoietic cells?
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Inhibits mitochondrial peptidyltransferase --> leucopenia, thrombocytopenia, and fatal apastic anemia
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What does decrease in G6PD predispose patients taking Chloramphenicol to?
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Hemolytic anemia
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Does Chloramphenicol inhibit P450?
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Yes
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What does Chloramphenicol cause in babies?
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GRAY BABY syndrome
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How does Chloramphenicol cause gray babies? What are other associated symptoms?
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1. insufficient glucoronyl transferase for conjugation for elimination
2. underdeveloped renal function to eliminate drug This leads to increased levels in blood that interfere with mitochondrial ribosoes Also causes depressed respiration and cardiovascular collapse |
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What class drugs do Quinupristin and Dalfopristin belong to?
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Streptogramins
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Route for Quinupristin and Dalfopristin? What are they used to treat? Why do you use it together?
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IV
MRSA and Vancomycin resistant infections They are SYNERGISTIC |
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What is the mechanism of Quinupristin?
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Premature release of peptidyl tRNA from donor site of peptidyl tranferase
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What is the mechanism of dalfopristin?
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Inhibits binding of aminoacyl-tRNA to acceptor site and of peptidyl-tRNA to donor site of peptidyltransferase
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How does Quinupristin/Dalfopristin affect metabolism of Warfarin/Diazepam?
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Decreases metabolism
b/c inhibit CYP3A |
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Side effects of Quinupristin/Dalfopristin?
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1. Superinfection --> colitis
2. Arthralgias/myalgias 3. Venous irritation --> hyperbilurubenemia |
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What can Linezolid be used to treat?
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Enterococcus faecium
MSSA MRSA other Vancomycin resistant infections |
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Is Linezolid static or cidal?
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Both depending on organism
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Route for Linezolid?
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Oral and IV
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Side effect of Linezolid?
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Myelosupression --> blood dyscrasias and colitis
**Recommend weekly CBC |
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What is the mechanism of Linezolid?
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Inhibits formation of initiation complex on ribosome
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What is Linezolid's effect on MAO-A? What syndrome does this cause?
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Weakly inhibits MAO-A --> 5HT syndrome when used with Rxs that enhance 5HT activity (some antidepressants)
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What are some symptoms associated with 5HT syndrome?
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Restlessness
Tremor Delirium Rigidity Myoclonus Hyperthermia Hyperreflexia Sweating Shivering Blunted senses Seizures Coma |
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What are three things chronic use of linezolid can cause?
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1. Reversible optic neuropathy
2. Irreversible peripheral neuropathy 3. Lactic acidosis |
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Can you use Linezolid forever and ever?
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NO - not longer than 28 days
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What is a risk associated with Clindamycin?
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Risk of pseudomembranous colitis (killing off other bacteria allows C difficile to grow)
Clindamycin - cleeeans your GI tract out (except for C diff. cuz its difficult. |
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Where does Clindamycin spread to in our body?
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Penetrates most tissues well except CNS even if meninges inflamed
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Route for Clindamycin?
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Topical
Suppository Oral IV |
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Some uses for Clindamycin?
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Acne
Bacterial vaginosis Group A strep with high dose of PCN |
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What is the mechanism of Clindamycin?
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Inhibits translocation from A to P site of the ribosome
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What kind of organisms is polymyxin B effective against?
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G neg
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What kind of toxcicity can Polymyxin cause?
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Nephrotoxic
Neurotoxic - can cause neuromuscular block |
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Route for Polymyxin?
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Topical
Rarely IV |
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What is the mechanism for Polymyxin?
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Cidal cationic detergent
Has a post antibiotic effect |
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What is a use for Polymyxin B?
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Bacterial infections of conjunctiva and lids
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What kind of drug is Colistimethate?
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Polymyxin E
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Similarities between Colistimethate and Polymyxin B?
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Both are:
Cidal cationic detergents Very nephrotoxic and neurotoxic Good for Gram negative |
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Route for colistimethate?
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IV/IM
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Is Rifaximin absorbed locally or systemically?
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Local
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What are some uses of Rifaximin?
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1. Travelers' diarrhea from noninvasive strains of E. coli
2. Decreases risk of hepatic encephalopathy in patients with advanced liver disease by decreasing the number of ammonia producing bacteria |
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What is the mechanism of Rifaximin?
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Binds DNA-dependent RNA polymerase
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What are side effects of Rifaximin?
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Flatulence
Abdominal Pain Urgency to defecate |
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Route of Mupirocin?
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Topical ointment and cream
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What is a use of Mupirocin and Retapalmulin?
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IMPETIGO (skin infection) from Group A Strep of S. aureus
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What is the mechanism of Mupirocin?
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Inhibits bacterial Isoleucyl t-RNA synthesis
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What is the mechanism of Retapamulin?
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Blocks Acceptor and Donor sites of peptidyl transferase
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What is Nitrofurantoin used for?
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Prevention and treatment of G+ and G- UTIs
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Where in your body does nitrofurantoin concentrate?
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Renal tubules
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What is the mechanism of Nitrofurantoin?
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UTI bacteria reduces it into reactive intermediates that damages DNA, ribosomes, cell wall, etc.
kind of like suicide for UTI bacteria... |
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What does Nitrofurantoin do to your pee?
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BROWN
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What is one warning associated with Nitrofurantoin?
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Pulmonary reactions and sometimes deaths
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Acute symptoms of pulmonary reactions from Nitrofurantoin? When do they appear? Is acute reversible?
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Fever, chills, cough, pulmonary infiltrates during 1st week of treatment
REVERSIBLE |
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Chronic symptoms of Nitrofurantoin? When do they appear?
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Malaise, DOE, cough, altered PFTs, pneumonitis, fibrosis
6 months of treatment |
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What patients should avoid Nitrofurantoin? Why?
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Pts with history of cholestatic jaundice or hepatic dysfunction with prior use.
Has rarely led to hepatitis, jaundice, hepatic necrosis and death |
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Is Daptomycin Cidal or Static?
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Cidal
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Is daptomycin protein, lipid, sugar?
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Lipopeptide
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What is Daptomycin used for?
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Gram +
MRSA skin and systemic infections |
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Is Daptomycin good for pneumonia? Why?
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NOO!
It is inactivated by pulmonary surfactant |
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What is the mechanism of Daptomycin?
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Forms pores in cytoplasmic membrane --> loss of K+ --> depolarization and inhibition of DNA, RNA, and protein synthesis
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What is a side effect of Daptomycin?
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Increases creatine kinase
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How is Daptomycin excreted?
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By kidneys unchanged
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What is Quinidine used for? Route?
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IV for life threatening Plasmodium falciparum = malaria
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What should you worry about when giving a patient Quinidine?
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Can cause arrhythmias
So monitor ECG |
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What is organisms can Rifampin be used for?
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G+ and G-
Staph MRSA |
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Mechanism of Rifampin?
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Inhibits DNA dependent RNA polymerase --> inhibits RNA synthesis
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Does Rifampin kill intracellular or extracellular organisms?
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BOTH
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Conditions that Rifampin can be used for? Why do you need to combine it with other drugs?
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Lung abcesses (it penetrates lung cavities well)
Combine with other Rxs to prevent emergence of resistant organisms |
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How is Rifampin excreted?
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Bile --> enterohepatic recirculation
Adjust dose for liver function? |
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Do you want to give Rifampin for MORE than 2 weeks or LESS? Why?
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More than 2 weeks or may cause a flu-like syndrome
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What are some side effects of Rifampin?
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1. Red orange color to urine, feces, saliva, sweat, tears
2. Rash, fever N & V 3. Jaundice but fatalities rare 3. Hepatitis if liver disease, alcohol, old |
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How does Rifampin affect activity of digoxin, anticoagulants, quinidine, oral contraceptives?
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Decrase
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