• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/280

Click to flip

280 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
cell wall/cell membrane
G+. lipoteichoic acid induces TNF and IL1
outer membrane
G-. lipid A induces TNF and IL-1
periplasm
beta lactamases
These Rascals may microscopically lack color
don't gram stain well.
Treponema, rickettsia, mycobacteria, mycoplasma, legionella, chlamydia
giemsa stains
borrelia, trypanosomes, chlamydia
PAS stains
glyogen, mucopolysaccharides, Whipples dz
Ziehl-Neelsen for
acid-fast
silver stain for
fungi, legionella
tellurite, lofflers for
diphtheriae
eatons for
m. pneumoniae
e coli turns what color on EMB
metallic blue-black
Nagging Pests Must Breathe
aerobes are nocardia, pseudomonas, m tb, bacillus
anaerobes Can't Breathe Air
lack catalase and/or superoxide dismutase. produce gas. clostridium, bacteroides, actinomyces
aminO2glycosides are ineffective
Some Nasty Bugs May Live FacultativeLY (intracellular)
salmonella, neisseria, brucella, mycobacterium, listeria, francisella, legionella, yersinia
encapsulated. ShiN SKiS
strep pneumo, h. influ, n. mening, salmonella, klebsiella pneumo, group B strep. asplenic get lots of these.
PUNCH K
urease positive. proteus, ureaplasma, nocardia, cryptococcus, h pylori, klebs
protein A
staph aureus. binds Fc, prevents opsonization/phago
IgA protease
SHiN (s. pneumo, Hib, Neiss)
M protein
group A strep, prevents phago
eNdotoxin
Gram NEG
liPOteic acid
gram POS
exotoxin
highly toxic, toxoid vaccines
endotoxin
stable at 100 deg C, ie. meningococcemia, sepsis
c. diphtheriae exotoxin
inactivates EF-2 (tranlation) via ADP ribosylation
pseudomonas exotoxin
inactivates EF-2 (tranlation) (exotoxin A) via ADP ribosylation
shigella exotoxin
inactivate 60S ribosome
EHEC exotoxin
inactivate 60S ribosome
(does not invade host)
ETEC exotoxin
heat LABILE toxin overactivates adenylate cyclase, incr cAMP, incr Cl secretion
heat STABLE toxin overactivates guanylate cyclase, incr cGMP, decr resorp of NaCL and H20 in gut
Labile in the Air, Stable on the Ground
Yersinia enterocolitica exotoxin
heat STABLE toxin overactivates guanylate cyclase, incr cGMP, decr resorp of NaCL and H20 in gut. invades.
bacillus anthracis exotoxin
mimics adenylate cyclase, incr cAMP, incr secretion. edema factor. cutaneous anthrax.
v. cholerae exotoxin
overactivates adenylate cyclase, incr cAMP, permanently activating Gs, incr Cl secretion in gut. ADP ribosylation
bordatella pertussis exotoxin
overactivates adenylate cyclase, incr cAMP, disables Gi, impairing phago. ADP ribosylation
c. tetani exotoxin
cleaves SNARE protein req to release inhibitory GABA and glycine
c. botulinum exotoxin
cleaves SNARE protein req to release stimulatory ACh.
c, perfringens exotoxin
phospholipase degrades cell mems (alpha toxin). myonecrosis, gas gangrene
s. pyogenes exotoxin (not superantigen)
streptolysin O degrades cell mem, lyses RBCs
s. pyogenes exotoxin (not streptolysin O)
exotoxin A. brings MHCII and TCR together.
s. aureus
TSST1. brings MHCII and TCR together. also scalded skin syndrome and food poisoning.
ADP ribosylating A-B toxin
B is binding component, enables endocytosis. A is active component that attaches ADP-ribosyl to host protein
effect of endotoxin
sctivates hageman factor, leads to DIC
OVRPS (overpass)
optochin viridans resistant, pneumoniae sensitive
color of alpha hemolysis
green ring
non-strep beta hemolytics
s. aureus, listeria
s. aureus causes...
clusters. bacterial endocarditis, osteomyelitis
s. pneumo causes...
MOPS. Most Optochin Sensitive, Meningitis, Otitis media, Pneumonia, Sinusitis. rusty sputum. sepsis in sickle and splenectomy. lancet shaped, encapsulated, IgA protease
viridans are not afraid of the chin!
optochin resistant
s. pyogenes causes
(group A) ASO
pyogenic - pharyngitis, cellulitis, impetigo
toxigenic - scarlet fever, toxic shock-like
immunologic - rheumatic fever (M protein), acute GN
no rheum for SPECCulation: SubQ plaques, polyarthritis, erythema marginatum, chorea, carditis
s. agalactiae
group B. B for Babies!
enterococci
PCN G resistant. Cause UTI and subacute endocarditis. VREs.
strep bovis
colonizes gut, causes bacteremia and subacute endocarditis in CRC pts
diphtheriae lab dx
metachromatic (blue and red) granules and Elek test for toxin. club shaped, tellurite agar
spores
bacillus, coxiella
clostridia perf and diff
obligate anaerobe bacilli. PERFinges PERForates wound.
difficile: toxin A, enterotoxin, brinds brush border of gut. Toxin B, cytotoxin, destroys cytoskeleton of enterocytes, causing pseudomem colitis (tx with flagyl or vanc)
pulmonary anthrax
woolsorters dz. pulm hemorrhage, mediastinitis, shock
listeria tx for infants
ampicillin
actinomyces
oral/facial abscess. normal oral flora
SNAP: sulfa for nocardia, actinomyces use PCN
norcardia
acid-fast aerobe in soil, pulm ifxn in immunocompromised
SNAP: sulfa for nocardia, actinomyces use PCN
severe bacteremia with TB
miliary TB
m. kansasii
pulm TB like sx
MAC prophylaxis
azithro
leprosy (hasen's dz)
cool temps. tx: oral dapsone. tox is hemolysis and methemogloblinemia.
lepromatous: low cell-med immunity, humoral Th2. lethal.
tuberculoid: high cell-med immunity, Th1 response.
PCN and G negs
resistant to PCNG but maybe susceptible to ampicillin
gonococci
Fitz-Hugh-Curtis syn.
meningococci prophylaxis
give rifampin to close contacts
h. influenza causes...
Epiglottitis, Meningitis, Otitis media, Pneumonia. Grow with factor V & X. tx meningitis wit ceftriaxone, rifampin for close contacts
legionella
pontiac fever. detect antigen in urine. tx: erythromycin
iron dagger - he is no cyssy - need Fe and CYS for culture
pseudomonas
diabetic osteomyelitis. endotoxin (fever, shock), exotoxin A (inactivates EF2) tx: aminogly + piperacillin
e coli K capsule
virulence factor for pneumonia, neonatal meningitis
EIEC has which toxin?
no toxins
ETEC causes
travelers diarrhea
EPEC produces dz in
Pediatrics
EHEC
shiga-like toxin, HUS (anemia, thrombocytopenia, acute renal fail), mechanical hemolysis and reduced RBF. dysentery, does not ferment sorbitol (unlike other e coli)
klebsiella
intestinal flora. red currant jelly sputum. nosocomial UTIs. alcoholics, diabetics
salmonella and shigella
salmon swim. salmonella hematogenous, H2S, abx prolong. typhi has rose spots on abdomen, carry in GB. shigella propel via actin polym, use abx!
yersinia entercolitica
diarrhea from day cares, mesenteric adenitis that mimics chrohns or appendicitis
h pylori
creates alkaline environ. tx with: 1 PPI, 2 clarithro, 3 amox or flagyl
spirochetes
BLT. B is Big. Borrelia, Leptospira, Treponema.
leptospira
question mark shape. flulike, jaundice, photophobia, conjunctivitis. Weil's dz: icterhemorrhagic leptospirosis. severe jaundice and azotemia, fever, hemorrhage, anemia
lyme
borrelia burgdorferi. erythema chronicum migrans. mice and deer. stage 3: arthritis. tx: doxy, ceftriaxone
syphilis
3: aortitis (vasa vasorum destruction). broad based ataxia, positive rhomberg, charcot joint, stroke w/o HTN.
congenital: saber shins, saddle nose, deafness, hutchinson's teeth, mulberry molars
borrelia recurrentis trasmitter
louse
chlamydophila psittaci
psittacosis. transmitted by parrots and birds
pasteurella multocida causes
cellulitis, osteomyelitis
rickettsia prowazekii
causes epidemic typhus, vector is louse
get brucellosis from
unpasteurized dairy
Q fever transmitter
spores from tick feces and cattle placenta
ehrlichiosis vector
lone star tick
tularemia vectors
ticks, rabbits, deer fly
clue cells are
vaginal epithelial cells covered with bacteria
RMSF
rash starts on hands/feet. HA, fever, rash.
Rickettsia on Wrists, Typhus on Trunk
R prowazeikii rash
Rash starts centrally and spreads out, sparing palms and soles
epidemic typhus
Rickettsia on Wrists, Typhus on Trunk
tx: doxy
ehrlichia lab findings
granulocytes with berry cluster organisms
tx: doxy
Q fever
pneumonia. tx: doxy
Q fever is Queer because it has no rash, has no vector, and has negative Weil-Felix
Weil-Felix
Abs against Rickettsia agglutinate with Proteus antigens
chlamydiae
elementary is enfectious and enters
reticulate body replicates
causes reactive arthritis, conjunctivitis. lacks muramic acid. dx with cytoplasmic inclusions on giemsa. tx: doxy or azithro
c. pneumoniae and c. psittaci cause atypical pneumonia, transmitted aerosol
c. trachomatis A,B,C: Africa Blindness, Chronic ifxn
mycoplasma
cold agglutinins (IgM) can lyse RBCs. Eatons agar.
tx: tetra or eryth
dimorphic fungi
cause pneumonia, cold mold, heat yeast (except coccidioido, which is spherule in heat.
tx: fluconzaole or ketoconazole for local, amphotericin for systemic
histoplasmosis
Miss. and Ohio river valleys. histo hides (in macros)
blastomycosis
east. skin and bone too. granulomatous nodules. blasto buds broadly
coccidioidomycosis
meningitis too. spherule filled with endospores, much larger than RBC
paracoccidioidomycosis
latin america. captains wheel
tinea versicolor
tx topical miconazole, selsun. spaghetti and meatballs on KOH. acid damages melanocytes
other tinea
rings. microsporum, trichophyton, epidermophyton. mold hyphae in KOH. not dimorphic
candida causes
endocarditis in IV drug users
aspergillus causes
in immunocomp and chronic granulomatous dz: 1. allergic bronchopulm aspergillosis with asthma or CF 2. aspergillomas in lung cavities after TB 3. can make aflatoxins (HCC)
cryptococcus neoformans
menigitis, cryptococcosis. heavily encapsulated yeast. soil, pigeon droppings, inhale. stains india ink. soap bubble lesions in brain.
pneumocystis jiroveci
yeast. tx: bactrim, pentamidine, dapsone. proph @ 200.
sporothrix
sporotrichosis. dimorphic cigar shaped budding yeast. rose gardeners dz. local pustule and ascending lymphangitis
tx: itraconazole or POTassium iodide
entamoeba histolytica dx and tx
dx serology, stool
tx flagyl and iodoquinol
cryptosporidium dx, tx
cysts on acid-fast stain
no treatment
congenital toxo
chorioretinitis, hydrocephalus, intracranial calcifications
gen tx: sulfadiazine and pyrimethamine
naegleria fowleri
rapidly fatal meningoencephalitis. Nalgene from freshwater lake. amoebas in spinal fluid.
trypanosoma (not cruzi)
african sleeping sickness. big LNs, recurring fever, somnolence, coma
tsetse fly (painful bite) dx: blood smear. tx: SURamin for blood dz or MELArsoprol for CNS. sure is nice to go to sleep, melatonin helps
P vivax and ovale cycle, p malariae cycle
48 hrs VO, 72 hrs M
choloroquine blocks...
heme polymerase
babesia tx
quinine, clindamycin
trypanosoma cruzi
chagas. dilated CM, megacolon and megaesoph. S. Am.
reduviid bug (kissing), painless bite. dx: blood smear, tx: nufurtimox
leishmania
spiking fevers, HSMeg, pancytopenia
dx: macros with amastigotes
tx: sodium stibogluconate
ascaris tx
nematode. tx: bendazoles or pyrantel pamoate
trichinella tx
nematode.tx: bendazoles
strongyloides tx
nematode. tx: bendazoles or ivermectin.
intestinal.
ancylostoma duodenale, necator americanus (hookworms)
nematodes. penetrate feet. intestinal. tx: bendazole, pyrantel pamoate
dracunculus medinensis
in drinking water, skin inflamm/ulcer
tx: niridazole, prolonged extraction
onchocerca volvulus
blackflies. causes hyperpig skin and river blindness. BLACKflies, BLACK skin, BLACK sight.
tx: ivermectin (for rIVER blindness)
loa loa
deer fly
tx: diethylcarbamazine
wuchereria bancrofti
mosquito
tx: diethylcarbamazine
toxocara canis
granulomas
tx: diethylcarbamazine
taenia solium
tapeworm. ingestion of larvae in pork leads to tapeworms. egg ingestion casuse cysticercosis
tx: praziquantel (bendazole if neurocysticercosis)
diphyllobothrium latum
tapeworm. raw freshwater fish. B12 def.
tx: praziquantel
echinococcus
tapeworm. eggs in dog feces. surgeons inject ethanol before removal to kill cysts
bendazoles
schistosomes
trematodes (flukes). snails host. penetrate skin. spleen and liver.
S. haematobium leads to bladder cancer
praziquantel
clonorchis sinensis
trematodes (flukes) undercooked fish, inflamm of biliary tract, pigmented gallstones. cholangiocarcinoma.
praziquantel
paragonimus westermani
trematodes (flukes), undercooked crab, causes inflamm and secondary bacterial ifxn in lung, hemoptysis
praziquantel
You'll get sick if you EAT these!
enterobius, ascaris, trichinella are ingested
these get into your feet from the SANd!
cutaneous - strongyloides, ancylostoma, necator
vaccines
killed only humoral
no booster if live
Live! See small yellow chickens get vaccinated with Sabin's MMR!
Live: smallpox, yellow fever, chickenpox, sabin, MMR
recombinant vaccines
HBV, HPV
DNA viruses dsDNA except
parvoviruses
DNA viruses are linear except
papilloma, polyoma, hepadna (circular)
all RNA viruses ssRNA except
Reoviridae
postive strand RNA viruses:
I went to a RETRO TOGA party where I drank FLAVored CORONA and ate HIPPY (hepe) CALIfornia PICO de gallo (pircorna)
purified nucleic acids of most dsDNA and positive strand RNA viruses are infectious except
pox and HBV
DNA viruses replicate in nucleus except
pox
RNA viruses replicate in cytoplasm except
influenza, retro
Naked CPR and PAPP smears
naked viruses:
Calci, picorna, reo (RNA)
parvo, adeno, papilloma, polyoma (DNA)
all DNA viruses are icosahedral except
pox
hepadnavirus is
HBV
parvovirus cases
aplastic crises in sickle cell, hydrops fetalis, RBC aplasia & rheum arthritis-like in adults
polyomas
JC: junky cerebrum. PML
BK: bad kidney. transplant patients
pox viruses
smallpox, vaccinia, molluscum
HSV labs
tzanck smear. intranuclear cowdry A inclusions
EBV
atyp Ls are cytotox Ts. monospot is heterophile Abs detected by agglutination of sheep or horse RBCs. assoc with hodgkins
reoviruses
coltivirus (CO tick fever), rotavirus
picornaviruses
poliovirus, echovirus (aseptic meningitis), rhinovirus, coxsackievirus, HAV
calicivirus
norwalk
flavivirus
HCV, yellow fever, dengue, st louis encephalitis, west nile virus
togavirus
rubella
eastern equine
western equine
orthomyxo
influenza
paramyxo
Parainfluenza
RSV
MMR
arenaviruses
LCMV, lassa fever (from mice)
circular
bunyaviruses
circular. hantavirus
deltavirus
circular
always bring polymerase or fail replication
negative stranded viruses.
arena
bunya
paramyxo
orthomyxo
filo
rhabdo
BOAR
segmented viruses.
bunya
ortho
arena
reo
PERCH on a Peak
Picornas. can cause meningitis (except rhino and HAV), all are enteroviruses except rhino
yellow fever
high fever, black vomitus, jaundice
rotavirus
segmented dsRNA. villous destruction with atrophy
influenza
killed vacc. hemagglutinin promotes viral entry, neuraminidase promotes progeny release. bacterial superinfection.
rubella
togavirus. 3 day fever, postauric adenopathy, LApathy, arthralgia, fine truncal rash that starts at head and moves down
paramyxovirus virulence
dz in kids. croup. surface F (fusion) protein causes resp epithelial cells to fuse and form multinuc cells. palivixumab is a mab agst F that prevents pneumo in premies
measles
can cause SSPE years later, encephalitis, and giant cell pmeumo. rash includes hands and feet
mumps
Parotitis
Ocrhitis
aseptic Meningitis
rabies
bullet shape, purkinje cells of cerebellum
hepatitis
HAV picorna
HBV DNA hepadna
HCV flavi
HEV hepe. fecal-oral - Enteric, Expectant mothers, Epidemic
fever, jaundice, high ALT & AST
vowels hit your bowels
In HBV, cellular RNA pol transcribes RNA from DNA template. Reverse transcriptase transcribes RNA intermediate into DNA genome. virion enzyme is a DNA-dependent DNA polymerase
HIV
diploid RNA genome
gp120 attachment to T cell
gp41 fusion and entry
HIV ELISA IS a rule... test
out
AIDS when CD4 is
200
superficial vascular proliferation in AIDS pt
neutrophilic inflamm. bartonella henselae. bacillary angiomatosis
encephalopathy in AIDS pt with demyelination
JC
meningitis, CD4<50
cryptococcus neoformans
cotton wool spots, esophagitis, CD4<50
CMV
superficial neoplastic proliferation of vasculature with lymphocytic inflammation
HHV8
hairy leukoplakia from which virus
EBV
lymphoma on oropharynx (Waldeyer's ring), assoc with AIDS
EBV. non-hodgkins (large cell)
squamous cell carcinoma in AIDS
HPV
primary CNS lymphoma in AIDS caused by
EBV
interstitial pneumonia with Owls eyes in AIDS
CMV
pleuritic pain, hemoptysis, infiltrates in AIDS
aspergillus
prions
mutant forms beta pleats
bug in reheated meat
C. perfringens
bug in undercooked meat
e coli O157:H7
bugs that mimic appendicitis
yersinia entercolitica, campylo, non-typhoid salmonella
neonate (<4wk) pneumonia
group B strep
e coli
children pneumo
Runts May Cough Sputum
RSV
Mycoplasma
Chlamydia
Strep pneumo
adult to 40 pneumo
mycoplasma
c. pneumo
s. pnuemo
40-65 yo pneumo
s. pneumo
h. influ
anaerobes
viruses
mycoplasma
elderly pneumo
s. pneumo
influenza virus
anaerobes
h. influ
gram neg rods
postviral infection
staph, h. influ
newborn meningitis
group b strep
e coli
listeria
peds mening (6mos-6yrs)
s. pneumo
n. mening
hib
enteroviruses
6-60yo mening
s pneumo
n. mening
enteroviruses
HSV
elderly mening
s. pneumo
Gram neg rods
listeria
meningitis empirical tx
ceftriaxone and vanc (add ampicillin if listeria suspected)
viral meningitis
enteroviruses (esp coxsackie), HSV2, HIV, West Nile, VZV
HIV: CMV
osteomyelitis
most ppl - s. aureus
sex active - n. gon (rare)
diabetics and IV drugs - pseudo
sickle cell - salmonella
prosthetic - s aureus and s epidermidis
cat and dog bite - pasteurella
urinalysis
positive Nitrite=gram Negative
leukocyte esterase=bacteria
3nd leading cause of community UTIs in sex active women
staph saprophyticus
congenital toxo
asymp mom
baby: chorioretinitis, hydrocephalus, intracranial calcifications
congenital rubella
PDA (or pulm artery hypoplasia), cataracts, deaf, blueberry muffin rash
Congenital CMV
mom asym
baby: hearing loss, seizures, petechiae, blueberry muffin rash
congenital HIV
recurrent diarrhea
congenital HSV2
temporal encephalitis
congenital syphillis
stillbirth, hydrops fetalis, facial abnormalities, saber shins, deaf
ddx rash
rubella starts head, moves down, postauric LA
measles starts head, moves down
VZV begins trunk
HHV6 infants after high fever
B19 hydrops fetalis
s. pyogenes sandpaper rash with fever and sore throat
chancroid bug
haemophilus ducreyi
lymphogranuloma venereum bug
C. trachomatis (L1-L3). infection of lymphatics. genital ulcers, LA, rectal strictures
trichomonas lab finding
corkscrew motility on wet prep
condylomata acuminata bug
HPV 6 and 11
PID complication
Fitz-Hugh-Curtis: infection of liver capsule and violin string adhesions of parietal peritoneum to liver
urinary catheterization bugs
e coli, proteus mirabilis
cherry red epiglottis
HiB
neutopenia
candida, aspergillus
block cell wall synthesis by inhibiting peptidoglycan cross-linking
PCNs
block peptidoglycan synthesis
bacitracin, vanco
block mRNA synthesis
rifampin
damage DNA
flagyl
block 50S
chloramphenicol, macrolides, clindamycin, streptogramins, linezolid
block 30S
aminogly
tetra
PCN
block transpeptidase crosslinking of peptidoglycan and activates autolytic enzymes
use: Gram Neg cocci, spirochetes
tox: hemolytic anemia
resist: beta lactamase
methicillin, nafcillin, dicloxacillin
penicillinase resistant because of bulkier R group.
use: s. aureus
tox: interstitial nephritis
ampicillin, amoxicillin
wider spectrum. clavulanic acid protects against beta lactamases.
use: ampicillin HELPSS kill
H. influ
E. coli
Listeria
proteus mirabilis
salmonella
shigella
ticarcillin, carbenicillin, piperacillin
use: pseudomonas and gram neg rods susceptible to penicillinase. use with clavulanic acids.
cephalosporins
beta lactams less susceptible to penicillinases.

tox: vit K def, incr nephro with amino, disulfiram with alcohol
bugs not covered by cephalosporins are LAME
Listeria, atyps (chlamydia, mycoplasma), MRSA, Enterococci
1st gen cephalosporins
PEcK Proteus, E coli, Klebs
2nd gen cephalosporins
HEN PEcKS: H influ, Enterobacter, Neisseria, Proteus, E coli, Klebs, Serratia
3rd gen cephalosporins
ceftriaxone (meningitis, gonorrhea)
ceftazidime (pseudo)
4th gen cephalosporins
pseudomonas and gram pos
aztreonam
monobactam resistant to beta lactamase. inhibits cell wall synthesis (binds PBP3). synergy with aminogly. no allergy.
use: gram neg rods
imipenem/cilastatin, meropenem
broad spectrum beta lactamase-resistant carbapenem. cilastatin decr inactiv in renal tubules
use: only life threatening infections because tox: seizures
vanco
inhibits cell wall mucopeptide formation by binding D-ala D-ala cell wall
use: Gram pos only. C diff
aminoglycosides
bactericidal. inhibits formation of initiation complex and causes misreading of mRNA.
use: severe gram neg rod. synergy with beta lactams. neomycin for bowel surgery
tox: nephrotox (esp with cephalos), ototox (esp with loops), teratogen
resistance: acetylation, phosphorylation, adenylation
tetracyclines
Demeclocycline - ADH antagonist, acts as a Diuretic in SIADH. Bacteriostatic. binds to 30S and prevents attachment of aminoacyl-tRNA, limited CNS penetration. DON'T take with milk, antacids, iron
use: borrelia, m. pneumo, riskettsia, chlamydia
tox: GI
resist: plasmid-encoded transport pumps
macrolides
blocking translocation (macroSLIDES). bacteriostatic
use: atyp pneumo, URI, STD, gram pos cocci, Neisseria
tox: prolonged QT, GI, cholestatic hepatitis, eosinophilia, skin rashes, increases conc. of theophyllines, oral anticoags
resist: methylation of 23S rRNA binding site
chloramphenicol
blocks peptide bond formation at 50S
use: meningitis in develop countries
tox: aplastic anemia
resist: plasmid-encoded acetyltransferase inactivates
clindamycin
blocks peptide bond formation at 50S
use: anaerobes ABOVE diaphragm
Sulfonamides
PABA antimetabolites inhibit dihydropteroate synthetase
use: gram Pos, gram neg, nocardia, chlamydia
tox: nephro, photo, kernicterus in infants, displace warfarin from albumin
trimethoprim
inhibits bacterial dihydrofolate reductase
tox: megaloblastic anemia, leukopenia, granulocytopenia (leucovorin helps)
fluoroquinolones
can't take with antacids. use: GI, neisseria, some gram pos
tox: GI, rash, HA, dizzy. NO pregnant, kids
resist: chromosome-encoded mutation in DNA gyrase
metronidazole
free radicals. bactericidal.
use: anaerobes BELOW diaphragm
tox: disulfiram with alcohol, HA, metallic taste
MAC prophylaxis
azith
INH
decr synthesis of mycolic acids
INH Injures Neurons and Hepatocytes
Rifampin
RNA polymerase inhibitor
Revs up p450
Red/orange body fluids
Rapid resistance if used alone
pyrazinamide
tox: hyperuricemia, hepatotox
ethambutol
tox red-green colorblind
meningococcal prophylaxis
cipro
endocarditis prophylaxis
PCN
HIV prophylaxis
200, 100: bactrim (PCP, toxo)
50: azith MAC
VRE tx
linezolid and streptogramins
empiric therapy for community pneumonias
outpt: macrolides
inpatient: fluoro
ICU: beta lactam + one of above
amphotericin B
TEARS holes in membrane. intrathecal for mening. supplement with K and Mg
tox: SHAKE AND BAKE, HYPOTEN, NEPHRO, ARRHYTHMIA, ANEMIA, PHLEBITIS
azoles
tox: inhibit p450, fever, chill
flucytosine
inhibits DNA synthesis by conversion to 5-FU by cytosine deaminase.
use: cryptococcus, systemic fungal ifxns with ampho
tox: N/V/D, BM sup
caspofungin
inhibits synthesis of beta glucan
use: aspergillus, candida
toxL GI, flush
terbinafine
inhibits squalene epoxidase
treats dermatophytoses, onychomycosis
tox: LFTs, vision
griseofulvin
for superficial ifxns, tinea, ringworm (dermatophytes)
tox: teratogen, carcinogen, confusion, HA, induces p450 & warfarin metab
amantadine
blocks uncoating (M2 protein), releases dopamine from nerves
use: influ A proph, Parkinsons
A Man 2 dine takes off his coat.
tox: ataxia, dizzy, slur speech
resist: mutated M2. 90% influ A resistant
Rimantidine has fewer sfx (no cross BBB)
zanamivir, oseltamivir
inhibits influ neuraminidase, decr progeny release
use: influ A & B
ribavirin
inhibits synth of guanine by comp inhib IMP DH
use: RSV, chronic hep C
tox: hemolytic anemia, teratogen
acyclovir
monophosphorylated by HSV/VZV thymidine kinase. guanosine analog.
use: HSV, VZV, EBV. no effect on latent. valacyclovir better oral avail. for zoster, use famciclovir
resist: no thymidine kinase
ganciclovir
5' monophosphate formed by CMV viral kinase. guanosine analog.
use: CMV. valganciclovir better oral avail.
tox: leukopenia, neutropenia, thrombocytopenia, renal tox.
resist: mutated CMV DNA pol or no viral kinase
foscarnet
viral DNA pol inhib that binds to pyrophos binding site of enzyme. no kinase activation.
FOScarnet is pyroPHOS analog
use: CMV retinitis when ganciclovir fails.
tox: nephro
resist: mutated DNA pol
cidofovir
inhibits viral DNA pol, no kinase activ.
use: CMV retinitis, when others fail
tox: nephro. probenecid helps
HIV tx
at 350. 2 NRTIs, 1 other
protease inhibitors
-navir. ritonavir inhibits p450.
tox: hyperglycemia, GI, lipodystrophy
NRTIs
AZT. must be phosphorylated by thymidine kinase. Have you dined (vudine) with my nuclear (nucleosides) family?
tox: BM sup (rev w GCSF and erythro), periph neurop, lactic acidosis, rash, megaloblastic anemia (AZT)
NNRTIs
VIR in middle. no phosp necess, don't compete with NTs.
tox same as NRTIs
raltegravir
integrase inhibitors
tox: hyperchol
IFN alpha
chronic hep B,C kaposi, melanoma
tox: neutropenia
abx to avoid in preg
Countless SAFe Moms Take Really Good Care
clarithromycin embryotoxic
Sulfas kernicterus
Amino oto
Fluro cart
Metronidazole mutagen
tetra teeth, bone
ribavirin terato
griseofulvin terato
chloramphenicol gray baby