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25 Cards in this Set

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Nitrofurantoin (Macrodantin)
Synthetic Compound
- prevention and tx of UTI
- antibacterial activity higher in an acidic pH.
- High reactive intermediates are responsible for the observed activity of the drug to damage DNA.
Nitrofurantoin are excreted:
- glomerular filtration
- tubular filtration

- HEMOLYTIC ANEMIA in G6PDH Deficient patient.
- Neuropathies.
Polymyxin (peptide):
Polymyxin A (COLISTIN)
Polymyxin B (COLISTIMETHANE)
- Aerobic (-) gram bacteria
- Bacteriocidal
- MOA: Interacts strongly with phospholipids, penetrate, and disrupt cell membrane.
A.E. of polymyxin
- reversible nephrotoxicity
- neurotoxicity
- paresthesia, vertigo, dizziness, slurred speech, tinglign of extremites.
Vancomycin
S. Orientalis
- Gram + bacteria
- Cell wall synthesis inhibitor
- Bactericidal agents
Vanco resistance mechanism:
Alt. of D-Ala-D-Ala target to lactate or serine
Elimination of vanco
- RENAL
- a.e. of red man syndrome
- reverisble nephrotoxicity
- irreversible ototoxicity.
Bacitracin:
- gram (+) cocci and bacilli
- inhibit cell wall synthesis.
- nephrotoxicity.
Linezolid:
MOA
- gram (+) organism
- MOA: INHIBITS PROTEIN SYNTHESIS.
~ Binds to 23S subunit of the 50S subunit.
~ Early, ribosome - assembly step
Linezolid A.E.:
Hematological: thrombocytopenia
- MOA inhibitor: tyramine foods.
Streptogramins: semisynthetic
gram (+) inhibitor
- Protein synthesis inhibitor (50S)
- Quinupristin (70): Late phase: peptide elongation
- Dalfopristin (30): early stage: polypeptide chain formation.
Resistance Streptogramins:
1. Modification of quinipristin binding site
2. Enzymatic inactiviation of dalfopristin
3. Efflux
How is streptogramins:
- Hepatic metabolism: both compounds
- 80% - biliary excretion
A.E. of streptogramins:
- arthralgia and myalgia.
Metronidazole (Flagyl): Indications for:
- bactericidal.
- Indications:
1. Protozoan (amebiasis, giardiasis)
2. H. pylori
3. Infections from BActeriodes, Clostridium
How are metrondiazoles excreted?
- LIVER
- oxidative metabolism is induced by:
1. Phenobarb
2. Phenytoin
3. Rifampin
Metrondiazoles A.E. is:
- Disulfiram type reactions with alcohol.
- Numbness or paresthesias
Drug interactions of Metrondiazole:
1. Lithium toxicity
2. Potentiate Warfarin
3. Teratogenicity
Ketek (MOA):
INHIBIT protein synthesis
- binds to 23S of the 50S ribosomonal subunit.
A.E. OF KETEK
- Prolong QT interval
- Acute liver failure and severe hepatic injury.
- Loss of conciousness/ visual disturbances
Drug Interactions vs. Ketek
Inhibits CYP3A4:
1. SIMVASTATIN, eryth. Increase.
Substrate CYP3A4: REDUCE LEVELS OF kETEK

1. Phenobarb., rifampin, phenytoin
Contraindication with Ketek:
1. Myasthenia gravis
Tigecycline: MOA


Indications:
- bacteriostatic
- inhibit bacterial protein translation:
- block entry of aminoacyl tRNAs to A site
- bind to 30 S
INDICATIONS:
- skin structure infection
- intra-abdominal
DAPTOMYCIN:
- cyclic lipopeptide
bidns to bacterial membranes and causes a rapid depolarization of membrane potential.
Daptomycin (Reversible bound to plasma protein 90%)
s.e.

and indication
- s.e. myalgia and elevated CPK
- SKIN/SKIN structure infections and bactermia.