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67 Cards in this Set
- Front
- Back
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what kind of incontinence can lead to complicated UTI
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overflow incontinence
you have an obstruction that prevents the urine from fully being cleared from the bladder and urine is a good medium for growth |
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if you have a UTI in the kidney what is the cause
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it is due to other causes such as metabolic disorders, kidney stones, etc
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what are contributers of uncomplicated UTI
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spermicides
onset sexual activity loss of estrogen |
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why would the onset of sexual activity cause a UTI
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it causes uncomplicated UTI because the skin between the anus and the urethra has bacteria that during sexual intercourse get stuck in the bladder
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what is the source of infection for UTI
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enterric bacteria
skin flora (gram +) |
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why are sulfonamides not used often
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due to a lot of resistance
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how do Sulfa drugs fool bacteria
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since not all bacteria have a good food source they must make their own folic acid at times by using PABA.
Sulfa drugs look like PABA structurally so the enzyme will act on it and get inhibited therefore no folic acid will be made |
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what enzyme do sulfa drugs inhibit
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Dihydropteroate synthetase
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what is the antibiotic resistance to sulfonamides
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the bacteria bypass the pathway they use to make folates and use preformed folates instead
decrease in affinity for Sulfonamides to Dihydropteroate synthetase increased production of PABA causing competitive inhibition for the sulfa drugs |
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what is the main therapeutic use of Sulfasalazine
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inflammatory bowel conditions and ulcerative colitis
this is because sulfasalazine metabolite is an antiinflammatory and since its poorly absorbed it will stay in the gut |
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what enzyme does trimethoprim inhibit
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dihydrofolate reductase
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what is Bactrim
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Sulfamethoxazole + Trimethoprim
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what are the properties of Sulfamethoxazole + Trimethoprim
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drug synergy
coverage against gram+/- and atypicals |
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what bugs are resistant to Sulfamethoxazole + Trimethoprim
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Bacteriodes
pseudomonads enterococci |
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what is the therapeutic application of Sulfamethoxazole + Trimethoprim
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UTI
respiratory infections |
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what is Narcardiosis and what can be used to treat it
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Narcardiosis is a respiratory tract infection caused by Narcardia that is seen in immunosuppressed patients
treated by using Sulfamethoxazole + trimethoprim |
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what combo drug is given to children with respiratory infections
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Sulfisoxazole + erythromycin (pediazole)
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what can be used to treat Toxoplasmosis anti malaria
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sulfadiazine + pyrimethamine
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what drug acts similar to trimethoprim
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pyrimethamine
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how are sulfonyureas used to treat diabetes
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they enhance insulin secretion from Beta cells
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how is metformin used to treat diabetes
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sensitizes cells to insulin
suppresses hepatic gluconeogenesis |
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how does thiazolidindiones treat diabetes
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acts on adipose tissue
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what is the resistance to Sulfamethoxazole + trimethoprim
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resistance to combo is on the rise
trimethoprim has the same resistance as sulfa drugs |
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what was the first gen quinolone
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nalidixic acid
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what sulfonamides are topical
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sulfacetamide
sulfadiazine |
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what are the 2nd gen fluoroquinolones
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ciprofloxacin
norfloxacin ofloxacin |
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what are the 3rd gen fluoroquinolones
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gemifloxacin
levofloxacin moxifloxacin |
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how do flouroquinolones work
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they inhibit/interfere w/ DNA gyrace and topoisomerase 4
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what is the function of topoisomerase 4
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untangles the daughter strands (catenate)
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what is the spectrum of fluoroquinolones
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bactericidal for most enterobacteriaceae
not effective against MRSA can use against MSSA useful for atypicals drug of choice for anthrax no useful against anaerobes or streptococci |
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what atypicals can fluoroquinolines be used against
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mycoplasma
chlamydia brucella legionella |
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what infections can fluoroquinolones be used against
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respiratory infection (3rd gen)
urinary tract infection (complicated/uncomplicated) (any fluoroquiniolone) |
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what infection would you not use flouroquinolones against
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skin infections
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what is the ADME of fluoroquinolones
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good post antibiotic effect b/c drug [] greater in tissue and cells than in plasma (means that drug will still be working after you finish it)
effective against organisms that reproduce intracellularly (n gonorrhea) pregnant women shouldn't use it due to birth defects |
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what are the adverse drug reactions w/ fluoroquinolones
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photosensitivity
prolonged QT |
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what is the drug of choice against travelers diarrhea
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fluoroquinolones
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how many doses of Fosfomycin are given to treat uncomplicated UTI
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single dose because it accumulates in the bladder walls and kidney tubules
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what drug can Fosfomycin be given w/ to work synergistically
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Beta Lactams
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what is the MOA of fosfomycin
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inhibits cell wall synthesis before transpetidation (analog of enolpyruvate and inhibits the enzyme)
stops glucosamine synthesis |
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what is disease is Fosfomycin used to treat
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UTI
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what is the coverage of Fosfomycin
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gram + (enterococci)
gram - (E. Coli) |
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what is a Urinary Antiseptic
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Nitrofurantoin
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what is the MOA of Nitrofurantoin
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interfers w/ bacterial Acetyl CoA synthesis
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what disease are Nitrofurantoin used to treat
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UTI only because it is rapidly metabolized and renally excreted and secreted (enters urine) and never achieves an effective concentration in the blood
only have a high concentration in the urine |
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what drug can be used against C. Dificcile infections
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vancomycin can be used against suprainfection
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what is metronidazole used against
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anaerobes and certain protozoan infections
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how do anaerobes decarboxylate pyruvate
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via PFOR
after this reaction occurs there is a spare electron which gets taken up by Ferredoxin (e- acceptor) ferredoxin usually donates the electrons to NAD+ to make NADH but when metronidazole is around it will take the electrons and form an anionic free radical which will target bacterial DNA metronidazole then gets recycled and is ready to go again |
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why is metronidazole not used for aerobes
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due to aerobes having oxygen they will take up the spare electrons therefore metronidazole never gets them
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what is ferredoxin
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e- acceptor
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why does metronidazole have no effect on our DNA
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we use aerobic metabolism
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what is the antibiotic spectrum of metronidazole
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protozoans
anaerobic/microaerobic bacterial infections gram + and gram - bugs (broad spectrum for anaerobes) |
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what are the strict anaerobes that Metronidazole can target
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Clostridium sp.
Bacteriodes sp. |
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what is the mechanism of resistance for metronidazoles
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genes that encode an enzyme for nitroimidazole reductase which converts metronidazole into a compound that doesnt accept electrons anymore
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what is a furuncle and carbuncle
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furuncle is a staph infection of hair follicle
carbuncle is a group of furuncles |
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what is impetigo
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infected skin abrassions usually infected w/ staph aureus or streptococcus pyogens (GROUP A STREP)
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what is the MOA of bacitracin
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inhibits cell wall synthesis by interfering with a lipid moiety that shuttle the peptidoglycans into the growing segment of the cell wall
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what is the coverage of bacitracin
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gram + and gram - bacteria
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how is bacitracin used
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topically
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why can't bacitracin be used against carbuncle/furuncle and what can
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bacitracin doesn't have enough skin penetration
mupirocin can be used to treat them |
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what is a lipopeptide antibiotic
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daptomycin
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what is the coverage of Daptomycin
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aerobic and anaerobic bacteria (gram + bacteria)
can use against MRSA, MSSA, Clostridium |
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why is use reserved in Daptomycin
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due to MRSA, MSSA, E facecalis/faceium
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what is the MOA of Daptomycin
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it inserts itself into the bacterial membrane forms a complex w/ calcium then several complexes come together to form a pore which leaks K out of the cell DEPOLARIZING the bacterial membrane
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what can Daptomycin be used synergistically w/
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Vancomycin
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what is the ADME of daptomycin
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doesn't reach therapeutic levels in the lung so it shouldn't be used for pulmonary infections
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what are the drug interactions of sulfonamides
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warfarin
anticonvulsants high dentoin (phenytoin) |
