Pharm 46: Sulfonamides, Trimethoprim And Quinolones

Front 1

antifolate drugs that inhibit microbial enzymes involved in folic acid synthesis

Back 1

sulfonamides

Front 2

selective inhibitor of dihydrofolate reductase

Back 2

trimethoprim

Front 3

weakly acidic compounds that have a common chemical nucleus resembling PABA

Back 3

sulfonamides

Front 4

where are sulfonamides metabolized

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liver

Front 5

what happens to sulfonamides with acidic urine

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decreases solubility - increased risk for stones

Front 6

which sulfa can you give to reduce the liklihood of precipitation

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triple sulfa

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short acting sulfonamide

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sulfisoxazole

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intermediate acting sulfonamide

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sulfamethoxazole

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long acting sulfonamide

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solfadoxine

Front 10

drug structurally similar to folic acid and is excreted in high concentrations in prostatic and vaginal fluids, large amount excreted unchanged in the urine

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trimethoprim

Front 11

MOA of sulfonamide

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bacteriostatic inhibitor of folic acid synthesis

COMPETITVE INHIBITOR OF DIHYDROPTEROATE SYNTHASE

Front 12

why do sulfonamides not harm mammallian folate synthesis

Back 12

because mammalian cells use preformed folic acid, not denovo formed

Front 13

trimethoprim MOA

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dihydrofolate reductase that prevents formation of the active form of folic acid

Front 14

what is treatment with both trimethoprim and sulfonamide called

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sequential blockade

Front 15

increased production of what from bacteria will increase resistance to sulfonamides

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PABA

Front 16

what are sulfonamides active against

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gram positive and gram negative

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what two organisms are sulfonamides active against

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chlamydia and nocardia

Front 18

simple UTI, ocular infections, burn infections, ulcerative colitis and rheumatoid arthritis and toxoplasmosis can be treated with what class

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sulfonamides

Front 19

effective orally in the tx of UTIs and in respiratory, ear and sinus infections by h influenzae and moraxella catarrhalis

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TMP SMZ

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what is used for infections of aeromonas hydrophilia in immunocompromised patients

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TMp - SMZ

Front 21

what to use for prevention and treatment of pneumocystitis pneumonia

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TMp SMZ

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listeria monocytogenes treatment

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TMP smz

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toxicity of sulfonamides (hypersensitivity)

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skin rashes and fever,

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GI toxicity associated with sulfonamides

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nausea, vomiting and diarrhea, hepatic dysfunction

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what can occur in patients taking sulfonamides with a G6P deficiency

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acute hemolytic anemia

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hematotoxicity of sulfonamides

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ganulocytopenia, thrombocytopenia and aplastic anemia

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nephrotoxicity of sulfonamides

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can precipitate in the urine at low Ph - cause stones

Front 28

sulfonamides can increase the plasma levels of what two drugs by competeint for plasma binding spots

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warfarin and methotrexate

Front 29

this drug can cause megaloblastic anemia, leukopenia and granulocytopenia

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trimethoprim

Front 30

TMP SMZ toxicity

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with aids - fever, rash, leukopenia and diarrhea

Front 31

what is norfloxacin used for

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UTI

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what are ciprofoxacin and ofloxacin used for (5)

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gram negatives
gonococcus
gram positive cocci
mycobacteria
atypical pneumonia

Front 33

levofloxacin
gemifloxacin
and moxifloxacin used for?

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gram positive (better than 2nd gen)
gram negatvie (worse than 2nd gen)
MRSA
s pneumonae

Front 34

gemifloxacin and moxifloxacin are useful against what

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anaerobes

Front 35

what GI drug interferes with fluoroquinolones

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antacids with multivalent cations

Front 36

which should you not use for systemic infections

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norfloxacin

Front 37

how are fluoroquinolones eliminated from the bloodstream

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kidneys

Front 38

what can slow fluoroquinolone excretion

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probnecid

Front 39

which should not be used in UTI

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moxifloxacin

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MOA for fluoroquinolones

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topoisomerase II inhibitors (gram neg)
topoisomerase IV in gram positive

Front 41

which fluoroquinolones have the widest spectrum of activation

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gemifloxacin and moxifloxacin

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what is the most common fluoroquinolone side effet

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GI toxicity

Front 43

insomnia, abnormal liver function, phototoxicity, tendonitis and tendon rupture

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fluoroquinolones toxicity

Front 44

opportunitstic infections from what with fluoroquinolones

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c albicans and streptococci

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can you use fluoroquinolones with children and pregnant women

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no