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70 Cards in this Set
- Front
- Back
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fluoroquinolone MOA and metabolized by what organ
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impairs gyrase (G-) and topoisomerase IV (G+); metabolized by kidney; with two exceptions:perfloxacin and moxifloxacin
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perfloxacin metabolism
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metabolized by the liver
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moxifloxacin
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metabolized by the liver
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What are 3 Flouroquinilones that are excreted in breast milk?
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cipro, oflo, perfloxacin
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What are 2 STD's that are susceptible to FQ's?
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chlamydia and h. ducreyi
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gatifloxacin use
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respiratory infx
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moxifloxacin
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respiratory infx
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2 ciprofloxacin uses that are not what you'd think 1st
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anthrax and tularemia
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Who don't you give fluoroquinilones to and why?
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FQ's cause arthropathy in children
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norfloxacin
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low serum levels but good concentration in urine
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Penicillin MOA and cidal or static
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bactericidal by inhibiting transpeptidase
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Which acheives greater serum concentration Pen G or V?
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Pen V bc V in Latin is 5
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cefazolin
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parenterally
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cephalexin
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orally and parenterally
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cephedroxil
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orally and parenterally
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ceftriaxone excretion
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kidney and bile
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metabolism of cefotaximine
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deacetylated
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Which cephalosporin penetrates CNS?
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cefepime and ceftriaxone
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cilastin
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given with imipenem to prevent degradation by dipeptidase in kidney
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What is the carbepenem that requires cilastin for absorption?
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imipenem
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Which carbepenem isn't effective against anaerobes?
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aztreonam; note that the other carbepenems like imipenem, meropenem, andertapenem are good for anaerobes
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Which is the only carbepenem that doesn't elicit a hypersensitivity rxn?
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aztreonam
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streptomycin and use; toxicity; requirement for its effectiveness
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aminoglycoside used for TB, tularemia, and the plaque; reversible ototoxicity (hearing and vestibular); nephrotoxocity; requires O2 to enter the cell
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How well is linezolid absorbed orally? IV? Does food interfere with its absorption?
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both have 100% absorbance; food doesn't alter the absorbance
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What are the 3 tetracyclines that are only incompletely absorbed if taken orally? What is their method of excretion?
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tetracycline, oxytetracycline, and demeclocycline; excreted via kidneys
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What are 2 tetracyclines that are completely absorbed when taken orally? How are they excreted?
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minocycline and doxycycline; excreted via liver
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Side effects of tetracyclines?
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THRILLS-teeth discoloration; hepatotoxicity; renal prob-Fanconi or azotemia; increased ICP in neonates; light sensitivity; SKIP
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Chloramphenicol MOA and toxicity
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inhibits transpeptidase part of 50S; BIG-bone marrow suppression (reversible) and irreversible aplastic anemia; gray baby syndrome
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Resistance to chloramphenicol
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acyetlyation of the drug
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What is the metabolite of chloramphenicol and which organ is responsible for its production? What activates chloram. and what inactivates it?
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the liver makes glucuronide; esterase activates and CYP450 acetylates it to inactivate it
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Resistance to macrolides
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ribosomal methylation
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Difficulty with oral macrolide administration
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readily broken up by stomach acid
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What 2 macrolides shouldn't be taken with food and which one can be?
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azithromycin and erythromycin shouldn't be taken with food; clarithromycin can be
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Macrolide toxicity
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MAC-motility enhanced GI prob; allergy or auditory toxicity; cholestatic hepatitis
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What 2 macrolides inihbit P450?
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erythromycin and clarithromycin
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dalfopristin and quinipristin; MOA, excretion, toxicity
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streptogramins; translocation blockade; mostly excreted by the liver; myalgia and arthralgia-sitting on a dolphin isn't too comfortable
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Resistance to clindamycin and uses
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ribosomal methylation; anaerobic infxs that are not in the brain
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Which anaerobe is resistant to clindamycin?
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Clost. diff because it is hard for a DA (dental assistant to clean in a "closet")
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Side effects of clindamycin
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PHD-since when does a dental assistant need a PhD?-pseudomembranous colitis; hypersensitivity-Stevens Johnson; diarrhea
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What is the one fact to remember about linezolid in terms of its absorption?
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it is 100% absorbed both orally and IV
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teicoplanin
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same thing as vancomycin
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Toxicity of vancomycin
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FLoOR-flushing (red man due to increased histamine); ototoxicity; renal toxicity
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isoniazide MOA; requirement for it to work; side effects
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prevents mycolic acid production because it's so lazy; requires catalse-peroxidase for its activation; INH-idiosyncratic SLE, neurotoxicity due to decreased B6, hepatotoxicity
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rifampin MOA; static or cidal
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RIF-RNA polymerase (DNA dep) inhibitory factor (inhibits transcription); bactericidal
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What are 6 bactericidal drugs?
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penicillin, all beta lactams, aminoglycosides, quinolones, rifampin, pyrizinamide
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3 uses of rifampin
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This PIN has its MS degree: mycobacterium tb, mening, staph or strep (beta lactam + rifampin)
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rifabutin
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same as rifampin but given in HIV because better action against MAC in HIV pts
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rifapentine
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same as rifabutin therefore useful in HIV pts for TB with added benefit of fighting MAC BUT this has a longer half life than rifabutin
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rifampin side effects (note that rifapentin and rifambutin isn't mentioned)
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RIF-red orange urine, inflammation of the liver (hepatitis), and flu like sx; P450 induction!!!!
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rifambutin side effects
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same as rifampin but also has induction of P450 and polymyalgia, pseudojaundice, anterior uveitis (infl. of the iris)
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ethambutol MOA and side effect
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inhibits arabinosyl transferase used to make the cell wall; optic neuritis-impaired visual acuity with inability to tell red from green
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pyrizinamide MOA and 2 toxic side effects
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inhibits fatty acid synthase I which is used for mycolic acid production; hepatotoxic and can cause hyperuricemia
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Which drug can cause an acute attack of gout?
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pyrizinamide
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What are 2 fluoroquinolones that can be used to treat S. pneumo?
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moxifolxacin or gatifloxacin
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What is IV pen G often given with to increase its half life from 30 min to something longer?
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probenecid (blocks renal secretion) or procaine or benzathine (slowly release pen G)
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Why does oral pen V reach 5x the amount in the blood than pen G?
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pen G is rapidly degraded by stomach acid while pen V isn't
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Which isoxazolyl penicillin has to be given parentally and why?
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nafcillin is unstable in gastric acid
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Which one is given orally, amoxicillin or ampicillin, and why?
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amoxicillin is better absorbed and more stable in the acid
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What is ticarcillin used to treat?
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pseudomonas
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Which cephalosporin is effective against anaerobes?
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2nd generation: cefuroxime
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What are 3 2nd generation cephalosporins and how are they administered?
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cefaclor and cephadroxil: oral or IV; cefuroxime: IV
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What is the major side effect that distinguishes penicillins from cephalosporins?
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nephrotoxicity
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What is cilastin?
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adjunct for imipenem administration; prevents dipeptidase in the KIDNEY from cutting up imipenem
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What is the only feature that distinguishes meropenem and ertapenem from imipenem?
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meropenem and ertapenem don't require cilastin
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Which macrolide's primary metabolite which is excreted is still active?
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clarithromycin; all the other macrolides are excreted in an inactive form
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What gene is responsible for metabolism of isonizaid and how is it metabolized?
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NAT2 acetylates isoniazid
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What are the 4 nationalities of people who are fast acetylators of isoniazid?
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Scandinavian, Jew, Caucasian, North African Caucasian
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What are 2 nationalities of people who are slow acetylators?
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Japanese and Inuit
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Which OTC drug should you avoid if taking a rifamycin?
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aspirin inhibits the absoprtion of all the rifamycins
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pyrazinamide cidal or static
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cidal at low pH like inside macros
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