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44 Cards in this Set
- Front
- Back
What is the MOA of sulfonamides?
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inhibit DHP synthase, the "bacterial enzyme" responsible for the incorporation of PABA into dihydropteroic acis, the immediate precursor of folic acid.
Selective for bacteria |
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What is the MOA of trimethoprim?
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It inhibits DHFR which reduces dihydrofolate to tetrahydrofolate (one carbon transfers for pyrimidine and purine synthesis)
note: REASONABLE selective for bacteria (4 to 5 times more sensitive than mammals) |
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Sulfisoxazole (Gantrisin) is marketed in combination with what for treatment of otitis media in kids?
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with Erythromycin
- Pediazole, Eryzole, Pediagen |
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Azo Gantrisin and Azo Ganatol are combinations of what two drugs and what do they treat?
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Phenazopyridine
+ Sulfisoxazole = Gantrisin + Sulfamethoxazole = Ganatol used as an antiseptic and analgesic to treat urinary tract inf. - pee turns orange red! |
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Crystalluria is associated with what kind of drugs?
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Sulfonamides (sulfadiazine)
- adequate urine output is necessary to avoid or give Na bicarbonate to reduce |
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Which sulfonamide is used to treat both inflammation and infection?
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Sulfasalazine
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Sulfasalazine is broken down by the intestinal bacteria to what?
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Sulfapyridine, an active sulfonamide and 5-aminosalicylate, (antiinflammatory - management of IBD)
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Which sulfonamide is topically used for ophthalmic infections because it is non-irritating to the eyes even at high concentrations?
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SulFACE(eyes)tamide
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Which sulfonamide is used topically for the prevention of infection of burns?
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Silver sulfadiazine
note: side effects - burning, rash, itching |
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Which combination of sulfonamides are used to treat bacterial vaginosis caused by Hemophilus (Gardnerella) vaginalis?
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Sulfabenzamide, Sulfacetamide, Sulfathiazole
( sultrin, dayto sulf, gynesulf, triple sulfa, trysul) |
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Which topical sulfonamide is effective in preventing the colonization of burns ?
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Mafenide (sulfamylon)
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Which long acting sulfonamide is combined with pyrimethamine for prophylaxis and treatment of Mefloquine resistant Plasmodium falciparum (Malaria) ?
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Sulfadoxine!
note: only used in high risk cases because may cause Steven-Johnson syndrome! |
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ORAL trimethoprim-sulfamethoxazole combination (TMP-SMZ) is effective for what?
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Pneumocystis Jeroecii pneumonia (low dose for prophylaxis in AIDS and neutropenic patients, May cause rash, leukopenia, and hepatitis) ...
-Shigellosis, Salmonella inf (SLD for Typhoid fever) - UTI -Bact. respiratory inf - acute otitis media, chronic bronchitis, maxillary sinusitis. respiratory pathogens (Hemophilus, Moraxella catarrhalis, and klebsiaella pneumonia), MRSA. -prostatitis, non TB mycobacterial infections. |
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What is IV trimethoprim-sulfamethoxazole used for?
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Management of PJP in AIDS patients.
Also, G(-) spesis caused by multi drug resistant species such as enterobacter and Serratia, Shigellosis, typhoid fever, and UTI |
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Sulfonamides is combined with what to treat Leishmaniasis and Taxoplasmosis (protozoans)?
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ORAL Pyrimethamine
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Proguanil (PLASMODIAL folate reductase inhibitor) and Atavaquine (Malarone) are used in combination for treatment of what?
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Malaria.
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What are the adverse reactions of sulfonmides?
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- Hypersensitivity
- Steven-Johnson -GI disturbance - Mild hepatic dysfunction - Acute hemolytic anemia in G6PDH deficient patients. -Rarely granulocytopenia, thrombocytopenia, and aplastic anemia -Crystalluria and hematuria -Drug interactions with methotraxate and warfarin b/c it competes for binding site -Kernicterus in neonate (bilirubin displacement from plasma binding site) |
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Trimethoprim may cause hematological disorders that can be ameliorated with what?
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supplementary folinic acid (leucovorin)
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Trimethoprim may cause hematological disorders that can be ameliorated with what?
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supplementary folinic acid (leucovorin)
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What sulfonamides is used to treat NOCARDIOSIS ( G+ filamentous nonmotile - w/ primary pulmonary lesions with or without hematogenous spread to deep viscera and CNS)
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Sulfadiazine
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What is the MOA of Fluoroquinolones?
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Inhibits gyrase mediated DNA supercoiling - topoisomerase II and IV - by binding to the A subunit that carries out the strand cutting.
At high concentrations it inhibits eukaryotic topoisomerase |
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T/F: Floroquinolones are bacteriostatic
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False.
Bactericidal! |
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Norfloxacin, Cirpofloxacin, Ofloxacin, and TMP-SMX are equally efficacious in treatment of what?
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UTIs.
Cipro #1. |
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Fluoroquinolones have NO activity against what STD causing organism?
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Treponema Pallidum = SYPHILIS.
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Flouroquinolones are CONTRAndicated in what kind of patients?
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PREGNANT and UNDER 18!
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What is the #1 treatment for Anthrax?
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Cipro
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What gen. of fluoroquinolones have good activity against Strep Pneumonia and aerobic bacteria?
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4th gen - Moxifloxacin, Gatifloxacin, Lomefloxacin
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What are side effects of flouroquinolones?
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Athralgia, joint swelling, tendonitis, tendon rupture (don't exercise!)
- CI in pregnant and <18 yo |
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What is the use and CI of Nitrofurantoin?
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UTI infections.
CI in pregnant and neonates due to hemolytic anemia. May cause hemolysis in G6PDH deficient patients. |
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What is the use and CI of Methanamine?
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UTI, chronic suppresice therapy- decomposes ad acidic PH to produce formaldehyde. (inactive against proteus)
CI with sulfonamides (complexes), renal insufficient pts, and hepatic insufficient pts (NH3 production) |
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What is the cell wall of mycobacteria composed of?
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High lipid content with long-chain (C70-90) fatty acids.
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What does XDR TB mean?
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Extensive drug resistance - TB that is resistant to isoniazid and rifampin, plus any fluoroquinolones and at least one of three injectable SLD (amikacin, kanamycin, capreomycin)
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What is the MOA of isoniazid?
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Inhibits synthesis of enzymes needed for mycolic acid synthesis via oxygen dependent pathways such as catalase-peroxidase aciton
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What is a major side effect of Isoniazid?
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Hepatotoxicity (age dependent) and neurotoxicity (alleviated by Pyridoxine)
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What is DOC for prophylaxis of TB?
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Isoniazid
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What is the MOA of rifampin?
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Blocks bacterial RNA synthesis by bindng to DNA dependent RNA polymerase (B subunit) in Mycobacteia.
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What is the clinical use of Rifampin?
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Tx for TB AND Leprosy! Also, meningococcal and staphyococcal carrier states)
(Isoniazid is TB only) |
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What drug can be tested for compliance by examining the color of body fluids?
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Rifampin - oragne-red color.
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Rifampin can't be used with what other type of drug in HIV patients?
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Protease inhibitors.
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What is the first line agent in patients taking retroviral drugs (HIV)?
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Rifapentine (1x weekly) and Rifabutin
*Also contraincated in pts taking protease inhibitors but not as serious as Rifampin |
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What is the MOA of ethambutol?
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blocks arabino-galactin (cell wall component of mycoB)
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What FLD for TB causes visual disturbances (green blindness) and retinal damage (retrobulbar optic neuritis), headache, and confusion.
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ethambutol
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What flouroquinolones are used as SLD for TB?
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Cipro and Levo
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What is the use of Dapsone?
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Most effective drug for M. Leprea.
note: If used in US, it is for PJP in immune suppresed. |