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33 Cards in this Set
- Front
- Back
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Who is most at risk for a tendon rupture when taking flouroquinolones?
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1) Elderly
2) pts on steroids 3) heart, kidney, or lung transplant |
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What is the MOA for flouroquinilones?
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inhibit TP2 (DNA gyrase) & TP4 enzymes that are required for DNA replication and repair.
(interrupts transcription & splitting into daughter cells) |
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Which flouroquinolones treat bacterial conjunctivitis?
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Gatifloxacin
Monifloxacin |
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Which flouroquinolone is used preoperatively to prevent post-op UTI in patients undergoing transrectal and transurethral surgical procedures?
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Lomefloxacin
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Which flouroquinolone is used to treat complicated intra-abdominal infections?
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Monifloxacin
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Which flouroquinolone is excreted in the feces?
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Moxifloxacin
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What causes flouroquinolone restistance?
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mutation of the binding site on DNA gyrase & TP4 enzymes --- abx can't bind
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Which flouroquinolone is most likely to cause photosensitivity?
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Lomefloxacin
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Which flouroquinolone is most likely to cause hyperglycemia in DM pts?
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Gatifloxacin
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What are the indications for Metronidazole?
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B. fragilis
Vaginosis C.Diff - drug of choice Hepatic Encephalopathy Crohns Protozoal infections |
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What is the MOA for Metroimidazole?
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inhibits DNA synthesis
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What causes Rifampin resistance?
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mutation in the rpoB gene causes changes that make it impossible for Rifampin to bind
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Which drug is most effective against M. avium (in AIDS pts) ?
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Rifabutin
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What are the ADR of Rifampin?
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orange urine, tears, sweat
cholestatic jaundice nephritis light chain proteinuria thrombocytopenia rash |
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Rifampin ________cytochrome P450 and thereby decreases concentrations of ________, _______, and _______
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induces P450
methadone, bcp, anticoagulants |
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Which sulfa drug is used to treat Crohn's and UC because of its anti-inflammatory effects?
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Sulfasalazine
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What is the MOA of sulfa drugs?
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interferes with folic acid synthesis & utilization in bacteria cells
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What are the 2 pharmacokinetic properties of sulfonamides that could cause the most problems?
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-crosses BBB & placenta
-hepatic metabolism to inactive but toxic metabolite that precipitates to form crystals |
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What causes resistance to sulfonamides?
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-alterations in dihydropteroate sythetase
-reduced permeability to sulfonamides -increase synthesis of PABA (endogenous substrate) |
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What are the ADR associated with sulfonamides?
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crystalluria
hemopoietic anemia kernicterus |
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Which drugs are potentiated by sulfonamides?
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tolbutamide
warfarin methotrexate |
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What are the contraindications to sulfonamide use?
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-avoid in newborns < 2mo & pregnant women
-do not give with methenamine |
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What are the indications for Trimethoprim?
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UTI
Prostatitis Vaginitis **20-50 times more potent than sulfonamides |
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How do you increase the rate of excretion of Trimethoprim?
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acidify the urine
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What are the ADRs of Trimethoprim?
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Induces folic acid deficiency which can lead to:
megaloblastic anemia leukopenia granulocytopenia *tx is folic acid supplements |
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What are the ADR of CO-Trimaxazole (Septra)
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derm rxn
megaloblastic anemia leukopenia thrombocytopenia stomatitis n/v |
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What are the drug interactions to watch for when prescribing Septra?
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increased half life of phenytoin
increased methotrexate levels |
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What is the MOA of Isoniazid ?
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-enters phagocytic cells & is effective against extracellular & intracellular organisms
-Prodrug that is activated by KatG (mycobacterial peroxidase) -binds to acyl carrier protein and inhibits mycolic acid sythesis (a component of the cell wall) |
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What causes Isoniazid resistance?
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-overexpression of inhA
-mutation of katG gene -overexpression of ahpC |
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What are the ADR of isoniazid?
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allergic = fever, rash
lupus erythematous hepatitis peripheral neuropathy (especially in pts with malnutrition, alcoholics, DM, AIDS, gout) |
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Pyrazinamide is not active at physiologic pH, therefore it must _________ to become active.
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must be taken up by macrophages with a pH of 5.5
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Which drug can cause retrobulbar neuritis which leads to loss of visual acuity and red-green color blindness?
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Ethambutol
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What is the MOA of ethambutol?
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inhibits mycobacterial arabinosyl transferase (embCAB), which is essential for cell wall synthesis
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