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31 Cards in this Set

  • Front
  • Back
What is Chloramphenicol used for?

How is it administered?
Last resort! Wide spectrum of coverage--aerobic/anaerobic G+/G- microbes.

Available IV ONLY
What is the downside to Chloroamphenicol?
Serious side effects:

--fatal blood dyscrasias
--hemolytic anemia
--fatal aplastic anemia
What is Chloramphenicol an alternate for?
Alt to:

doxycycline for Rocky Mountain Spotted Fever (Rickettsia)

Fluoroquinolones and ceftrixone for Salmonella typhi (typhoid fever)

Gentamicin for Yersinia pestis (plague)
What is the mechanism of Chloramphenicol?
Acts same as tetracyclines: inhibits binding of aminoacyl-tRNA to acceptor site
What is the problem with Chloramphenicol that leads to side effects?
inhibits MAMMALIAN mitochondrial protein synthesis.

Erythropoietic cells are most sensitive (progenitor cells--not mature RBCs b/c they lack nuclei!)

Results in leukopenia, thrombocytopenia, fata aplastic anema.
How does hemolytic anemia result from Chloramphenicol use?
decrease G6PDH
What causes Gray Baby Syndrome?
High levels of Chloramphenicol in system due to:

insufficient glucuronyl transferase to conjugate the drug.

underdeveloped renal function in the baby. Baby is unable to eliminate the drug.
What do increased Chloramphenicol levels cause?
interference w/ mictochondrial ribosomes which cause:

1. depressed respiration
2. cardiovascular collapse
3. cyanosis (grey pallor)
How is Quinupristin/Dalfopristin administered?
IV for MRSA and vancomycin resistant infections.

Work synergistically
What class of drug is Quinupristin/Dalfopristin?
a streptogramin
What is the mechanism of Quinupristin?

Both Quinupristin and Dalfopristin--release peptidyl-tRNA from the DONOR site of peptidyltransferase

In addition, Dalfopristin--inhibits binding of amino acyl-tRNA from the ACCEPTOR site and of peptidyl-tRNA to the donor site of peptidyltransferase.
What does Quinupristin/Dalfopristin inhibit?
CYP3A leads to a decrease in drug metabloism. (be careful when using warfarin and diazepam)
What are the side effects of Quinupristin/Dalfopristin?
superinfection --pesudomembranous colitis


What is Linezolid used for and how is it administered?
use for MRSA and vancomycin resistant infections.

What are the side effects of Linezolid and what should be done to minimize them?
colitis, myelosuppression resulting in blood dyscrasias.

Recommend weekly CBC
What is the mechanism of Linezolid?
prevents formation of initiation complex. Inhibition of protein synthesis.
What kind of toxicity might linezolid cause?
5-HT toxicity when used with drugs taht enhance 5-HT

--What is 5-HT???--
What are the uses of clindamycin?
alternative for Bacteroides fragilis, Corynebacterium diptheria
What is the major side effect of Clindamycin?
pseudomembranous colitis C difficile
What is the route of administration for Clindamycin?
oral, IV, topical for acne, suppository for bacterial vaginosis.
What is the mechanism for Clindamycin?
same as that of erythromycin

inhibits the translocation of the aminoacyl tRNA from the acceptor to the donor site.
What is Polymixin B effective against?
G - organisms
What type of toxicity does Polymixin exhibit?
nephro and neurotoxic

this is why it is limited to topical use.
What is the mechanism of Polymixin B?
Cidal--cationic detergent. Dissolves membrane.
What is Polymixin B used for?
common bacterial infection of the conjunctiva and eyelids
What are the common combinations of Polymixin B?
Neosporin= polymixin B + bacitracin + neomycin

Polysporin = bacitracin + polymixin B

Polytrim = polymixin B and TMP
How many times should Spectinomycin be used?
EXCLUSIVELY as a single dose IM for Gonorrhea in patients w/ allergy to PCN or for PCN resistant strains of gonorrhea.
What does Rifacimin treat?
travelers diarrhea from noninvasive strains of E. coli
What is Muripocin used for? What is its pitfall?
ointment and cream.

Alternate for Impetigo from group A Strep or Staph aureus. [first choice is diclocacillin]

Pitfall is price
What is the mechanism of Muripocin?
binds bacterial isoleucyl t-RNA synthetase
What is Nitrofurantoin used for?
treatment and prevention of UTI.

Use if local E. Coli is >20%.

Can color urine brown