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8 Cards in this Set

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What are the sulfonamides? What is their MOA? What are the MOR of bacteria?
Sulfisoxazole, Sulfamethoxazole, Sulfadoxine/Sulfadiazine (short -> long-acting)

bacterioSTATIC inhibitors of FOLIC ACID synthesis by competing with PABA (inh enzyme dihydropteroate synthase)

MOR: mutation, R-factor: dec permeability
Folic acid: needed for nucleic acid and protein synthesis

Wide distrib (incl CNS!)
Metab by liver
Excreted in urine (solubility dec in acidic urine, use TRIPLE SULFA)
What are the toxicities of sulfonamides?
Lots!

Chemical: displace bilirubin from albumin -> KERNICTERUS in neonate
Nephro: CRYSTALLURIA/HEMATURIA (ppt in acidic urine)

GI: N/V/D

Allergic: RASHES (steven-johnson), FEVER

Rare: agranulocytosis, aplastic/hemolytic anemia, thrombocytopenia, hepatitis
What organisms are sulfonamides active against? What are their uses (incl special sulfonamides)?
Gram+/-, Chlamydia, Nocardia

Simple UTI
Toxoplasmosis (with pyrimethamine, dihydrofolate reductase inhibitor)

Ulcerative colities/RA (Sulfasalazine, Salicylazosulfapyridine)
Burns (topical sulfamylon, silvadene)
Ocular (topical sulfacetamide)
What is the MOA of trimethoprim? What do you give to correct its toxicity, folic acid deficiency? Where does it accumulate?
bacterioSTATIC inhibitor of DIHYDROFOLATE REDUCTASE, prevent folic acid formation

Give folinic acid to correct folic acid deficiency

Accum in prostate, vaginal fluids
Wide distrib, wide susceptibility, similar MOR to sulfonamides

Use for UTIs
What is the MOA of trimethoprim-sulfamethoxazole (bactrim)? What patients experience the most AEs? What are its uses?
bacteriCIDAL sequential block in FOLIC ACID synthesis

Most AEs in AIDs pts (fever, rashes, leukopenia, diarrhea)

UTIs!!!!
Otitis media, chronic bronchitis, enteric inf, nocardiosis, pneumocystis jiroveci, soft tissue/skeletal inf, prophylaxis in neutropenic pts
What is the MOA of pyrimethemine? What are its uses?
same as trimethoprim

Toxoplasmosis, with sulfadiazine
Malaria, with sulfadoxine
What are the older quinolones and their use?
Nalidixic acid
Cinoxacin

Weak activity, only UTIs
What are the newer fluoroquinolones?
"oxacin"

Norfloxacin, Ciprofloxacin, Ofloxacin, Levofloxacin, Moxifloxacin

Also Gatifloxacin, Gemifloxacin