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8 Cards in this Set
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- 3rd side (hint)
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What are the sulfonamides? What is their MOA? What are the MOR of bacteria?
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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) |
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What are the toxicities of sulfonamides?
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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 |
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What organisms are sulfonamides active against? What are their uses (incl special sulfonamides)?
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Gram+/-, Chlamydia, Nocardia
Simple UTI Toxoplasmosis (with pyrimethamine, dihydrofolate reductase inhibitor) Ulcerative colities/RA (Sulfasalazine, Salicylazosulfapyridine) Burns (topical sulfamylon, silvadene) Ocular (topical sulfacetamide) |
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What is the MOA of trimethoprim? What do you give to correct its toxicity, folic acid deficiency? Where does it accumulate?
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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 |
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What is the MOA of trimethoprim-sulfamethoxazole (bactrim)? What patients experience the most AEs? What are its uses?
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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 |
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What is the MOA of pyrimethemine? What are its uses?
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same as trimethoprim
Toxoplasmosis, with sulfadiazine Malaria, with sulfadoxine |
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What are the older quinolones and their use?
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Nalidixic acid
Cinoxacin Weak activity, only UTIs |
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What are the newer fluoroquinolones?
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"oxacin"
Norfloxacin, Ciprofloxacin, Ofloxacin, Levofloxacin, Moxifloxacin Also Gatifloxacin, Gemifloxacin |
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