Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
37 Cards in this Set
- Front
- Back
|
Which drugs work on ribosomes?
|
Macrolides
Clindamycin Quinupristin/Dalfopristin Linezolid |
|
|
Which drugs work on the membrane
|
Polymyxin and daptomycin
|
|
|
Which drugs work on the cell wall
|
Bacitracin and vancomycin
|
|
|
What is the difference between Clarithomycin and azithromycin
|
1) Clarith has a much longer halflife
2) Clarith has to be adjusted for renal insufficiency 3) Calrith is metabolized by p450 |
|
|
Macrolides Mech and spectrum
|
Clarithomycin and azithromycin:
Mech: Bind to 50s inhibiting protein synth. Uses: Given for resp infections. Active against G+ cocci like strep and pneumonia, active against G- baccili like influenza and bordetella. Active against Mycobacteria. Not active for G+ enterococcus, staph. Not for anaerobes. |
|
|
Macrolides pharmacokinetcs (admin, distrib, elim)
|
Admin: Can be oral
Distrib: Not to CNS, bound to protein. Elim: Clarith is metabolized by liver and inhibits p450. Excreted in Urine. Azith is excreted hepatically, does not effect p450. |
|
|
Macrolides resistance
|
Via plasmid. Resistance to one is to both.
1) Increased efflux via pumps 2) Production of methylase, modifies target site. 3) Hydrolysis by esterase. |
|
|
Macrolides side effects and drug interactions
|
SE: Naseua, GI, Diarhea. Clarith can increase QT.
DI: Clarith inhibits p450 |
|
|
Clindamycin Mech and spectrum
|
Mech: Binds to 50s inhibits protein synth.
Spectrum: Good for Ana and Aer G+ as well as Ana G-. Not good for enterococcus, or C.dificile. |
|
|
Clindamycin pharmacokinetcs (admin, distrib, elim)
|
Admin: Can be oral
Distrib: No CNS, widely distribed even to bones. Bound to proetin Elim: Metabolized and excreted by liver (therefore can still get C.dificile even if IV). |
|
|
Clindamycin Resistance
|
Via mech similar to macrolides and chloramphenicol via methylation of ribosomes reducing affinity for drug. All 3 of these classes therefor will have Cx resistance.
|
|
|
Clindamycin side effects and drug interactions
|
SE: C. Dificile, Neuromuscular blockade.
DI: Additive with neuromuscular blockers |
|
|
Quinupristin/Dalfopristin mech and spectrum
|
Mech: Quin binds to 50s at same site as macrolides, dalf binds to a nearby site.
Spectrum: Good for G+ aerobes. Good for VRE (e.faecium). Bad for anaerobes, G-, VSE (e.fecalis) |
|
|
Quinupristin/Dalfopristin pharmacokinetcs (admin, distrib, elim)
|
Admin: Central Vein IV
Distrib: No CNS Elim: Metabolized by p450 and excreted hepatically. |
|
|
Quinupristin/Dalfopristin Side effects and drug interactions
|
SE: Not for preg. arthralgia, myalgia.
DI: Inhibits p450s |
|
|
Linezolid Mech and spectrum
|
Mech: Binds to 50s at a unique binding site preventing 70s formation.
Spectrum: Good for G+, good for VRE and MRSA. Bad for G-, anaerobes |
|
|
Linezolid pharmacokinetcs (admin, distrib, elim)
|
Admin: Can be oral
Distrib: Goes to CNS, Elim: Urine |
|
|
Linezolid Resistance
|
Due to mutation of 50s, no Cx resistance with other drugs though.
|
|
|
Linezolid Side effects and Drug interactions
|
SE: Rash, mild thrombocytopenia/leukopenia
DI: May enhance effects of seritonergic drugs like SSRIs. Can also cause hypertensive crisis if given with pseudoephedrine. |
|
|
Bactrin Mech and spectrum
|
Mech: Inhibits cell wall synth
Spec: Topically for conjunctivitis and infected corneal ulcers. Good for G+ cocci, Sprochets, Some G- like Nesseria and H. influenza |
|
|
Bactrin pharmacokinetcs (admin, distrib, elim)
|
Admin: Usually topically, never oral.
Distrib: While not usually systemic, can get to CNS Elim: Feces |
|
|
Bactrin Side effects and drug interactions
|
SE: Nephrotoxicity if given perenternaly.
DI: Increase NM blockade by non-depolarizing muscle relaxants. |
|
|
Polymyxins Mech and Spec
|
Mech: Cationic detergents that effect cell membrane function
Spec: Usually used Topically. Good for G-, pseudomonas Bad for Anaerobes |
|
|
Polymyxins pharmacokinetcs (admin, distrib, elim)
|
Admin: Usually topical, not given oral.
Distrib: No CNS Elim: Urine |
|
|
Polymyxins side effects and drug interactions
|
SE: Nephrotoxicity if given perenternaly. Adjust dose for renal failure.
DI: Increase NM blockade by non-depolarizing muscle relaxants. |
|
|
Daptomycin Mech and Spec
|
Mech: Disrupts bacterial membranes and Oxphos.
Spec: Good for G+ aerobes, MRSA, E.fecalis/faecium, VRE Not good for anaerobes or resp infections (inactivated by surfactant). |
|
|
Daptomycin pharmacokinetcs (admin, distrib, elim)
|
Admin: No oral or IM
Distrib: Bound to protein, no CNS Elim: Renal |
|
|
Daptomycin Side effects and drug interactions
|
SE: Muscle damage, constipation, headache. Inactivated by surfactant.
DI: Discontinue statins which also might produce muscle damage. |
|
|
Vancomycin mech and spec
|
Mech: Inhibits cell wall synth by binding to peptidoglycan precursur.
Spec: G+ including staph and C.dif. Not for anaerobes |
|
|
Vancomycin pharmacokinetcs (admin, distrib, elim)
|
Admin: No oral
Distrib: Gets to CNS when meninges are inflamed. Bound to protein Elim: Renal, adjust dose for kidney probs. |
|
|
Vancomycin resistance
|
Caused by change from D-alanine/D-alanine, to D-alanine/D-lactate or D-serine.
|
|
|
Vancomycin Side Effects and Drug interactions
|
SE: Redneck syndrome - flushing of face and neck. Nephrotox, hypersensitivity.
DI: Aminoglycosides and polymxin increase nephrotox. |
|
|
Which drugs require dose adjustment with renal impairment
|
Dialysis Provokes Value Clarification:
Daptomycin, Polymyxin, Vanvomycin, Clarithromycin. |
|
|
Which drugs penetrate CNS
|
LBV. Little bit Vane (goes to your head)
Linezolid, Bacitracin, vancomycin |
|
|
Which drugs are good for MRSA?
|
Could D Vorse
Clindamycin, Daptomycin, Vancomycin |
|
|
Which drugs have nephrotox?
|
BP
Bactracin and Polymyxin |
|
|
Which drugs do u have to adjust dose for renal failure?
|
Clarithromycin
Daptomycin Vancomycin Polymyxin B |
