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23 Cards in this Set
- Front
- Back
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Durgs that are Metabolic and DNA synthesis inhibitors (5)?
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Sulfonamides
Trimethoprim Fluroquinolones Urinary Antiseptics Polymyxin B |
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Sulfonamides MOA, indictions?
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MOA: Inhibit folate production and incorporation into purines to prevent DNA synthesis (looks like PABA)
Indictions: UTI, otitis media, URTI, SSTI Resistance is on rise Bacteriostatic unless in combo with TMP |
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Sulfonamides kinetics
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Absorbed, bound to proteins
N-Acetylated in urine, concentrated and can crystallize **Keep hydrated Adj for renal insuff |
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Specific Sulfonamides:
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Sulfasalazine - poorly absorbed, metabolized to 5-aminosalicylic acid (antiflammatory); used for ulcerative colitis, IBD, surgery, arthritis
Sulfadozine + Pyrimethamine used in malaria |
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Sulfonamide tox
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Varrying allergic rxns (rash/fever to sever exfoliative dermatitis or Stevens Jognson syndrome)
May ppt in urine Hemolytic anemia due to decrease in G6Phos Electrolyte abnormalities (decreased K and Mg) |
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Stevens-Johnson Syndrome
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Red splotches on skin
Blisters of skin, mouth, eyes, eats, nose, genital area swelling of eyelids flu-like syndrome |
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Sulfonamide Resistance
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Plasmid mediated to change enzyme affinite (increased affinity for PABA), or lose permeability, or to increase production of PABA (so you cant keep the conc of drug high enough)
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Trimethoprim MOA, indications
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MOA: inhibits dihydrofolate reductase to prevent tetrahydrofolate foamtion
Bactrim and Septra (TMP/SMX) usef in UTI, otitis media, bronchitis no need for refridge |
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TMP Tox
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Hematopoietic problems
GI, hepatitis, exfoliative dermatitis |
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FQ generally against? CHange with generations?
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mostly gram NEG with increasing POS with the generations
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FQ MOA in gram NEG and POS
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FQ gram NEG against DNA gyrase
-- can't supercoil FQ gram POS against topoisomerase type IV -- daughter cells can't uncoil |
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FQ Kinetics
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orally avail, readily absorbed
Concentration dependent killing adj in renal insuff |
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FQ Indications
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- UTI, prostatitis
- SSTI - STDs - Infectious diarrhea - Anthrax - Intra-ab infections - CAP |
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FQ Resistance
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mutatiuons in topoisomerase IV or in DNA gyrase
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FQ Toxicity
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GI N/V/D, CNS dizziness/HA/insomnia, cartilage damage in children and preggos, QT Prolongation so don't combine with 1A and III antiarrhythmics
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Name the 3 Bacillis
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Bacillis Anthracis - anthraz gram POS spores
Cutaneous anthrax - localized red lesions Anthrax pneumonia - spores inhaled lead to pneumonia |
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Name 4 Clostridium
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Clostridium tetani - in puncture wounds, leads to spastic paralysis
Clostridium perfringens - food poisoning, secretory diarrhea, wound infections (gas gangrene) Clostridium botulinum - flaccid paralysis Clostridium difficile - GI tract, ATB induced overgrowth |
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What do Clostridium and Bacillis produce?
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Spores
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UT Antiseptics (2)
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Methenamine
Nitrofurantoin |
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Methanamine notes
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decomposes to formaldehyde
concentrated in urine CI in hepatic disease can be used in chronic UTI |
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Nitrofurantoin notes
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reduced form will damage bacterial DNA
for E. Coli and enterococci bacteriocidal *Will color urine orange/brown |
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Nitrofurantoin Tox
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N/V/D
Pulmonary fibrosis with chronic use |
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Polymyxin B MOA, notes
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MOA: cationic detergent, will distrupt gram NEG membrane
Nephrotoxic with sustemic use (so only topical), systemic can cause N/V too combined with Bacitracin and Neosporin |
