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67 Cards in this Set
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- Back
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Chloramphenicol mechanism
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interacts w/ the 50s ribosomal subunit inhibiting bacterial protein synthesis by inhibiting transpeptidation thru blocking the binding of charged tRNA to acceptor site on the ribosome-mRNA complex
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adverse effect of chloramphenicol
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bone marrow toxicity
anemias (aplastic anemia) gray baby syndrome |
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Chloramphinicol has excellent activity against?
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H. flu, Neisseria meningitidis and BACTEROIDES
also backup for Rickettisia ** 3rd line agent for meningitis (Haemophilis influenzae, Neisseria meningitidis, Strep pneumoniae and campylobactor fetus)... EMPIRICAL therapy for bacterial meningitis and encephalitis in kids 1m.-15 yrs in combo w/ ampicillin |
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Can u use chloramphenicol w/ warfarin?
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no
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clindamycin mechanism
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binds to site on 50s subunit of bacterial ribosome, inhibiting the translocation steps of protein synthesis
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Can clindamycin treat Moraxella?
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no, because its a gm(-) aerobe (like haemophillus) and they cannot treat gm (-) aerobes
-only gm (+) aerobes, gm (-) anaerobes, gm (-) aerobes |
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If pt is allergic to PCN, what do yougive them for prophylaxis of endocardities
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clindamycin
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what drugs would you use for refractory bone infections
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cefazolin and clindamycin
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clindamycin is fist line for
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bacteroides and fusobacterium (gingivitis)
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How is clindamycin distributed
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all except CSF, it also PENETRATES BONE (so does cefazolin)
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TQ: adverse effects of clindamycin
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1. PSEUDOMEMBRANOUS COLITIS: due to C. diff overgrowth
also skin rashes and impaired hepatic function |
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How is mupirocin (bactroban) administered?
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Ointment, cream, and intranasal
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TQ: Mechanism of Mupirocin
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inhibits bacterial protein synthesis thru reversibly inhibiting bacterial isoleucyl transfer RNA synthetase (only abx that does not bind to ribosome)
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Mupirocin bacteriostatic or bacteriocidil?
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cidil
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TQ: What is mupirocin primarily indicated to treat?
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secondarily infected traumatic skin lesions and impetigo due to gm + cocci including staph and *MRSA!!
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How is spectinomycin given?
wont be on exam |
IM
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Mechanism of action of spectinomycin
wont be on exam? |
inhibits bacterial protein synthesis by interacting w/ bacterial 30s ribsomal subunit, blocking the binding of mRNA to the ribosome
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TQ: what is exclusively employed as the optional treatment to gonnorrhea?
wont be on exam? waht about the oral gonnorhea tx? |
Spectinomycin
Cefixame |
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Mechanism of action of sulfonamides
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inhibit synthesis of bacterial folic acid (structual analogs of PABA)
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mechanism of action of trimethoprim
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inhibit synthesis of bacterial folinic acid (tetrahydrofolate)
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are sulfonamides bacteriostatic or cidil?
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static
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Which sulfonamides are orally absorbable?
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1, sulfisoxazole
2. sulfisoxazole acetyl + ertythromycin 3. sulfamethoxazole 4 sulfamethoxazole +Trimethoprim (Bactrim) 5. sulfadiazine 6. ssulfadiazine +pyrimethamine 7. sulfadoxine 8. sulfadoxine +pyrimethamine **ALL SULFONAMIDES EXCEPT sulfasalazine, SULFACETAMIDE, AND SILVER SULFADIAZINE "silver facet fact" |
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what sulfonamides or nonabsorbable?
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sulfasalazine
** treats inflammatory bowel disease |
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TQ: What treats inflammatory bowel disease/
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sulfasalazine :
it is poorly absorbed from GI tract, then degraded by intestinal bacteria to sulfapyridine and 5-aminosalicylate (anti-inflammatory agent) which accumulates in feces and manages : ulcerative colitis, granulomatous colitis and regional enteritis |
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TQ: TOPICAL SULFONAMIDES
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SULFACETAMIDE, SILVER SULFADIAZINE
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TQ resistance of sulfanamides...
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1. altered target protein (dihydropteroate synthetase)
2. decreased permeability 3. enzymatic inactivation **4. increased synthesis of PABA (it will overwhelm the effects cuz it competes w/ the drug) |
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adverse effects of sulfanamides
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1. crystalluria and nephrotoxicity
2. kernicterus (newborns) 3. drug potentiation (warfarin) |
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what drug is contraindicated in pregnant females at term cuz of risk of kernicterus
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sulfonamides
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TQ: what is trimethoprim used to treat
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UTI and bacterial prostatits
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When trimethoprim combined with polymyxin B, what does it treat?
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topical tx for external infections of the eye
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adverse effects of trimethoprim
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megaloblastic anemia, leukopenia, granulocytopenia
** reversed by folinic acid administration |
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Mechanism of SMX-TMP (bactrim
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synergistic
sulfamethoxazole: reduces production of folic acid from PABA Trimethoprim: inhibits conversion of dihydrofolate to tetrahydrofolate |
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TQ: smx-tmp used to treat
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URIs: H. influenzae, Moraxella catarrhalis, Legionella
GI: salmonella, Shigella *UTIs: E. coli, Proteus, *Enterobacter, Klebsiella Prostatitis STDs: Lymphogranuloma venereum (Chlamydia trachomatis), *Granuloma inguinale (Calymmatobacterium), *H. ducreyi(chancroid) Brucella Vibrio cholerae *Nocardia *Pneumocystis jiroveci (AIDS patients) |
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does smx-tmp interact w/ warfarin?
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yes
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How to remember which belong to floroquinolones?
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-oxacin
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Mechanism of action of fluoroquinolones
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inhibit dna gyrase
1 and 2 gen: inhibit topoisomerase II 3 and 4 gen: inhibit topoisomerase II and IV |
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what can fluoroquinolones be synergistic w/ ?
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b-lactam abx
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name the
1. 2nd gen fluoroquinolones 2. 3rd 3. 4th |
The "CON" took "le Gem" from "MaG"
1. Ciprofloxacin, Ofloxacin, Norfloxacin 2. Levofloxacin, Gemifloxacin 3. Moxifloxacin, Gatifloxacin |
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Cipro is used to treat
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Mostly gm (-) (especially rods)
the only gm (+) is anthrax **UTIs: Proteus, E. coli, Klebsiella, Enterococcus, Pseudomonas Prostatitis: Proteus, E. coli, Klebsiella, **Pseudomonas URIs: Moraxella, Haemophilus, Pseudomonas, Klebsiella Conjunctivitis Enteritis: **Shigella, **Salmonella, Campylobacter, Vibrio cholera |
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TQ: what is the best drug for chlamydia trachomatis (urethritis)
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ofloxacin
chlamydia trachOOOOmatis |
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Can norfloxacin treat system infections
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no
used for UTIs and prostatitis |
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What is the most commonly prescribed fluoroquinolone?
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Levofloxacin
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What fluoroquinolone treats MDRSP
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Levofloxacin, Gemifloxacin, moxifloxacin, and gatifloxacin
"Le gem from MaG" |
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What is first line agent for E. Coli
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Levofloxacin
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What is the advantage of 4th generatioin fluoroquinolones
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increased activity against anaerobes (bacteroides fragilis, fusobacterium, peptostreptococcus)
treats gm - ... as you move down the generations: more gm + are added |
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Is there cross Resistance among fluoroquinolones
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yes
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Which fluoroquinolones would you use to treat strep pneumonia?
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3rd and 4th generations
Le Gem from MaG Levofloxacin Gemifloxacin Moxifloxacin Gatifloxacin |
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Which fluoroquinolone is excreted primarily in bile
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Moxifloxacin
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Can fluoroquinolones treat intracellular organisms (legionella, chlamydia, mycoplasma)
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yes cuz they accumulate in macrophages and PMNs
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Adverse effects of Fluoroquinolones
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tendinits
nephrotoxicity phototoxicity cns GI cardiac (prolong QT interval) |
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Which fluoroquinolones are not ok to give w/ warfarin?
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all
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Fluoroquinolones are contraindicated in?
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preggers, nursing moms and kids under 18
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How is Methenamine mandelate and methenamine hippurate given?
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oral
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Which antibiotics decompose at acidic pH into formaldehyde
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Methenamine mandelate and methenamine hippurate
- acts as UT antiseptic, killing the bacteria |
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What is the most commonly prescribed urinary tract antiseptic
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Nitrofurantoin (macrobid)
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What antiseptic is a prodrug
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Nitrofurantoin
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Which antiseptic is active against E coli
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Nitrofurantoin
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What antiseptic turns urine brown
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nitrofurantoin
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Mechanism of Linezolid (zyvox)
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inhibits bacterial protein synthesis by interacting w/ 23s ribosomal RNA on the 50s ribosome, inhibiting formation of initiation comlex and translation in gm +
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TQ: what are primary clinical applications of linezolid
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MRSA, VISA, VRSA, VRE, and MDRSP
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what drugs does linezolid have cross resistance w/
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none
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TQ: linezolid treats...
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pneumonia is a main thing it treats... also mrsa, vrsa, vre, visa, MDRSP
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adverse effects of linezolid
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myelosuppression, reversible anemia and thrombocytopenia
(bone marrow toxicity) |
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What does Quinupristin-dalfopristin (synercid) treat?
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VRE,
MRSA, VISA and VRSA (skin only) NOT MDRSP |
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does synercid treat mdrsp
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no
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what is an adverse effect of synercid
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infusion phlebitis
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Difference b/w synercid and zyvox?
1. Route of administration 2. IS it compromised in reduced renal function 3. Has resistance developed? 4. Can it treat Pneumonia? |
1. Zyvox (orally and IV), Synercid (IV)
2 Zyvox (yes: excreted in urine, Synercid (no: excreted in feces)) 3 Zyvox: no, Synercid: Yes 4. Zyvox: yes, Synercid: No because synercid cannot accumulate in the lung also: synercid cannot treat enterococcus faecalis, linezolid can synercid is snygergistic like SMX-TMP, not linezolid |
