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17 Cards in this Set
- Front
- Back
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Metronidazole
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- Prodrug converted to a free radical by anaerobic bacteria
- Given IV for severe anaerobic infections - SE: peripheral neuropathy, seizures |
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Nitrofurantoin
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- Prodrug converted to a reactive intermediate
- Tx UTI because it concentrates in the urine - SE: cough, brown urine, hemolytic anemia |
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Agents used only topically (4)
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1- Polymixin B
2- Gramicidin 3- Mupirocin 4- Retapamulin |
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Polymixin B
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- Binds to sites on LPS of G-
- Inc bacterial membrane permeability - SE: nephro/neurotoxic- neuromuscular blockade, perioral paraesthesia |
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Gramicidin
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- Mix of 3 diff antibiotics
- Opens ion channels in bacterial cell membrane - G+ - SE: severe systemic toxicity for all organs |
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Mupirocin
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- Protein synthesis inhibitor
- Binds to and inhibits isoleucyl tRNA sythetase |
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Retapamulin
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- Protein synthesis inhibitor- blocks peptidyl transferase & P site
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Mixture of topical ointments
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- Neosporin= neomycin+polymixin+gramicidin
- Polysporin= polymixin + bacitracin - Polytrim= trimethoprim + polymixin - Terak= oxytetracycline + polymixin |
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Anti-mycobacterial agents (5)
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1- Isoniazid
2- Rifampin 3- Pyrazinamide 4- Ethambutol 5- Dapsone |
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Isoniazid
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- Prodrug=> inhibits cell wall synthesis by inhibiting mycolic acid
- Cidal in rapidly growing cell and static in slow growing cells - Metabolized by acetylation - SE: inc excretion of vitamin B6 (Pellegra), optic neuritis/peripheral neuropathy, hepatoxicity |
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Rifampin
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- Inhibits DNA dependent RNA polymerase, inhibits RNA synthesis
- SE: hepatic toxicity, red urine, strongly induces P450 - Cidal |
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Pyrazinamide
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- Prodrug converts to pyrazinoic acid in macs where TB accumulates
- Inhibits enzyme responsible for lipid metabolism - SE: inc uric acid (gout), joint pain, hepatitis |
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Ethambutol
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- Inhibits arabymosyl transferase- required for synthesis of a component of cell wall
- SE: optic neuritis, altered color vision |
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Dapsone
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- Tx Hanson's disease (leprosy)
- Like the sulfonamides, inhibit folate synthesis - SE: hemolytic anemia, rash |
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Appropriate uses for antibiotics
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1- Known susceptible organism
2- Serious infection w/ unknown organism 3- For prophylaxis or high rash situation * Narrowest spectrum, lowest toxicity, least invasive, lowest cost |
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Inappropriate uses for antibiotics
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1- Fever of unknown origin
2- Viral respiratory infection * Best practice, get a culture first then find appropriate agent |
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Problems w/ antibiotic combos
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Two agents w/ the same toxicities, i.e. ototoxicity
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