Renal Pharm 1

Front 1

Block cell wall synthesis by inhibition of peptidoglycan cross-linking

Back 1

Penicillin, ampicillin, ticarcillin, piperacillin, imipenem, aztreonam, cephalosporins

Front 2

Block peptidoglycan synthesis

Back 2

Bacitracin and vancomycin

Front 3

Disrupt bacterial cell membranes

Back 3

Polymyxins and daptomycin

Front 4

Block nucleotide synthesis

Back 4

Sulfonamides and trimethoprim

Front 5

Block DNA topoisomerases

Back 5

Fluoroquinolones

Front 6

Block mRNA synthesis

Back 6

Rifampin

Front 7

Block protein sythesis at 50S ribosomal subunit

Back 7

Chloramphenicol, macrolides, clindamycin, streptogramins (quinupristin, dalfopristin), linezolid, daptomycin

Front 8

Macrolides

Back 8

Erythromycin, clarithromycin, azithromycin

Front 9

Block protein synthesis at 30S ribosomal subunit

Back 9

Aminoglycosides, tetracyclines

Front 10

Aminoglycosides (5)

Back 10

Streptomycin, Gentamicin, Tobramycin, Amikacin, Neomycin

Front 11

Tetracyclines (4)

Back 11

Tetracycline, doxycycline, minocycline, tigecycline

Front 12

Aminoglycosides good against

Back 12

Gram negative aerobic infections

Front 13

Aminoglycosides a DOC for these 3

Back 13

Pseudomonas, Invasive enterococcal infections, Francisella tularensis

Front 14

2 things that block the transport of Aminoglycosides

Back 14

Anaerobic environment and low extracellular pH

Front 15

Most common Aminoglycosides resistance mechanism

Back 15

Aminoglycoside modifying enzymes (AME)

Front 16

Aminoglycosides: IV or parenterally

Back 16

Usually given parenterally unless local GI effect desired

Front 17

How are aminoglycosides eliminated?

Back 17

Largely eliminated by the kidneys; must adjust dose relative to creatinine clearance

Front 18

Primary toxicities of Aminoglycosides

Back 18

Nephrotoxicity, Ototoxicity, and Neuromuscular blockade

Front 19

Absolute contraindication for aminoglycosides

Back 19

Myasthenia gravis - high risk of neuromuscular blockade causing respiratory depression

Front 20

How to reverse the neuromuscular blockade caused by aminoglycosides

Back 20

Calcium gluconate or neostigmine

Front 21

Can be used alone to treat tularemia and plague

Back 21

Streptomycin

Front 22

Drugs to treat brucellosis

Back 22

Streptomycin and doxycycline

Front 23

Used in combination with a cillin for Pseudomonas or Enterococcal; most frequently used AG

Back 23

Gentamicin

Front 24

Used when other Aminoglycosides fail; has the broadest spectrum

Back 24

Amikacin

Front 25

Primarily used orally to sterilize the gut; when taken systemically is the most toxic of the Aminoglycosides

Back 25

Neomycin

Front 26

The 4 tetracyclines

Back 26

Tetracycline, doxycycline, minocycline, tigecycline

Front 27

Preferred tetracycline for patients with poor renal function

Back 27

Doxycycline

Front 28

Preferred tetracycline for meningococcal carrier state (enters CSF in therapeutic amounts)

Back 28

Minocycline

Front 29

Drug of choice for Bacillus anthracis

Back 29

Tetracyclines

Front 30

Drug of choice for Mycoplasma p., chlamydia, Rickettsiae, Lyme disease

Back 30

Tetracyclines

Front 31

Tetracyclines: bacteriocidal or -static

Back 31

Bacteriostatic

Front 32

Primary resistance to tetracyclines via:

Back 32

Efflux pumps and ribosome protection

Front 33

Form stable 'chelates' with cations

Back 33

Tetracyclines

Front 34

Tetracycline given IV, with biliary excretion, and effective against resistant organisms (MRSA, etc)

Back 34

Tigecycline

Front 35

6 adverse reactions to tetracyclines

Back 35

Gastrointestinal, Bony structures and teeth, liver toxicity, local tissue toxicity, photosensitization, vestibular reactions

Front 36

Outdated and degraded tetracyclines can cause this if taken

Back 36

Fanconi syndrome

Front 37

50S inhibitor that can cause bone marrow suppression and serious and fatal blood dyscrasias

Back 37

Chloramphenicol

Front 38

Gray syndrome

Back 38

Adverse effect of Chloramphenicol caused by a lack of glucuronyl transferase activity

Front 39

Drug of choice for Campylocbacter jejuni, H. pylori, Shiggella spp

Back 39

Macrolides

Front 40

Drug of choice for children and pregnant females or allergic to penicillin

Back 40

Macrolides

Front 41

Macrolides: bacteriocidal or bacteriostatic

Back 41

Bacteriostatic

Front 42

Resistance to Macrolides via:

Back 42

Active efflux pump and Ribosome modification

Front 43

Less frequent dosing than erythromycin

Back 43

Clarithromycin

Front 44

Differs from erythromycin and clarithromycin in its long half-life (around 70 hours)

Back 44

Azithromycin

Front 45

Of the macrolides, which doesn't inhibit CYP3A4

Back 45

Azithromycin

Front 46

Inhibits CYP3A4

Back 46

Macrolides

Front 47

Macrolides adverse effects

Back 47

CYP3A4 inhibitor, GI effects, Cholestatic hepatitis

Front 48

Primary reason for stopping erythromycin

Back 48

GI effects - epigastric distress

Front 49

Fever, jaudice, impaired liver function primarily seen with erythromycin estolate dose form

Back 49

Cholestatic hepatitis

Front 50

Aerobic Gram negative bacilli are intrinsically resistant to

Back 50

Clindamycin

Front 51

Treatment of anaerobic and streptococcal and staphylococcal infections

Back 51

Clindamycin

Front 52

Drug of choice for C. perfringens

Back 52

Clindamycin

Front 53

Don't use this with erythromycin and chloramphenicol as it binds close to their binding sites

Back 53

Clindamycin

Front 54

Resistance to this drug primarily by methylation (like the macrolides)

Back 54

Clindamycin

Front 55

Adverse effects of Clindamycin

Back 55

Severe diarrhea and Pseudomembranous colitis

Front 56

Drug of choice for Vancomycin resistant Enterococcus faecium (VRE)

Back 56

Quinupristin and dalfopristin; also linezolid/daptomycin

Front 57

Quinupristin binds here:

Back 57

At the same site as macrolides (50S)

Front 58

Dalfopristin works via:

Back 58

Directly interfers with polypeptide chain formation; synergistically enhances binding of quinupristin

Front 59

Quinupristin and dalfopristin bacteriocidal or -static

Back 59

Bacteriocidal

Front 60

Adverse effects of Quinupristin and Dalfopristin

Back 60

Infusion related events, severe arthralgias and myalgias, cost

Front 61

Drug of choice for vancomycin resistant Enterococcus faecium and faecalis

Back 61

Linezolid

Front 62

Linezolid should be reserved for

Back 62

Multi-Drug resistant Gram positives

Front 63

Potent CYP3A4 inhibitor

Back 63

Quinupristin and dalfopristin; also Macrolides

Front 64

Adverse effects of Linezolid

Back 64

Thrombocytopenia (most common), Anemia, leukopenia, cost

Front 65

Mechanism of action via binding to bacterial membranes; causing rapid depolarization; loss of membrane potential; cell death

Back 65

Daptomycin

Front 66

Adverse effects of Daptomycin

Back 66

Skeletal muscle damage, superinfection (pseudomembranous colitis), cost