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;
70 Cards in this Set
- Front
- Back
Penicillin
-Class? -Drugs to know? (5) -MOA? -Mechanism of Resistance (3) |
Class
-Beta Lactam antibiotics Drugs to know -Ampicillin -Amoxicillin -Penicillin -Nafcillin -Dicloxacilin MOA -Binds transpeptidases and prevent cross linking -Inhibit growth of bacterial cell wall Resistance -Mutations in the genes encoding penicillin binding proteins or transpeptidases -Beta-lactamases which hydroxyze the beta-lactam ring -Altered uptake |
|
Penicillin
-Pharmacokinetics (4) -SEs? (4) -Administration -Penicillin Allergies can also have allergies to which other drugs? (2) -No allergies seen with? (1) |
Kinetics
-Good bioavaliability -Cross BBB if inflammation present -Short half lives -Can be desensitized to drug (only pregnant women w/ syphilis) Administration -Given several times a day -IV, PO or both SEs -Allergic reactions -Nausea, vomiting, diarrhea -Hives, asthma, shortness of breath or other systemic reactions Allergy possible with: -Cephalosporins (5-10%) -Carbapenems Not with: -Monobactams |
|
Beta-lactamase inhibitors
-MOA -Used with? -Uses? (1) Drugs to know in penicillin w/ beta-lactamase inhibitor class (3) -Administration? (2) |
MOA
-Bind strongly to beta lactamases (which hydrolyse the beta-lactam rings) -Inactivate these beta-lactamase Used with: -Beta-lactams Uses -Given so that other antibiotics are not inactivated Drugs to know: -Amoxicillin-clavulanate (PO or IV) -Ampicillin-sulbactam -Pipericillin-tazobactam (IV) |
|
Cephalexin
-Class -MOA? -Mechanism of Resistance (3) |
Class
-1st Gen. Cephalosporin class MOA -Inhibit transpeptidases or penicillin binding proteins -Stop cross-linking and weaken cell wall Resistance -Altered transpeptidases or altered penicillin binding proteins* -Reduced permeability* -Beta-lactamases-hydrolysis* |
|
Cephalexin
-Pharmacokinetics (4) -SEs? (4) -Reaction seen with? |
Kinetics
-Good bioavaliability -Cross BBB if inflammation present -Short half lives SEs -Allergic reactions -Nausea, vomiting, diarrhea -Hives, asthma, shortness of breath or other systemic reactions Reaction with: -Pencillin (5-10%) |
|
Ceftazidime
-Class -MOA? -Mechanism of Resistance (3) |
Class
-3rd Gen. Cyclosporin MOA -Inhibit transpeptidases or penicillin binding proteins -Stop cross-linking and weaken cell wall Resistance -Altered transpeptidases or altered penicillin binding proteins* -Reduced permeability* -Beta-lactamases-hydrolysis* -Extended spectrum beta lactamases(ESBLs) -->hydrolyze 3rd generation cephalosporins and many synthetic penicillins |
|
Ceftazidime
-Pharmacokinetics (4) -SEs? (4) -Reaction seen with? |
Kinetics
-Good bioavaliability -Cross BBB if inflammation present -Short half lives SEs -Allergic reactions -Nausea, vomiting, diarrhea -Hives, asthma, shortness of breath or other systemic reactions Reaction with: -Pencillin (5-10%) |
|
Cefotaxime
-Class -MOA? -Mechanism of Resistance (3) |
Class
-3rd Gen. cyclosporin MOA -Inhibit transpeptidases or penicillin binding proteins -Stop cross-linking and weaken cell wall Resistance -Altered transpeptidases or altered penicillin binding proteins* -Reduced permeability* -Beta-lactamases-hydrolysis* -Extended spectrum beta lactamases(ESBLs) -->hydrolyze 3rd generation cephalosporins and many synthetic penicillins |
|
Cefotaxime
-Pharmacokinetics (4) -SEs? (4) -Reaction seen with? |
Kinetics
-Good bioavaliability -Cross BBB if inflammation present -Short half lives SEs -Allergic reactions -Nausea, vomiting, diarrhea -Hives, asthma, shortness of breath or other systemic reactions Reaction with: -Pencillin (5-10%) |
|
Ceftriaxone
-Class -MOA? -Mechanism of Resistance (3) |
Class
-3rd Gen. Cylcosporin MOA -Inhibit transpeptidases or penicillin binding proteins -Stop cross-linking and weaken cell wall Resistance -Altered transpeptidases or altered penicillin binding proteins* -Reduced permeability* -Beta-lactamases-hydrolysis* -Extended spectrum beta lactamases(ESBLs) -->hydrolyze 3rd generation cephalosporins and many synthetic penicillins |
|
Ceftriaxone
-Pharmacokinetics (4) -SEs? (4) -Reaction seen with? |
Kinetics
-Good bioavaliability -Cross BBB if inflammation present -Short half lives SEs -Allergic reactions -Nausea, vomiting, diarrhea -Hives, asthma, shortness of breath or other systemic reactions Reaction with: -Pencillin (5-10%) |
|
Imipenem/cilastatin
-Class -MOA -Role of cilastatin |
Class
-Carbapenems class MOA -Inhibit transpeptidases or penicillin binding proteins -Stop cross-linking and weaken cell wall Role -Cilastatin = No antibacterial action but prolongs half-life Imipenem and prevents nephrotoxic effects |
|
Aztreonam
-Class -MOA -Mechanism of Resistance (3) |
Class
-Monobactams MOA -Inhibit transpeptidases or penicillin binding proteins -Stop cross-linking and weaken cell wall Resistance -Altered transpeptidases or altered penicillin binding proteins* -Reduced permeability* -Beta-lactamases-hydrolysis* |
|
Vancomycin
-MOA? -Mechanism of Resistance? (2) -Pharmacokinetics -Administration |
MOA
-Bind to D-alanine dimer at the end of the crosslinking peptide in the peptidoglycan of the bacteria Resistance -Set of genes on a transposon that encode enzymes that make a cell wall w/ D-serene or D-lactate instead of D-alanine* -Altered targets/bypass Kinetics -Good tissue availability but not to CNS w/o inflammation and not to bone Administration -Usually IV* -Can be given orally but not really absorbed there (remains in lumen) --therefore can only treat GI tract infections w/ oral administration |
|
Vancomycin
-Use (1) -SEs? (3) |
Use
-MRSA SEs -Rapid IV administration --> can cause Red Man Syndrome (histamine mediated rxn w/ flushing and redness of upper body) -Anaphylaxis -Nephrotoxicity esp if given with aminoglycosides |
|
Bacitracin
-MOA? -Mechanism of resistance? -Administration -Used with? (2) -Uses (1) -SEs (1) |
MOA
-Inhibits dephosphorylation of the lipid carrier -Blocks transfer of cell wall components thru the bacterial membrane by binding to the carrier molecule - Gram+ and anaerobic cocci Resistance -Unclear Administration -Topical Used with -Neomycin -Polymixin B -All = neosporin Uses (neosporin) -Prevention of infection in minor cuts, scrapes, burns SEs -Very few -Rarely allergic reaction giving anaphylaxis - frequent use can give allergic contact dermatitis |
|
Quinupristin/dalfopristin
-Class -MOA -Mechanism of Resistance (3) -SEs? (3) Administration? |
Class
-Streptogramins MOA -Both block protein synthesis -Binds to 50s ribosomal subunit Resistance -Target alteration by ribosome methylation -Efflux pumping -Resistance readily occurs in only 1/2 is given SEs -Athralgias -Myalgias -Dose needs adjustment if pts have liver problems Administration -IV |
|
Linezolid
-Class -MOA? -Mechanisms of resistance (1) -Administration? |
Class
-Oxazolidinones MOA -Block protein synthesis -Bind to 50s subunit Resistance -Mutation of 23s rRNA Administration -IV or PO |
|
Linezolid
-Pharmacokinetics -SEs -Need to monitor? (4) -Contraindications? (1) |
Kinetics
-Good absorption SEs -Thrombocytopenia Monitor -Platelets -CBC -Creatinine -LFT (liver function test) Contraindications -Pts on SSRIs |
|
Erythromycin
-Class -MOA? -Mechanisms of Resistance (2) -Used when? -Pharmacokinetics? |
Class
-Macrolides MOA -Block protein synthesis -Binds 50S subunit of ribosome Resistance -Methylation of ribosomes (block drug binding)* -Efflux pumping Used when: -Pts are allergic to penicillin Kinetics -Reasonable oral bioavailability -Good tissue distribution |
|
Erythromycin
-Administration -Differences from other Macrolides? (2) -SEs? (2) -Additional use? (1) |
Administration
-IV or PO Differences -New, extended release version now available -Topical form available SEs -More nausea -Greater risk of QT prolongation - topically can get burning and irritation Use -Acne |
|
Clarithromycin
-Class -MOA? -Mechanisms of Resistance (2) -Used when? -Pharmacokinetics? -Administration |
Class
-Macrolides MOA -Block protein synthesis -Binds 50S subunit of ribosome Resistance -Methylation of ribosomes (block drug binding)* -Efflux pumping Used when: -Pts are allergic to penicillin Kinetics -Reasonable oral bioavailability -Good tissue distribution Administration -IV or PO |
|
Azithromycin
-Class -MOA? -Mechanisms of Resistance (2) -Used when? |
Class
-Macrolides MOA -Block protein synthesis -Binds 50S subunit of ribosome Resistance -Methylation of ribosomes (block drug binding)* -Efflux pumping Used when: -Pts are allergic to penicillin |
|
Azithromycin
-Pharmacokinetics? -Administration -Differences from other Macrolides -Given to? (2) |
Kinetics
-Reasonable oral bioavailability -Good tissue distribution Administration -IV or PO Differences -Longer half life -Taken less often Given to: -Children -Pregnant women |
|
Clindamycin
-Class -MOA -Mechanisms of resistance (4) |
Class
-Lincosamines MOA -Block protein synthesis -Binding to 50s subunit of ribosome Resistance -Ribosome RNA methylation -Alterned ribosomal proteins -Adenylation -Both chromosomal and plasmid resistance genes |
|
Clindamycin
-Pharmcokinetics? -Administration? -SEs? (1) |
Kinetics
-Well absorbed -Good tissue penetration but NOT in CNS Adminstration -IV, PO or topically SEs -Some allergic rnxs |
|
Streptomycin
-MOA? -Transport into bacteria -Transport inhibition? (4) |
MOA
-Block protein synthesis -Bind to 30S subunit -Bactericidal Transport -Disrupt Mg2+ bridges btw LPS molecules -Transported across membrane in energy dependent manner Transport inhibition -Divalent cations -Increase osmolality -Acidic pH -Anaerobic environment |
|
Streptomycin
-Mechanisms of Resistance (7) -Pharmacokinetics -Used in combo with? |
Resistance
-Found on plasmids and transposons -Altered binding by ribosome* -Efflux pumping -Decreased uptake by outer membrane changes--altered permeability* -Enzymatic inactivation by acetylation, phosphorylation or adenylation** Point mutation in: -rpsL gene, encoding S12 ribosomal protein gene -rrs gene, encoding 16S ribosomal rRNA Kinetics -Post-antibiotic effect --> suppress bacteria growth after drug is gone -Concentration dependent --> higher conc induced more rapid, complete killing Combo with -Beta-lactams (cell wall active agents) --synergistic effect |
|
Streptomycin
-SEs -Contraindications -Administration -Additional SE? (1) -Uses? (3) |
SEs
-Nephrotoxicity -Ototoxicity Contraindications -Pts with impaired renal function -Pts taking other nephrotoxic drugs Administration -IV or IM* - muti drug regime for TB Additional info -High ototoxicity Use -First line drug for several bioterriorism agents -M TB, mainly Extracellular -Resistant TB Strains -M avium complex -M kansaii -Other M species are resistant to it |
|
Gentamicin
-Class -MOA? -Transport into bacteria -Transport inhibition? (4) |
Class
-Aminoglycosides MOA -Block protein synthesis -Bind to 30S subunit -Bactericidal Transport -Disrupt Mg2+ bridges btw LPS molecules -Transported across membrane in energy dependent manner Transport inhibition -Divalent cations -Increase osmolality -Acidic pH -Anaerobic environment |
|
Gentamicin
-Mechanisms of Resistance (5) -Pharmacokinetics -Used in combo with? |
Resistance
-Found on plasmids and transposons -Altered binding by ribosome* -Efflux pumping -Decreased uptake by outer membrane changes--altered permeability* -Enzymatic inactivation by acetylation, phosphorylation or adenylation** Kinetics -Post-antibiotic effect --> suppress bacteria growth after drug is gone -Concentration dependent --> higher conc induced more rapid, complete killing Combo with -Beta-lactams (cell wall active agents) --synergistic effect |
|
Gentamicin
-SEs -Contraindications -Administration |
SEs
-Nephrotoxicity -Ototoxicity Contraindications -Pts with impaired renal function -Pts taking other nephrotoxic drugs Administration -IV or IM* |
|
Tobramycin
-Class -MOA? -Transport into bacteria -Transport inhibition? (4) |
Class
-Aminoglycosides MOA -Block protein synthesis -Bind to 30S subunit -Bactericidal Transport -Disrupt Mg2+ bridges btw LPS molecules -Transported across membrane in energy dependent manner Transport inhibition -Divalent cations -Increase osmolality -Acidic pH -Anaerobic environment |
|
Tobramycin
-Mechanisms of Resistance (5) -Pharmacokinetics -Used in combo with? |
Resistance
-Found on plasmids and transposons -Altered binding by ribosome* -Efflux pumping -Decreased uptake by outer membrane changes--altered permeability* -Enzymatic inactivation by acetylation, phosphorylation or adenylation** Kinetics -Post-antibiotic effect --> suppress bacteria growth after drug is gone -Concentration dependent --> higher conc induced more rapid, complete killing Combo with -Beta-lactams (cell wall active agents) --synergistic effect |
|
Tobramycin
-SEs -Contraindications -Administration |
SEs
-Nephrotoxicity -Ototoxicity Contraindications -Pts with impaired renal function -Pts taking other nephrotoxic drugs Administration -IV or IM* |
|
Tetracycline
-Class -MOA? -Mechanisms of Resistance (3) -Kinetics? |
Class
-Tetracyclines MOA -Block protein synthesis by ribosomes -Bind 30S subunit Resistance -Found on plasmids and transposons -Efflux pumping** -Produce proteins that binds ribosome and blocks tetracylines* Kinetics -Good absorption -Reasonable tissue distribution, including CNS |
|
Tetracycline
-Administration? -Not given with? (1) -SEs? (3) -Contradictions (2) -Exception to Contraindications? (1) |
Administration
-IV or PO Not given with: -Beta-lactams since they are antagonists SEs -Nausea -Photosensitivity -Sun exposure --> rash Contraindications -Children under 8 b/c of long lasting discoloration of teeth -Pregnancy Exception -Rocky mountain spotted fever |
|
Doxycycline
-Class -MOA? -Mechanisms of Resistance (3) -Kinetics? |
Class
-Tetracyclines MOA -Block protein synthesis by ribosomes -Bind 30S subunit Resistance -Found on plasmids and transposons -Efflux pumping** -Produce proteins that binds ribosome and blocks tetracylines* Kinetics -Good absorption -Reasonable tissue distribution, including CNS |
|
Doxycycline
-Administration? -Not given with? (1) -SEs? (3) -Contradictions (2) -Exception to Contraindications? (1) |
Administration
-IV or PO Not given with: -Beta-lactams since they are antagonists SEs -Nausea -Photosensitivity -Sun exposure --> rash Contraindications -Children under 8 b/c of long lasting discoloration of teeth -Pregnancy Exception -Rocky mountain spotted fever |
|
Tigecycline
-MOA? -Resistance? -Kinectics? -Administration? |
MOA
-Block protein synthesis by ribosomes -Bind 30S subunit Not affected by resistance -Tigecycline Kinetics -Good absorption -Reasonable tissue distribution, including CNS Administration -IV or PO |
|
Tigecycline
-Not given with? (1) -SEs? (3) -Contradictions (2) -Exception to Contraindications? (1) |
Not given with:
-Beta-lactams since they are antagonists SEs -Nausea -Photosensitivity -Sun exposure --> rash Contraindications -Children under 8 b/c of long lasting discoloration of teeth -Pregnancy Exception -Rocky mountain spotted fever |
|
Chloramphenicol
-MOA? -Mechanism of Resistance? (2) -Administration? |
MOA
-Block protein synthesis -Binds to 50s subunit Resistance -Acetyltransferases* -Efflux pumping Administration -IV or PO |
|
Chloramphenicol
-SEs? (4) |
SEs
-Aplastic anemia -Bone marrow suppression -Gray syndrome (circulatory collapse, coma, death) -Dose adjustment if patient has liver problems |
|
Mupirocin
-MOA -Mechanism of Resistance? (1) -Adminstration - Vehicle |
MOA
-Blocks protein synthesis -Inhibits isoleucine tRNA synthetase Resistance -Target site mutation Administration -Topical on skin or mucosal surface - intranasal Vehicle - polyethylene glycol |
|
Mupirocin
-Uses? (2) -SEs? |
Uses
-Elimination of nasopharyngeal carriage of S. aureus -Skin infections (Gram+) - impetigo SEs -Unclear - some irritation of mucous membranes |
|
Sulfamethoxazole
-Class -MOA? -Specificity? -Given with? (1) |
Class
-Sulfonamides MOA -Analog of para-aminobenzoic acid (PABA) that binds to dihydropteroate synthetase -Results in a fall of folic acid levels -Bacteria stop growing as folic acid levels fall Specificity -Humans do not have this enzyme (we obtain folate acid in diet) Given with: -Trimethoprim |
|
Sulfamethoxazole
-Do not work in which situation? -Problems due to? -Mechanism of Resistance? (4) |
Problematic situations
-Problems with sites of tissue destruction -Purulent exudate -Wounds Problems due to: -Enough of the final products made with folate acid are still available -Growth can then resume Resistance -Mutated genes for target enzymes -High levels of expression of enzymes -Newly transferred genes with resistant enzymes -Altered uptake and efflux -Major problems with this class |
|
Sulfamethoxazole
-Pharmacokinetics -Administration -Addition fact for sulfa drugs (1) -SEs? (3) -Contraindications? (3) |
Kinetics
-Both act synergistic (given together) -Good bioavailability Administration -IV or PO -Sulfa--can be given along w/ silver ions in a topical cream SEs -HIV pts can develop neutropenia and exfoliative dermatitis -HIV pts given these drugs prophylaxically -Allergic rxns including anaphylaxis Contraindications -Glucose-6-phosphate deficiency -Folic acid deficiency -Pregnant |
|
Sulfadiazine
-Class -MOA? -Specificity? -Given with? (1) |
Class
-Sulfonamides MOA -Analog of para-aminobenzoic acid (PABA) that binds to dihydropteroate synthetase -Results in a fall of folic acid levels -Bacteria stop growing as folic acid levels fall Specificity -Humans do not have this enzyme (we obtain folate acid in diet) Given with: -Trimethoprim |
|
Sulfadiazine
-Do not work in which situation? -Problems due to? -Mechanism of Resistance? (4) |
Problematic situations
-Problems with sites of tissue destruction -Purulent exudate -Wounds Problems due to: -Enough of the final products made with folate acid are still available -Growth can then resume Resistance -Mutated genes for target enzymes -High levels of expression of enzymes -Newly transferred genes with resistant enzymes -Altered uptake and efflux -Major problems with this class |
|
Sulfadiazine
-Pharmacokinetics -Administration -Addition fact for sulfa drugs (1) -SEs? (3) -Contraindications? (3) |
Kinetics
-Both act synergistic (given together) -Good bioavailability Administration -IV or PO -Sulfa--can be given along w/ silver ions in a topical cream SEs -HIV pts can develop neutropenia and exfoliative dermatitis -HIV pts given these drugs prophylaxically -Allergic rxns including anaphylaxis Contraindications -Glucose-6-phosphate deficiency -Folic acid deficiency -Pregnant |
|
Dapsone
-Class -MOA? -Useful against? (2) -Mechanism of Resistance? (4) |
Class
-Sulfonamides MOA -Folic acid blocker -Analog of PABA Useful against -Mycobacteria (esp leprosy) -Pneumocytis jiroveci/carinii (fungus) Resistance -Mutated genes for target enzymes -High levels of expression of enzymes -Newly transferred genes with resistant enzymes -Altered uptake and efflux -Major problems with this class |
|
Dapsone
- Metabolism -SEs? (3) -Contraindications? (3) -Administration -Addition fact for sulfa drugs (1) |
Metabolism
- kidney eliminated (dose adjust in kidney failure) SEs -HIV pts can develop neutropenia and exfoliative dermatitis -HIV pts given these drugs prophylaxically -Allergic rxns including anaphylaxis Contraindications -Glucose-6-phosphate deficiency (get hemolysis) -Folic acid deficiency -Pregnant Administration -IV or PO -Sulfa--can be given along w/ silver ions in a topical cream - w/ rifampin and clofazimine for leprosy (better result, less resistance) |
|
Trimethoprim
-MOA? -Specificity? -Given with? (1) |
MOA
-Analog of dihydrofolic acid --> binds to bacterial dihydrofolic acid reductase -Blocks formation of folic acid Selectivity -Does not readily inhibit mammalian dihydrofolic acid reductase Given with? -Sulfa drugs -Produced sequential block of folic acid synthesis -Synergistic |
|
Trimethoprim
-Mechanisms of resistance? (2) -Pharmacokinetics -Administration -Addition fact for sulfa drugs (1) |
Resistance
-Altered targets/bypass* -Metabolic bypass is most common as new enzymes are provided** -Reduced permeability* Kinetics -Both act synergistic (given together) -Good bioavailability Administration -IV or PO -Sulfa--can be given along w/ silver ions in a topical cream |
|
Trimethoprim
-SEs? (3) -Contraindications? (3) |
SEs
-HIV pts can develop neutropenia and exfoliative dermatitis -HIV pts given these drugs prophylaxically -Allergic rxns including anaphylaxis Contraindications -Glucose-6-phosphate deficiency -Folic acid deficiency -Pregnant |
|
Ciprofloxacin
-Class -MOA? -Basis for selective action? -Administration? (1) |
Class
-Fluoroquinolones MOA -Inhibit Type II topoisomerases -Inhibit DNA gyrase (supercoiling) -Inhibit TopoIV (decatenation) -Blocks DNA replication and transcription Selectivity -These do NOT exist in eukaryotic cells Administration -Can be given either orally or IV |
|
Ciprofloxacin
-Mechanisms of Resistance? (4) -Pharmacokinetics (2) |
Resistance mechanisms
-Target modification in gyrase or topoIV genes* -Altered uptake or efflux (drugs blocked from being transported into cells) -Reduced permeability* -Plasmid-mediated drug modification by quinolone transacetylase (evolved from aminoglycoside transacetylase) Kinetics -Absorbed well from oupper GI tract -Tissue distribution is good |
|
Ciprofloxacin
-Contraindications? (2) -Due to? -Adverse reactions? (2) -Do not use in which pts? (2) |
Contraindications
-Pregnant patients -Under 18 yrs old Due to -Anthropathy (joint problems) observed in animals SEs -Arthropathy (joint pain esp in Achilles tendon) -Levofloxacin --> Prolonged QT interval Should NOT be used in pts. -Receiving class I or III antirrhythmics -Known conduction abnormalities or taking other drugs that prolong the QT interval or induce bradycardia |
|
Levofloxacin
-Class -MOA? -Basis for selective action? -Administration? (1) |
Class
-Fluoroquinolones MOA -Inhibit Type II topoisomerases -Inhibit DNA gyrase (supercoiling) -Inhibit TopoIV (decatenation) -Blocks DNA replication and transcription Selectivity -These do NOT exist in eukaryotic cells Administration -Can be given either orally or IV |
|
Levofloxacin
-Mechanisms of Resistance? (4) -Pharmacokinetics (2) |
Resistance mechanisms
-Target modification in gyrase or topoIV genes* -Altered uptake or efflux (drugs blocked from being transported into cells) -Reduced permeability* -Plasmid-mediated drug modification by quinolone transacetylase (evolved from aminoglycoside transacetylase) Kinetics -Absorbed well from oupper GI tract -Tissue distribution is good |
|
Levofloxacin
-Contraindications? (2) -Due to? -Adverse reactions? (2) -Do not use in which pts? (2) |
Contraindications
-Pregnant patients -Under 18 yrs old Due to -Anthropathy (joint problems) observed in animals SEs -Arthropathy (joint pain esp in Achilles tendon) -Levofloxacin --> Prolonged QT interval Should NOT be used in pts. -Receiving class I or III antirrhythmics -Known conduction abnormalities or taking other drugs that prolong the QT interval or induce bradycardia |
|
Metronidazole
-MOA? -Mechanism of resistance? |
MOA
-Produces compounds that are toxic to DNA -Exact mechanism is unclear Resistance -Rare and mechanism is not clear |
|
Metronidazole
-Pharmacokinetics -Administration? -Uses (4) |
Kinetics
-Excellent tissue penetration, including CNS -Reduction of metronidazole creates conc gradient --> drives uptake of more drug -Then promotes formation of intermediate compounds and free radicals that are toxic to cell Administration -IV or PO administration -Topical Uses (w/ topical) -Inflammatory pustules -Papules -Bacterial vaginosis - acne rosacea |
|
Metronidazole
-Adverse reactions? (2) -Contraindications? (1) |
SEs
-Promote renal retention fo Li+ -Decreased elimination of ergot derivatives Contraindications -Pts. should not drink alcohol - pregnant/lactating women |
|
Nitrofurantoin
-MOA? -Mechanism of resistance? (1) -Administration |
MOA
-Unclear -Attacks bacterial metabolism -Mimics radiation damage -Drug must be reduced inside bacteria Resistance -Altered levels of reduction enzymes Administration -PO |
|
Nitrofurantoin
-Pharmacokinetics? -Use (1) -SEs (2) |
Kinetics
-Drug concentrated in urine Use -Uncomplicated UTIs SEs -Turns urine brown (harmless) -Lung problems in pts on prolonged or prophylaxis treatment |
|
Polymixins
-MOA? -Mechanism of Resistance? -Administration? |
MOA
-Disrupts bacterial membranes by charge alternation Resistance -Unclear Administration -Topical -IV or IM |
|
Polymixins
-Used with? (2) -SEs? -Uses (1) |
Used with:
-Neomycin -Bacitracin (Neosporin) SEs -Few if used topically Uses (neosporin) -Prevention of infection in minor cuts, scrapes, burns - Gram+ organisms |
|
Daptomycin
-MOA? -Mechanisms of resistance? -Administration? (1) -SEs? |
MOA
-Cyclic lipopeptide interferes w/ bacterial membrane function and pore formation Resistance -Unclear Administration -IV SEs -Elevated liver function tests and creatine phosphokinase -Muscle weakness and pain w/ elevated creatine phosphokinase (discontinue drug) |