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169 Cards in this Set
- Front
- Back
the parasites treated by metronidazole
|
giardia lamblia
entamoeba histolytica trichomonas vaginalis |
|
giardia rx
|
metronidazole
|
|
entamoeba histolytica rx
|
metronidazole and iodoquinol
|
|
the parasites treated by iodoquinol
|
entamoeba histolytica
|
|
cryptosporidium rx
|
prevention -- filtering water supplies
|
|
toxoplasma gondii rx
|
sulfadiazine + pyrimethamine
|
|
sulfadiazine + pyrimethamine
treats what |
toxoplasma gondii
|
|
metronidazole and iodoquinol treats what
|
entamoeba histolytica
|
|
naegleria fowleri rx
|
amphotericin has been effective for a few survivors
|
|
amphotericin has been effective for a few survivors of what parasite?
|
naegleria fowleri
|
|
trypanosoma brucei rx
|
suramin for blood-borne disease
melarsoprol for CNS penetration |
|
suramin and melarsoprol treat what
|
trypanosoma brucei
|
|
plasmodium rx
|
chloroquine
mefloquine primaquine begin with chloroquine if resistant, use mefloquine vivax/ovale -- add primaquine for dormant hypnozoite in liver |
|
babesia rx
|
quinine
clindamycin |
|
quinine, clindamycin can treat what
|
babesia
|
|
nifurtimox treats what
|
trypanosoma cruzi
|
|
leishmania donovani rx
|
sodium stibogluconate
|
|
sodium stibogluconate treats what
|
leishmania donovani
|
|
trypanosoma cruzi rx
|
nifurtimox
|
|
trichomonas vaginalis rx
|
metronidazole
|
|
-bendazoles treat what?
|
a worm will EAT what it EATS
enterobius ascaris trichinella echinococcus ancyclostoma; necator taenia solium strongyloides |
|
pyrantel pamoate treats what?
|
enterobius
ascaris ancyclostoma; necator |
|
"-bendazoles or pyrantel pamoate"
treat what? |
enterobius
ascaris ancyclostoma; necator |
|
niridazole treats what?
|
dracunculus medinensis
|
|
dracunculus medinensis rx
|
niridazole
|
|
enterobius vermicularis rx
|
-bendazoles or pyrantel pamoate
|
|
ascaris lumbricoides rx
|
-bendazoles or pyrantel pamoate
|
|
trichinella spiralis rx
|
-bendazoles
|
|
strongyloides stercoralis rx
|
-bendazoles or ivermectin
|
|
ivermectin treats
|
strongyloides stercoralis
onchocerca volvulus |
|
-bendazoles or ivermectin
treats what? |
strongyloides stercoralis
|
|
onchocerca volvulus rx
|
ivermectin
|
|
ancyclostoma duodenale
necator americanus rx |
-bendazoles or pyrantel pamoate
|
|
diethylcarbamazine rx
|
loa loa
wuchereria bancrofti toxocara canis |
|
loa loa rx
|
diethylcarbamazine
|
|
wuchereria bancrofti rx
|
diethylcarbamazine
|
|
toxocara canis rx
|
diethylcarbamazine
|
|
taenia solium rx
|
praziquantel
use -bendazoles for neurocysticercosis |
|
diphyllobothrium latum rx
|
praziquantel
|
|
echinococcus granulosus rx
|
-bendazoles
|
|
schistosoma rx
|
praziquantel
|
|
clonorchis sinensis rx
|
praziquantel
|
|
paragonimus westermani rx
|
praziquantel
|
|
praziquantel rx
|
taenia solium
echinococcus granulosus schistosoma clonorchis sinensis paragonimus westermani |
|
protozoa that cause GI infections
|
giardia lamblia
entamoeba histolytica cryptosporidium |
|
protozoa that cause CNS infections
|
toxoplasma gondii
naegleria fowleri trypanosoma brucei |
|
protozoa that cause hematologic infections
|
plasmodium
babesia |
|
protozoa that cause visceral infections
|
trypanosoma cruzi
leishmania donovani |
|
protozoa that cause STDs
|
trichomonas vaginalis
|
|
intestinal nematodes
|
enterobius vermicularis
ascaris lumbricoides trichinella spiralis strongyloides stercoralis ancyclostoma; necator |
|
tissue nematodes
|
dracunculus medinensis
onchocerca volvulus loa loa wuchereria bancrofti toxocara canis |
|
cestodes
|
taenia solium
diphyllobothrium latum echinococcus granulosus |
|
trematodes
|
schistosoma
clonorchis sinensis paragonimus westermani |
|
chloroquine mechanism
|
blocks plasmodium heme polymerase
|
|
plasmodium vivax / ovale have a dormant hypnozoite form in the liver
rx? |
add primaquine
|
|
leishmania donovani rx
|
sodium stibogluconate
|
|
trypanosoma cruzi rx
|
nifurtimox
|
|
what drugs block cell wall synthesis by inhibition of peptidoglycan cross-linking?
|
pennicillin
methicillin ampicillin piperacillin cephalosporins aztreonam imipenem |
|
what drugs block peptidoglycan synthesis?
|
bacitracin
vancomycin |
|
what drugs block nucleotide synthesis?
|
sulfonamides
trimethoprim |
|
what drugs block DNA topoisomerases?
|
fluoroquinolones
|
|
what drugs block mRNA synthesis?
|
rifampin
|
|
what drugs damage DNA
|
metronidazole
|
|
what drugs block protein synthesis at the 50S ribosomal subunit
|
chloramphenicol
macrolides clindamycin streptogramins --quinupristin --dalfopristin linezolid |
|
what drugs block protein synthesis at the 30S ribosomal subunit?
|
aminoglycosides
tetracyclines |
|
penicillin IV vs. oral form
|
penicillin G is IV
penicilin V is oral |
|
penicillin G vs. penicillin V
|
G is IV
V is oral |
|
penicillin moa
|
bind penicillin binding proteins
block transpeptidase cross-linking of peptidoglycan activate autolytic enzymes |
|
penicillin clinical use
|
gram-positive organisms
-- strep pneumo -- strep pyogenes -- actinomyces and syphilis |
|
penicillin is bactericidal for
|
gram + rods
gram + cocci gram - cocci spirochetes |
|
penicillin s/e
|
hypersensitivity
hemolytic anemia |
|
penicillin resistance
|
beta-lactamases cleave beta-lactam ring
|
|
the drugs on the upgraded penicillin page
|
penicillinase-resistant penicillins
--methicillin --nafcillin --dicloxacillin aminopenicillins --ampicillin --amoxicillin antipseudomonals --ticarcillin --carbenicillin --piperacillin |
|
penicillinase-resistant penicillins
|
methicillin
nafcillin dicloxacillin |
|
aminopenicillins
|
ampicillin
amoxicillin |
|
antipseudomonals
|
ticarcillin
carbenicillin piperacillin |
|
which of the "upgraded penicillins" have a narrow spectrum?
|
penicillinase-resistant penicillins
|
|
penicillinase resistant penicillins
rx |
S. aureus
except MRSA |
|
mechanism of MRSA resistance against
methicillin nafcillin dicloxacillin |
altered penicilin binding protein
|
|
which of the upgraded penicillins are penicillinase sensitive?
what do you do about that? |
ampicillin
amoxicillin ticarcillin carbenicillin piperacillin use with clavulanic acid |
|
beta-lactamase inhibitors include
|
clavulanic acid
sulbactam tazobactam |
|
ampicillin
amoxicillin s/e |
hypersensitivity
ampicillin rash pseudomembranous colitis |
|
ampicillin
amoxicillin rx |
HELPSS kill enterococci
Haemophilus influenzae E. coli Listeria monocytogenes Proteus mirabilis Salmonella Shigella enterococci |
|
what drug HELPSS kill enterococci?
|
ampicillin
amoxicillin |
|
ampicillin
amoxicillin s/e |
hypersensitivity
ampicillin rash pseudomembranous colitis |
|
ampicillin
amoxicillin resistance |
beta-lactamases cleave beta-lactam ring
|
|
ticarcillin
carbenicillin piperacillin rx |
pseudomonas
gram - rods |
|
organisms not covered by cephalosporins
|
they are LAME
listeria atypicals (chlamydia, mycoplasma) MRSA enterococci |
|
1st generation cephalosporins
|
cefazolin
cephalexin |
|
2nd generation cephalosporins
|
cefoxitin
cefaclor cefuroxime |
|
3rd generation cephalosporins
|
cefixime
cefotaxime ceftriaxone ceftazidime |
|
4th generation cephalosporins
|
cephipime
|
|
cephipime is a _ generation cephalosporin
|
4th
|
|
cefotaxime is a _ generation cephalosporin
|
3rd
|
|
ceftazidime is a _ generation cephalosporin
|
3rd
|
|
cefazolin is a _ generation cephalosporin
|
1st
|
|
cephalexin is a _ generation cephalosporin
|
1sttttttttt
|
|
1st generation cephalosporins
rx |
G+ cocci
Proteus mirabilis E coli Klebsiella pneumoniae PEcK |
|
2nd generation cephalosporins
rx |
G+ cocci
Haemophilus influenzae Enterobacter aerogenes Neisseria Proteus mirabilis E coli Klebsiella pneumoniae Serratia marcescens HEN PEcKS |
|
3rd generation cephalosporins
rx |
serious G - infections
that are resistant to other beta-lactams |
|
ceftriaxone rx
|
meningitis
gonorrhea |
|
ceftazidime rx
|
pseudomonas
|
|
cephalosporins that can be used against pseudomonas
|
ceftazidime
cefipime |
|
4th generation cephalosporins
rx |
^ activity against
pseudomonas gram + organisms |
|
cephalosporins s/e
|
hypersensitivity
-- 5-10% cross-hypersensitivity with penicillins vitamin K deficiency ^ nephrotoxicity of aminoglycosides disulfiram-like rxn with EtOH |
|
the page with cephalosporins on it also has _ drug
|
aztreonam
|
|
aztreonam mechanism
|
inhibits cell wall synthesis
(binds to PBP 3) |
|
aztreonam rx what bugs?
|
G - rods only
no activity against G + or anaerobes |
|
aztreonam rx what bugs and what patients?
|
G - rods only
no activity against G+ or anaerobes penicillin-allergic patients those with renal insufficiency who cannot tolerate aminoglycosides |
|
aztreonam s/e
|
occasional GI upset
no cross-allergenicity with penicillins or cephalosporins |
|
the page after cephalosporins includes what drugs?
|
imipenem / cilastatin
meropenem vancomycin |
|
imipenem is given with _ why? mecahnism?
|
cilastatin
to decrease inactivation of drug in renal tubules cilastatin inhibits renal dehydropeptidase I |
|
imipenem/cilastatin
meropenem rx |
G+ cocci
G- rods anaerobes s/e limit use to life-threatening infections or after other drugs have failed |
|
meropenem vs. imipenem/cilastatin
|
meropenem:
less risk of seizures stable to dihydropeptidase I |
|
imipenem/cilastatin
meropenem s/e |
GI distress, skin rash, and CNS toxicity (seizures) at high plasma levels
|
|
vancomycin moa
|
inhibits cell wall mucopeptide formation
by binding D-ala D-ala portion of cell wall precursors |
|
vancomycin rx
|
G+ only
serious, multidrug resistant organisms, including-- S. aureus enterococci Clostridium difficile |
|
vancomycin s/e
|
Nephrotoxicity
Ototoxicity Thrombophlebitis diffuse flushing -- "red man syndrome" well tolerated in general -- does NOT have many problems |
|
how can you prevent red man syndrome as caused by _ drug?
|
pretreatment with antihistamines
slow infusion rate |
|
aminoglycosides include
|
gentamycin
neomycin amikacin tobramycin streptomycin |
|
which of the protein synthesis inhibitors is bactericidal?
|
aminoglycosides
|
|
mechanisms of all the protein synthesis inhibitors
|
aminoglycosides
--inhibit formation of initiation complex --cause misreading of mRNA tetracyclines --bind to 30S --prevent attachment of aminoacyl-tRNA macrolides --block translocation --bind to the 23S rRNA of the 50S ribosomal subunit chloramphenicol and clindamycin -- block peptide bond formation at 50S |
|
_____ antibiotics
inhibit formation of initiation complex and cause misreading of mRNA |
aminoglycosides
|
|
_____ antibiotics
bind to 30S and prevent attachment of aminoacyl-tRNA |
tetracyclines
|
|
______ antibiotics
block translocation bind to the 23S rRNA of the 50S |
macrolides
|
|
_____ antibiotics
block peptide bond formation at 50S |
chloramphenicol
clindamycin |
|
aminoglycosides rx
|
severe G- rod infections
|
|
aminoglycosides moa
|
inhibit formation of initiation complex
cause misreading of mRNA |
|
aminoglycosides s/e
|
nephrotoxicity
--esp. with cephalosporins ototoxicity --esp. with loop diuretics teratogen |
|
side effects of vancomycin vs. aminoglycosides
|
nephrotoxicity
ototoxicity thrombophlebitis red man syndrome nephrotoxicity -- esp with cephalosporins ototoxicity -- esp with loops teratogen |
|
resistance to aminoglycosides
|
transferase enzymes inactivate the drug by
acetylation phosphorylation adenylation |
|
tetracyclines include
|
tetracycline
doxycycline demeclocycline minocycline |
|
tetracyclines moa
|
bind to 30S and prevent attachment of aminoacyl-tRNA
|
|
pharmacokinetic features of tetracyclines
|
limited CNS penetration
doxycycline is fecally eliminated and can be used in renal failure pts do not take with milk, antacids, or iron-containing preparations because divalent cations inhibit absorption in the gut |
|
tetracyclines rx
|
borrelia burgdorferi
mycoplasma pneumoniae ability to accumulate intracellularly makes it very effective against Rickettsia and Chlamydia |
|
tetracyclines s/e
|
GI distress
in children: --discoloration of teeth --inhibition of bone growth photosensitivity contraindicated in pregnancy |
|
tetracyclines
|
v uptake or
^ efflux by plasmid-encoded pumps |
|
macrolides include
|
erythromycin
azithromycin clarithromycin |
|
macrolides moa
|
block translocation
bind to the 23S rRNA of the 50S subunit |
|
macrolides rx
|
*atypical pneumonias*
--mycoplasma --chlamydia --legionella URIs STDs G+ cocci --strep in pts with pcn allergy Neisseria |
|
macrolides s/e
|
prolonged QT interval
--esp erythromycin GI discomfort --most common cause of noncompliance acute cholestatic hepatitis eosinophilia skin rashes |
|
macrolides drug interactions
|
increases serum concentration of
--theophyllines --oral anticoagulants |
|
macrolides resistance
|
methylation of 23S rRNA binding site
|
|
_____ antibiotic blocks peptide bond formation at 50S
|
chloramphenicol
clindamycin |
|
chloramphenicol rx
|
meningitis
--haemophilus influenzae --neisseria meningitidis --strep pneumo |
|
chloramphenicol
s/e |
anemia (dose dependent)
aplastic anemia (dose independent) gray baby syndrome (in premature infants because they lack UDP-glucuronyl transferase) conservative use b/c of s/e but often still used in developing countries due to low cost |
|
chloramphenicol resistance
|
plasmid-encoded acetyltransferase inactivates the drug
|
|
clindamycin moa
|
blocks peptide bond formation at 50S
|
|
clindamycin rx
|
anaerobic infections
--bacteroides fragilis --clostridium perfringens in aspiration pneumonia or lung abscesses |
|
____ treats anaerobes above the diaphragm
____ treats anaerobes below the diaphragm |
clindamycin
metronidazole |
|
sulfonamides include
|
sulfamethoxazole
sulfisoxazole sulfadiazine |
|
sulfonamides moa
|
PABA antimetabolites inhibit dihyropteroate synthetase
|
|
sulfonamides rx
|
G+
G- Nocardia Chlamydia triple sulfas or sulfamethoxazole for simple UTI |
|
sulfonamides s/e
|
hypersensitivity
hemolysis if G6PD deficient nephrotoxicity (tubulointerstitial nephritis) kernicterus in infants |
|
sulfonamides drug interaction
|
displaces other drugs from albumin (e.g. warfarin)
|
|
sulfonamides resistance
|
altered enzyme bacterial dihydropteroate synthetase enzyme
v uptake ^ PABA synthesis |
|
folate synthesis inhibitors include...
they inhibit what enzymes specifically? |
sulfonamides
-- dihydropteroate synthetase trimethoprim pyrimethamine -- dihydrofolate reductase |
|
TMP-SMX rx
|
UTIs
Shigella Salmonella Pneumocystis jiroveci pneumonia |
|
trimethoprim s/e
|
megaloblastic anemia
leukopenia granulocytopenia may alleviate with supplemental folinic acid (leucovorin rescue) |
|
two fluoroquinolones that have unusual names
|
enoxacin
nalidixic acid (a quinolone) |
|
fluoroquinolones & a quinolone
(9) |
cipro
nor levo o gati moxi spar enoxacin nalidixic acid |
|
fluoroquinolones moa
|
- DNA gyrase (topoisomerase II)
|
|
fluoroquinolones drug interactions
|
must not be taken with antacids
|
|
fluoroquinolones clinical use
|
G- rods of urinary and GI tracts
(including Pseudomonas) Neisseria some G+ organisms |
|
fluoroquinolones s/e
|
GI upset
superinfections skin rashes headache dizziness contraindicated in pregnant women and children because of possible damage to cartilage tendonitis and tendon rupture in adults leg cramps and myalgias in kids |
|
fluoroquinolones resistance
|
chromosome-encoded mutation in DNA gyrase
|
|
metronidazole moa
|
forms free radical toxic metabolites
in the bacterial cell that damage DNA |
|
metronidazole rx
|
Giardia
Entamoeba Trichomonas Gardnerella vaginalis Anaerobes --bacteroides --c. difficile used in triple therapy against H pylori GET GAP on the metro |
|
metronidazole s/e
|
disulfiram-like reaction with alcohol
headache metallic taste |