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226 Cards in this Set
- Front
- Back
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Most surgery prophylaxis DOC
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Cefazolin
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Moraxella catarrhalis
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TMP-SMZ, Cephalosporin
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N. gonorrhoeae
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Ceftriaxone
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N. menigitidis
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Penicillin G
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E. coli, Klebsiella, Proteus
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Cefazolin, TMP-SMZ
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Enterobacter, Citrobacter, Serratia
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TMP-SMZ, quinalone, carbapenem
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Shigella
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Quinalone
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Salmonella
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TMP-SMZ, quinalone, cephalosporin (3rd gen)
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Campylobacter
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Erythromycin or azithromycin
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Brucella
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Doxycycline + rifampin or aminoglycoside
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Helicobacter pylori
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Bismuth + metronidazole + tetracycline or amoxicillin
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Vibrio
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Tetracycline
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Pseudomonas
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Antipseudomonal penicillin + aminoglycoside
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Legionella
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Azithromycin or quinalone + rifampin
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Streptococcus (all)
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Penicillin
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Staph aureus
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Penicillin (penicillinase-resistant if needed)
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MRSA
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Vancomycin
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Enterococcus
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Penicillin + aminoglycoside
Vacnomycin + aminoglycoside Dalfopristin |
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Bacillus
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Vancomycin
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Listeria
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Ampicillin
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Nocardia
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Sulfadiazine, TMP-SMZ
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Gram positive anaerobes (clostridia, peptococcus, actinomyces, peptostreptococcus)
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Penicillin, clindamycin
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Gram neg. anaerobes (C. diff, bacteroides, fusobacterium, prevotella, porphyromonas)
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Metronidazole
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Mycoplasma pneumoniae
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Tetracycline, erythromycin
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Chlamydia (all)
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Tetracycline
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Borrelia
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Doxycycline
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Leptospira, Treponema
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Penicillin
alt. Tetracycline |
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Drugs used to treat TB
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Rifampin
Isoniazid Pyrazinamide Ethambutol |
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Best second line drugs for TB
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Caperomycin
Kanamycin Fluoroquinalones |
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Drugs used to treat leprosy
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Rifampin
Dapsone Clofazimine |
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Natural penicillin is DOC for...
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Neisseria meningitidis
All Streptococcus Staph Aureus (penicillinase neg) Enterococcus (+aminoglycoside) Clostridia Leptospira Treponema |
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Penicillinase resistant penicillins are DOC for...
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Staph aureus (penicillinase pos)
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Ampicillin is DOC for...
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Listeria
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Extended spectrum penicillins spectrum
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Less gram pos.
More gram neg - H. influenzae, E. coli, Listeria, Proteus, Salmonella, Shigella Anaerobic in combo w/penicillinase inhibitors |
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Cefazolin is DOC for...
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Surgical prophylaxis
Proteus E. coli Klebsiella |
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Ceftriaxone is DOC for...
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N. gonorrhea
Penicillin-resistant S. pneumoniae |
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Second generation cephalosporin spectrum
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H. Influenzae
Enterobacter Neisseria sp. Proteus E. coli Klebsiella Serratia Moraxella |
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Aztreonam clinical use
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Gram negatives only including Pseudomonas
Good for patients with penicillin allergy |
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Carbapenem spectrum
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Broad spectrum including anaerobes & pseudomonas
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Vancomycin is DOC for...
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MRSA
C. diff superinfections |
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Macrolide spectrum
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Atypical pneumonias: Mycoplasma, Chlamydia, Legionella, Moraxella
Alternative to penicillin for Listeria, S.aureus, Strep sp. |
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Clarithromycin & Azithromycin clinical use
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More effective than Erythromycin for pneumonia - MAC & H.influezna
Chlamydia & gonorrhea |
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Telithromycin clinical use
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S. pneumonia resistant to erithromycin and penicillin
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Chloramphenicol clinical use
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Very wide spectrum, side effects limit use
Alternative for meningitis and gram neg. |
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Tetracycline clinical use
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Intracellular and blood borne
DOC for Mycoplasma, Chlamydia, Ricketssia, Vibrio Cholerae (alt. for spirochetes) Plague, Tularemia, Brucellosis, acne |
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Tigecycline clinical use
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Decreased resistance compared to Tetracyclines
Other resistant organisms - MRSA, MRSE, PESP, VRE Complicated skin infections |
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Clindamycin clinical use
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Anaerobes
Toxoplasmic encephalitis in AIDS pts |
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Dalfopristin, Quinupristin clinical use
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VRSE, VRSA, complicated skin infections
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Aminogylcoside clinical use
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Gram neg. enterics (synergistic with penicillins)
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Streptomycin clinical use
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Tularemia, bubonic plague, tuberculosis
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Sulfonamide clinical use
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DOC for Nocardia
UTIs, Pneumocystis carinii, Toxoplasmosis, Trachomatis |
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Silver sulfadiazine use
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Topical agent for burn wounds
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TMP-SMX use
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Uncomplicated UTIS, Moraxella
Shigella, Salmonella, Pneumocystis jiroveci, Nocarida, Listeria |
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Nitrofurantoin clinical use
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Acute and chronic UTIs
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Methenamine mandelate clinical use
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Chronic UTI, catheter prophylaxis
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Nalidixic acid clinical use
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UTIs caused by Proteus, E.coli, Enterobacter, Klebsiella
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Fluoroquinalones clinical use
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Best for gram neg. UTIs, GI infections (some gram pos)
Not effective against S.pneumoniae or anaerobes |
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Levofloxacin clinical use
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Expanded gram pos. coverage
Community acquired pneumonia Skin infections |
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Gatifloxacin clinical use
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Topical for ocular infections
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Moxifloxacin & Gemifloxacin clinical use
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Penicillin resistant S. pneumoniae
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Mupirocin clinical use
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Impetigo
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Polymixin B&E, Colistimethate, Colistin clinical use
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Topical application for wounds, burns
Otitis externa |
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Ototoxicity
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Aminoglycosides
Vancomycin Erythromycin i hAVE ears |
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Visual toxicity
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Ethambutol
Isoniazid Oh my IEs! |
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Hematopoietic toxicity
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Chloramphenicol
Sulfonamides |
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Hemolytic anemia
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Chloramphenicol
Nitrofurantoin Isoniazid |
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Photosensitivity
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Tetracyclines
Fluoroquinalones You're really Fucking Tan |
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Seizures
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Imipenem
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Red man syndrome
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Vancomycin
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Vancomycin side effects
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Otoxicity, nephrotoxicity, Red man syndrome
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QT elongation (torsades de pointes)
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Erythromycin
Flouroquinalones |
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Macrolide side effects
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GI disturbances (less with clarithro)
Elevated LFTs, jaundice Ototoxicity QT prolongation, torsades de pointes |
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Gray baby syndrome
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Chloramphenicol
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Chloramphenicol side effects
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Fatal aplastic anemia
Hemolytic anemia Gray baby syndrome |
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Excellent tissue distribution
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Chloramphenicol
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Chelation
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Tetracycline (Ca, Fe, Al)
Fluorquinalones (Mg) |
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Deposition in bones/teeth
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Tetracycline
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Inhibition of ADH
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Demeclyocycline
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Psuedomembranous colitis
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Clindamycin
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High concentration in bones
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Clindamycin
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MAO inhibitor
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Linezolid
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Neuromuscular weakness
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Aminoglycosides
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Aminoglycoside side effects
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Nephrotoxic
Ototoxic Neuromuscular weakness |
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Kernicterus
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Sulfonamides
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Stevens-Johnson syndrome
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Sulfonamides
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Peripheral nerve damage
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Sulfonamides
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Tendon rupture
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Fluoroquinalones
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Fluoroquinolone side effects
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Increased QT
Tendon rupture C/I in pregnancy and children |
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Isoniazid side effects
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Liver damage
Peripheral neuritis Hemolysis |
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Pyrazinamide side effects
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Nephrotoxic, Hepatotoxic
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Ethionamide side effect
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Neurologic complications
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Cycloserine side effect
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Peripheral neuropathy, CNS dysfunction, psychosis
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Capreomycin side effect
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Kidney damage
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Dapsone side effects
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Blood dyscrasias
Nasal obstruction |
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Clofazimine side effects
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Hepatitis
Crystalline deposits found in many organs at autopsy |
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Thalidomide side effects
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Extremely teratogenic
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Nitrofurantoin side effects
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Brown urine
Intersitial pulmonary fibrosis |
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Renal toxicity
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Cephalosporins
Vancomycin Aminglycosides Sulfonamides Keds are made out of CanVAS |
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Hepatotoxicity
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Tetracyclines
Isoniazid Erythromycin Clindamycin Sulfonamides kaTIE likes Chardonnay and Syrah |
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Sulfonamide side effects
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Crystulluria/nephrotoxicity
Kernicterus Blood dyscrasia Hepatotoxicity Steven Johnson syndrome Peripheral nerve damage |
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Beta-lactam mechanism
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Cell wall synthesis inhibitor
Inhibit transpeptidase (PBPs) Prevent crosslinking of peptides |
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Beta-lactam resistance mechanisms
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Penicillinase production (plasmid)
Alteration of PBPs (MRSA, DNA) Change of porins Lack of cell wall, peptidoglycan, or activation of autolytic enzymes |
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Vancomycin mechanism
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Cell wall synthesis inhibitor
Binds D-Ala-D-Ala Prevents elongation |
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Vancomycin resistance mechanism
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Mutation to D-Ala-D-Lac
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Fosfomycin mechanism
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Cell wall synthesis inhibitor
Inhibits one of initial steps Accumulation of of precursors |
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Bacitracin mechanism
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Cell wall synthesis inhibitor
Inhibits activation of phospholipid carrier Accumulation of subunits |
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Cycloserine mechanism
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Cell wall synthesis inhibitor
Competitive antagonist of D-alanine Inhibits incorportation into cell wall |
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Macrolide mechanism (Erythromycin)
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Protein synthesis inhibitor
Binds 50S Interferes with translocation |
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Macrolide resistance mechanism (Erythromycin)
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Methyltransferases alter binding site
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Chloramphenicol mechanism
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Protein synthesis inhibitor
Binds 50S Inhibits transpeptidation/peptidyl tranferase |
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Choramphenicol resistance mechanism
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Acetyltransferase inactivation
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Tetracycline mechanism
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Protein synthesis inhibitor
Binds 30S Prevent binding of incoming tRNA |
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Tetracycline resistance mechanism
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Pumped out of cell (plasmid)
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Clindamycin mechanism
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Protein synthesis inhibitor
Binds 50S Blocks peptidyl transferase/translocation |
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Dalfopristin, Quinopristin mechanism
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Protein synthesis inhibitor
Bind 50S |
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Linezolid mechanism
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Protein synthesis inhibitor
Bind 50S Prevent formation of 70S initiation complex |
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Aminoglycoside mechanism
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Protein synthesis inhibitor
Binds 30S Prevent formation of initiation complex Misreading of mRNA (wrong AA, termination) *Requires oxygen |
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Aminoglycoside resistance mechanism
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Enzymes that acetylate, phosphorylate or adenylate (plasmid)
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Sulfonamide mechanism
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Inhibit folic acid synthesis
PABA antagonist, blocks dihydropeteroate synthase |
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Sulfonamide resistance mechanisms
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Decreased sensitivity of target enzymes
Increased formation of PABA Use of exogenous folate |
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Trimethorprim mechanism
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Blocks dihydrofolate reductase
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Metheamine mandelate mechanism
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Decomposes to formaldehyde
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Flouroquinalone mechanism
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Inhibit DNA gyrase (topoisomerase)
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Flouroquinalone resistance mechanism
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Mutation in DNA gyrase
Pumped out |
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Daptomycin mechanism
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Binds membrane and causes depolarization
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Mupirocin mechanism
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binds isoleucyl-tRNA synthetase
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Polymixin, Colistin mechanism
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Bind phospholipds in gram-neg cell wall and increase permeability
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Isoniazid mechanism
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Inhibits synthesis of mycolic acid
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Rifampin mechanism
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Inhibits DNA-dependent RNA polymerase activity
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Ethambutol mechanism
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Inhibits arabinosyl transferase involved in cell wall synthesis
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Pyrazinamide mechanism
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Inhibits trans-translation in non-replicating bacteria
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Dapsone mechanism
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PABA antagonist
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Clofazamine mechanism
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Binds bacterial DNA, inhibits reproduction and growth
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Thalidomide mechanism
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Decreases levels of TNF-a
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Bactericidal drugs
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All CWS inhibitors
Aminoglycosides (conc. dep) Fluoroquinolones (conc. dep) Daptomycin Rifampin Polymyxins |
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Bacteriostatic drugs
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All protein synthesis inhibitors (except Aminglycosides)
Sulfonamides (except in urine) Nitrofurantoin (except in urine) Isoniazid, Ethambutol, Trimethorprim (use in combo) |
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Naficillin
Oxacillin Cloxacillin Methicillin |
Penicillinase-resistant penicillins
(Beta-lactam) |
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Ampicillin
Amoxicillin |
Extended spectrum penicillins
(Beta-lactam) |
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Carbenicillin
Ticarcillin Mezlocillin Piperacillin |
Anti-pseudomonal penicillins
(Beta-lactam) |
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Cefazolin
Cephalexin monohydrate Cephradine |
First generation cephalosporins
(Beta-lactam) |
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Cefoxitin
Cefamandole Cefaclor Cerfuroxime Cefprozil Loracarbef |
Second generation cephalosporins
(Beta-lactam) |
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Cefotaxime sodium
Cefoperazone Ceftazidime Ceftriaxone Cefixime |
Third generation cephalosporins
(Beta-lactam) |
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Cefepime class
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Fourth generation cephalosporin
(Beta-lactam) |
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Aztreonam class
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Monobactam
(Beta-lactam) |
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Imipenem
Meropenem Ertapenem |
Carbapanems
(Beta-lactam) |
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Clavulanic acid
Sulbactam Tazobactam |
Beta-lactamase inhibitors
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Erythromycin
Clarithromycin Azithromycin Telithromycin |
Macrolides
|
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Gentamicin
Neomycin Amikacin Tobramycin Streptomycin |
Aminoglycosides
|
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DOC for herpes viruses (HSV, VZV, EBV)
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Acyclovir
Valacyclovir - oral Genital lesions, keratitis, encephalitis (IV) |
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Acyclovir toxicity
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Somnolence with zidovudine
Otherwise well tolerated, safe in pregnancy |
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Acyclovir mechanism
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Guanosine analog
Activated by viral thymidine kinase Inhibits DNA synthesis |
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OTC cold sore treatment
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Docosanol
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Docosanol mechanism
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Inhibits herpes virus fusion
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Ganciclovir mechanism
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Similar to acyclovir
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Ganciclovir use
|
Effective against CMV and Herpes
Prophylaxis in transplant patients Valganciclovir - oral prodrug |
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Ganciclovir toxicity
|
Neutropenia, thrombocytopenia
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DOC for resistant CMV & herpes
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Foscarnet
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Foscarnet mechanism
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Inhibits viral DNA polymerase
|
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Oseltamivir/Zanamivir use
|
Influenza A&B
Oseltamivir - oral Zanamivir - nasal |
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Oseltamivir mechanism
|
Neuraminidase inhibitors
Block release of progeny |
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Oseltamivir/Zanamivir side effects
|
Oseltamivir - nausea/vomiting
Zanamivir - bronchospasm, pulmonary function |
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Amantidine/rimantidine mechanism
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Blocks viral uncoating (M2 protein)
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Amantidine use
|
Influenza A only
Parkinson's |
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Amantidine side effects
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Hallucinations
Ataxia, dizziness |
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Ribivarin use
|
RSV, chronic hepatitis C
|
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Ribivarin toxicity
|
Anemia
Category X teratogen |
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Palvizumab
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RSV antibody
|
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DOC for chronic hepatitis B
|
Lamivudine
|
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Telaprevir/Boceprevir mechanism/use
|
Protease inhibitors for Hep C genotype 1
|
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Telaprevir/Boceprevir side effects
|
Anemia, neutropenia, rash
|
|
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Zifovudine
Lamivudine Didanosine Tenofovir Emticitabine |
Nucleoside reverse transcriptase inhibitors
|
|
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Common NRTI combination
|
Zifovudine & lamivudine
|
|
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NRTIs used in naive patients
|
Tenofovir & Emtricitabine
|
|
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NRTI use
|
Part of HAART therapy, always use 2
Decrease risk of transmission in pregnancy |
|
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NRTI side effects
|
Neutropenia, anemia
Lactic acidosis Hepatotoxicity |
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NRTI that causes peripheral neuropathy
|
Didanosine
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Efavirenz
Nevirapine |
Non-nucleotide reverse transcriptase inhbitors
Evafirenz cannot be used in pregnancy |
|
|
Which HIV drugs are metabolized by CYP3A?
|
NNRTIs, protease inhibitors
|
|
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Atazanavir
Lopinavir Saquinavir Ritonavir |
Protease inhibitors
Atazanavir is DOC |
|
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Protease inhibitor side effects
|
Lipodystrophy - buffalo hump, increase abdominal fat, thin face
Hyperglycemia, hyperlipidemia |
|
|
What can be used to increase bioavailability of protease inhibitors?
|
Ritonavir at subtherapeutic doses (inhibits CYP3A)
Grapefruit juice, fatty foods |
|
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Enfuvirtide mechanism/side effect
|
Fusion inhibitor - binds GP41
Swelling at injection site |
|
|
Amphotericin B mechanism
|
Interacts with ergosterol in cell membrane creating pores
|
|
|
Amphotericin B use
|
DOC for most systemic fungal infections
Exceptions: Aspergillus, combined w/flucytosine for Cryptococcus |
|
|
Amphotericin B toxicity
|
Fever/chills
Nephrotoxicity Hepatoxicity |
|
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Nystatin mechanism/use
|
Same as amphotericin
Thrush |
|
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Cryptococcus treatment
|
Flucytosine + amphotericin B
|
|
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Flucytosine mechanism
|
Converted to 5-flourouracil, inhibits DNA synthesis
|
|
|
Flucytosine toxicity
|
Bone marrow suppresion
|
|
|
Aspergillus DOC
|
Voriconazole
|
|
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Azole mechanism
|
Inhibit ergosterol synthesis
Inhibit fungal CYP3A enzyme |
|
|
Fluconazole use
|
Excellent CNS penetration - cryptococcal meningitits
|
|
|
Which azole does NOT inhibit CYP3A?
|
Fluconazole
|
|
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Azole side effects
|
Inhibit CYP3A - drug interaction, gynecomastia
|
|
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Capsofungin mechanism
|
Inhibit cell wall synthesis, bind B-glucan
|
|
|
Capsofungin use
|
Invasive aspergillosis
Esophageal candidiasis |
|
|
Griseofulvin mechanism
|
Binds microtubules, disrupts mitotic spindle
Accumulates in keratin-containing tissues |
|
|
Griseofulvin use
|
Oral treatment of onchyomycosis
|
|
|
Terbinafine mechanism
|
Interferes with ergosterol synthesis by inhibiting sqaulene oxidase
|
|
|
Terbinafine use
|
Onchyomycosis- oral or topical
|
|
|
Which malarial drug is the only tissue schizonticide?
|
Primaquine - the rest are all blood schizonticides
|
|
|
Which malaria strain has hypnozoites?
|
Vivax, ovale - can only cure with primaquine/tissue schizonticide
|
|
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Which malaria strain is most severe?
|
Falciprum - cure with blood schizonticide
|
|
|
DOC for sensitive malarial strains
|
Chloroquine
|
|
|
DOC for chloroquine-resistant P. vivax
|
Quinidine
|
|
|
DOC for chloroquine resistant P. falciprum
|
Malarone
|
|
|
When is doxycycline/tetracycline used?
|
In combination with Quinidine for severe malaria
Prophylaxis of MDR malaria |
|
|
DOC for malaria prophylaxis
|
Chloroquine
|
|
|
DOC for chloroquine-resistant malaria prophylaxis
|
Mefloquine
Alternatives - Doxycycline, Malarone |
|
|
Chloroquine & quinidine toxicity
|
These only occur at high doses or cholorquine
Tinnitus, dizziness, headache, visual disturbances Arrythmias |
|
|
Mefloquine toxicity
|
Sleep disturbances, psychosis
|
|
|
Primethamine/sulfadioxine use in malaria
|
Presumptive treatment
|
|
|
Primiquine toxicity
|
Hemolysis in G6PD deficiency
Teratogenic |
|
|
Metronidazole is DOC for...
|
E. histolytica
Giardia Trichomonas |
|
|
Effective luminal agents for E. histolytica
|
Iodoquinol
Paramomycin |
|
|
DOC for pneumocystosis
|
TMP-SMX
|
|
|
DOC for toxoplasmosis
|
Pyrimethamine + sulfadiazine
|
|
|
Mebenazole is DOC for...
|
Roundworms
Pinworm Whipworms Hookworms Trichonosis |
|
|
DOC for tapeworms
|
Niclosamide
|
|
|
DOC for schistosomiasis and all flukes
|
Praziquantel
|
|
|
Mebendazole mechanism
|
Binds tubulin, interferes with protein function
|
|
|
Pyrantel pamoate mechanism
|
Cholinesterase inhibitor
|
|
|
Praziquantel mechnanism
|
Increases Ca permeability, paralysis of the worm
|
|
|
Nephrotoxic
|
Gancyclovir
Amphotericin |
|
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Teratogenic
|
Ribivarin
Efavirenz Mebendazole Primiquine |
|
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Hepatotoxic
|
Terbinafine
Amphotericin B NRTIs |
