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97 Cards in this Set
- Front
- Back
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block cell wall synthesis by inhibition of peptidoglycan cross-linking
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penicillin, ampicillin, ticarcillin, piperacillin, imipenem, aztreonam, cephalosporins
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block peptidoglycan synthesis
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bacitracin, vancomycin, cycloserine
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disrupt bacterial/fungal cell membranes
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polymyxins
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disrupt fungal cell membranes
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amphotericin B, nystatin, fluconazole/azoles
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block nucleotide synthesis
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sulfonamides, trimethoprim
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block DNA topoisomerases
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quinolones
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block mRNA synthesis
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rifampin
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block protein synthesis at 50S ribosomal subunit
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chloramphenicol, erythromycin/macrolides, lincomycin, clindamycin, streptogramins (quinupristin, dalfopristin), linezolid
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block protein synthesis at 30S ribosomal subunit
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aminoglycosides, tetracyclines
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bacteriacidal antibiotics (6)
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penicilin, cephalosporins, vancomycin, aminoglycosides, fluoroquinolones, metronidazole
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penicillin mechanism
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bind PBPs, block transpeptidase cross-linking of cell wall; activate autolytic enzymes
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penicillin toxicity
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hypersensitivity reactions, hemolytic anemia
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mechanism of methicillin, nafcillin, dicloxacillin
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bind PBPs, block transpeptidase cross-linking of cell wall - penicillinase resistant because of bulkier R group
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methicillin toxicity
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interstitial nephritis
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ampicillin, amoxicillin toxicity
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hypersensitvity, ampicillin rash (esp. in pts. w/ mono), pseudomembranous colitis
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ticarcillin, carbenicillin, piperacillin usage
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pseudomonas (Takes Care of Pseudomonas)
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mechanism of cephalosporins
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beta-lactam drugs that inhibit cell wall synthesis - less susceptible to penicillinases
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antibiotic for penicillin-allergic patients and patients w/ renal toxicity who can't tolerate aminoglycosides
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aztreonam (synergistic w/ aminoglycosides)
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drug of choice for enterobacter
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imipenem/cilastin
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antibiotic that can cause seizures at high plasma levels
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imipenem/cilastin
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mechanism of vancomycin
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inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall precursors
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mechanism of resistance to vancomycin
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amino acid change of D-ala D-ala to D-ala D-lac
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vancomycin toxicity
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well tolerated in general - does NOT have many problems: nephrotoxicity, ototoxicity, thrombophlebitis
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aminoglycosides
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streptomycin, gentamicin, tobramycin, amikacin - bacteriacidal
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mechanism of action of aminoglycosides
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inhibit 30S subunit - inhibit formation of initiation complex and cause misreading of mRNA
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are aminoglycosides effective agains anaerobes?
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no! require O2 or uptake
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aminoglycosides cause nephrotoxicity especially when used in combination with _________
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cephalosporins
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aminoglycosides cause ototoxicity especially when used with_________
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loop diuretics
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are aminoglycosides safe to use in pregnancy?
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no! teratogenic
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which tetracycline can be used in patients with renal failure?
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doxycycline because it is fecally eliminated
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can you take tetracyclines with milk?
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no! nor atacids or iron-containing preparations because divalent cations inhibit its absorption in the gut
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tetracycline toxicity
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discoloration of teeth and inhibition of bone growth in children, photosensitivity
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mechanism of action of macrolides
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inhibit protein synthesis by blocking translocation - bind to 23S rRNA of the 50S subunit
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name 3 macrolides
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erythromycin, azithromycin, clarithromycin
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when can sulfonamides cause hemolysis?
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G6PD deficiency
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most common cause of noncompliance with macrolides
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GI discomfort
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macrolides increase the serum concentration of what drugs?
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theophyllines, oral anticoagulants
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acute cholestatic hepatitis & eosinophilia are toxicities of which class of antibiotics?
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macrolides
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clinical use of chloramphenicol
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meningitis - H. flu, neisseria, strep pneumo
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why does chloramphenicol cause gray baby syndrome?
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because infants lack liver UDP-glucoronyl transferase
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is the aplastic anemia seen with chloramphenicol dose dependent?
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no! the anemia is, however
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mechanism of action of chloramphenicol
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inhibits 50S peptidyltransferase
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what is the clinical use of clindamycin?
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treatment of anaerobic infections - B. frag, C. perfringfens
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clindamycin toxicity
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pseudomembranous colitis - destroys normal GI flora
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mechanism of action of sulfonamides (sulfamethoxazole, sulfisoxazole, triple sulfas, etc.)
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PABA antimetabolites inhibit dihydropteroate synthase
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what side effect can sulfonamides cause in infants?
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kernicterus
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mechanism of action of trimethoprim
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inhibits bacterial dihydrofolate reductase
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trimethoprim toxicity
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megaloblastic anemia, leukopenia, granulocytopenia (may alleviate with supplemental folinic acid)
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mechanism of action of fluoroquinolones
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inhibit DNA gyrase (topoisomerase II)
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what class of antibiotics can cause cartilage damage in kids?
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fluoroquinolones
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what drug is associated with a disulfiram-like reaction with alcohol and a metallic taste
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metronidazole
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what can prevent the neurotoxicity associated with INH?
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pyridoxine (vitamin B6)
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INH toxicity
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hemolysis if G6PD deficient, neurotoxicity, hepatotoxicity, SLE-like syndrome
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mechanism of action of rifampin
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inhibits DNA-dependent RNA polymerase
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what drug delays resistance to dapsone when used for leprosy?
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rifampin
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resistance mechanism for penicillins/cephalosporins
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beta-lactamase cleavage of beta lactam ring
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resistance mechanism for aminoglycosides
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modification via acetylation, adenylation, or phosphorylation
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resistance mechanism for chloramphenicol
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modification via acetylation
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resistance mechanism for macrolides
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methylation of rRNA near erythromycin's ribosome binding site
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resistance mechanism for tetracycline
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decreased uptake or increased transport out of cell
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resistance mechanism for sulfonamides
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altered enzyme (bacterial dihydropteroate synthetase), decreased uptake, or increased PABA synthesis
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mechanism of action of amphotericin B
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binds ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes and disrupt homeostasis
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drug of choice for systemic mycoses
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amphotericin B
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amphotericin B toxicity
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fever/chills, hypotension, nephrotoxicity, arrhythmias, hypochromic normocytic anemia
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do ketoconazole and ampho B act synergistically?
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no - they antagonize each other's actions, so should never be used together
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which has greater oral availability - amoxicillin or ampicillin?
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amOxicillin
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spectrum of ampicillin, amoxicillin
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HELPS kill enterococci:
h. flu, e. coli, listeria, proteus, salmonella, enterococci |
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cefazolin and cephalexin are what generation cephalosporins?
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first
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coverage of cefazolin and cephalexin?
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PEcK:
proteus, e. coli, klebsiella (and gram-positives) |
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cefoxitin, cefaclor, cefuroxamine are what generation?
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second
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coverage of cefoxitin, cefaclor, cefuroxamine?
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HEN PEcKS:
h. flu, enterobacter, neisseria, proteus, e. coli, klebsiella |
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ceftriaxone, cefotaxime, and ceftazidime are what generation?
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third
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use of ceftriaxone, cefotaxime, and ceftazidime?
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serious gram-negative infections resistant to other beta lactams; meningitis; ex. ceftazidime for pseudomonas, ceftriaxone for gonorrhea
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cefepime, cefpiramide belong to what generation?
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fourth
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use of cefepime, cefpiramide?
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increased activity against pseudomonas and gram-positive organisms
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serum-like sickness in infants and kids can be seen with what cephalosporin?
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ceflacor (2nd generation)
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this is an inhibitor of renal dihydropeptidase I
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cilastin - decreases inactivation of imipenem in renal tubules
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why are aminoglycosides ineffective against anaerobes?
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require O2 for uptake
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drug used for bowel surgery?
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neomycin
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this tetracycline is an ADH antagonist - acts as a diuretic in SIADH
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demeclocylcine
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clinical use of tetracyclines?
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VACUUM THe BedRoom: vibrio cholerae, acne, chlamydia, ureaplasma urealyticum, mycoplasma, tularemia, h. pylori, borrelia burgdorferi, rickettsia
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this drug treats anaerobes above the diaphragm
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clindamycin
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these drugs can cause leg cramps and myalgias in kids
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fluoroquinolones
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used for anaerobes below the diaphragm
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metronidazole
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how does nystatin work?
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binds to ergosterol, disrupting fungal membranes (too toxic for systemic use)
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mechanism of the -azoles?
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inhibit fungal steriod (ergosterol) synthesis
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toxicities of -azoles?
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hormone synthesis inhibition (gynecomastia), liver dysfunction (inhibition of P450), fever, chills
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this antifungal inhibits DNA synthesis by conversion to fluorouracil, which competes with uracil
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flucytosine
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toxicity of flucytosine
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nausea, vomiting, diarrhea, bone marrow suppression
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mechanism of caspofungin?
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inhibits cell wall syntehsis
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use of caspofungin?
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invasive aspergillosis
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toxicity of caspofungin?
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GI upset, flushing
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this antifungal inhibits the fungal enzyme squalene epoxidase
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terbinafine
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use of terbinafene?
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used to treat dermatophytoses (especially onychomycosis)
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mechanism of griseofulvin?
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interferes with microtubule function; disrupts mitosis; depostis in keratin-containing tissues (e.g. nails)
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clinical use of griseofulvin?
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oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm)
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toxicity of griseofulvin?
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teratogenic, carcinogenic, confusion, headaches, increases warfarin metabolism
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