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104 Cards in this Set
- Front
- Back
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What are examples of fluoroquinolones?
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Ciprofloxacin
Gatifloxacin |
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What is example of quinolone?
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Nalidixic acid.
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What is mechanism of ciprofloxacin and gatifloxacin?
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Inhibits DNA gyrase (topoisomerase II).
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What is toxicity of ciprofloxacin gatifloxacin?
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Damages cartilage!!!!!!
Cause tendonitis in aduls Cause leg cramps/myalgias in children!!! |
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What is MOA of metronidazole?
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Forms toxic metabolites in bacterial cell.
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What can metrondiazole treat?
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Giardia
Entamebola histolytica trichomonas Gardenella Bacteroides/Clostridium! Anaerobes BELOW diaphragm. |
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What is the triple therapy for H. pylori?
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Metronidazole
Bismuth Amoxicillin! |
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What is side effects of metronidazole?
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Metallic taste
Disulfuram like reaction with alcohol!!! |
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What is MOA of polymyxins?
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Binds to cell membranes of bacteria and disrupt osmotic properties.
Cationic proteins that can bind to negative protein on cell wall and destroy them. |
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What drug is used alone for TB prophylaxis?
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Only isoniazid!!!!!
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What drugs are used for TB treatment?
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STreptomycin
Pyrazinamide Isoniazid Rifampin Ethambutol. |
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What is 2nd line therapy for TB?
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Cycloserine.
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What is similar among all Anti-TB drugs?
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All hepatotoxic!!!!!
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What is MOA of isoniazid?
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Decreases mycolic acid synthesis!!!!!!!
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What is the agent used for solo prophylaxis of TB?
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Isoniazid!!
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What is side effect of isoniazid?
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Peripheral neuropathy (decreases Vit B6 concentrations)
Hemolysis if G6PD deficient Hepatotoxicity |
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What effect does isoniazid have on P450?
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INHIBITS IT!!!
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What is MOA of rifampin?
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Blocks RNA polymerase!!!!!
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What is a non-TB use of rifampin?
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1)Used for meningococcal prophylaxis in close contacts
2) Used for prophylaxis in contact with H. influenzae B. |
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What is drug toxicity?
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Induces Cytochrome p450!!!!
Induces Red/Orange body fluids! |
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Rifampin facts!
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1) RNA polymerase inhibitor
2) Activates microsomal P450! 3) Rapid resistance when used alone 4) Red/Orange body fluids!! |
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A child is in close contact with someone who has H influenzae type B, but is not vaccinated. What to treat with?
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Rifampin: used for chemoprophylaxis in contacts of children with H influenzae type B!!!!
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What is the mechanism of resitance to penicillins?
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Bugs have beta-lactamase which degrades the beta lactam ring of penicillin.
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What is mechanis of resitance of aminoglycosides?
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Bacteria modify via:
1) acetylation 2) adenlyation 3) phosphorylation |
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What is mechanism of resistance to vancomycin?
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Dala-Dala
Replaced by Dala-D lac so decreased affinity for vancomycin |
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What is resistance to chloramphenicol?
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Acetylation
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What is mode of resistance to macrolides (erythromycin, azithromycin, clarithromycin)?
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Methylation of rRNA near erythromycin ribosome binding site.
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What is mode of resistance to sulfonamides?
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Altered bacterial dihydropteroate synthetase or increase PABA synthesis.
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How do you treat meningococcal infection for prophylaxis???
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Rifampin
2nd choice: minocycline!! |
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Patient comes in with gonorrhea?
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Ceftriaxone.
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Patient has syphilis. Tx?
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Benzathine Penicillin G (IV)
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History of recurrent UTIs. What you treat with?
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TMP-SMX.
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Pneumocytis carinii pneumonia. What you treat with?
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TMP-SMX
2nd: aerosolized pentamidine. |
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What you treat a patient with having endocarditis and surgical/dental procedures?
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Penicillins (Ampicillin).
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What are side effects of ethambutol?
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Retrobulbar neuritis
Optic neuritis **Regular opthalmic exams are recommended in patients taking ethambutol. |
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What is MOA of ethambutol?
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inhibits arabinosyl transferases.
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What are some side effects of streptomycin?
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irreversible ototoxicity: its an aminoglycoside!!!!!!!!!!!!!
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What is MOA of amphotericin B?
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Binds ergosterol (unique to fungi) and forms holes in membrane!!!!!
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Amphotericin B facts:
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1) Puts holes in ergosterol membrane
2) Use for systemic mycoses. 3) Does NOT cross BBB!!!!!! 4) fevers/chills; arrythmias, nephrotoxicity. |
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What are the side effects of amphotericin B?
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1) Does NOT cross BBB
2) Fevers/Chills ("Shake and Bake") 3) Hypotension! 4) Arrythmias!! |
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What is MoA of nystatin?
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1) Same as amphotericin B!!
2) Binds ergosterol and disrupts cell membrane. |
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What is best way to treat oral candidiasis?
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Nystatin: "swish and swallow"!!!!
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what drug is used to treat diaper rash?
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Nystatin: binds ergosterol and disrupts cell membrane.
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What drug is used to treat vaginal candidiasis?
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Nystatin: binds ergosterol and disrupts cell membrane.
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What is MOA of the azoles? flucanazole, ketocanozole, miconazole, itracanazole?
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INHIBITS FUNGAL STEROID (ERGOSTEROL) SYNTHESIS!
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What is drug of choice to treat cryptococcal meningitis?
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FLUCANOZOLE!!!!
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What drug is used to treat all candidial infections?
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Fluconazole.
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What are the side effect of "azoles"?
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Inhibits P450!!!!
Gynecomastia (Inhibits steroid hormones)!! |
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What is side effect of ketoconazole?
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Inhibits steroid synthesis
Gynecomastia in men Menstrual irregularities in women. |
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What is Flucytosine used for?
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Systemic fungal infections.
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What is MOA of flucytosine?
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Inhibits DNA synthesis by conversion to 5-FU which competes with uracil!!!!!
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What are the side effects of flucytosine?
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Bone marrow suppression (neutropenia, thrombocytopenia).
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What is mechanism of action of caspofungin?
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Inhibits cell wall synthesis!!
Inhibits Beta-glucan formation. |
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What is MOA of terbinafine?
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Inhibits fungal enzyme squalene epoxidase!!!!
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What is the MOA of drug used to treat dermatophytes?
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Terbinafine: inhibits fungal enyzme squalene epoxidase.
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What is MOA of griseofulvin?
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Disrupts microtubule function do disrupts mitosis!!!
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What are side effects of griseofulvin?
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Teratogenic
Activates cytochrome p450!!! |
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What is MAO of amantadine, rimantadine?
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Blocks viral penetration!!!
Blocks uncoating of virus!!! Also causes release of dopamine from nerve terminal. |
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What is amantadine used to treat?
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Influenza A!!!
Also used to treat RubellA!! Also causes problems with Cerebella!!!! |
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What is side effect of amantadine?
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Ataxia, dizziness, slurred speech!!!!
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What What is zanamivir used for?
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Inhibits influenza neuraminidase.
Used to treat Influenza A and B. |
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Wat is MOA of ribavarin?
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Inhibits IMP dehydrogenase so inhibits synthesis of guanine nucleotides!
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What is ribavirin used to treat?
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Hepatitis C
RSV |
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This drug inhibits influenza neuraminidase.
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Zanamivir, Oseltamivir.
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What is MOA of acyclovir?
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Inhibits VIRAL Dna polymerase preferentially. So acyclovir is phosphorylated by viral thymidine kinase.
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What is acyclovir used to treat?
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Herpes
Varicella Ebstein Barr. Mucocutaneous and genital herpes |
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What is MOA of ganciglovir.
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Same as acyclovir. Needs thymidine kinase!!!!! But preferentially inhibits CMV DNA polymerase.
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What is drug of choice to treat CMV?
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gangcyclovir.
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What drug is used prophylactically in renal transplant patients to prevent CMV?
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Gancyclovir.
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What are side effects of ganciclovir?
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Luekopenia, neutropenia, thrombocytopenia.
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What is MOA of foscarnet?
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Viral DNA polymerase inhibitor but binds to pyrophosphate binding site!!!! Does not require thymidine kinase!!!
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What is special about foscarent?
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Does NOT require viral thymidine kinase!!!!!!!!
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A patient comes in with CMV retinitis that is refractory to ganciclovir. What do you treat patient with?
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Foscarnet.
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A patient comes in with acyclovir resistant HSV. What do you treat with?
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Foscarnet!
Remember when resistant to acyclovir and ganciclovir most likely means that mutated viral thymidine kinase, so use foscarnet b/c does NOT require thymidine kianse to work!!!!!!!!!!!!! |
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Thsi drug is an inorganic phosphate analog used to treat viruses?
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Foscarnet!!!!!!
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What interferon alpha used for?
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Hepatitis B or C
Kaposi's sarcoma!! |
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How you treat kaposi's sarcoma?
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IFN-alpha
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How you treat multiple sclerosis?
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IFN-beta.
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How you treat NADPH oxidase deficiency?
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IFN-gamma.
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What is MOA of interferons?
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1) Inhibit viral replication
2) Increase lymphocyte function 3) Increase macrophage action. |
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How you treat onchocerciasis?
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Ivermectin. Increases GABA so paralyzes worm.
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How you treat nematode/roundworms?
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mebendazole.
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How you treat ascaris?
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pyrantel pamoate
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How you treat enterobius?
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pyrantel pamoate
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How you treat necator?
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Pyrantel pamoate
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How you treat schistosomiasis?
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praziquantel.
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How you treat clonorchis?
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Praziquantel.
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How you treat cystercercosis?
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Praziquantel.
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How you treat diphloobothrium lateum?
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Niclosamide.
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How you treat cysticercosis?
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praziquantel. Just like schistosomiasis.
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How you treat leishmaniasis?
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pentavalent antimony.
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How you treat the latent hypnozoite in the liver?
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Primaquine!!
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How you treat chagas disease?
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nifurtimox
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How you treat T. cruzi?
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Nifurtimox.
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How you treat african sleeping sickness?
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Suramin.
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What is used as prophylaxis vs malaria?
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Proguanil and pyrimethamine because they are folate antagonists.
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What is side effect of sulfonamide use in pregnancy?
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kernicterus
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What is side effect of aminoglycoside in pregnancy?
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ototoxicity
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What is side effect of fluoroquinolones in pregnancy?
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Cartilage damage.
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what is side effect of erythryomycin on mother in pregnancy?
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cholestatic hepatitis!!!!!
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What is side effect of metronidazole in pregnancy?
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mutagenesis.
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What is side effect of tetracyclines in pregnancy?
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discolored teeth, and inhibition of bone growth.
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What is side effect of griseofulvin in pregnancy?
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teratogenic.
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What is side effect of ribavrian in pregnancy?
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teratogenic.
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