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280 Cards in this Set
- Front
- Back
- 3rd side (hint)
cell wall/cell membrane
|
G+. lipoteichoic acid induces TNF and IL1
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|
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outer membrane
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G-. lipid A induces TNF and IL-1
|
|
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periplasm
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beta lactamases
|
|
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These Rascals may microscopically lack color
|
don't gram stain well.
Treponema, rickettsia, mycobacteria, mycoplasma, legionella, chlamydia |
|
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giemsa stains
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borrelia, trypanosomes, chlamydia
|
|
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PAS stains
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glyogen, mucopolysaccharides, Whipples dz
|
|
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Ziehl-Neelsen for
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acid-fast
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|
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silver stain for
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fungi, legionella
|
|
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tellurite, lofflers for
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diphtheriae
|
|
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eatons for
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m. pneumoniae
|
|
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e coli turns what color on EMB
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metallic blue-black
|
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Nagging Pests Must Breathe
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aerobes are nocardia, pseudomonas, m tb, bacillus
|
|
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anaerobes Can't Breathe Air
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lack catalase and/or superoxide dismutase. produce gas. clostridium, bacteroides, actinomyces
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aminO2glycosides are ineffective
|
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Some Nasty Bugs May Live FacultativeLY (intracellular)
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salmonella, neisseria, brucella, mycobacterium, listeria, francisella, legionella, yersinia
|
|
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encapsulated. ShiN SKiS
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strep pneumo, h. influ, n. mening, salmonella, klebsiella pneumo, group B strep. asplenic get lots of these.
|
|
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PUNCH K
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urease positive. proteus, ureaplasma, nocardia, cryptococcus, h pylori, klebs
|
|
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protein A
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staph aureus. binds Fc, prevents opsonization/phago
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IgA protease
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SHiN (s. pneumo, Hib, Neiss)
|
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M protein
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group A strep, prevents phago
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eNdotoxin
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Gram NEG
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liPOteic acid
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gram POS
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exotoxin
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highly toxic, toxoid vaccines
|
|
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endotoxin
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stable at 100 deg C, ie. meningococcemia, sepsis
|
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c. diphtheriae exotoxin
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inactivates EF-2 (tranlation) via ADP ribosylation
|
|
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pseudomonas exotoxin
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inactivates EF-2 (tranlation) (exotoxin A) via ADP ribosylation
|
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shigella exotoxin
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inactivate 60S ribosome
|
|
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EHEC exotoxin
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inactivate 60S ribosome
(does not invade host) |
|
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ETEC exotoxin
|
heat LABILE toxin overactivates adenylate cyclase, incr cAMP, incr Cl secretion
heat STABLE toxin overactivates guanylate cyclase, incr cGMP, decr resorp of NaCL and H20 in gut Labile in the Air, Stable on the Ground |
|
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Yersinia enterocolitica exotoxin
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heat STABLE toxin overactivates guanylate cyclase, incr cGMP, decr resorp of NaCL and H20 in gut. invades.
|
|
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bacillus anthracis exotoxin
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mimics adenylate cyclase, incr cAMP, incr secretion. edema factor. cutaneous anthrax.
|
|
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v. cholerae exotoxin
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overactivates adenylate cyclase, incr cAMP, permanently activating Gs, incr Cl secretion in gut. ADP ribosylation
|
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bordatella pertussis exotoxin
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overactivates adenylate cyclase, incr cAMP, disables Gi, impairing phago. ADP ribosylation
|
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c. tetani exotoxin
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cleaves SNARE protein req to release inhibitory GABA and glycine
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c. botulinum exotoxin
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cleaves SNARE protein req to release stimulatory ACh.
|
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c, perfringens exotoxin
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phospholipase degrades cell mems (alpha toxin). myonecrosis, gas gangrene
|
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s. pyogenes exotoxin (not superantigen)
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streptolysin O degrades cell mem, lyses RBCs
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s. pyogenes exotoxin (not streptolysin O)
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exotoxin A. brings MHCII and TCR together.
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s. aureus
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TSST1. brings MHCII and TCR together. also scalded skin syndrome and food poisoning.
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ADP ribosylating A-B toxin
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B is binding component, enables endocytosis. A is active component that attaches ADP-ribosyl to host protein
|
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effect of endotoxin
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sctivates hageman factor, leads to DIC
|
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OVRPS (overpass)
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optochin viridans resistant, pneumoniae sensitive
|
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color of alpha hemolysis
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green ring
|
|
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non-strep beta hemolytics
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s. aureus, listeria
|
|
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s. aureus causes...
|
clusters. bacterial endocarditis, osteomyelitis
|
|
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s. pneumo causes...
|
MOPS. Most Optochin Sensitive, Meningitis, Otitis media, Pneumonia, Sinusitis. rusty sputum. sepsis in sickle and splenectomy. lancet shaped, encapsulated, IgA protease
|
|
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viridans are not afraid of the chin!
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optochin resistant
|
|
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s. pyogenes causes
|
(group A) ASO
pyogenic - pharyngitis, cellulitis, impetigo toxigenic - scarlet fever, toxic shock-like immunologic - rheumatic fever (M protein), acute GN |
no rheum for SPECCulation: SubQ plaques, polyarthritis, erythema marginatum, chorea, carditis
|
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s. agalactiae
|
group B. B for Babies!
|
|
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enterococci
|
PCN G resistant. Cause UTI and subacute endocarditis. VREs.
|
|
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strep bovis
|
colonizes gut, causes bacteremia and subacute endocarditis in CRC pts
|
|
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diphtheriae lab dx
|
metachromatic (blue and red) granules and Elek test for toxin. club shaped, tellurite agar
|
|
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spores
|
bacillus, coxiella
|
|
|
clostridia perf and diff
|
obligate anaerobe bacilli. PERFinges PERForates wound.
difficile: toxin A, enterotoxin, brinds brush border of gut. Toxin B, cytotoxin, destroys cytoskeleton of enterocytes, causing pseudomem colitis (tx with flagyl or vanc) |
|
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pulmonary anthrax
|
woolsorters dz. pulm hemorrhage, mediastinitis, shock
|
|
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listeria tx for infants
|
ampicillin
|
|
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actinomyces
|
oral/facial abscess. normal oral flora
SNAP: sulfa for nocardia, actinomyces use PCN |
|
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norcardia
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acid-fast aerobe in soil, pulm ifxn in immunocompromised
SNAP: sulfa for nocardia, actinomyces use PCN |
|
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severe bacteremia with TB
|
miliary TB
|
|
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m. kansasii
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pulm TB like sx
|
|
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MAC prophylaxis
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azithro
|
|
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leprosy (hasen's dz)
|
cool temps. tx: oral dapsone. tox is hemolysis and methemogloblinemia.
lepromatous: low cell-med immunity, humoral Th2. lethal. tuberculoid: high cell-med immunity, Th1 response. |
|
|
PCN and G negs
|
resistant to PCNG but maybe susceptible to ampicillin
|
|
|
gonococci
|
Fitz-Hugh-Curtis syn.
|
|
|
meningococci prophylaxis
|
give rifampin to close contacts
|
|
|
h. influenza causes...
|
Epiglottitis, Meningitis, Otitis media, Pneumonia. Grow with factor V & X. tx meningitis wit ceftriaxone, rifampin for close contacts
|
|
|
legionella
|
pontiac fever. detect antigen in urine. tx: erythromycin
iron dagger - he is no cyssy - need Fe and CYS for culture |
|
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pseudomonas
|
diabetic osteomyelitis. endotoxin (fever, shock), exotoxin A (inactivates EF2) tx: aminogly + piperacillin
|
|
|
e coli K capsule
|
virulence factor for pneumonia, neonatal meningitis
|
|
|
EIEC has which toxin?
|
no toxins
|
|
|
ETEC causes
|
travelers diarrhea
|
|
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EPEC produces dz in
|
Pediatrics
|
|
|
EHEC
|
shiga-like toxin, HUS (anemia, thrombocytopenia, acute renal fail), mechanical hemolysis and reduced RBF. dysentery, does not ferment sorbitol (unlike other e coli)
|
|
|
klebsiella
|
intestinal flora. red currant jelly sputum. nosocomial UTIs. alcoholics, diabetics
|
|
|
salmonella and shigella
|
salmon swim. salmonella hematogenous, H2S, abx prolong. typhi has rose spots on abdomen, carry in GB. shigella propel via actin polym, use abx!
|
|
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yersinia entercolitica
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diarrhea from day cares, mesenteric adenitis that mimics chrohns or appendicitis
|
|
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h pylori
|
creates alkaline environ. tx with: 1 PPI, 2 clarithro, 3 amox or flagyl
|
|
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spirochetes
|
BLT. B is Big. Borrelia, Leptospira, Treponema.
|
|
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leptospira
|
question mark shape. flulike, jaundice, photophobia, conjunctivitis. Weil's dz: icterhemorrhagic leptospirosis. severe jaundice and azotemia, fever, hemorrhage, anemia
|
|
|
lyme
|
borrelia burgdorferi. erythema chronicum migrans. mice and deer. stage 3: arthritis. tx: doxy, ceftriaxone
|
|
|
syphilis
|
3: aortitis (vasa vasorum destruction). broad based ataxia, positive rhomberg, charcot joint, stroke w/o HTN.
|
congenital: saber shins, saddle nose, deafness, hutchinson's teeth, mulberry molars
|
|
borrelia recurrentis trasmitter
|
louse
|
|
|
chlamydophila psittaci
|
psittacosis. transmitted by parrots and birds
|
|
|
pasteurella multocida causes
|
cellulitis, osteomyelitis
|
|
|
rickettsia prowazekii
|
causes epidemic typhus, vector is louse
|
|
|
get brucellosis from
|
unpasteurized dairy
|
|
|
Q fever transmitter
|
spores from tick feces and cattle placenta
|
|
|
ehrlichiosis vector
|
lone star tick
|
|
|
tularemia vectors
|
ticks, rabbits, deer fly
|
|
|
clue cells are
|
vaginal epithelial cells covered with bacteria
|
|
|
RMSF
|
rash starts on hands/feet. HA, fever, rash.
Rickettsia on Wrists, Typhus on Trunk |
|
|
R prowazeikii rash
|
Rash starts centrally and spreads out, sparing palms and soles
epidemic typhus Rickettsia on Wrists, Typhus on Trunk tx: doxy |
|
|
ehrlichia lab findings
|
granulocytes with berry cluster organisms
tx: doxy |
|
|
Q fever
|
pneumonia. tx: doxy
Q fever is Queer because it has no rash, has no vector, and has negative Weil-Felix |
|
|
Weil-Felix
|
Abs against Rickettsia agglutinate with Proteus antigens
|
|
|
chlamydiae
|
elementary is enfectious and enters
reticulate body replicates causes reactive arthritis, conjunctivitis. lacks muramic acid. dx with cytoplasmic inclusions on giemsa. tx: doxy or azithro |
c. pneumoniae and c. psittaci cause atypical pneumonia, transmitted aerosol
c. trachomatis A,B,C: Africa Blindness, Chronic ifxn |
|
mycoplasma
|
cold agglutinins (IgM) can lyse RBCs. Eatons agar.
tx: tetra or eryth |
|
|
dimorphic fungi
|
cause pneumonia, cold mold, heat yeast (except coccidioido, which is spherule in heat.
tx: fluconzaole or ketoconazole for local, amphotericin for systemic |
|
|
histoplasmosis
|
Miss. and Ohio river valleys. histo hides (in macros)
|
|
|
blastomycosis
|
east. skin and bone too. granulomatous nodules. blasto buds broadly
|
|
|
coccidioidomycosis
|
meningitis too. spherule filled with endospores, much larger than RBC
|
|
|
paracoccidioidomycosis
|
latin america. captains wheel
|
|
|
tinea versicolor
|
tx topical miconazole, selsun. spaghetti and meatballs on KOH. acid damages melanocytes
|
|
|
other tinea
|
rings. microsporum, trichophyton, epidermophyton. mold hyphae in KOH. not dimorphic
|
|
|
candida causes
|
endocarditis in IV drug users
|
|
|
aspergillus causes
|
in immunocomp and chronic granulomatous dz: 1. allergic bronchopulm aspergillosis with asthma or CF 2. aspergillomas in lung cavities after TB 3. can make aflatoxins (HCC)
|
|
|
cryptococcus neoformans
|
menigitis, cryptococcosis. heavily encapsulated yeast. soil, pigeon droppings, inhale. stains india ink. soap bubble lesions in brain.
|
|
|
pneumocystis jiroveci
|
yeast. tx: bactrim, pentamidine, dapsone. proph @ 200.
|
|
|
sporothrix
|
sporotrichosis. dimorphic cigar shaped budding yeast. rose gardeners dz. local pustule and ascending lymphangitis
|
tx: itraconazole or POTassium iodide
|
|
entamoeba histolytica dx and tx
|
dx serology, stool
|
tx flagyl and iodoquinol
|
|
cryptosporidium dx, tx
|
cysts on acid-fast stain
|
no treatment
|
|
congenital toxo
|
chorioretinitis, hydrocephalus, intracranial calcifications
|
gen tx: sulfadiazine and pyrimethamine
|
|
naegleria fowleri
|
rapidly fatal meningoencephalitis. Nalgene from freshwater lake. amoebas in spinal fluid.
|
|
|
trypanosoma (not cruzi)
|
african sleeping sickness. big LNs, recurring fever, somnolence, coma
|
tsetse fly (painful bite) dx: blood smear. tx: SURamin for blood dz or MELArsoprol for CNS. sure is nice to go to sleep, melatonin helps
|
|
P vivax and ovale cycle, p malariae cycle
|
48 hrs VO, 72 hrs M
|
|
|
choloroquine blocks...
|
heme polymerase
|
|
|
babesia tx
|
quinine, clindamycin
|
|
|
trypanosoma cruzi
|
chagas. dilated CM, megacolon and megaesoph. S. Am.
|
reduviid bug (kissing), painless bite. dx: blood smear, tx: nufurtimox
|
|
leishmania
|
spiking fevers, HSMeg, pancytopenia
|
dx: macros with amastigotes
tx: sodium stibogluconate |
|
ascaris tx
|
nematode. tx: bendazoles or pyrantel pamoate
|
|
|
trichinella tx
|
nematode.tx: bendazoles
|
|
|
strongyloides tx
|
nematode. tx: bendazoles or ivermectin.
intestinal. |
|
|
ancylostoma duodenale, necator americanus (hookworms)
|
nematodes. penetrate feet. intestinal. tx: bendazole, pyrantel pamoate
|
|
|
dracunculus medinensis
|
in drinking water, skin inflamm/ulcer
|
tx: niridazole, prolonged extraction
|
|
onchocerca volvulus
|
blackflies. causes hyperpig skin and river blindness. BLACKflies, BLACK skin, BLACK sight.
|
tx: ivermectin (for rIVER blindness)
|
|
loa loa
|
deer fly
|
tx: diethylcarbamazine
|
|
wuchereria bancrofti
|
mosquito
|
tx: diethylcarbamazine
|
|
toxocara canis
|
granulomas
|
tx: diethylcarbamazine
|
|
taenia solium
|
tapeworm. ingestion of larvae in pork leads to tapeworms. egg ingestion casuse cysticercosis
|
tx: praziquantel (bendazole if neurocysticercosis)
|
|
diphyllobothrium latum
|
tapeworm. raw freshwater fish. B12 def.
|
tx: praziquantel
|
|
echinococcus
|
tapeworm. eggs in dog feces. surgeons inject ethanol before removal to kill cysts
|
bendazoles
|
|
schistosomes
|
trematodes (flukes). snails host. penetrate skin. spleen and liver.
|
S. haematobium leads to bladder cancer
praziquantel |
|
clonorchis sinensis
|
trematodes (flukes) undercooked fish, inflamm of biliary tract, pigmented gallstones. cholangiocarcinoma.
|
praziquantel
|
|
paragonimus westermani
|
trematodes (flukes), undercooked crab, causes inflamm and secondary bacterial ifxn in lung, hemoptysis
|
praziquantel
|
|
You'll get sick if you EAT these!
|
enterobius, ascaris, trichinella are ingested
|
|
|
these get into your feet from the SANd!
|
cutaneous - strongyloides, ancylostoma, necator
|
|
|
vaccines
|
killed only humoral
no booster if live |
|
|
Live! See small yellow chickens get vaccinated with Sabin's MMR!
|
Live: smallpox, yellow fever, chickenpox, sabin, MMR
|
|
|
recombinant vaccines
|
HBV, HPV
|
|
|
DNA viruses dsDNA except
|
parvoviruses
|
|
|
DNA viruses are linear except
|
papilloma, polyoma, hepadna (circular)
|
|
|
all RNA viruses ssRNA except
|
Reoviridae
|
|
|
postive strand RNA viruses:
|
I went to a RETRO TOGA party where I drank FLAVored CORONA and ate HIPPY (hepe) CALIfornia PICO de gallo (pircorna)
|
|
|
purified nucleic acids of most dsDNA and positive strand RNA viruses are infectious except
|
pox and HBV
|
|
|
DNA viruses replicate in nucleus except
|
pox
|
|
|
RNA viruses replicate in cytoplasm except
|
influenza, retro
|
|
|
Naked CPR and PAPP smears
|
naked viruses:
Calci, picorna, reo (RNA) parvo, adeno, papilloma, polyoma (DNA) |
|
|
all DNA viruses are icosahedral except
|
pox
|
|
|
hepadnavirus is
|
HBV
|
|
|
parvovirus cases
|
aplastic crises in sickle cell, hydrops fetalis, RBC aplasia & rheum arthritis-like in adults
|
|
|
polyomas
|
JC: junky cerebrum. PML
BK: bad kidney. transplant patients |
|
|
pox viruses
|
smallpox, vaccinia, molluscum
|
|
|
HSV labs
|
tzanck smear. intranuclear cowdry A inclusions
|
|
|
EBV
|
atyp Ls are cytotox Ts. monospot is heterophile Abs detected by agglutination of sheep or horse RBCs. assoc with hodgkins
|
|
|
reoviruses
|
coltivirus (CO tick fever), rotavirus
|
|
|
picornaviruses
|
poliovirus, echovirus (aseptic meningitis), rhinovirus, coxsackievirus, HAV
|
|
|
calicivirus
|
norwalk
|
|
|
flavivirus
|
HCV, yellow fever, dengue, st louis encephalitis, west nile virus
|
|
|
togavirus
|
rubella
eastern equine western equine |
|
|
orthomyxo
|
influenza
|
|
|
paramyxo
|
Parainfluenza
RSV MMR |
|
|
arenaviruses
|
LCMV, lassa fever (from mice)
circular |
|
|
bunyaviruses
|
circular. hantavirus
|
|
|
deltavirus
|
circular
|
|
|
always bring polymerase or fail replication
|
negative stranded viruses.
arena bunya paramyxo orthomyxo filo rhabdo |
|
|
BOAR
|
segmented viruses.
bunya ortho arena reo |
|
|
PERCH on a Peak
|
Picornas. can cause meningitis (except rhino and HAV), all are enteroviruses except rhino
|
|
|
yellow fever
|
high fever, black vomitus, jaundice
|
|
|
rotavirus
|
segmented dsRNA. villous destruction with atrophy
|
|
|
influenza
|
killed vacc. hemagglutinin promotes viral entry, neuraminidase promotes progeny release. bacterial superinfection.
|
|
|
rubella
|
togavirus. 3 day fever, postauric adenopathy, LApathy, arthralgia, fine truncal rash that starts at head and moves down
|
|
|
paramyxovirus virulence
|
dz in kids. croup. surface F (fusion) protein causes resp epithelial cells to fuse and form multinuc cells. palivixumab is a mab agst F that prevents pneumo in premies
|
|
|
measles
|
can cause SSPE years later, encephalitis, and giant cell pmeumo. rash includes hands and feet
|
|
|
mumps
|
Parotitis
Ocrhitis aseptic Meningitis |
|
|
rabies
|
bullet shape, purkinje cells of cerebellum
|
|
|
hepatitis
|
HAV picorna
HBV DNA hepadna HCV flavi HEV hepe. fecal-oral - Enteric, Expectant mothers, Epidemic |
fever, jaundice, high ALT & AST
vowels hit your bowels In HBV, cellular RNA pol transcribes RNA from DNA template. Reverse transcriptase transcribes RNA intermediate into DNA genome. virion enzyme is a DNA-dependent DNA polymerase |
|
HIV
|
diploid RNA genome
gp120 attachment to T cell gp41 fusion and entry |
|
|
HIV ELISA IS a rule... test
|
out
|
|
|
AIDS when CD4 is
|
200
|
|
|
superficial vascular proliferation in AIDS pt
|
neutrophilic inflamm. bartonella henselae. bacillary angiomatosis
|
|
|
encephalopathy in AIDS pt with demyelination
|
JC
|
|
|
meningitis, CD4<50
|
cryptococcus neoformans
|
|
|
cotton wool spots, esophagitis, CD4<50
|
CMV
|
|
|
superficial neoplastic proliferation of vasculature with lymphocytic inflammation
|
HHV8
|
|
|
hairy leukoplakia from which virus
|
EBV
|
|
|
lymphoma on oropharynx (Waldeyer's ring), assoc with AIDS
|
EBV. non-hodgkins (large cell)
|
|
|
squamous cell carcinoma in AIDS
|
HPV
|
|
|
primary CNS lymphoma in AIDS caused by
|
EBV
|
|
|
interstitial pneumonia with Owls eyes in AIDS
|
CMV
|
|
|
pleuritic pain, hemoptysis, infiltrates in AIDS
|
aspergillus
|
|
|
prions
|
mutant forms beta pleats
|
|
|
bug in reheated meat
|
C. perfringens
|
|
|
bug in undercooked meat
|
e coli O157:H7
|
|
|
bugs that mimic appendicitis
|
yersinia entercolitica, campylo, non-typhoid salmonella
|
|
|
neonate (<4wk) pneumonia
|
group B strep
e coli |
|
|
children pneumo
|
Runts May Cough Sputum
RSV Mycoplasma Chlamydia Strep pneumo |
|
|
adult to 40 pneumo
|
mycoplasma
c. pneumo s. pnuemo |
|
|
40-65 yo pneumo
|
s. pneumo
h. influ anaerobes viruses mycoplasma |
|
|
elderly pneumo
|
s. pneumo
influenza virus anaerobes h. influ gram neg rods |
|
|
postviral infection
|
staph, h. influ
|
|
|
newborn meningitis
|
group b strep
e coli listeria |
|
|
peds mening (6mos-6yrs)
|
s. pneumo
n. mening hib enteroviruses |
|
|
6-60yo mening
|
s pneumo
n. mening enteroviruses HSV |
|
|
elderly mening
|
s. pneumo
Gram neg rods listeria |
|
|
meningitis empirical tx
|
ceftriaxone and vanc (add ampicillin if listeria suspected)
|
|
|
viral meningitis
|
enteroviruses (esp coxsackie), HSV2, HIV, West Nile, VZV
HIV: CMV |
|
|
osteomyelitis
|
most ppl - s. aureus
sex active - n. gon (rare) diabetics and IV drugs - pseudo sickle cell - salmonella prosthetic - s aureus and s epidermidis cat and dog bite - pasteurella |
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urinalysis
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positive Nitrite=gram Negative
leukocyte esterase=bacteria |
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3nd leading cause of community UTIs in sex active women
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staph saprophyticus
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congenital toxo
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asymp mom
baby: chorioretinitis, hydrocephalus, intracranial calcifications |
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congenital rubella
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PDA (or pulm artery hypoplasia), cataracts, deaf, blueberry muffin rash
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Congenital CMV
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mom asym
baby: hearing loss, seizures, petechiae, blueberry muffin rash |
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congenital HIV
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recurrent diarrhea
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congenital HSV2
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temporal encephalitis
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congenital syphillis
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stillbirth, hydrops fetalis, facial abnormalities, saber shins, deaf
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ddx rash
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rubella starts head, moves down, postauric LA
measles starts head, moves down VZV begins trunk HHV6 infants after high fever B19 hydrops fetalis s. pyogenes sandpaper rash with fever and sore throat |
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chancroid bug
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haemophilus ducreyi
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lymphogranuloma venereum bug
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C. trachomatis (L1-L3). infection of lymphatics. genital ulcers, LA, rectal strictures
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trichomonas lab finding
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corkscrew motility on wet prep
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condylomata acuminata bug
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HPV 6 and 11
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PID complication
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Fitz-Hugh-Curtis: infection of liver capsule and violin string adhesions of parietal peritoneum to liver
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urinary catheterization bugs
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e coli, proteus mirabilis
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cherry red epiglottis
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HiB
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neutopenia
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candida, aspergillus
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block cell wall synthesis by inhibiting peptidoglycan cross-linking
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PCNs
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block peptidoglycan synthesis
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bacitracin, vanco
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block mRNA synthesis
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rifampin
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damage DNA
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flagyl
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block 50S
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chloramphenicol, macrolides, clindamycin, streptogramins, linezolid
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block 30S
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aminogly
tetra |
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PCN
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block transpeptidase crosslinking of peptidoglycan and activates autolytic enzymes
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use: Gram Neg cocci, spirochetes
tox: hemolytic anemia resist: beta lactamase |
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methicillin, nafcillin, dicloxacillin
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penicillinase resistant because of bulkier R group.
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use: s. aureus
tox: interstitial nephritis |
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ampicillin, amoxicillin
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wider spectrum. clavulanic acid protects against beta lactamases.
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use: ampicillin HELPSS kill
H. influ E. coli Listeria proteus mirabilis salmonella shigella |
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ticarcillin, carbenicillin, piperacillin
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use: pseudomonas and gram neg rods susceptible to penicillinase. use with clavulanic acids.
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cephalosporins
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beta lactams less susceptible to penicillinases.
tox: vit K def, incr nephro with amino, disulfiram with alcohol |
bugs not covered by cephalosporins are LAME
Listeria, atyps (chlamydia, mycoplasma), MRSA, Enterococci |
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1st gen cephalosporins
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PEcK Proteus, E coli, Klebs
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2nd gen cephalosporins
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HEN PEcKS: H influ, Enterobacter, Neisseria, Proteus, E coli, Klebs, Serratia
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3rd gen cephalosporins
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ceftriaxone (meningitis, gonorrhea)
ceftazidime (pseudo) |
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4th gen cephalosporins
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pseudomonas and gram pos
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aztreonam
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monobactam resistant to beta lactamase. inhibits cell wall synthesis (binds PBP3). synergy with aminogly. no allergy.
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use: gram neg rods
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imipenem/cilastatin, meropenem
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broad spectrum beta lactamase-resistant carbapenem. cilastatin decr inactiv in renal tubules
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use: only life threatening infections because tox: seizures
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vanco
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inhibits cell wall mucopeptide formation by binding D-ala D-ala cell wall
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use: Gram pos only. C diff
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aminoglycosides
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bactericidal. inhibits formation of initiation complex and causes misreading of mRNA.
use: severe gram neg rod. synergy with beta lactams. neomycin for bowel surgery |
tox: nephrotox (esp with cephalos), ototox (esp with loops), teratogen
resistance: acetylation, phosphorylation, adenylation |
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tetracyclines
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Demeclocycline - ADH antagonist, acts as a Diuretic in SIADH. Bacteriostatic. binds to 30S and prevents attachment of aminoacyl-tRNA, limited CNS penetration. DON'T take with milk, antacids, iron
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use: borrelia, m. pneumo, riskettsia, chlamydia
tox: GI resist: plasmid-encoded transport pumps |
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macrolides
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blocking translocation (macroSLIDES). bacteriostatic
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use: atyp pneumo, URI, STD, gram pos cocci, Neisseria
tox: prolonged QT, GI, cholestatic hepatitis, eosinophilia, skin rashes, increases conc. of theophyllines, oral anticoags resist: methylation of 23S rRNA binding site |
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chloramphenicol
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blocks peptide bond formation at 50S
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use: meningitis in develop countries
tox: aplastic anemia resist: plasmid-encoded acetyltransferase inactivates |
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clindamycin
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blocks peptide bond formation at 50S
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use: anaerobes ABOVE diaphragm
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Sulfonamides
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PABA antimetabolites inhibit dihydropteroate synthetase
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use: gram Pos, gram neg, nocardia, chlamydia
tox: nephro, photo, kernicterus in infants, displace warfarin from albumin |
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trimethoprim
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inhibits bacterial dihydrofolate reductase
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tox: megaloblastic anemia, leukopenia, granulocytopenia (leucovorin helps)
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fluoroquinolones
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can't take with antacids. use: GI, neisseria, some gram pos
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tox: GI, rash, HA, dizzy. NO pregnant, kids
resist: chromosome-encoded mutation in DNA gyrase |
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metronidazole
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free radicals. bactericidal.
use: anaerobes BELOW diaphragm |
tox: disulfiram with alcohol, HA, metallic taste
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MAC prophylaxis
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azith
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INH
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decr synthesis of mycolic acids
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INH Injures Neurons and Hepatocytes
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Rifampin
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RNA polymerase inhibitor
Revs up p450 Red/orange body fluids Rapid resistance if used alone |
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pyrazinamide
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tox: hyperuricemia, hepatotox
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ethambutol
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tox red-green colorblind
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meningococcal prophylaxis
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cipro
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endocarditis prophylaxis
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PCN
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HIV prophylaxis
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200, 100: bactrim (PCP, toxo)
50: azith MAC |
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VRE tx
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linezolid and streptogramins
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empiric therapy for community pneumonias
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outpt: macrolides
inpatient: fluoro ICU: beta lactam + one of above |
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amphotericin B
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TEARS holes in membrane. intrathecal for mening. supplement with K and Mg
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tox: SHAKE AND BAKE, HYPOTEN, NEPHRO, ARRHYTHMIA, ANEMIA, PHLEBITIS
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azoles
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tox: inhibit p450, fever, chill
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flucytosine
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inhibits DNA synthesis by conversion to 5-FU by cytosine deaminase.
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use: cryptococcus, systemic fungal ifxns with ampho
tox: N/V/D, BM sup |
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caspofungin
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inhibits synthesis of beta glucan
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use: aspergillus, candida
toxL GI, flush |
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terbinafine
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inhibits squalene epoxidase
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treats dermatophytoses, onychomycosis
tox: LFTs, vision |
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griseofulvin
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for superficial ifxns, tinea, ringworm (dermatophytes)
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tox: teratogen, carcinogen, confusion, HA, induces p450 & warfarin metab
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amantadine
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blocks uncoating (M2 protein), releases dopamine from nerves
use: influ A proph, Parkinsons |
A Man 2 dine takes off his coat.
tox: ataxia, dizzy, slur speech resist: mutated M2. 90% influ A resistant Rimantidine has fewer sfx (no cross BBB) |
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zanamivir, oseltamivir
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inhibits influ neuraminidase, decr progeny release
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use: influ A & B
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ribavirin
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inhibits synth of guanine by comp inhib IMP DH
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use: RSV, chronic hep C
tox: hemolytic anemia, teratogen |
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acyclovir
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monophosphorylated by HSV/VZV thymidine kinase. guanosine analog.
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use: HSV, VZV, EBV. no effect on latent. valacyclovir better oral avail. for zoster, use famciclovir
resist: no thymidine kinase |
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ganciclovir
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5' monophosphate formed by CMV viral kinase. guanosine analog.
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use: CMV. valganciclovir better oral avail.
tox: leukopenia, neutropenia, thrombocytopenia, renal tox. resist: mutated CMV DNA pol or no viral kinase |
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foscarnet
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viral DNA pol inhib that binds to pyrophos binding site of enzyme. no kinase activation.
FOScarnet is pyroPHOS analog |
use: CMV retinitis when ganciclovir fails.
tox: nephro resist: mutated DNA pol |
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cidofovir
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inhibits viral DNA pol, no kinase activ.
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use: CMV retinitis, when others fail
tox: nephro. probenecid helps |
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HIV tx
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at 350. 2 NRTIs, 1 other
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protease inhibitors
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-navir. ritonavir inhibits p450.
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tox: hyperglycemia, GI, lipodystrophy
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NRTIs
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AZT. must be phosphorylated by thymidine kinase. Have you dined (vudine) with my nuclear (nucleosides) family?
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tox: BM sup (rev w GCSF and erythro), periph neurop, lactic acidosis, rash, megaloblastic anemia (AZT)
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NNRTIs
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VIR in middle. no phosp necess, don't compete with NTs.
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tox same as NRTIs
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raltegravir
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integrase inhibitors
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tox: hyperchol
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IFN alpha
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chronic hep B,C kaposi, melanoma
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tox: neutropenia
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abx to avoid in preg
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Countless SAFe Moms Take Really Good Care
clarithromycin embryotoxic Sulfas kernicterus Amino oto Fluro cart Metronidazole mutagen tetra teeth, bone ribavirin terato griseofulvin terato chloramphenicol gray baby |
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