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PharmQ1Questions > AbxinterferingwithFolatesynthesisC > Flashcards

AbxinterferingwithFolatesynthesisC Flashcards

1
Q

Disruption of the folate pathway is generally what in single agent therapy?

A

Bacteriostatic

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2
Q

What are the 2 enzyme targets for bactericidal folate antagonists ?

A

Dihydropteroate sythetase, Dihydrofolate reductase

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3
Q

Folate is a cofactor for what?

A

Transfer of 1-carbon groups ad electrons in intracellular synthesis and degradation reduction

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4
Q

Sulfonamides target bacteria that are used in what pathway?

A

PABA pathway

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5
Q

T/F- Sulfonamides are bacteriostatic against gram +/- bacteria?

A

TRUE

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6
Q

What are the 3 major groups of sulfonamides?

A

Oral absorbable, Oral nonabsorbable, Topical agents

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7
Q

What are the oral absorbable sulfonamides?

A

Sulfadiazine- uti, uncomplicated malaria. Sulfadoxine, Sulfisoxazole- otitis media, UTI, chloroquine resistant malaria, drug resistant malaria, and toxoplasma gendii
Sulfamethoxazole- URI, UTI, prophylaxis and tx of p carinii (HIV)

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8
Q

What is the nonabsorbable agent and its uses?

A

Sulfasalazine, Delayed release in RA, UC, enteritis

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9
Q

What is sulfasalazine not indicated for?

A

Infectious disease inflammations

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10
Q

What are the topical agents are their uses?

A

Sodium sulfacetamide,Ophthalmic, Chlamydia trachorra,/ silver sulfadiazine ñ burn infection prophylaxis

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11
Q

What is the most common cause of preventable blindness worldwide? How is it treated?

A

Chlamydia trachoma,Sodium sulfacetamide

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12
Q

What special populations need to be considered for sulfa use?

A

Pregnant women and neonates

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13
Q

What is trimethoprim?

A

Competitive inhibitor of dihydrofolic acid reductase, Similar to sulfonamides but more potent and has increased penetration to the prostate

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14
Q

What are indications for trimethoprim?

A

Community acquired UTI or prophylaxis of UTI, RARELY used ALONE

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15
Q

What 2 agents create bactrim?

A

Sulfamethoxazole+ trimethoprim

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16
Q

What are the clinical uses of bactrim?

A

Pneumocystis carinii, bacterial diarrhea, prophylaxis- UTI, PCP, peritonitis

17
Q

What category of drugs inhibit DNA topoisomeroses?

A

Quinolones

18
Q

What category of drugs inhibit DNA dependant RNA polymerase?

A

Directly: rifampin, Indirectly: nitrofurantoin

19
Q

Are quinolones cidal or static?

A

Bactericidal

20
Q

Which quinolone has gram ñ coverage w/ moderate gram + activity?

A

Ciprofloxacin

21
Q

Which quinolone has excellent gram ñ coverage w/ improved gram +

A

Levofloxain, moxifloxacin

22
Q

Which quinolone has continued gram +/- coverage with increased anaerobic coverage?

A

Trovafloxacin

23
Q

Which atypical pneumonia organisms and intracellular pathogens are also covered by quinolones?

A

Atypical: Chlamydia pneumo, mycoplasma pneumo, Intracellular: legionella, mycobacteria tb, mycobacteria avium complex

24
Q

In general, how often are quinolones used and what are their clinical uses?

A

VERY frequently, UTI, sinusitis, mycobacterial infections, bacterial diarrhea, soft tissue/bone/joint infections, gonococcal and chlamydial, pneumonia, post-exposure prophylaxis for anthrax

25
Q

Which quinolone is FDA restricted to life or limb threatening infections?

A

Trovafloxacin

26
Q

Why should fluoroquinolone not be used for routine URIs or skin/soft tissue infections?

A

We want to prevent resistance! Save these for last to minimize resistance

27
Q

Quinolones are widely distributed throughout the body, including what typically underpenetrated area?

A

Prostate

28
Q

What are the most common ADRs of quinolones? Rare?

A

N/V/D, Seizure w/use of NSAIDs, blood dyscrasias, irreversible peripheral neuropathy

29
Q

Which quinolone is approved to treat mild- moderate CAP d/t multi-drug resistant strep pneumo?

A

Gemifloxacin

30
Q

What is metronidazole (flagyl) spectrum of activity?

A

Anaerobic and protozoan infections. -amebiasis, trichomonias, cns infections, c. diff, and h. pylori

31
Q

Can metronidazole be given in pregnancy?

A

NOT 1st TRIMESTER, category B in 2/3

32
Q

With what drug interaction can metronidazole cause disulfiram-like rxns? What is this rxn?

A

ETOH! Flushing, HA, N/V, sweating, tachycardia

33
Q

When is nitrofurantoin cidal? Static?

A

High concentrations= cidal Low concentrations= static

34
Q

What is nitrofurantoinís biggest indication and why?

A

UTI – d/t increased concentrations in the urine

35
Q

What pt population should you avoid nitrofurantoin in?

A

Elderly

36
Q

What are indications of polymyxin B? what is its spectrum of activity?

A

Gram negative Topical prep, antibiotic ointments, washes for wounds, surgery prep

37
Q

Why is polymyxin B limited to topical use?

A

High nephro/neurotoxicity

38
Q

Can you give polymyxin B IV or IM?

A

Only in life or death situations

PharmQ1Questions (13 decks)

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