Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Infectious Disease Therapeutics > Aminoglycosides > Flashcards

Aminoglycosides Flashcards

1
Q

Aminoglycoside Examples

A

Streptomycin
Gentamicin
Tobramycin
Amikacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Aminoglycoside MOA

A

inhibit protein synthesis by inhibiting 30S subunit of bacterial ribosome

inhibit protein synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Resistance to Aminoglycosides

A

Mutation or methylation of 16S rRNA-binding site
Enzymatic destruction of the drug
Lack of permeability to the drug molecule –> drug cannot get into the organism
Active efflux (or lack of active transport)

CHANGE to BINDING SITE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Aminoglycoside Spectrum

A

aerobic gnb bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Aminoglycosides are synergistic with….

A

penicillins for enterococci and streptococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Streptomycin can be used for…

A
  • TB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Aminoglycoside Route of Admin

A
  • IV/IM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Aminoglycosides absorbtion

A

Penetrate tissues relatively poorly; not CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Aminoglycoside Adverse Effects

A

Nephrotoxicity
Ototoxicity
Neuromuscular blockade
Allergies rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Aminoglycosides Drug Interactions

A

Other nephrotoxic drugs
Other ototoxic drugs
Neuromuscular blocking agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Fluoroquinolone Examples

A
  • Ciprofloxacin
  • Levofloxacin
  • Moxifloxacin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fluoroquinone MOA

A
  • inhibit DNA gyrase or topoisomerase II & IV
    Bacteriocidal; concentration dependent killing

Inhibit DNA replication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Fluoroquinone Resistance

A

alteration of the A or B subunit of DNA gyrase

-
Mutation in ParC or ParE of topoisomerase IV
Change in outer membrane permeability –> cannot get in to act at DNA
Efflux pumps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

In general, fluoroquinones spectrum is

A

highly active against gnb, Haemophilus sp, neisseriae, chlamydiae, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ciprofloxacin Spectrum

A

most active against .P aeruginosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Levofloxacin Spectrum

A

activity against S. pneumoniae –> gram positive cocci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Moxifloxacin Spectrum

A

activity against anaerobes

18
Q

Fluoroquinone Uses

A

urinary tract infections, STIs due to chlaymdia, lower respiratory tract infections, enteritis/travellers diarrhea, drug resistant mycobacterial infections

19
Q

Fluroquinones Elimination

A

Ciprofloxacin and levofloxacin – renal elimination; moxifloxacin has a biliary pathway

20
Q

Adverse Effects of Fluoroquinolones

A

Nausea, vomiting, diarrhea
Insomnia, headache and dizziness
Other CNS effects including seizures
Skin rashes
Impaired liver function
-
Tendinitis/tendon rupture –> tends to occur more in elderly (can occur I. young) –> risk factors –> age over 60, being on corticosteroids, and female –> Counsel –> If develop tenderness, stop and see healthcare professional right away
-
Prolongation of QTc interval
Hypo/hyperglycemia
C. difficile
Peripheral neuropathy –> tingling, prickling,

21
Q

Drug Interactions of Fluoroquinolones

A

Bind di and tri-valent cations –> Mg, Ca, Zinc, Iron –> Lower serum inf
QTc prolongation
CYP 1A2 inhibition can result in increased levels of many drugs ( e.g. clozapine, duloxetine, methotrexate, quinapril, rasagiline, ropinirole, varenicline,etc)
Increased INR with warfarin

22
Q

Fluroquinolones exception uses… C.I.

A

Many toxicities
Many have been removed from the market
Reserve for resistant organisms and situations where you cannot use the DOC

Not used in children <18 years of age ( some exceptions)

Exceptions –> Pseudomonas, resistant infections
–> Cystic Fibrosis in Children –> Seen

23
Q

Sulfamethoxazole MOA

A

structural analogue of PABA; competitively inhibits dihydrofolic acid synthesis

Inhibit folic acid synthesis

24
Q

Trimethoprim MOA

A

binds to dihydrofolate reductase therefore inhibiting the reduction of dihydrofolic acid to tetrahydrofolic acid

  • Inhibit folic acid synthesis
25
Q

Sulfamthoxazole and Trimethoprim mainly found as….

A

Most commonly combined as TMP/SMX or
co-trimoxazole

26
Q

Sulfonamides and Trimethoprim Killing Mechanism

A

Bacteriostatic but together bacteriocidal

27
Q

Sulfonamides and Trimethoprim Resistance

A

ability of cell to use preformed folic acid (don’t have to make it)

28
Q

Sulfonamides and Trimethoprim Spectrum

A

Spectrum – wide spectrum of gp, gn, chlamydiae, nocardiae and protozoa
No activity against anaerobes

Staphylococci – including MRSA
Streptococcus pneumonia; NOT Group A Strep
S. maltophilia
Moraxella
H. influenza
Enterobacteriaciae
Brucella
Pneumocystis jirovecii

29
Q

Sulfonamides and trimethoprim Uses

A

Urinary tract infections
Skin and soft tissue infections- MRSA
PJP –> can be seen in other immunocompromised states but mainly HIV
Many others

30
Q

Drug Interactions of TMP/SMX

A

2C9 inhibitor; 3A4 substrate – increased levels of carvedilol, digoxin, phenytoin
Increased INR and bleeding with warfarin
Hypoglycemic agents – increased risk of hypoglycemia

31
Q

Contraindications of TMP/SMX

A

CI in first and 3rd trimester of pregnancy
Caution in renal dysfunction  excaberates higher K+ levels, hypoglycemic risk

32
Q

Metronidazole MOA

A

unknown but possible inhibition of nucleic acid synthesis and disruption of DNA

33
Q

Metronidazole Resistance

A

–> Do not know –> Susceptibility testing is extremely difficult

34
Q

Metronidazole Spectrum

A

anaerobes including C. difficile
Protozoa – trichomonas, Giardia (diarhhea from drinking H2O out of streams), etc
Propionibacterium are resistant –> acne –> Not used in this situation

35
Q

Metronidazole Adverse Effects

A

gi
Metallic taste
Headache
Dark urine
Peripheral neuropathy –> usually not until later (weeks, often not used for long durations)
Disulfiram-like reaction with alcohol (N, V, D, Headache, Chest Pain)
Insomnia
Stomatitis  mouth sores

36
Q

Metronidazole Drug Interactions

A

Alcohol – disulfiram reaction
Warfarin – increased INR and bleeding

37
Q

Linezolid MOA and KIlling

A

MOA – inhibits protein synthesis
Usually bacteriostatic; bactericidal against Streptococci

38
Q

LInezolid Spectrum

A

Streptococci, Enterococci (including VRE), Staphylococci (including MRSA)

39
Q

Linezolid is reserved for….

A

multi-drug resistant organisms

40
Q

Linezolid Adverse Effects

A

Headache
Nausea, vomiting diarrhea
Rash
Increased LFT’s
Myelosuppression (Bone Marrow) –> Causes neutropenia, low platelets, anemia –> dose and duration dependnent
Optic/peripheral neuropathy –> nerve damage in eye –> Sight problems
Lactic acidosis
Decreased seizure threshold

41
Q

Linezolid Drug Interactions

A

Increased serotonin syndrome risk with SSRIs and MAOIs (other drugs that cause serotonin syndrome)
Rifampin decreases linezolid levels

Infectious Disease Therapeutics (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions