Anti-biotics part 2 Flashcards
What drug class is metronidazole (flagyl)
Imidazole anti-biotic
What sorts of bugs is metronidazole (flagyl) effective against
anaerobic bugs (given in gut perforation), and protozoa
What is metronidazole (flagyl) commonly used for
BV, trichomoniasis, acne (topical application), part of cocktail for H. pylori, giardia
What is the MOA of metronidazole (flagyl)
Activated intermediates of the drug bind to DNA and inhibit further nucleic acid synthesis
What is the go-to drug for first treatment of C. dif
metronidazole (save vancomycin for 2nd line)
What are common side-effects of metronidazole
Metalic taste in the mouth, diminished appetite
What is the disulfiram (antabuse)-like effect of metronidazole
Drinking alcohol with metronidazole can cause n/v, flushing, and tachycardia
What is the rule for alcohol use with metronidazole
no alcohol for 24hr before treatment and none for 2 days after. Of course none during treatment
What drug class is nitrofurantoin
nitrofuran antibacterial
What is the MOA of nitrofurantoin
Disrupts both DNA and RNA of bacteria which are sensitive to the drug
When is nitrofurantoin used
in UTI (it concentrates in the urine)
What are the most common side effects of nitrofurantoin
Known for causing N/V (more than other abx). rarely causes pulmonary fibrosis or AI hepatitis
What drug class is clindamycin
lincosamide antibiotic. Not related to erythromycin
What bugs is clindamycin effective against
anaerobic bacteria, but also come protozoans like malaria
What are common side effects of clindamycin
N/V, skin rashes, oral thrush, C. diff, yeast vaginitis
What drug class is vancomycin
glycopeptide antibiotic
What type of bug is vancomycin used for
gram positive that are unresponsive to less toxic abx (last resort abx)
When is vancomycin used
MRSA, endocarditis, C. diff (2nd line)
How is vancomycin administered
IV, unless for unresponsive C. diff, then admin PO, since vanco is poorly absorbed
Why is vancomycin given so slowly?
Because it causes Red-man syndrome, pain, thrombophlebitis
What is red-man syndrome
rxn to vancomycin that includes intense facial flushing, diffuse erythema and possible bullae formation and desquamation
What is rifampicin used to treat
mycobacterium like tuberculum, lepreae; neissera meningitidis prophylaxis
what is the MOA of rifampicin
Inhibits DNA-dependent RNA polymerase in bacterial cells thus preventing transcription to RNA and subsequent translation to proteins
What is a common side effect of rifampicin
causes orange urine and tears
What lab work must be done with rifampicin use
LFTs because rifampicin can cause hepatitis
What is rifaximin used for
traveler’s diarrhea, IBS, SIBO (it is absorbed poorly so stays in the gut)
What is a good first line tx for MRSA
TMP-sulfa, or even TMP-sulfa combined with rifampicin
How is mupirocin/bactroban used
topically only, prescription only
How is mupirocin/bactroban used
for treatment of MRSA, especially in the nares; impetigo and other skin infections
what is the MOA of mupirocin/bactroban
unique mechanism of action, which is selective binding to bacterial isoleucyl-tRNA synthetase, which halts the incorporation of isoleucine into bacterial proteins
what is polymyxin B used for
topical skin infections
What is neomycin used for
skin infections, particularly gram negative
What drug class is neomycin
aminoglycoside antibiotic
