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Pharmacology > Anti microbial > Flashcards

Anti microbial Flashcards

1
Q

Penicillin

A

tx: GRam + bacteria
neisseria meningitis
affects cell wall by inhibiting Dala-Dala
sensitive to beta lactamases

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2
Q

What are the side effects of penicillin

A

Type 1 hypersensitivity
autoimmune hemolytic anemia
interstitial nephritis

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3
Q

Nafcillin, Oxacillin,Methicillin, Dicloxacillin

A

tx. resistant strains of gram + bacteria

bind to PBP and decrease cell wall synthesis

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4
Q

Cephalxin, cefazolin

A

1st generation
tx: gram +
pharyngitis
surgical prophylaxis

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5
Q

Cefuroxitime, cefoxetan, cefoxitin

A

2nd generation
extended gram - coverage
tx: HEN h.flue, neisseria, serratia

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6
Q

Ceftriaxone, cefuxtaxime, cefaxidime

A

3rd generation
gram + and -
given IV crosses BBB
tx; meningitis, h.flu, pneumonia, pseudomonas ,strep viridian’s, lyme disease, gonorrhea

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7
Q

Cefaprime

A

4th generation
broad spectrum
tx: pseudomonas , meningitis

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8
Q

Ceftarline

A

5th generation
broad spectrum
tx: MRSA

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9
Q

What are the side effects of cephalosporins

A

interstitial nephritis
hemolytic anemia
hypersensitivity

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10
Q

Monoobactem, aztreonam

A 
tx: pseudomona
anaerobic bacteria 
meningits
sepsis 
 best for penicillin allergies 
are beta lactase resistant
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11
Q

Carbapenem

A 
"penem" 
 broad spectrum 
tx: pseudomona
pneumonia 
\+ & - bacteria
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12
Q

What is imepenem given with ?

A

cilastin

decreases the degradation by dehydropeptidase by the renal tubule

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13
Q

What are the side effects of carbapenem?

A

skin rash
GI upset
decrease seizure threshold

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14
Q

What drug class is resistant to extended spectrum betalactamases?

A

monobactam

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15
Q

Vancomycin

A

bind directly to DALA D-ALA to decrease cell wall synthesis
Given IV

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16
Q

What does vancomycin treat?

A 
meningitis 
hospital pneumonia 
MRSA
staph epidermis 
endocarditis 
enterococcus 
c. difficile
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17
Q

What are the side effects of vancomycin ?

A 
Red man syndrome (flushing based on histamine release)
thrombophlebitis 
otoxicity 
renal insufficiency 
DRESS syndrome 
Renal toxicity
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18
Q

Daptomycin

A

tx: gram +
staph: endocarditis
enterococcus
MRSA
depolarizes the cells–> decrease cell wall

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19
Q

What are the side effects of daptomycin ?

A

ineffective in pneumonia

myopathy

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20
Q

Tetracyclines

A

bind 30 s inhibiting translation
bacteriostatic
decrease Ca, Mg, Fe absorption
removed fecally

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21
Q

What are the side effects of tetracyclines ?

A 
tooth discolouration in young children 
teratogenic : deposits in teeth and bones 
Nausea , vomiting 
photosensitivity 
fanconi syndrome--> RTA type 2
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22
Q

What cause resistance to tetracyclines?

A

efflux pumps

altered ribosomes

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23
Q

Macrolides

A

“Mycin”
bind the 50s subunit decreasing translocation
bacteriostatic

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24
Q

What are the side effects of macrolide?

A

hepatitis
prolong QT–> torsade de point
P450 inhibitor

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25
Q

Clindamycin

A

binds the 50s ribosome–> decreases translation
tx: gram + and anaerobic
oral infections
endometriosis

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26
Q

What is the best drug for female genital tract illnesses ?

A

Gentamycin + clindamycin

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27
Q

What are the effects of clindamycin?

A

c. difficile . diarrhea

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28
Q

Chloramphenicol

A

binds to 50 s –> decrease translocation
tx: meningitis, rickettesia
mostly in 3rd world countries

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29
Q

What are the adverse effects of chloraphenicol ?

A

repressed production of RBC
aplastic anemia
grey baby syndrome

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30
Q

Linezolid

A 
bind to 50 s subunit 
tx: MRSA
VRSA
resistant enterococcus 
hospital acquired pneumonia
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31
Q

What are the side effects of linezolid?

A

thrombocytopenia
optic neuropathy
peripheral neuropathy (stock & glove)
serotonin syndrome

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32
Q

Aminoglycosides

A

bind to 30s ribosome unit
bactericidal –> decrease ignition complex
coupled with cell wall penetrating drug
IV administration

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33
Q

Neomycin

A

remains active in GI ‘used before surgery

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34
Q

Paromycin

A

used for parasitic GI infections

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35
Q

Streptomycin

A

gram - bacteria

especially pseudomonas

36
Q

Amikacin

A

resistant free

best for pseudomonas

37
Q

What are the side effects of aminoglycocides

A

ototoxicity
teratogenic: deafness of the newborn
acute tubular necrosis
neuromuscular blockade

38
Q

SXM - sulfamethoxazole

A

is a PABA analog that block dihydropteroate synthesis

39
Q

TMP- trimethoprim

A

blocks dihydrofolate reductase

40
Q

What does TMP- SMX treat?

A 
UTIs
acute prostatitis 
GI bacteria 
MRSA
nocardia 
prophylaxis in pneumocystis jirevecii 
prophylaxis in CD <200 
CD< 100 against toxoplasmosis
41
Q

What are the side effects of TMP-SMX?

A 
pancytopenia 
megoblastic anemia 
teratogenic in 1st trimerst--> neural tube defects 
sulpha allergy 
hemolytic anemia in G6PD
renal tubular acidosis -type 4 
interstitial nephritis 
photosensitivty 
kernicterus in last month of pregnancy 
Diplaces drug like warfarin --> increased bleeding 
inhibits P450
42
Q

Fluroquinolones

A

decrease topoisomerase - DNA gyrase –> decreased replication

43
Q

Levofloxacin, Ciprofloxacin

A 
tx; pseudomonas 
pyelonephritis 
UTI- complicated 
gastroenteritis 
salmonella 
osteomyelitis 
bacillis anthrasis 
walking pneumonia 
legionella
44
Q

What are the side effects of fluoquinolones?

A

decrease absorption of Fe, Mg, Ca
risk of prolonged QT
nausea, vomiting, diarrhea
Tendon and cartilage damage in elderly & those on steroids
Teratogenic
not recommended for children <10 yrs –> cartilage damage

45
Q

Metronidazole

A

free radical metabolites that disrupt bacterial DNA

46
Q

Metronidazole treats?

A 
polymicrobial infections 
entamoeba histolytica 
Giardia 
Trichomonas - vaginits &amp; cervivitis (given to pt &amp; partner)
C. difficile 
Anearobic bacteria 
Gardenella 
H.pylori
47
Q

What is the side effect of metronidazole ?

A

Disulfram reaction with alcohol - metallic taste, flushing, nausea ,tachycardia)

48
Q

Amphotericin

A

bind ergosterol that then cause holes and leakage of the cell
given IV
liposomal drug formation decreases toxicity
intrathecal for CNS infections

49
Q

Side effects of amphotericin

A 
bind human cholesterol - headache &amp; hypotension
fever &amp; chills 
CNS effects 
thrombophlebitis 
Renal tubule acidosis -type 1 
hypokalcemia 
magnesium wasting 
volume expansion w IV normal saline before drug is given 
decreased EPO --> anemia
50
Q

Flucytosine

A

cytosine deaminase converts flu cytosine into 5-fluoruacil –> halts DNA & RNA
tx: cryptococcus

51
Q

Nystatin

A

bind to ergosterol to form holes in cell membrane

tx; vaginal and oral candidiasis

52
Q

Azoles

A

inhibit the conversion of lanosterol to ergosterol –> decrease ergosterol synthesis
inhibitor of p450

53
Q

Voriconazole

A

inhibit p450
tx; aspergillosis
candida

54
Q

Side effects of voriconazole

A

blurry vision - flashes of light

changes in colour vision

55
Q

Fluconazole

A

tx; mucutaneous candida
vaginal candid
oral , stomatitis, esophagitis - candida
cryptococcal meningitis

56
Q

Itraconazole

A

dimorphic infections

tine infections

57
Q

ketoconazole

A

tx: dermatophytosis
inhibit cushings
decrease androgenic effects

58
Q

Side effects of ketoconazole

A

inhibit human cholesterol

inhibit 17, 20 desmolase–> decrease androgen & estrogens

59
Q

Griseofulvin

A

bind fungal microtubules–> halting mitosis
Cyp450 inducer
tx: dermatophytic - especially keratin area

60
Q

Terbinafine

A

tx: dermatophytis
onychomycosis
destroys the ergosterol
increases squalene –> liver toxicity , diarrhea

61
Q

Echinocandins

A

Capsofungin, micafungin, anidula fungin
inhibit beta 1,3 glucan in the cell wall–> decreased polysaccharide synthesis
tx: candida, invasive aspergillosis

62
Q

NRTIs

A

competitive inhibit of reverse transcriptase–>missing 3’ OH –> premature chain –> termination

63
Q

What is required for nucleosides to be active ?

A

phosphorylation

64
Q

What are the side effects of NRTIs ?

A

mitochondrial toxicity

lactic acidosis

65
Q

Lamivudine

A

tx: hepatitis B
SE: peripheral neuropathy

66
Q

Tenofovir

A

nucleotide- does not need phosphorylation to be active

tx: hepatitis

67
Q

Zidovudine

A

used in pregnancy & breast feeding to decrease vertical transmission

68
Q

What are the side effects of zidovudine?

A

myelosuppression–> anemia , granulocytopenia

lipodystrophy

69
Q

Stavudine

A

se: lipodystrophy

peripheral neuropathy

70
Q

Didanosine

A

pancreatitis

increased peripheral neuropathy with other drugs

71
Q

Abacavir

A

se: hypersensitivity associated with HLA B 57:01 allele –> type 4 rash

72
Q

Emticitabine

A

SE: hyper pigmentation of palms and soles

73
Q

Elfavirenz , Efavirenz, Delavirdine

A

“VIR”
do not need phosphorylation
bind allostericlly to reverse transcription –> chain termination

74
Q

What are the side effect os NNRTIs

A

hepatotoxicity & jaundice after 6 weeks with drug
CNS - dizziness, drowsiness , headache, psychosis
teratogenic
activate p450
steven johnson syndrome

75
Q

Protease inhibitors

A

“NAVIR” ending
inhibit cleavage of poly proteins
dont need phosphorylization
stop POL gene –> decreases proteases

76
Q

Side effects of protease inhibitors

A

hyperglycaemia due to insulin
dyslipidemia
lipodystrophy

77
Q

Indinavir

A

SE: nephroliathiasis

78
Q

Ritonavir

A

greatest CYP 450 inhibition

can be given to increase concentration of other drugs that are metabolized by CYP450

79
Q

What is the reaction between protease inhibitors and Rifampin

A

rifampin activates p450–> decrease concentration of protease inhibitors

80
Q

Maraviroc

A

binds to CCR5

81
Q

Enfuvirtide

A

bind gp41

82
Q

Raltegravir

A

bind intergrase

SE: rhabdomyolysis

83
Q

GAG structural gene code for ?

A

p24, p7

84
Q

ENV structural gene codes for

A

proteins for inflation gp41, gp 120

85
Q

POL gene encodes for

A

reverse transcriptase
protease
integrase

Pharmacology (15 decks)

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