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Kaplan: Antimicrobial Agents > Antibacterial Agents (continued) > Flashcards

Antibacterial Agents (continued) Flashcards

1
Q

Indications for Sulfasalazine?

A

prodrug used in UC and RA broken down to 5-ASA (5-aminosalicylic acid) for (UC) and SP (sulfapyridine)

This drug can treat Crohns confined to the colon as well

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2
Q

Trimethoprim and pyrimethamine inhibit what part of folic acid synthesis?

A

dihydrofolate reductase

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3
Q

Sulfonamides inhibit what part of folic acid synthesis?

A

dihydropteroate synthetase

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4
Q

Indication for Cotrimoxazole? What is another name for it?

A

trimethoprim-sulfamethoxazole

DOC nocardia
listeria (backup)
gram negative infections (E. coli, Salmonella, Shigella, H. influenza
Gram-positive infections (staph, including community acquired MRSA, Strep)

Fungus Pneumocycstis jiroveci (back up drugs are pentamidine and atovaquone)

protozoa: toxoplasma gondii (sulfadiazine and pyrimethamine)

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5
Q

What are the S/E of using folic acid inhibitors?

A

kernicterus in neonates (avoid in third trimester)

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6
Q

What are the S/E of sulfonamides?

A

HSR (SJS)
Hemolysis in G6PD deficiency
phototoxic

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7
Q

S/E trimethoprim or pyrimethamine.

A

bone marrow suppression (leukopenia)

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8
Q

What are the direct inhibitors of nucleic acid synthesis drugs?

A

quinolones

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9
Q

What microbials are useful against bacillus anthraces?

A

anthrax is treated with quinolones as well as pens and tetracyclines

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10
Q

What is the common suffix of the quinolone family of drugs?

A

“floxacins”

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11
Q

MOA of quinolones?

A

are bactericidal and interfere with DNA synthesis

inhibit topoisomerase II (DNA gyrase) and topoisomerase IV (responsible for separation of replicated DNA during cell division_

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12
Q

Indications for use of quinolones?

A

anthrax

UTI and other gram (-) especially in cases of drug resistance

drug resistant pneumococci( levofloxacin)

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13
Q

What can limit the absorption of quinolones?

A

iron and calcium

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14
Q

What are the side effects of quinolones?

A

NEED TO REMEMBER TENDONITIS, tendon rupture, nerve damage
(peripheral neuropathy)

phytotoxicity, rashes

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15
Q

What are quinolones contraindicated in? Why?

A

pregnancy and in children (inhibition of chondriogenesis)

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16
Q

MOA of metronidazole?

A

in anaerobes, converted to free radicals by ferredoxin, binds to DNA and other macromolecules and is bactericidal

17
Q

What spectrum of organisms can metronidazole work against?

A

antiprotozoal: giardia, trichomonas, entamoeba

antibacterial: strong activity against most anaerobic gram-negative bacterioides species Clostridium species, Gardnerella, and H. pylori

GET BaC on the METro G

18
Q

Indication for Metronidazole?

A

pseudomembranous colitis

19
Q

S/E of using Metronidazole?

A

metallic taste, disulfiram-like effect

20
Q

How many months would you use rifampin and isoniazid for prophylactic treatment in the management of mycobacterium tuberculosis?

A

rifampin (4 months)
isoniazid (9 months)

21
Q

What type of antibiotics are typically used for H. pylori induced GI ulcers?

A

clarithromycin and amoxicillin (2 antibiotics) with PPI omeprazole

BMT regimen bismuth, metronidazole, and tetracycline

22
Q

How can prophylaxis of MAC be treated?

A

azithromycin or clarithromycin

23
Q

Other ways besides macros to treat MAC?

A

clarithromycin + ethambutol + rifabutin (rifampin like drug)

24
Q

Isoniazid MOA and how an organism may confer resistance to this drug?

A

inhibits mycolic acid synthesis

prodrug requires conversion by catalase

high level resistance deletions in katG gene (encodes catalase needed for INH bioactivation

25
Q

S/E INH?

A
  • hepatitis
  • peripheral neuritis (use vit. B6)
  • sideroblastic anemia (use B6)
  • SLE in slow acetylators (rare)
26
Q

Rifampin MOA?

A

inhibits DNA - dependent RNA polymerase (nucleic acid synthesis inhibitor)

27
Q

S/E of rifampin?

A

hepatitis

red orange metabolites

28
Q

MOA of Ethambutol?

A

inhibits synthesis of arabinogalactan (cell-wall component)

29
Q

S/E of ethambutol?

A

dose dependent retrobulbar neuritis >visual acuity and red green discrimination

30
Q

Pyrazinamide S/E?

A

hepatitis
hyperuricemia

31
Q

Streptomycin S/E?

A

deafness
vestibular dysfunction
nephrotoxicity

Kaplan: Antimicrobial Agents (5 decks)

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