Antibacterial/fungal/viral Flashcards
How does the bacteria resist macrolides by alter target binding site?
Bacteria produce methyltransferases that alter 50s subunit
How does bacteria develop resistance to sulfonamides?
Increase production of PABA to out compete with sulfonamides
Which enzyme does beta lactam inhibit?
Transpeptidase
Do nafcillin/oxacillin resist beta lactamase?
Yes
Penicillin can be given with ___ to cover pseudomonas and enterococcus?
Aminoglycosides like gentamycin
How does beta lactamase inhibitor does its job?
Suicide inhibitor (irreversible inhibition)
What drug would inhibit penicillin/fluoroquinolone excretion, thus increase level of penicillin in the body?
Probenecid
Which 2 penicillins are excreted largely in the bile?
Nafcillin and oxacillin
What kind of pen G is used for syphilis?
Benzathine pen G (repository form)
How are most penicillin excreted?
Through kidney
What type of hypersensitivities can penicillin cause?
all 4 types
Which 2nd gen cephalosporin can enter CNS?
Cefuroxime
What generations of cephalosporins are resistant to beta lactamase?
3rd and 4th gen
What bacteria can’t cephalosporin kill?
Listeria/syphilis/enterococci
What is the role of cilastatin for imipenem?
Prevent imipenem to be metabolized into nephrotoxic metabolites
If you are sensitive to penicilin or cephalosporin, what else can you get?
Aztreonam
Tx for mild and serious enterococcus?
Mild—>ampicilin
Serious—>vanco
What causes the red man syndrome?
Infuse vanco too fast
What do macrolides/tetracycline/chloramphenicol block?
Macrolides—>50s subunit—>block translocation
Tetracycline—>30s subunit—>block docking of tRNA
Chloramphenicol—>block peptidyl transferase
What can aminoglycosides do to your swole muscle?
Make it weak
Antibiotics that has side effect of phototoxicity? and how will it present clinically?
Tetracycline/sulfonamides/fluoroquinolone
Rash
What else can you use to treat chlamydia?
Azithromycin
What is the alternative for treating lyme disease for young kids?
Amoxicillin
What is tetracycline’s effect on kids?
Teeth discoloration and decrease bone growth
How does macrolides treat gastroparesis?
Stimulate motilin receptors
How do you develop resistance to macrolide?
Methylation of binding site
Drug most used for CAP?
Macrolides
What is streptogramins? MOA? what are they used for?
Quinupristin + dalfopristin
Bind to 50s
Used like linezolid–>for VRSA/VRE
The mechanism of sulfonamide is similar to which drug?
Dapsone
What cancer drug has the same MOA as trimethoprim?
MTX
Where is sulfasalazine metabolized into 5-ASA? and why it is not as effective treating Crohn disease? and what drug do we usually used for Crohn disease?
Colon
It would only treat Crohn disease confined in the colon
Mesalamine
What else can treat listeria besides ampixillin?
Bactrim
How does sulfonamide cause kernicterus in neonate?
Compete with UCB to bind to albumin—>displace UCB—>UCB goes into the brain—>kernicterus
DNA gyrase is also called?
Topoisomerase II
If you can’t used macrolide for CAP, what else can you used instead?
Levofloxacin
How does metronidazole kill the bacteria?
Convert to free radicals
How does terbinafine work against fungus?
Inhibit squalene epoxidase—>accumulate squalene—>toxic to the fungus
Which conazole cross BBB?
Fluconazole
MOA of flucytosine?
Activated by cytosine deaminase—>convert to 5-FU—>inhibit thymidylate synthase—>decrease thymine
How does phosphorylation of acyclovir come about?
Nucleoside—>First phosphate comes from the virus (thymidine kinase) the other 2 comes from host cells—>nucleotide
Why pt who’s taking acyclovir need to be hydrated?
It might cause crystalluria
How does nucleoside become active as an anti metabolite?
Need to be phosphorylated first
Which 2 NRTIs can’t you use at the same time?
Lamivudine and emtricitabine
They are both cytosine analogs
Which 2 NRTIs do we usually use nowadays?
Emtricitabine or lamivudine
What drug is used for prophylaxis for RSV for kids?
Palivizumab
What drugs are needed to treat P. vivax/ovale?
Chloroquine and primaquine
What drugs are used for prophylaxis of malaria?
Chloroquine for chloroquine sensitive area
Mefloquine is used otherwise
What cause hemolytic anemia with G6PD deficiency?
Primaquine/quinine/sulfonamide
