Antibiotics in the renal system

Question 1

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Answer 1

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Question 2

What is the MOA and therapeutic use for Nitrofurantoin?

Answer 2

activity against certain Gram-positive and Gram-negative bacteria

Therapeutic use:
acute uncomplicated urinary tract infections

Question 3

What is the MOA for Nitrofurantoin?

Answer 3

after activation by bacterial flavoproteins:

Inhibition of protein synthesis, aerobic energy metabolism, DNA synthesis, RNA synthesis, and cell wall synthesis.

Question 4

What are the SE of Nitrofuratoin?

Answer 4

Lung and hepatic toxicity,
peripheral neuropathy,
Clostridium difficile associated diarrhea,
gastrointestinal symptoms.

Avoid in suspected early pyelonephritis due to poor tissue penetration.

Contraindicated in pregnant women after 38 weeks or when labor is imminent.

Question 5

What is the combo Sulfamethoxazole, trimethoprim Therapeutic use?

Answer 5

bacteriostatic antibacterial agent

E. coli, Klebsiella and Enterobacter sp,
M. morganii,
P. mirabilis and P. vulgaris.

Question 6

What is the combo Sulfamethoxazole, trimethoprim MOA?

Answer 6

synergic action to inhibit the tetrahydrofolic acid (THF) pathway.

THF is an essential precursor for thymidine and is essential for bacterial DNA synthesis.

Question 7

What is the SE ofSulfamethoxazole and trimethoprim combination?

Answer 7

Thrombocytopenia, diarrhea, hyperkalemia, vomiting, anorexia, and skin reactions

DO NOT use during the last 8 weeks of pregnancy

Question 8

What is fosfomycin Therapeuutic use?

Answer 8

broad spectrum antibiotic that concentrates in kidney and bladder.

uncomplicated urinary tract infections.

Question 9

What is the SE of fosfomycin?

Answer 9

Headache
 rash, 
dysmenorrhea,
 diarrhea, 
nausea, 
vaginitis,
 angioedema.

Question 10

What are the fluroquinolones used for renal?

What is the therapeutic use?

Answer 10

ciprofloxacin,
ofloxacin,
levofloxacin

Therapeutic use:
urinary tract infections,
acute uncomplicated cystitis, chronic bacterial prostatitis, uncomplicated cervical and urethral gonorrhea

Question 11

What is the MOA of the Fluroquinlones ciprofloxacin, ofloxacin, levofloxacin ?

Answer 11

inhibitors of bacterial DNA synthesis (DNA gyrase and topoisomerase)

Question 12

What are the SEs of Fluroquinlones ciprofloxacin, ofloxacin, levofloxacin ?

Answer 12

anorexia, nausea, vomiting, headache, dizziness, insomnia, alterations in mood), rashes and other allergic reactions, tendinitis and tendon rupture, QT prolongation, hypoglycemia and hyperglycemia, and hematologic toxicity.

Question 13

What are the penicillin beta lactams?

What is the therapeutic use?

Answer 13

amoxicillin,
piperacillin,
ampicillin

Therapeutic use:
urinary tract infections (complicated and uncomplicated)

Question 14

What are the MOA penicillin beta lactams?

Answer 14

Inhibits peptidoglycan synthesis in bacterial cell walls

Question 15

What are the SEs penicillin beta lactams?

Answer 15

IgE-mediated allergic reactions, rash, diarrhea, renal toxicity, and other hypersensitivity and immune-mediated reactions.
High doses can cause seizures.
Penicillins are the most common antibiotics to cause encephalopathy

Question 16

What are the Beta lactamase inhibitors?
MOA?
Therapeutic use?

Answer 16

Clavulanic acid, tazobactam

Mechanism of action:
inhibit the activity of a number of plasmid-mediated beta-lactamases

Therapeutic use:
association with other beta-lactams

Note:
Beta-lactamase inhibitors have little intrinsic antibacterial activity

Question 17

What are the Beta Lactam Cephlasporins?

Answer 17

First generation: cephalexin, cefazolin,

Second generation: cefuroxime

Third generation: ceftriaxone, cefpodoxime, cefotaxime, ceftazidime

Fourth generation: cefepime

Question 18

MOA of Cephlasporins?s
Therapeutic use?
SEs?
Note?

Answer 18

Mechanism of action:
Inhibits peptidoglycan synthesis in bacterial cell walls

Therapeutic use:
urinary tract infections (complicated and uncomplicated)

Side effects:
Similar to penicillins

Note: most short serum half-lives and require frequent administration.
All but ceftriaxone require dose modification if of severe renal failure.

Question 19

What are the Beta lactam Carbapenem?

What is the therapeutic use?

Answer 19

Imipenem, meropenem, doripenem active against gram-negative organisms (including those that produce extended spectrum beta-lactamases), anaerobes (including Bacteroides fragilis), and gram-positive organisms (including Enterococcus faecalis and listeria).

Therapeutic use:
Complicated urinary tract infections.

Question 20

What is the MOA, SE and MOA of Beta lactam: Carbapenem?

Answer 20

Mechanism of action:
Inhibits peptidoglycan synthesis in bacterial cell walls

Side effects:
Similar to other beta lactams.

Note: Imipenem inactivation in the kidney (PT) is prevented by cilastatin

Question 21

What are the aminoglycosides MOA and Therapeutic use?

Answer 21

Gentamycin, Tobramycin
Mechanism of action:
Block ribosome function (16SrRNA) and protein synthesis.

Therapeutic use:
complicated urinary tract infections

Question 22

What is the SE and toxicity of aminoglycosides?

Answer 22

Side effects and toxicity:
nephrotoxicity and ototoxicity (generally reversible) 10-20%
rare Neuromuscular blockade

Note: high urine concentration
Synergic action with wall-active agents