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Renal > Antibiotics in the renal system > Flashcards

Antibiotics in the renal system Flashcards

1
Q

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A

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2
Q

What is the MOA and therapeutic use for Nitrofurantoin?

A

activity against certain Gram-positive and Gram-negative bacteria

Therapeutic use:
acute uncomplicated urinary tract infections

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3
Q

What is the MOA for Nitrofurantoin?

A

after activation by bacterial flavoproteins:

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

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4
Q

What are the SE of Nitrofuratoin?

A

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.

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5
Q

What is the combo Sulfamethoxazole, trimethoprim Therapeutic use?

A

bacteriostatic antibacterial agent

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

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6
Q

What is the combo Sulfamethoxazole, trimethoprim MOA?

A

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

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

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7
Q

What is the SE ofSulfamethoxazole and trimethoprim combination?

A

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

DO NOT use during the last 8 weeks of pregnancy

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8
Q

What is fosfomycin Therapeuutic use?

A

broad spectrum antibiotic that concentrates in kidney and bladder.

uncomplicated urinary tract infections.

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9
Q

What is the SE of fosfomycin?

A 
Headache
 rash, 
dysmenorrhea,
 diarrhea, 
nausea, 
vaginitis,
 angioedema.
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10
Q

What are the fluroquinolones used for renal?

What is the therapeutic use?

A

ciprofloxacin,
ofloxacin,
levofloxacin

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

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11
Q

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

A

inhibitors of bacterial DNA synthesis (DNA gyrase and topoisomerase)

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12
Q

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

A

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.

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13
Q

What are the penicillin beta lactams?

What is the therapeutic use?

A

amoxicillin,
piperacillin,
ampicillin

Therapeutic use:
urinary tract infections (complicated and uncomplicated)

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14
Q

What are the MOA penicillin beta lactams?

A

Inhibits peptidoglycan synthesis in bacterial cell walls

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15
Q

What are the SEs penicillin beta lactams?

A

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

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16
Q

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

A

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

17
Q

What are the Beta Lactam Cephlasporins?

A

First generation: cephalexin, cefazolin,

Second generation: cefuroxime

Third generation: ceftriaxone, cefpodoxime, cefotaxime, ceftazidime

Fourth generation: cefepime

18
Q

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

A

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.

19
Q

What are the Beta lactam Carbapenem?

What is the therapeutic use?

A

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.

20
Q

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

A

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

21
Q

What are the aminoglycosides MOA and Therapeutic use?

A

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

Therapeutic use:
complicated urinary tract infections

22
Q

What is the SE and toxicity of aminoglycosides?

A

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

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

Renal (15 decks)

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