Antibiotics: Others

Question 1

Flouroquinolones MOA

Answer 1

inhibit DNA gyrase and topoisomeraze IV. DNA can’t be replicated. Bactericidal.

Question 2

Flouroquinolone Spectrum

Answer 2

Aerobic gram negative rods and some gram positive coverage (MRSA). Wide tissue distribution and penetration.

Question 3

Ciprofloxacin (Cipro)

Answer 3

Flouroquinolone. Oral. antipsuedomonal.

Question 4

Norfloxacin (noroxin)

Answer 4

Flouroquinolone. Oral. Prostatitis.

Question 5

Ofloxacin (floxin)

Answer 5

Flouroquinolone. Oral. Prostatitis.

Question 6

Levofloxacin (levaquin)

Answer 6

Flouroquinolone. Oral

Question 7

Moxifloxacin (Avelox)

Answer 7

Flouroquinolone. Oral. anaerobes.

Question 8

Gatifloxacin (tequin)

Answer 8

Flouroquinolone. Ocular application only.

Question 9

Gemifloxacin (factive)

Answer 9

Flouroquinolone. Oral. Anaerobes.

Question 10

Anthrax prophylaxis DOC

Answer 10

Cipro.

Question 11

Pseudomonas aerginosa DOC

Answer 11

Cipro.

Question 12

Flouroquinolone toxicity

Answer 12

Increase in QT interval, cartilage erosion, tendon rupture, GI disturbances, photosensitivity.

Question 13

Flouroquinolone contraindications

Answer 13

pregnant and nursing women. children under 18 years of age.

Question 14

Flouroquinolone resistance

Answer 14

changes in gyrase enzyme, decreased permeability, antibiotic modification

Question 15

Metronidazole MOA

Answer 15

Prodrug. metabolites are taken into bacterial DNA where they form unstable molecules leading to fragmentation of the DNA. Need ferredoxin only found in anaerobes. bactericidal.

Question 16

Metronidazole Spectrum

Answer 16

Anaerobic only. Gram positive and negative.

Question 17

Pseudomembranous colitis (C-Diff) DOC

Answer 17

Metronidazole

Question 18

Metronidazole route

Answer 18

oral, IV or topical.

Question 19

Metronidazole toxicity

Answer 19

CNS with prolonged use, GI, Superinfections, metallic taste.

Question 20

Exclusive UTI Drugs (2)

Answer 20

nitrofurantoin (Furadantin) and methenamine

Question 21

Nitrofurantoin MOA

Answer 21

Prodrug reduced in bacteria to a metabolite that can attack and damage DNA and the ribosome. Bactericidal in the urine due to low pH.

Question 22

Nitrofurantoin Spectrum

Answer 22

Gram positive and negative. given orally.

Question 23

Nitrofurantoin toxicity

Answer 23

hemolytic anemia (G6PD deficiency), GI, hepatocellular damage, interstitial pulmonary fibrosis. Turns urine brown.

Question 24

Nitrofurantoin contraindications

Answer 24

late pregnancy, less than 1 month old, low creatine clearance.

Question 25

Methenamine MOA

Answer 25

prodrug that decomposes to formaldehye and ammonia in the urine and kills bacteria. Need low pH of the urine.

Question 26

Methenamine spectrum

Answer 26

Gram negative with some gram positive activity.

Question 27

Methenamine contraindications

Answer 27

hepatic and renal insufficiency.

Question 28

Sulfonamides MOA

Answer 28

Inhibit folate metabolism by competing with PABA to prevent the reduction of DHF to THF (folic acid). Prevents purine production and inhibits DNA synthesis.

Question 29

Sulfonamides spectrum

Answer 29

Gram positive and negative. Bacteriostatic.

Question 30

TMP-SMX (Bactrim)

Answer 30

Sulfonamide. Made of sulfamethoxazole (inhibits PABA) and trimethoprim (inhibits dihydrofolate reductase). Oral/IV.

Question 31

UTI DOC

Answer 31

TMP-SMX (Bactrim)

Question 32

Prophylaxis for pneumocystis jiroveci infections

Answer 32

TMP-SMX (Bactrim)

Question 33

Sulfamethoxazole (gantanol)

Answer 33

Sulfonamide. Oral. Slow excretion with high urine concentration.

Question 34

Sulfasalazine (azulfidine)

Answer 34

Sulfonamide. Oral. GI action, prodrug. Used to treat ulcerative colitis and RA.

Question 35

Silver sulfazalazine

Answer 35

Sulfonamide. topical burn treatment.

Question 36

Sulfonamides Elimination

Answer 36

metabolized in the liver, excreted by the kidney.

Question 37

Sulfonamides Contraindications

Answer 37

late pregnancy, nursing or premature/jaundiced infants. Any infants less than 2 months old.

Question 38

Sulfonamides resistance

Answer 38

increased PABA production, efflux pumps, decreased permeability, alternative metabolism (plasmids).

Question 39

Sulfonamides toxicity

Answer 39

SJS, kernicterus (compete with bili binding), aplastic anemia (G6PD), hematopoietic toxicity, kidney/liver damage, photosensitivity, common drug allergy.

Question 40

Daptomycin (cubicin) MOA

Answer 40

Lipoprotein antibiotics that forms transmembrane channels that lead to rapid depolarization causing cell death. Bactericidal.

Question 41

Daptomycin (cubicin) spectrum

Answer 41

Bactericidal against Gram positives (MRSA and MSSA)

Question 42

Daptomycin (cubicin)

Answer 42

IV. Empiric therapy in patients with a serious gram positive infection. Used as an alternative to vancomycin.

Question 43

Mupirocin (bactroban) MOA

Answer 43

reversibly binds to tRNA synthetase so it can't make isoleucine tRNA. Inhibits protein and RNA synthesis. Produced by pseudomonas fluorescens.

Question 44

Mupirocin (bactroban) spectrum

Answer 44

Gram positive and negative. Usually bacteriostatic but can be bactericidal at high concentrations.

Question 45

Mupirocin (bactroban)

Answer 45

topical or intranasal application for infections of MRSA. Also used for impetigo (S. aureus and Streptococcus pyogenes).

Question 46

Polypeptide antibiotics MOA

Answer 46

lipid a endotoxin (gram negative cell membranes only).

Question 47

Polypeptide antibiotics spectrum

Answer 47

gram negative bacilli

Question 48

Polymyxin B (aerosporin)

Answer 48

Polypeptide antibiotics. topical

Question 49

Colistin (polymyxin E)

Answer 49

Polypeptide antibiotics. topical.

Question 50

Polypeptide antibiotics uses

Answer 50

Usually used in combination with neomycin and bacitracin as topical ointment. Also active against pseudomonas in the eye.