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Pharm > Antibiotics That Interfere With Folate Synthesis or Nucleic Acid Processing > Flashcards

Antibiotics That Interfere With Folate Synthesis or Nucleic Acid Processing Flashcards

1
Q

What step of the bacterial folic acid pathway do sulfonamides stop?

A

First step

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2
Q

Disruption of the folate pathway is generally ______ in single agent therapy

A

bacteriostatic

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3
Q

What was the first sulfonamide that is no longer used? Was a pro-drug. worked against staph and strep

A

Prontosil

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4
Q

What type anitiobitcs are sulfonamides considered on their own?

A

Bacteriostatic

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5
Q

What bacteria do sulfonamides work against?

A

Gram positive and negative bacteria

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6
Q

How do bacteria have resistance against sulfonamides?

A

Additional production of PABA

changes in binding sites from sulfonamides

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7
Q

What are the three sulfonamides used today (oral absorbable)?

A

Sulfadiazine
Sulfisoxazole
Sulfamethoxazole (+Trimethoprim)

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8
Q

What is the oral, non absorbable sulfonamide?

A

Sulfasalazine

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9
Q

What is sulfasalazine used for?

A

Anti-rheumatic (used for RA)

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10
Q

What are 2 topical sulfonamides agents?

A

Sodium sulfacetamide

Silver sulfadiazine

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11
Q

What topical sulfonamide is used in opthalmic solution or ointment for bacterial conjunctivitis or treatment of chalmydia trachoma?

A

Sodium sulfacetamide (Sulamyd)

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12
Q

What is a topical sulfonamide used for topical burn infection prophylaxis?

A

Siver sulfadiazine (Silvadene)

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13
Q

Are sulfas well absorbed?

A

Yes, excpet sulfasalazine

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14
Q

What sulfa drug is highly protein bound to albumin?

A

Sulfamethoxazole

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15
Q

What are other protein bound drugs that you should be careful with prescribing sulfamethoxazole with?

A

Warfarin
Phenytoin
Sulfonylureas

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16
Q

What is the most common AE with sulfonamides?

A

Photosensitivity (N/V/D, HA)

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17
Q

What is the pregnancy category of silver sulfadizine?

A

Category B (because it is applied topically)

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18
Q

What is the problem with giving sulfa drugs to pregnant patients?

A

Neonatal kernicterus

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19
Q

What part of the folic acid pathway does trimethoprim interfere with?

A

Second part

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20
Q

Are trimethoprim or sulfa drugs more potent?

A

Trimethoprim

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21
Q

What is the prime indication of sulfa plus trimethoprim?

A

UTIs

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22
Q

When sulfas are combined with trimethoprim, what type antibiotic does it turn into?

A

Bactericidal

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23
Q

What sulfa drug is trimethoprim combined with?

A

Sulfamethoxazole

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24
Q

What is sulfamethoxazole/ trimethoprim the drug of choice for?

A

Pneumocystis carinii
bacterial diarrhea
prophylaxis for UTI
Periotonitis prevention in patients w/ cirrhosis

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25
Q

Is there a lot of resistance to sulfamethoxazole/ trimethoprim?

A

Yes

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26
Q

What is sulfamethoxazole/ trimethoprim used for in AIDS patients?

A

PCP & toxoplasma gondii

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27
Q

What is another name for sulfamethoxazole/ trimethoprim?

A

Bactrim

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28
Q

What are three drugs that inhibit DNA processing?

A

Quinolones (same as floroquinolones)
Rifampin
Nitrofuratoin

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29
Q

How do quinolones block bacterial DNA synthesis ?

A

Inhibit DNA topoisomerases

30
Q

What bacterias do quinolones act against?

A

Gram + and gram - bacteria

31
Q

What type antibiotic are quinolones considered?

A

Bactericidal

32
Q

What type bacteria does ciprofloxacin cover?

A

Really good gram -

lost a lot of gram positive

33
Q

Levofloxacin and moxifloxacin cover against what bacterias and how well?

A

Really good gram negative covered

even better gram positive coverage than Cipro

34
Q

What quinolone class has continued gram negative and gram positive coverage but also covers anaerobic (B. fragilis)

A

trovafloxacin

35
Q

What atypical pneumonia organisms do quinolone cover?

A

CHalymydia penumoniae

mycoplasm pneumoniae

36
Q

What intracellular pathogens do quinolones cover?

A

Legionella
Mycobacteria TB
mycobacteria avium complex

37
Q

what quinolone is indicated for post-exposure prophylaxis for anthrax?

A

Cipro

38
Q

What quinolone treats anthrax?

A

Levofloxacin

39
Q

What is trovafloxacin restricted to due to severe hepatic toxicity?

A

FDA restricted to life or limb threatening infections

40
Q

What should quinolones not be used for in order to avoid increase in resistance?

A

Upper or lower respiratory infections

Skin/ soft tissue infections

41
Q

What do the quinolone class end in?

A

“floxacin”

42
Q

How are most quinolones excreted?

A

renally

43
Q

How is Cipro excreted?

A

50% renal, 40% bile (still need dose adjustment for renal insufficiency)

44
Q

What are the most common AE for quinolone?

A

N/V/D

45
Q

What are some people who may have seizures with cipro?

A

little old ladies with renal impairments, on NSAIDs

46
Q

What are some rare AEs of quinolones?

A

Seizures
blood dyscarsias
peripheral neuropathy (irreversible)

47
Q

What is the most common type of interaction with cipro?

A

CYP interactions

48
Q

What drugs can cipro interact with?

A

Antacids
sucralfate
Iron
Multivitamins

49
Q

What type patients do you want to be worried about tendinitis and tendon rupture on Cipro?

A

Elderly

Renal failure, glucoccorticoid use

50
Q

With Cipro, levels of what drugs will be increased due to CYP interactions?

A

Increased levels of methadone and theophyilline

with glyburide- will get severe levels hypoglycemia

51
Q

What forms is moxifloxacin avaliable as?

A

Oral or IV; broad spectrum single dose

52
Q

What is gemifloxacin used to treat?

A

mild-moderate CAP due to multi-drug resitsanct Streptococcus pneumoniae

53
Q

What type antibiotic is metronidazole?

A

bactericidal

54
Q

How is metrondiazole avalaible?

A

Oral
IV
Topical

55
Q

What is the main type organism that metrondiazole works against?

A

Anaerobic and protozoan infections

56
Q

Metrondiazole treats what two GI conditions? (main indications)

A

C. diff

H. pylori

57
Q

What trimesters of pregnancy in metrondiazole ok in?

A

2nd and 3rd (not in first trimester)

58
Q

What 3 drugs does metrondiazole interact with?

A

Warfarin (increased INR)
cimetidine (increase metrondiazole levels)
lithium toxicity

59
Q

What happens when metrondiazole and ETOH?

A

disulfiram-liek rxn. (flushin, HA< N/V)

60
Q

What are some side effects with metrondiazole?

A

N/V/D/ constipation
Darkened urine
Edema (patients w/ heart failure)
transient luekopenia, neutropenia

61
Q

When is nitrofurantoin bacteriostatic? Bactericidial?

A

Bacteriostatic in low concentrations

bactericidal in high concnetrations

62
Q

Nitrofuratoin reaches high concentrations where?

A

In the urine

63
Q

What are some side effects with nitrofuratoin?

A

N/V

interstitial pulmonary fibrosis w/ chronic use

64
Q

Patients with G6PD deficiency will experience what with nitrofuratoin?

A

hemolysis

65
Q

What type antibiotic is polymyxin B?

A

Bactericidial (leads to lysis)

66
Q

What type bacteria does plymyxin B work against?

A

Gram negative (Pseudomonas aeruginosa)

67
Q

Polymyxin B has high rates of what toxicities, so it is limited to only topical use?

A

Nephro and neuro toxicity

68
Q

What is polymyxin B used for (topical)?

A

gut sterilization
bladder irrigation
ophthalmic

69
Q

How can polymyxin B be used?

A

only topically

70
Q

What is daptomycin used for (what type bacteria)?

A

Multi-drug resistant gram + bacteria

71
Q

What are some side effects of daptomycin?

A

Reversible myopathy, GI

72
Q

What type antibiotic is daptomycin?

A

Bactericidal

Pharm (29 decks)

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