ANTIINFECTIVES Flashcards
AMINOGLYCOSIDES ( GANTS)
gram negative bacteria
Gentamicin (Garamycin)
AMINOGLYCOSIDES
AMINOGLYCOSIDES ( GANTS)
Bactericidal
Amikacin (Amikin)
AMINOGLYCOSIDES
Tobramycin (Tobrex)
AMINOGLYCOSIDES
Streptomycin
AMINOGLYCOSIDES
CEPHALOSPORINS
Bactericidal & Bacteriostatic
CEPHALOSPORINS Related to
Penicillin (PCN)
CEPHALOSPORINS
Ok to give with Aldactone (Spironolactone)
CEPHALOSPORINS
Antabuse-like effects
Cefadroxil
1st gen
Cefaclor
2nd Gen
Cefixime
3rd Gen
Cefepime
4th Gen
Ceftriaxone
3rd Gen
Cefalexin
1st Gen
Cefuroxime
2nd Gen
Cefquinome
4th Gen
Ceftobiprole
5th Gen
Ceftolozane
5th Gen
Cefdinir
3rd Gen
Cefodizine
3rd Gen
Ceftibuten
3rd Gen
Cefpirome
4th Gen
Cefazolin
1st Gen
Cefazedone
1st Gen
Cefprozil
2nd Gen
Cefotetan
2nd Gen
Cephapirin
1st Gen
Cefmetazole
2nd Gen
Ceftaroline
5th Gen
Cefatoxime
3rd Gen
Cefdinir Moxalactam
3rd Gen
FLUOROQUINOLONES ( CLONG)
Bactericidal or Bacteriostatic
FLUOROQUINOLONES ( CLONG) against
gram negative bacteria
Ciprofloxacin
FLUOROQUINOLONES
Levofloxacin
FLUOROQUINOLONES
Levaquin
Levofloxacin
Not given coffee
Ciprofloxacin
Oflocacin
FLUOROQUINOLONES
Norfloxacin
FLUOROQUINOLONES
Gatifloxacin ( Tequin)
FLUOROQUINOLONES
“Floxacin” - most of the time
FLUOROQUINOLONES
Increase Theophylline level
● NSAIDs: Increased risk of CNS Stimulation
○ Paradoxical effect
○ Instead of decreased pain, you will be very
stimulated
FLUOROQUINOLONES
“-ithromycin”
MACROLIDES
MACROLIDES
Bactericidal, Bacteriostatic
Usually enteric coated
MACROLIDES
ADVERSE EFFECTS: Photosensitivity
FLUOROQUINOLONES ( CLONG)
Dirithromycin
MACROLIDES
Azithromycin
MACROLIDES
Clarithromycin
MACROLIDES
Erythromycin
MACROLIDES
Avoid IM administration
Erythromycin
3 stages of Liver Damage
Fatty liver -> Liver fibrosis ( reversible) -> liver cirrhosis ( irreversible)
DRUG TO DRUG INTERACTION/ These Drugs Can Interact ● Theophylline ( Theodur)
○ Not widely used anymore. A very strong brochodilator but it can impact your cardio -> tachycardia, hypertension
● Digoxin ( Lanoxin)
○ Heart failure
● Coumadin ( warfarin sodium)
○ Anticoagulant, blood thinner
MACROLIDES
Similar to Macrolides in terms of coverage
LINCOSAMIDES
Associated with severe toxicity
○ Not widely used
LINCOSAMIDES
Clindamycin ( Dalacin C)
LINCOSAMIDES
Lincomycin
LINCOSAMIDES
Pirlimycin
LINCOSAMIDES
MONOBACTAM ANTIBIOTIC
Bactericidal
MONOBACTAM ANTIBIOTIC effective against?
gram negative enterobacteria
Used for patients allergic to PCN or Cephalosporins
MONOBACTAM ANTIBIOTIC
Aztreonam ( Azactam)
MONOBACTAM
“-cillin”
PENICILLIN
Beta-lactams, Miracle drug
PENICILLIN
PENICILLIN
Bactericidal
PENICILLIN effective against?
gram positive bacteria
Carbenicillin ( Geocillin)
Extended Spectrum Penicillin
Amoxicillin ( Amoxil, Himox)
Extended Spectrum Penicillin
Ticarcillin ( Ticar)
Extended Spectrum Penicillin
Ampicillin ( Pensyn)
Extended Spectrum Penicillin
Dicloxacillin
Penicillinase Resistant Antibiotics
Oxacillin ( Prostaphillin)
Penicillinase Resistant Antibiotics
Nafcillin Na
Penicillinase Resistant Antibiotics
give 2 hrs minimum apart ( longer the better)
Carbeniccilin & Gentamicin
Bacteria produce enzymes capable of destroying PCNS
Penicillinase or Beta-lactamases
Clavulanic Acid
PENICILLINASE RESISTANT ANTIBIOTICS
Tazobactam
PENICILLINASE RESISTANT ANTIBIOTICS
Sulbactam
PENICILLINASE RESISTANT ANTIBIOTICS
Ampicillin and sulbactam
Unasyn
Amoxicillin and Clavulanic Acid
Augmentin, Co-Amoxyclav
Ticarcillin and Clavulanic Acid
Timentin
Piperacillin + Tazobactam
Zosyn, PipTazo
SIDE EFFECTS
Gray Baby Syndrome
○ Occurs in newborn infants with underdeveloped liver
○ Hypotension, cyanosis
CHLORAMPHENICOL
DRUG TO DRUG INTERACTIONS
● Decreased secretion of Methotrexate ( anticancer)
● Tetracycline, Chloramphenicol
○ Decrease PCN action
PENICILLINASE RESISTANT ANTIBIOTICS
WHAT IF PATHOGEN IS RESISTANT TO PENICILLIN?
Also resistant to Cephalosporins
LAST RESORT
○ Given via slow IV infusion ( 2hr and 45 mins infusion) = shortest is 1 hr and 30 mins
○ Rapid infusion
■ Lead to Red Man Syndrome or Red Neck
Syndrome
Vancomycin
CHLORAMPHENICOL
Treatment for severe infection caused by bacteria that are not sensitive to any other antibiotics. LAST APPROACH
“-xazole”
SULFONAMIDES
CHLORAMPHENICOL
Bacteriostatic
SULFONAMIDES
Bacteriostatic
SULFONAMIDES Effective against
gram negative and gram positive bacteria,
Given on empty stomach with full glass of water
Cotrimoxazole
Inhibit folic acid synthesis
Cotrimoxazole
Sulfacetamide
Sulfadiazine
Sulfadoxine
Sulfamethizole
Sulfamethoxazole
Sulfanilamide
Sulfasalazin
Cotrimoxazole
“Cycline” - majority
TETRACYCLINES
Acne Treatment
TETRACYCLINES
NOT USE in children under 8 years
TETRACYCLINES
Potential bone, teeth damage ( Tetracycline)
Enamel hypoplasia
A medical emergency because it causes sloughing, or degradation of the epidermis and dermis
Steven Johnson Syndrome
Oxytetracycline ( Terramycin)
Tetracycline
Doxycyline ( Doxin)
Tetracycline
Minocycline ( Minocin)
Tetracycline
Minocycline ( Minocin)
Tetracycline
Allocated for serious infection. Last approach
● Bactericidal
● Broad spectrum, Used for serious life treatening Gram positive, negative infections
CARBAPENEMS
Imipinem - cilastatin ( Tienam)
CARBAPENEMS
Meropenem ( Meronem)
CARBAPENEMS
Ertapenem ( Invanz)
CARBAPENEMS
ANTIMYCOBACTERIALS
Bactericidal
Hold stain even in presence of Destaining
○ “ Acid fast bacilli” ( AFB)
Mycobacteria
Isoniazid ( INH) + B6
ANTI TB DRUGS ( ANTI-KOCH) ( FRONTLINERS)
Rifampicin
ANTI TB DRUGS ( ANTI-KOCH) ( FRONTLINERS)
Peripheral Neuropathies, Hepatoxic
Isoniazid ( INH) + B6
Alters DNA, RNA Activity
Rifampicin
Side effect:
■ Orange Colored output, fever jaundice,
RUQ pain
Rifampicin
Ethambutol
ANTI TB DRUGS ( ANTI-KOCH) ( FRONTLINERS)
Inhibits cellular metabolism
Ethambutol
Side effect:
■ Optic neuritis (color blindness)
Ethambutol
Pyrazibamide ( PZA)
ANTI TB DRUGS ( ANTI-KOCH) ( FRONTLINERS)
Pyrazibamide ( PZA) is a what type of antibiotic?
Bactericidal, Bacteriostatic
Nephrotoxicity, hepatoxic
Streptomycin
Dapsone
ANTI LEPROSY
Rifampicin
ANTI LEPROSY
Clofazimine (Lamprene)
ANTI LEPROSY
Thalidomide
ANTI LEPROSY
inhibits folate synthesis
Dapsone
WiIl discolor your body fluids
Rifampicin
Tx of P. carinii pneumonia (AIDS)
Dapsone
Type of pneumonia that you can see only in people with very down immune system, that’s why we see it only with people with AIDS
Pneumocystis carinii pneumonia
Binds to bacterial DNA sites & causes cell death
Clofazimine (Lamprene)
Supposedly to be an antiemetic but it causes a lot of deformity in unborn children. So when they were born, they have deformed extremities
■ Teratogenic medication
Thalidomide
Tx of erythema nodosum leprosum
Thalidomide
Rifampicin, INH →
liver toxicity
Take combination of Anti-Tb early AM with an?
EMPTY STOMACH ( UPON WAKING UP)
are loner; they cannot be mixed with any other medication
Ciprofloxacin
any medication that you mixed with it, other medication will not be absorbed
Antacids
Most of the time a GI GU or blood infection
VRE (Vancomycin Resistant Enterococcus)
initially happening as a skin infection and eventually it will come like a pneumonia, but we can have a GI
GU and blood infection as well
○ When you have it, in 24 hours, it will reach your respiratory system
MRSA (Methicillin Resistant Staphylococcus Aureus).
Not that common like VRE and MRSA
○ Usually in septic conditions; usually blood infection
○ Resistant to penicillin
ESBL (Extended Spectrum Beta-lactamases)
If they are resistant to more than 2 drugs
MDRO (Multiple Drug Resistant Organism)
One of the opportunistic infection that usually
happen when the patient is in the hospital for more
than 1-2 weeks already
○ s/sx is usually explosive diarrhea
○ Taking anti-suppressive and anti-infectives for an extended period of time
○ Given yogurt and yakult
■ It has lactobacillus
C. Diff (Clostridium Difficile)
Hard to control
○ Only few antiinfective is able to control it
○ It has the same behavior as the buckholderia cepacia and similar with MRSA
Acinebacter baumanii
Very good in controlling superbug infection
Linezolid (Zyvox) 2000
More affordable than linezolid
○ IV infusion for 30 mins
○ Can cause bloody diarrhea
○ Note for pseudomembranous colitis
Daptomycin (Cubicin) 2003
VRE
contact isolations
MRSA
contact isolations, droplet isolation
ESBL
droplet isolation
MDRO
contact isolation
Buckholderia Cepacia
contact isolation as well, unless is pneumonia so we do the droplet isolation
*New Delhi metallo-beta-lactamase (NDM-1)
droplet isolation
MersCov (Middle Eastern CoronaVirus)
droplet isolation
Amantadine
AGENTS FOR INFLUENZA, RESPIRATORY VIRUSES
Ribavirin
AGENTS FOR INFLUENZA, RESPIRATORY VIRUSES
Rimantadine
AGENTS FOR INFLUENZA, RESPIRATORY VIRUSES
oseltamivir (Tamiflu)
AGENTS FOR INFLUENZA, RESPIRATORY VIRUSES
zanamivir (Relenza)
AGENTS FOR INFLUENZA, RESPIRATORY VIRUSES
Remdesivir
AGENTS FOR INFLUENZA, RESPIRATORY VIRUSES
No longer being used because it has a lot of interaction with any other med, instead it is being used for multiple sclerosis to decrease or relieve fatigue
Amantadine
Antiviral medication that is used in your AH1N1
oseltamivir (Tamiflu)
Adjunct tx to AH1N1
zanamivir (Relenza)
One of the antiviral medication that is able to manage COVID19
Remdesivir
Most of the time the sores are in the oral cavity in the lip area and commonly last for a
few days. Usually goes away within less than 1 week
Herpes type 1
usually the sores are in the genitalia
Herpes type 2
mild illness → serious congenital defects
CMV (cytomegalovirus)
Acyclovir (Zovirax)
AGENTS FOR HERPES & CYTOMEGALOVIRUS (CMV)
Cidofovir
AGENTS FOR HERPES & CYTOMEGALOVIRUS (CMV)
Famciclovir
AGENTS FOR HERPES & CYTOMEGALOVIRUS (CMV)
Foscarnet
AGENTS FOR HERPES & CYTOMEGALOVIRUS (CMV)
Rimantadine/Amantadine
AGENTS FOR HERPES & CYTOMEGALOVIRUS (CMV)
Ganciclovir
AGENTS FOR HERPES & CYTOMEGALOVIRUS (CMV)
Valacyclovir
AGENTS FOR HERPES & CYTOMEGALOVIRUS (CMV)
Retrovirus attacks helper T cells (CD4) >= cell entry
Human Immunodeficiency Virus (HIV)
are security guards on
the cell surface and usually where the virus will be trying to gain entry in order to attack the security guard,
CD4 and CD8
converts RNA to 2 stranded DNA >= cell replication
Retrovirus’ reverse transcriptase
Emergence of opportunistic infections and cancers
secondary to compromised immune system ( low CF4). Cluster of differentiation 4 = 200 below
AIDS-Related Complex ( ARC)
Reverse Transcriptase Inhibitors/ Nucleoside/Nucleotide reverse transcriptase inhibitors ( NRTIS)
AGENTS FOR HIV AND AIDS ( ANTIRETROVIRAL DRUGS)
Protease Inhibitors
AGENTS FOR HIV AND AIDS ( ANTIRETROVIRAL DRUGS)
Nucleosides
AGENTS FOR HIV AND AIDS ( ANTIRETROVIRAL DRUGS)
Antiretrovirus Agents
AGENTS FOR HIV AND AIDS ( ANTIRETROVIRAL DRUGS)
Chemokine coreceptor antagonists ( CCR5 antagonists)
AGENTS FOR HIV AND AIDS ( ANTIRETROVIRAL DRUGS)
Fusion Inhibitor
AGENTS FOR HIV AND AIDS ( ANTIRETROVIRAL DRUGS)
Integrase strand transfer inhibitors ( INSTIs)
AGENTS FOR HIV AND AIDS ( ANTIRETROVIRAL DRUGS)
Viral past through host cell membrane
Fusion Inhibitors
Bind at position distant from active sites of RT
NNRTIs
Completely inhibit reverse transcriptase
NRTIs
Hiv fusion to host cells
CCR5 antagonists
Hiv formation
Protease inhibitor
HIV integration into host genomes
Integrase inhibitors
as more effectivity and less in adverse effect. It is a combination of tenofovir and and emtricitabine. This are your antiviral medications.
Truvada
A once-daily prescription for adults and adolescents
at risk of HIV who weigh at least 77 pounds. It helps lower the chance of getting HIV through sex. You must be negative before and while taking TRUVADA for PrEP. Because if it is positive, it can no longer be effective.
TRUVADA for PrEP
Will be indicative of your immune system. The lower
it is, then most likely you will get into AIDS
T cell count
Fungal is a very common infection
● The common denominator is that it take a while before it goes
away because of their
Ergosterol
Steroid-type CHON in cell membrane of fungi
Ergosterol
Cellular organism with HARD CELL WALL
Fungus
Disease caused by fungus
Mycosis
Toxic to host
SYSTEMIC ANTIFUNGALS
Systemic antifungals inhibit?
CP450 enzyme
a thickened layer that usually be doing/ responsible for the drug metabolism. If this one will be inhibited, a lot of drug toxicity will be happening
CP450 enzyme
Shake and bake medication
Amphotericin B ( Fungisone)
Give antihistamine and antipyretic 30 mins to 1hr _______ we give the amphotericin B in order to decrease the fever and chills.
before
Given for vaginal fungal infection most of the time
Fluconazole ( Diflucan)
Amphotericin B ( Fungisone)
SYSTEMIC ANTIFUNGALS
Fluconazole ( Diflucan)
SYSTEMIC ANTIFUNGALS
Flucystosine
SYSTEMIC ANTIFUNGALS
Ketoconazole ( Nizoral)
SYSTEMIC ANTIFUNGALS
Itraconazole ( Sporanox)
SYSTEMIC ANTIFUNGALS
Miconazole
SYSTEMIC ANTIFUNGALS
Nystatin ( mycostatin)
SYSTEMIC ANTIFUNGALS
Very good for oral candidiasis. Oral fungal infection
or oral thrush ( down immune system)
Nystatin ( mycostatin)
Usually yellow and kinda thick and then you
swish it like a gargle for around 30 seconds to 1 minute for oral purposes because they have an oral thrush for local effect and then swallow it for systemic effect.
SS ( swish and swallow)
You gargle the medication for 30 seconds
to one minute and you spit it out on the kidney basin. Local effect only
SS ( swish and pit)
Athlete’s foot ( Tinea Pedis)
Tinea
Jock itch ( Tinea Crusis) = groin area
Tinea
Treatment for Tinea?
Terbinafien ( Lamisil)
Elderly patients
○ Thickening of the great toe
○ Painless, pulverizes
Tinea ungum ( toenails)
Treatment for Tinea ungum ( toenails)
Itraconazole ( sporanox); Nizoral tabs
Oral yeast infections ( Thrush) and Vagina
Moniliasis/Candida
Moniliasis/Candida Treatment
Hair Fungal
■ Nizoral Shampoo
Single-celled organism passes thru several stages in its life cycle + one phase as a human parasite
Protozoa
By bite of Anopheles Mosquito
○ Lead to fever, chills that can cause RBC destruction -> death
Malaria
Macrophages destruction -> serious skin lesions
Leishmaniasis
Amebiasis ( Amebic dysentery)
GI infection by Entamoeba Histolyca
○ Via contaminated food, H2O
○ Causes a lot of GI erosions + Tissue distruction
○ Via feces
GI infection that causes diarrhea, “rotten egg” stool
-> malnourished
Giardiasis
Vaginal itching + yellow-green drainage
Trichomoniasis
Metronidazole
ANTIPROTOZOAL AGENTS
Atovaquone ( Mepron)
ANTIPROTOZOAL AGENTS
Tinidazole ( Tindamax)
ANTIPROTOZOAL AGENTS
Treatment for amebiasis, trichomoniasis, giardiasis
Metronidazole
Treatment of P. Carinii
Atovaquone ( Mepron)
Treatment of trichomoniasis, giardiasis, amebiasis
Tinidazole ( Tindamax)
From a bite of the mosquito
● are specifically designed to treat malaria, a parasitic infection
transmitted by mosquitoes.
ANTIMALARIALS
Quinines
ANTIMALARIALS
Mefloquine ( lariam): prophylaxis
ANTIMALARIALS
chinchonism
Too much quinines in your system
Treatment for acute malaria
Quinines
Used before, during, after visit to malarial infested country
● Can be used as prophylaxis as well
Chloroquine ( Aralen)
Worm causing disease invading human body
HELMINTH
Pinworm, whipworm, threadworm, Ascaris, or hookworm
● One of the complications if di nag deworming
NEMATODE ( ROUNDWORM)
Tapeworm
● With head + segmented body parts
● Growing to several yards in human intestine
● Big tummy but very skinny
CESTODE
Ingestion of rounworm larvae in undercooked pork
○ Larvae invade muscle, nervous tissue ( muscle
biopsy)
Trichinosis
Blood and tissues infection of by worm embryos by
biting insects
○ Affects lymphatic system
○ Cause massive inflammatory reactions
○ Severe swelling of hands, feet, legs, arms, scrotum or
breast
Filariasis
Oxamniquine
ANTHELMINTHICS
Praziquantel
ANTHELMINTHICS
Blood infection carried by a snail
○ Common: tropical countries
○ Larvae burrow into skin in fresh water
○ > = migrate throughout human body
○ > = rash + symptoms of diarrhea, liver, brain
inflammation
Schistosomiasis
Ivermectin
ANTHELMINTHICS
Albendazole ( Albenza)
ANTHELMINTHICS
Mebendazole ( Vermox)
ANTHELMINTHICS
Pyrantel ( Pin X)
ANTHELMINTHICS
Thiabendazole
ANTHELMINTHICS
