Antimicrobial and Antifungal Therapy--chapter 31-33,35 WEEK 12--Q = 17 Flashcards
Cell Wall Inhibitors (chapter 31)
Action: target the __________in the cell wall
peptidoglycan
Cell Wall Inhibitors (chapter 31)
I. Penicillins:
Action:_____________(cell lysis)
indication: EXTENDED spectrum, gram+ve, some gram-ve
Indication use of ampicillin
- Gram +: Listeria
- Gram –ve: E.coli, haemophilus,proteus and salmonella
• Indication of anti-pseudomonal:
- Gram –ve: E.coli, proteus, haemophilus and pseudomonas
• Side effects of penicillin:
- ALLERGY: 5% of patients may develop ____OR_________
- diarrhea
- Interstitial nephritis
- seizure
- Bleeding
- SALT toxicity: more Na+ and less K+
bactericidal
rash or anaphylaxis
Cell Wall Inhibitors (chapter 31)
II. CEPHalosporins:
• Action: is β-lactam antibiotic (as penicillin)
• Indication: (except MRSA, Listeria, Clostridium
difficle), additional to Gram+ve
Advantages AND disadvantages of some cephalosporins
• Side effects: _______- anyone is allergic to ________ should NOT receive cephalosporins
allergy
penicillin
Cell Wall Inhibitors (chapter 31)
• VANcomycin:
–Action: inhibits cell wall phospholipids as well as
peptidoglycan
–Indication: gram+ve bacteria,
methicillin-resistance staph aureus (MRSA), enterococcus faecalis
Side effects of vancomycin: 1. Fever 2. Chills 3. Flushing (\_\_\_-\_\_\_\_ \_\_\_\_\_\_\_\_) 4. Phlebitis 5. Shock (histamine release in rapid IV)
red-man syndrome
Protein synthesis inhibitors (chapter 32)
I. TETRAcyclines:
- – actions: INHIBIT protein synthesis by binding 30S subunit of the bacterial ribosome (blocking access of the amino acyl-tRNA to mRNA) = ______________
- – Indications: (_________ ________ antibiotic)
- Against gram+ve, gram-ve, and others
Side effects of TETRAcyclines
- gastric stress: MUST taken with FOOD
- discoloration and hypoplasia of TEETH in children (temporary)
- LIVER failure with _________
- phototoxicity: causes severe sunburn
- VERTIGO (accumulation in endolymph of the inner ear)
- SUPERinfection: allows overgrowth of __________
- pseudotumer cerebri: rare in adult, benign (reversible)
bacteriostatic
broad-spectrum
pregnancy
Candida (yeast)
Protein synthesis inhibitors (chapter 32)
II. AMINOglycosides
• Such as: gentamycin, neomycin, streptomycin, tobramycin
• Action: BINDS to the 30S ribosomal subunit prior to ribosomal formation. = BACTERICIDAL
• Indication: Aerobic gram-ve bacilli (pseudomonas
aeruginosa), Gram+ve cocci,
Side effects of AMINOglycosides:
1. _________: accumulation in the endo and perilymph causes damage hair cells in the organ of Corti,
“________ ___________”
2. __________: acute tubular necrosis
3. __________: ↓acetylcholine release at NMJ.
Antidote is calcium gluconate or neostigmine
4. Skin rash: contact dermatitis with topical
ototoxicity fetal deafness
nephrotoxicity
paralysis
Protein synthesis inhibitors (chapter 32)
III. MACrolides
• Such as: erythromycin, clarithromycin, azithromycin
- –• Action: BIND to 50S subunit of the bacterial ribosomes = (____________)
- –• Indications: extended spectrum as shown:
Side effects of MACrolides:
- epigastric distress: MC side effect. Patient MUST take this drug with FOOD
- ________
- _________: deafness at the high doses
Contraindication with: LIVER dysfunction, HEART problem (rhythm) and myasthenia gravis
bactriostatic
jaundice
ototoxicity
Protein synthesis inhibitors (chapter 32)
IV. CHLORAmephanicol
• Action: inhibit protein synthesis by BINDING 50S ribosomal subunit.
EITHER bacteriostatic (MC) or bactericidal!!!
• Indication: BROAD spectrum antibiotic, gram+ve, gram-ve, rickettsia, good against anaerobe. But NOT good against pseudomonas
• Side effects: easy are GI DISTRESS and overgrowth candida.
But SERIOUS effects are:
1. reversible _______ anemia but….
irreversible _________ anemia
2. ______ _______ syndrome: damage mitochondria of newborn → poor feeding, less breathing, CV collapse, cyanosis and death
hemolytic
aplastic
Gray baby
Protein synthesis inhibitors (chapter 32)
v. CLINDAmycin
• Action: as erythromycin to INHIBIT 50S ribosomal bacterial subunit
• Indication: primarily against ________ _________ as
Bacteroides fragilis, (clostridium difficile resists)
• Side effects: super-infection of c.diff. bacteria causes
___________ ____________
(treated by Vancomycin or flagyl)
anaerobic bacteria
pseudomembranous colitis
QUINolones (chapter 33)
Action: inhibit replication of ________ ____
(DNA gyrase). = bacteriCIDAL.
Side effects of QUINolones:
- GIT: nausea, vomiting AND diarrhea
- CNS: headache, dizziness,
- _____________: severe sunburn, should avoid the sun
- Connective tissue _______: such as articular cartilage (arthropathy) or rupture tendons (maybe)
bacterial DNA
phototoxicity
erosions
Antifungal drugs (chapter 35)
Action of all antifungal is it binds the _________ in the cell membrane of the fungus →causes cell death
= (___________)
ergosterol
fungicidal
Antifungal drugs (chapter 35)
I. Treatment of SUBcutaneous and systemic infection
1—AMphotercin B
—-• Indication of amphotercin B: againts candida,
histoplasma, cryptococcus, coccidioides
immitus, blastomyces, aspergillus
—-• Side effects of AMphotercin: ______and________
nephrotoxic by IV, shock, anemia ( ↓RBCs production), phlebitis
2—KETOconazole:
—-• Indication of ketoconazole: histoplasma,
candida, blstomyces, coccidioides
—-• Side effects: allergy, GI disturbance,
____________, __________, irregular menstruation
and hepatic dysfunction
fever, chills,
gynecomastia, ↓libido
Antifungal drugs (chapter 35)
I. Treatment of SUBcutaneous and systemic infection
3—FLUCOnazole
Indication of FLUCOnazole: ___________(cryptococcus
neoformans), candida, coccidioides,
• Side effects of FLUCOnazole: less than ketoconazole, nausea, vomiting, rash, and teratogenic
(avoid in pregnancy)
4—ITRAconazole
• Indication of ITRAconazole: BROAD antifungal
• Side effects of ITRAconazole: NO endocrine side effects like ketoconazole. Nausea, vomiting, rash,
________ AND ___________
5–POSAconazole
• Indication of POSAconazole: BROAD antifungal-approved 2006
• Side effects of POSAconazole:
GI (nausea, vomiting, _______), ↑ LIVER enzymes
meningitis
edema AND hypokalemia
diarrhea
Antifungal drugs (chapter 35)
II. Treatment of CUTANEOUS fungal infection
Action: DECREASE synthesis of ergosterol of the cell fungal membrane (fungicidal)
1—- TERBINafine
Indication of TERBINafine (lamisil): dermatophytes & candida
• Side effects of TERBINafine: GI (diarrhea, dyspepsia, nausea), headache, rash and ↑ liver enzymes.
“_________ ______ ___ _________”
2—-GRISeofulvin
Indication of griseofulvin: ______________ of the nails,
(fungistatic). Treatment = ____-______MONTHS
• Side effects of griseofulvin: duration, induces __________ of other drugs, NO alcohol during therapy (toxic)
treatment for 3 months
dermatophytes
6-12 months.
metabolism
Antifungal drugs (chapter 35)
II. Treatment of CUTANEOUS fungal infection
Action: DECREASE synthesis of ergosterol of the cell fungal membrane (fungicidal)
3—NYstatin
Indication of NYstatin: TOPICAL ONLY OF CANDIDA
• Side effects of NYstatin: lack of _____ _______
GI absorption
