Antimicrobials Flashcards
- Which condition do you use Amphotericin B? Amphotericin B MOA?
- When would you add an antifungal adjuvant? The antifungal adjuvant MOA?
- Severe systemic mycotic infection. (binds ergosterol to allow leakage)
- Cryptococcal meningitis add flucytosine (blocks conversion of 5-FU by cytosine deaminase)
Adverse effects of using Amphotericin B
AAmPHotericiN
Anemia, **Arrhythmia, Makes u feverish, **Phlebitis, Hypotension, -oterici Nephrotoxicity B
Which condition do you use nystatin? MOA?
Oral candidiasis, vaginal/pelvic candidiasis. (binds ergosterol to allow leakage)
Which condition do you use Azoles? MOA? Key adverse effects?
Most local, less serious systemic infection. (inhibit 14-a-demethylase that forms ergosterol from lanosterol)
MOA: gynecomastia (esp ketoconazole)
Which condition do you use terbinafine? MOA?
Dermatophytoses (inhibits Squalene epoxide to form lanosterol from squalene) (strong TERBIN good against SQUAL)
Which condition do you use Griseofluvin? MOA? Key complications?
oral treatment for severe superficial infections, dermatophytes. (MOA: interferes with microtubule a/b-tubulin dimer)
A/E: teratogenic,carcinogenic, CNS symptoms, **disulfiram-like rxn
What do you use to treat influenza? Which mechanisms does it prevent? What is the point of consideration while prescribing this drug?
Zanamivir, oseltamivir
MOA: inhibit influenza neuraminidase to prevent release of progeny virus.
Use the drug within 48 hr of sx
When do we decide to use acyclovir, famciclovir, ganciclovir?
Acyclovir: VZV, HSV
famciclovir: VZV
ganciclovir: CMV
A/E of acyclovir and famciclovir. Difference between the MOA of both
crystal uropathy.
Both inhibits viral DNA polymerase.
Acyclovir via chain termination, famciclovir via act as competitive inhibitor for viral dGTP
A/E of ganciclovir
bone marrow suppression, nephrotoxicity
Mechanisms of viral drug resistance towards acyclovir, famciclovir, ganciclovir? Any drug good against drug resistance virus?
Mutated viral thymidine kinase
Foscarnet, Cidofovir
Viral DNA polymerase inhibitor
Penicillin which is good against pseudomonas
piperacillin, ticarcillin
Adverse effects of cephalosporins (5)
Hypersensitivity, AIHA, disulfiram-like rxn, Vit K deficiency. Aminoglycosides nephrotoxicity
Which cephalosporins can cross BBB?
3rd gen
B-lactamase inhibitors (4)
clavulanic acid, avibactam, sulbactam , tazobactam
Drug to reduce inactivation of carbapenem. MOA?
cilastatin, blocks renal dehydropeptidase 1
Adverse effects of carbapenem (2)
Rash, CNS toxicity (seizure) at high plasma lvl
Adverse effects of vancomycins (5)
vancomycin is great but NOT trouble Free
NOT F
Nephrotoxicity, Ototoxicity, Thrombophlebitis, Flushing (red man syndrome), DRESS syndrome
vancomycin:
1. MOA
2. Mechanism of resistance
- Bind to D-Ala-D-Ala to prevent cell wall peptidoglycan formation
- D-Ala-D-ala amino acid modification of bacteria
aminoglycoside: (name few)
1. MOA
2. Mechanism of resistance
amikacin, gentamycin, tobramcin, neomycin, streptomycin (b-ANGS-a-T) (Amin is a Bangsat who caNNOT kill anaerobes)
- inhibit initiation complex by bind to 30S ribosome (buy AT 30, CCEL at 50)
- deactivated by bacterial transferase enzymes