Antimicrobials Flashcards
Polyenes
Antifungals
Aspergillus
Candida
Azoles
Antifungals
Target cell membrane synthesis
Yeast
Chloroquine
Primaquine
Anti malarials active against strains other than falciparum
Quinine
Artemisinin
Antimalarials used in falciparum strains
Antimicrobial classes targeting DNA synthesis
Quinolones
Folic acid antagonists
Quinolone mechanism
Inhibition of topoisomerase II
Ciprofloxacin class
Quinolone
Ciprofloxacin DDIs
CYP450 inhibitor
Trimethoprim class
Folic acid antagonist
Trimethoprim use
UTI
Metronidazole class
Folic acid inhibitor
Metronidazole spectrum of action
Anaerobic bacteria
Amoebae
Giarda
Trichomonas
Sulfonamides DDIs
CYP450 inhibitor
Aminoglycosides mechanism
Bind to 30s ribosome
Gentamicin class
Aminoglycoside
Amino glycosides spectrum of activity
Gram negatives
Amino glycosides DDIs
Hypocalcaemia with bisphosphanates
Cardiac glycosides
Amino glycosides ADRs
Nephrotoxicity, ototoxicity
Macrolides mechanism
Prevent peptidyltransferase action
Classes targeting protein synthesis
Amino glycosides
Macrolides
Tetracyclines
Rifampin
Erythromycin class
Macrolides
Macrolides spectrum of activity
Mild gram positive infections
Tetracycline mechanism
Block A site of 30s ribosome
Tetracycline class
Polyketide
Tetracycline DDIs
Hypoglycaemia with sulfonylureas
Tetracycline ADRs
Liver Renal C. diff Dental GI
Classes targeting cell wall synthesis
Beta lactams
Glycopeptides
Sub classes of beta lactams
Penicillins
Cephalosporins
Carbapenems
Beta lactam mechanism
Inhibit cross linking of cell wall, causing cell lysis
Penicillin spectrum
Streptococci
Very good for syphillis
Amoxicillin spectrum
Streptococci
Gram negatives
Co amoxiclav
Amoxicillin with beta lactamase inhibitor
Activity as amoxicillin but also anaerobes.
Flocoxacillin spectrum
Staphylococci
Streptococci
Cephalosporin spectrum
Broad spectrum but no anaerobes
Ceftriaxone use
Meningitis as crosses BBB
Carbapenems spectrum
Very broad
Penicillin ADRs
Hypersensitivity Hepatotoxicity CNS toxicity Electrolyte disturbance C diff.
Penicillin DDIs
Rash with allopurinol.
Cephalosporin ADRs
Hepatotoxicity
Hypersensitivity
C diff
Carbapenem ADRs
CNS toxicity
Hypersensitivity (but safe in penicillin allergy)
C diff
Carbapenem DDIs
Gancyclovir
Anti epileptics
Glycopeptide mechanism
Inhibit peptidoglycan synthesis
Vancomycin class
Glycopeptide
Vancomycin spectrum
Most gram positives
Give IV.
Glycopeptide ADRs
Bone marrow
Hypersensitivity
Nephrotoxic
Ototoxicity
Neuraminidase inhibitor mechanism
Inhibit virus release
Zanamovir and oseltamivir class
Neuraminidase inhibitors
Neuraminidase inhibitor ADRs
Vomiting
Abdominal pain
Epistaxis
Headache
M2 channel inhibitor mechanism
Inhibit viral uncoating
Physically blocks ion channels (requires H+ mediated fall in pH)
Amantidine and rimantidine class
M2 channel inhibitors
M2 channel inhibitors spectrum
Influenza A
M2 channel inhibitors ADRs
CNS-confusion, insomnia
Renal
Hypotension
Aciclovir mechanism
Inhibits viral DNA polymerase
Rifampicin mechanism
Blocks RNA polymerase
Rifampicin DDIs
CYP450 inducer
Streptomycin
Aminoglycoside
Nystatin
Polyenes
Topical use only, toxic systemically
Good for candida
Amphotericin
Polyene
Can be given IV for systemic infections
Isoniazid
TB drug
Prodrug
Metabolite prevents synthesis of mycolic acid required for mycobacterial cell wall.
Isoniazid ADRs
Rash Abnormal LFTs Hepatitis Sideroblastic anaemia Metabolic acidosis Peripheral neuropathy (Vit B6 depletion) CNS effects
Isoniazid DDIs
Increased phenytoin or disulfiram
Reduces CYP450
Pyrazinamide
TB drug
Crosses BBB so can be used in tuberculous meningitis
Pyrazinamide ADRs
Arthralgia
Gout
Hepatotoxicity
Ethambutol
TB drug
Prevents formation of cell wall
Ethambutol ADRs
Optic neuritis Red-green colour blindness Peripheral neuropathy Arthralgia Hepatotoxicity Hyperuricaemia Vertical nystagmus
Rifampicin ADRs
Hepatotoxicity Breathlessness Rash Abdominal Flu like symptoms
Rifampicin DDIs
CYP450 inducer