Antimicrobials III/IV

Question 1

Name all the drugs (categories) that inhibit nucleic acid/DNA synthesis

Answer 1

Quinolones/Fluoroquinolones
Metronidazole
Nitrofurantoin
Rifampin

Question 2

Name all the drugs (categories) that inhibit cell metabolism

Answer 2

Sulfonamides
Trimethoprim
Silver sulfadiazine
TMP/SMX

Question 3

Name all the fluroquinolones

Answer 3

1st gen: FQ
2nd gen: ciprofloxacin
3rd gen: levofloxacin, ofloxacin
4th gen: moxifloxacin

Question 4

MOA of FQs

Answer 4

bactericidal
FQs interfere with bacterial DNA synthesis by inhibiting topo II (aka DNA gyrase) in Gram - organisms, and topo IV in gram + organisms

Question 5

Clinical use of FQs/Toxicity and contraindications of FQs

Answer 5

Gram - : neisseria, pseudomonas, chronic bone infections (osteomyelitis)

Tendonitis and Tendon rupture
GI upset

Do not take with antacids, and do not give to children and pregnant women – causes cartilage damage

Question 6

MOA of metronidazole

Answer 6

Forms free radicals that damage DNA

Question 7

Clinical use of Metronidazole/Toxicity and contraindications of metronidazole

Answer 7

Giardia, Entamoeba, Trichomonas, Gardenella vaginalis, Anaerobes, H. Pylori, bugs below the diaphragm, perforated abdominal organs

GET GAP on the METRO

Headache, Metallic taste, no alcohol

Question 8

MOA of Nitrofurantoin

Answer 8

Reactive drug intermediates damage DNA, ribosomes and others

Question 9

Clinical use of nitrofurantoin/Toxicity and contraindications of nitrofurantoin

Answer 9

UTIs

Hepatotoxicity, pulmonary fibrosis, drug induced lupus

Question 10

MOA of Rifampin

Answer 10

inhibits DNA dependent RNA polymerase

Question 11

Clinical use of Rifampin/Toxicity and contraindications of Rifampin

Answer 11

First line for TB
Leprosy treatment
Prophylactic drug of choice for meningococcal

Red orange body fluids
Jaundice
Elevated liver enzymes

4 Rs of Rifampin
RNA pol inhibitor
Rev up CYP450 -- increases metabolism of contraceptives and warfarin
Red/orange fluids
Rapid resistance if used alone

Question 12

Name the Suflonamides

Answer 12

Sulfamethoxazole

Sulfadiazine

Question 13

MOA of suflonamides

Answer 13

Bacteristatic

PABA antimetabolites inhibit dihyropteroate synthetase

Question 14

Clinical use of sulfonamides/Toxicity and contraindications of sulfonamides

Answer 14

Gram + and Gram -
Nocardia and Chlamydia

Hypersensitivity
Hemolysis if G6PD defcient
Nephrotoxicity
Photosensitivity
Kernicterus in infants

Question 15

MOA of Trimethoprim

Answer 15

bacteriostatic

inhibits dihydrofolate reductase

Question 16

Clinical use of Trimethoprim/Toxicity and contraindications of Trimethoprim

Answer 16

Recurrent UTIs
Shigella, Salmonella, pneumocystic jiroveci

C. diff
Hematological disorders
    - TMP = Treats marrow poorly
Fever
Diarrhea
Cellulitis

Used in conjunction with sulfonamides

Question 17

MOA of SIlver sulfadiazine

Answer 17

Blocks folate synthesis

Question 18

Clinical use of sulve sulfadiazine

Answer 18

Burns

Question 19

MOA of TMP/SMX

Answer 19

Combination drug mechanisms inhibits DNA synthesis

Question 20

Clinical use of TMP/SMX

Answer 20

1st line tx of pneumocystis jiroveci pneumonia

Recurrent UTIs

Question 21

What are specific uses of Ciprofloxacin?

Answer 21

Ciprofloxacin is a 2nd generation FQ

Drug of choice for prophylaxis or treatment of anthrax
Chronic bone infections
Traveler’s Diarrhea