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Pharmacology > Antimicrobials IV > Flashcards

Antimicrobials IV Flashcards

1
Q

mechanism of chloramphenicol

A

blocks peptidyltransferase at 50S ribosomal subunit (bacteriostatic) –> protein synthesis inhibition

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2
Q

what changes causes resistance to chloramphenicol

A
  • production of chloramphenicol acetyltransferase which inactivates drug
  • changes in membrane permeability
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3
Q

clinical application of chloramphenicol

A

topical treatment of ear and eye infections (no systemic adverse effects)

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4
Q

drug interaction of chloramphenicol

A

it is a CYP450 inhibitor

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5
Q

adverse effects of chloramphenicol

A

Aplastic Anemia
Gray Baby Syndrome (cyanosis): newborns do not have effective glucuronic acid conjugation mechanism needed for breakdown of chloramphenicol –> vomiting, flaccidity, hyperthermia, gray color, shock and collapse

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6
Q

mechanism of clindamycin

A

blocks peptide transfer (translocation) at 50S ribosomal subunit (bacteriostatic) -> inhibition of protein synthesis

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7
Q

clinical applications of clindamycin

A
  • Pneumocystis Jiroveci pneumonia in AIDs pts
  • Toxoplasmosis in AIDS pts
  • Prophylaxis for endocarditis for those who are undergoing a dental procedure
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8
Q

adverse effects of clindamycin

A

Fatal Pseudomembrane Colitis
diarrhea, nausea, skin disease
Impaired liver function and neutropenia

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9
Q

what is the streptogramins

A

Dalfopristin-Quinupristin

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10
Q

mechanism of dalfopristin-quinupristin

A

cause protein synthesis inhibition by binding to separate sites on 50S ribosome (mainly bacteriocidal)

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11
Q

clinical application of streptogramins

A

dalfopristin-quinupristin

infections caused by staph or vancomycin resistant strain of e. faecium (not e. faecalis)

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12
Q

mechanism of linezolid

A

binds to 23S ribosomal RNA of 50S subunit -> inhibition of protein synthesis

weak, reversible inhibitor of monoamine oxidase

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13
Q

main use of linezolid

A

treat multi drug resistant infections

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14
Q

what drug is 100% bioavailable after oral administration

A

linezolid

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15
Q

adverse effect of linezolid

A
  • inhibitor of MOA –> increased serotonin in brain
  • Lactic acidosis
  • Optic and Peripheral Neuropathy
  • Myelosuppression
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16
Q

mechanism of Fidaxomicin

A

binds to sigma subunit of RNA polymerase hence inhibiting it –> protein synthesis inhibition

17
Q

main clinical application for Fidaxomicin

A

C. difficile colitis

18
Q

mechanism of Mupirocin

A

binds to bacterial isoleucyl transfer-RNA synthetase –> inhibition of protein synthesis

19
Q

clinical use of mupirocin

A

MSSA or MRSA

20
Q

adverse effects of mupirocin

A

not used systemically so well tolerated

burning
edema
tenderness
dry skin
pruritis
21
Q

drugs that affect nucleic acid synthesis

A

Fluoroquinolones
Sulfonamides
Trimethoprim

22
Q

what are the fluoroquinolones

A

1st gen: Nalidixic acid
2nd gen: Ciprofloxacin
3rd gen: Levofloxacin
4th gen: Moxifloxacin and Gemifloxacin

23
Q

mechanism of fluoroquinolones

A

direct inhibitor of bacterial DNA synthesis

inhibits bacterial enzymes, DNA gyrase (topoisomerase II) and topoisomerase IV –> damage to bacterial DNA –> bacterial cell death

24
Q

mechanism of resistance in fluoroquinolones

A

mutation in genes that

  • encode DNA gyrase (II) and topoisomerase IV
  • regulate expression of efflux pumps
25
Q

name and use of first generation fluroquinolones

A

Nalidixic acid

uncomplicated urinary tract infection

26
Q

name and use of second generation fluoroquinolones

A

Ciprofloxacin

traveler’s diarrhea (e. coli)
pseudomonas aeruginosa (in CF patients)
prophylaxis for meningococcal infection

27
Q

name and use of third generation fluororquinolones

A

Levofloxacin

CA pneumonia (most common)
prostatitis caused by e. coli
STDs (not syphilis)
skin infections
acute sinusitis
chronic bronchitis
tuberculosis
28
Q

name and use of fourth generation fluoroquinolones

A

Moxifloxacin and Gemifloxacin

together with levofloxacin are referred to as respiratory fluoroquinolones

-used for pneumonia

29
Q

adverse effect of fluroquinolones

A

Connective tissue problems
QT prolongation
GI disturbances (most common)
Superinfections

30
Q

what drugs can enhance the toxicity of fluroquinolones

A

theophyllines, corticosteroids, NSAIDs,

31
Q

Levofloxacin, Gemifloxacin, and Moxifloxacin can increase the serum levels of what drugs

A

warfarin, caffeine, and cyclosporine

32
Q

contraindications of fluroquinolones

A
  • pregnancy and nursing mothers

- children under 18 - due to erosion of cartilage in weigh bearing joints

Pharmacology (79 decks)

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