Antimictobials, Antibacterial, Antifungal, Antiviral, Antiprotozoal, Antihelminths Flashcards
BacteriCIDAL Antibiotics
"Very Finely Proficient At Murder" vancomycin fluoroquinolones Penicillins Aminoglycosides Metronidazole
BacterioSTATIC Antibiotics
"we're ECSTaTic about bacteriostatics" erythromycin clindamycin sulfamethoxazole trimethoprim tetracycline chloramphenicol
[penicillin]
narrow spectrum penicillin
SE: hypersensitivity, GI upset
Pen G (inject) Pen V (oral) "vunganga"
[penicillin]
penicillinase-resistant penicillins
SE: interstitial nephritis, neutropenia
methicillin
[penicillin]
extended-spectrum penicillins
SE: pseudomembranous colitis
ampicillin (most likely to cause rash)
amoxicillin
AMPicillin- AMPed up penicillin
amOxicillin- greater Oral bioavailability
[penicillin]
antipseudomonal penicillins
SE: hypertension, hypervolemia, bleeding
piperacillin
[penicillin]
used for staph
nafcillin
Amoxicillin HELPS kill enterococci
Amoxicillin "HELPS" kill enterococci Haemophilus influenzae Escherichia coli Listeria monocytogenes Proteus mirabilis Salmonella spp. Enterococci
Takes Care of Pseudomonas
“TCP” Takes Care of Pseudomonas
ticarcillin
carbenicillin
piperacillin
1st generation cephalosporin, high bone penetration, surgical prophylaxis, greatest gram-positive coverage SE: hypersensitivity reaction
cefazolin
2nd generation cephalosporin,
added gram negative coverage
SE: disulfiram reaction
cefamandole
cefotetan
3rd generation cephalosporin, pseudomonas coverage
SE: disulfiram reaction
cefoPERAzone
most efficacious cephalosporin for pseudomonas aeruginosa
ceftaziDIME
4th generation cephalosporin, broad spectrum activity (gram positive and gram negative)
cefepime
which cephalosporin has the best penetrance to the BBB?
ceftriaxone
microbes covered by 1st gen cephalosporins
microbes covered by 1st gen cephalosporins "PEKs first" Proteus mirabilis escherichia coli klebsiella pneumoniae
1st generation cephalosporins
1st generation cephalosporins "PH, FAD, FAZ" ceFADroxil ceFAZolin cePHalothin cePHapirin cePHradine cePHalexin
microbes covered by 2nd gen cephalosporins
HEN has KEPS haemophilus influenzae enterobacter aerogenes neisseria spp. klebsiella pneumoniae escherichia coli proteus mirabilis serratia marcescens
2nd generation cephalosporins
2nd generation cephalosporins "fox, fur, for, fam, teta, fon, fac, lora, pro, azole" ceFOXitin ceFURoxime ceFORanide ceFAMandole cefoTETAN ceFONicid ceFAClor LORAcarbed cefPROzil cefmetAZOLE
cephalosporins causing disulfiram reaction
cephalosporins causing disulfiram reaction "man, azole, teta, pera" cefaMANdole cefmetAZOLE cefoTETAn cefoPERAzone
most commonly used against Bacteroides
ceftizoxime
most active cephs against penicillin-resistant streptococcus pneumoniae
ceftriaxone
cefotaxime
has a very good action on pseudomonas
ceftazidime
best CNS penetrance
ceftriaxone
has good activity against B. fragilis and thus used for abdominal and pelvic infections
cefotetan
cefoxitin
3rd generation cephalosporins
"FEnge PO PERA to FIX my TTTTTV" (about money) ceFEtamet cefPOdoxin cefoPERAzone ceFIXime cefTRIAxone cefTaziDIME cefoTAXime cefoTIZOxime cefTibuten
anti-pseudomonal cephalosporins
ceftaziDIME
ceFEPime
cefoPERAzone
silver bullet agains gram negative bacteria, no gram-positive activity,
with anti-pseudomonal coverage
aztreonam
beta-lactamase inhibitor
SE: cholestatic jaundice
“CAST”
clavulonic acid
sulbactam
tazobactam
treatment for MRSA
SE: red man syndrome
vancomycin
drug of last resort, broad spectrum of activity
SE: CNS toxicity (confusion, encephalopathy, seizures)
imipenem-cilastatin
Drugs of last resort
"I AM your Last Shot at Victory" imipenem amikacin meropenem linezolid streptogramins vancomycin
[protein synthesis inhibitors]
binds to 50S subunit
SE: aplastic anemia, gray baby syndrome
chloramphenicol - inhibits peptidyl transferase
[protein synthesis inhibitors]
binds to 30S subunit
SE: tooth enamel discoloration, photosensitivity
tetracycline
[protein synthesis inhibitors]
binds to 50S subunit
DOC for penicillin-allergic patients
SE: diarrhea, cholestatic jaundice, QT prolongation
Macrolides: erythromycin azithromycin clarithromycin telithromycin roxithromycin
used for macrolide-resistance
telithromycin
macrolide with highest Vd (volume distribution) and slowest elimination, single dose administration; binds to 50S subunit
azithromycin
all macrolides inhibit CYP450 except
azithromycin
binds to 50S subunit, anaerobic coverage
SE: pseudomembranous colitis
Lincosamide:
clindamycin
lancomycin
binds to 50S subunit, vancomycin-resistance
Oxazolidinone (linezolid, tedizolid)
streptogramins (quinupristin, dalfopristin)
blocks attachment of T-RNA to acceptor site
tetracyclines
for anaerobic infections ABOVE the diaphragm
clindamycin
for anaerobic infections BELOW the diaphragm
metronidazole
[aminoglycosides]
has lowest therapeutic index
amikacin
[aminoglycosides] bactericidal binds to 30S subunit treatment if endocarditis SE: nephrotoxicity, ototoxicity
gentamicin
[aminoglycosides]
treatment of ocular infections
tobramycin
[aminoglycosides]
treatment of tuberculosis
streptomycin
[aminoglycosides]
treatment of drug-resistant gonorrhea
spectinomycin
[aminoglycosides]
widest spectrum of activity, pseudomonas coverage, narrow therapeutic window
amikacin
[aminoglycosides]
treatment of hepatic encephalopathy
neomycin
Mean GiANTS canNOT kill anaerobes
Mean GiANTS canNOT kill anaerobes gentamicin amikacin neomycin tobramycin streptomycin nephrotoxicity ototoxicity teratogen (aminOglycosides require O2 for transport)`
[sulfonamides]
blocks dihydropteroate synthase
sulfamethoxazole
dapsone
[sulfonamides]
blocks dihydrofolate reductase
trimethoprim
[sulfonamides]
sequential blockade in folate synthesis, urinary tract infections
SE: hypersensitivity (SJS, TEN), kernicterus, hemolysis in patients with G6PD
TMP-SMX
trimethoprim suilfonamides
[sulfonamides]
treatment of burn infections that can cause neutropenia
sulfadiazine
[sulfonamides]
treatment of burn infections that can cause metabolic acidosis
mafenide acetate
[fluoroquinolone]
2nd generation quinolone, treatment of urinary tract infections and GIT infections
SE: tendinitis, tendon rupture, QT prolongation
ciprofloxacin
[fluoroquinolone]
3rd generation quinolone, treatment of pulmonary infections
levofloxacin
[fluoroquinolone] 3rd generation quinolone broad spectrum of activity, anaerobic coverage, treatment of ocular infections
moxifloxacin
[fluoroquinolone]
3rd generation quinolone
SE: diabetes mellitus
gatifloxacin
[fluoroquinolone]
3rd generation quinolone
SE: cardiotoxicity
grepafloxacin
[fluoroquinolone]
4th generation quinolone
SE: hepatotoxicity
trovafloxacin
[fluoroquinolone]
most active agent against gram (-) organisms esp pseudomonas
ciprofloxacin
fluoroquinolone MOA: inhibits DNA replication by binding to DNA gyrase and topoisomerase IV; cidal
inhibits cartilage development
fluoroquinolones
“FluoroquinoLONES hurt attachment to your BONES (cartilage damage)”
antimicrobial with anaerobic and antiprotozoal coverage,
treatment of pseudomembranous colitis
SE: disulfiram reaction, metallic taste, neurotoxicity
metronidazole
antimicrobial for treatment of urinary tract infections
SE: pulmonary fibrosis
nitrofurantoin
[Anti-mycobacterial agents]
Cidal;
inhibits mycolic acid synthesis
SE: neurotoxicity, hepatotoxicity, sideroblastic anemia, drug-induced lupus, Potent CYP450 INHIBITOR
isoniazid
[Anti-mycobacterial agents]
Cidal;
inhibits DNA-dependent RNA polymerase
SE: red orange urine, hepatotoxicity, CYP450 INDUCER
rifampicin
used in patients with PTB
rifabutin
used in patients with traveller’s diarrhea
rifaximin
[Anti-mycobacterial agents]
Static;
inhibits arabinoglactan sythesis
SE: visual dysfunction (retrobulbar neuritis, color blindness)
ethambutol
[Anti-mycobacterial agents]
Static but Cidal on actively dividing MTB
SE: hyperuricemia, hepatotoxicity (most)
pyrazinamide
[Anti-mycobacterial agents]
Cidal;
binds to 30S, IM
SE: nephrotoxicity, ototoxicity
streptomycin
Mnemonic:
INH Injures Neurons and Hepatocytes
INH Injures Neurons and Hepatocytes
Mnemonic: R= Rifampicin RNA polymerase inhibitor Red-orange body fluids Rapid development of resistance Revs up cytochrome P450 (inducer)
Mnemonic: R= Rifampicin RNA polymerase inhibitor Red-orange body fluids Rapid development of resistance Revs up cytochrome P450 (inducer)
[drugs for leprosy]
most active drug against M. leprae;
inhibits folate synthesis
SE: methemoglobinemia, hemolysis in G6PD deficient patients
dapsone
[drugs for leprosy]
inhibits DNA-dependent RNA polymerase
SE: red-orange urine, delays onset of dapsone resistance
rifampicin
[drugs for leprosy]
phenazine dye, binds to guanine bases
SE: skin discoloration
clofazimine
[antifungals]
most efficacious antifungal drug, forms artificial pores
SE: nephrotoxicity (RTA), infusion-related reactions
amphotericin B
[antifungals]
topical treatment of dermatophytosis and candidiasis
SE: gynecomastia, CYP450 inhibitor
ketoconazole
[antifungals]
DOC for treatment and secondary prophylaxis of cryptococcal meningitis
fluconazole
[antifungals]
interferes with fungal microtubules;
potent CYP450 inducer
griseofulvin
[antifungals]
treatment of candidiasis (oropharyngeal, esophageal, vaginal), swish and swallow or suppository preparations
nystatin
inhibits DNA polymerase
SE: nephrotoxicity
antivirals
[antivirals]
treatment of HSV and VZV;
requires activation by viral thymidine kinase
SE: crystalluria
acyclovir
[antivirals]
treatment of CMV;
requires activation by viral thymidine kinase
ganciclovir
[antivirals]
treatment of HSV, VZV and CMV;
does not require viral thymidine kinase activation
foscarnet, cidofovir
[antivirals]
prevents viral uncoating, influenza A coverage
SE: cerebellar dysfunction, livedo reticularis
amantadine
[antivirals]
neuramminidase inhibitor;
DOC for influenza
oseltamivir
[antivirals]
treatment of hepatitis B infection
lamivudine
[antivirals]
treatment of hepatitis C and RSV infection
ribavirin
mnemonics:
[AMANTADINE]
A man to dine takes off his coat
Amantidine prevents uncoating
mnemonics:
[AMANTADINE]
A man to dine takes off his coat
Amantidine prevents uncoating
[antivirals]
nucleoside reverse transcriptase inhibitor (NRTI),
requires phosphorylation, primary drug for HIV,
prevents vertical transmission of HIV
SE: lactic acidosis, bone marrow suppression
zidovudine
[antivirals]
non-nucleoside reverse transcriptase inhibitor (NNRTI),
no phosphorylation required
SE: hepatotoxicity
delavirdine
[antivirals]
protease inhibitor;
SE: fat redistribution syndrome, hyperlipidemia, insulin resistance
“-navir”
Ritonavir
[antivirals]
fusion inhibitor, binds gp41 subunit
enfuvirtide
[antivirals]
binding inhibitor, CCR5 antagonist
maraviroc
mnemonic [NNRTIs] Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs) Never Ever Deliver Nucleosides Nevirapine Efavirenz, Etravirine Delavirdine
mnemonic [NNRTIs] Nonnucleoside Reverse Transcriptase Inhibitors (NNRTIs) Never Ever Deliver Nucleosides Nevirapine Efavirenz, Etravirine Delavirdine
mnemonic
[Protease inhibitors]
All protease inhibitors end with -navir
NAVIR (never) tease a proTEASE
mnemonic
[Protease inhibitors]
All protease inhibitors end with -navir
NAVIR (never) tease a proTEASE
[anti-malarial]
primary drug for malaria, prevents heme polymerization into hemozoin
SE: retinal damage, hearing loss
chloroquine
[anti-malarial]
chloroquine-resistance, severe malaria,
DOC for pregnant patients with malaria
SE: hypoglycemia, blackwater fever, cinchonism
quinine (class 1a)
[anti-malarial]
eradication of hypnozoites of P. vivax and ovale
primaquine
[anti-malarial]
chemoprophylaxis (chloroquine-resistant areas)
mefloquine,
malarone
[anti-malarial]
chemoprophylaxis (multi-drug resistant areas)
doxycycline
[anti-malarial]
DOC for malaria in the Philippines (P. falciparum)
artemether/ lumefantrine
co-artem
[anti-protozoal drugs]
asymptomatic cyst carries of E. histolytica
SE: flatulence
diloxanide furoate
[anti-protozoal drugs]
amebic dysentery, trichomoniasis, bacterial vaginosis;
SE: disulfiram reaction
metronidazole (forms free radicals)
[anti-protozoal drugs]
cryptosporidium parvum infection
nitrazoxanide
[anti-protozoal drugs]
pneumocystitis jiroveci pneumonia
Trimethoprim/Sulfamethoxazole
[anti-protozoal drugs]
toxoplasmosis
pyrimethamine-sulfadiazine
[anti-protozoal drugs]
african sleeping sickness (T. bruceii)
malarsoprol +- suramin
“sure mellow sleep”
[anti-protozoal drugs] Chagas disease (T. Cruzi)
nifurtimox
[anti-protozoal drugs]
leishmaniasis
sodium stibogluconate
[anti-helminthic drugs]
inhibits helminthic microtubules;
ovicidal
mebendazole
any but not albendazole
[anti-helminthic drugs]
inhibits helminthic microtubules, ovicidal and larvicidal.
DOC for hydatid disease (echinococcosis)
albendazole
[anti-helminthic drugs]
DOC for filaria and loa loa
SE: filarial fever
diethylcarbam
[anti-helminthic drugs]
DOC for strongyloides and onchocerca
SE: mazzotti reaction (cause flaccid paralysis)
ivermectin
[anti-helminthic drugs]
DOC for enterobium (cause spastic paralysis)
pyrantel pamoate
[anti-helminthic drugs]
DOC for trichinosis
thiabendazole
[anti-helminthic drugs]
DOC for trematodes and cestodes
except echinococcosis
praziquantel
albendazole for echinococcosis
[anti-helminthic drugs]
back-up drug to praziquantel
niclosamide
[anti-fungal]
Broadest spectrum triazole (the only azole with activity against Rhizopus sp/ mucormycosis)
Posaconazole
[anti-fungal]
Can increase levels of cyclosporine and tacrolimus
Micafungin
Adverse effects of aminoglycoside
“NON”
Nephrotoxicity
Ototoxicity
Neuromuscular blockade
Is given for pre-exposure prophylaxis to reduce HIV acquisition in homosexuals, heterosexuals and IV drug users
Tenofovir + Emtricitabine
Is indicated for acyclovir resistant HSV and VZV in immunocompromised individuals
Foscarnet
Antiviral agent that prevent vertical transmission at the onset of labor
Nevirapine
First line Antiviral agent that prevent vertical transmission
Zidovudine
Prevents vertical transmission of HBV when given in the last 4 weeks of gestation
Lamivudine
A patient with Hepatitis B and co-infected with HIV is best treated with
Lamivudine
Antiviral agent that does not cause termination of chain elongation because of the presence of 3-OH group
Penciclovir