Block1b Flashcards
Vancomycin and Teicoplanin are what?
Glycopeptides
Vancomycin does not go where, can enter bone, has therapeutic concentrations when the meninges are inflammed
CSF
Clostridium difficile has what drug against it?
Metronidazole
Name problems that results from Vancomycin, it should not be given how?
Intramusculary, Ototoxicity, Nephrotoxicity, Red Man Syndrome (Type I HSR)
What drugs can be given if Vancomycin resistant happens?
Linezolid and Quinupristin/Daflopristin
What drug inhibits cell wall synthesis, active against various Gram + bacteria, only topical because it can be toxic to the kidneys?
Bacitracin
Fosfomycin, inhibits what? Ok during pregnancy, active against gram positive and negative
Bacterial cell wall synthesis, oral preparations are available
What drug causes dose related central nervous system toxicity, treats TB?
Inhibits incorporation of _________ into peptidoglycan pentapeptide
Cycloserine
D-alanine
Daptomycin has what ADR? Active against what strains?
What is the mechanism of Daptomycin?
Myopathy, Vancomycin Resistant
Binds to the cell membrane and depolarizes membrane, binds to phosphotidaylglycerol (IDR)
What is cystitis?
Infection of the bladder
No drugs cross the CNS except what?
Cefuroxime
Plague and Brucellosis is treated with what drugs (name 2)?
Streptomycin and Doxycycline
TB and Tularemia is treated with what drug?
Streptomycin
What Drug combination is used for Pseudomonal infections?
Tobracyclin plus an antipseudomonal penicillin (Piperacillin and Ticarcillin)
What drug combination would work with an entercoccus infection?
Gentamyocin/Streptomycin and ampicilin/penicilinG or Vancomycin
What two drug classes go after the 30S subunit via bacterial translation?
Tetracycline and Aminoglycosides
What endings do the aminoglycosides have?
What endings do the tetracyclines have?
- mycin, -in (aminoglycosides)
- cyclines
True or False: Tetracyclines are broad spectrum?
True
Neissera, H. Pylori, H. Ducrei, Brucella, and V. cholerae can be stopped by what?
Tetracyclines
What drug class is preferred against Mycoplasma?
Tetracyclines
What tetracyclines are completely absorbed?
How is absorption impaired?
Minocycline, Doxycycline
Dairy Foods and antacids
What drug is eliminated by the liver, best overall tetracycline, helpful with prostatitis?
Doxycycline
What tetracycline is useful in eliminating meningococcal state? But what drug is preferred?
Minocycline, but like Rifampin
What is the drug of choice for chylamida and Rickettsaie?
Tetracyclines are first line drugs for Mycoplasma pneumonia and what else?
Doxycycline
Lyme Disease (Spirochete)
What is the drug of choice for Plague (Yersenia pestis)?
Streptomycin (Aminoglycoside, attacks 30S subunit)
What drug is used for Brucellosis and decrease bacterial shedding (cholera), and Granuloma inguinale?
Doxycycline
What are therapeutic uses for tetracyclines?
H. pylori, chronic bronchitis, and malaria
What is an adverse drug effect of tetracycline in children (less than 9 years old)? Can give in pregnancy?
Tooth enamel dysplasia
Cannot give in pregnancy
What drug causes Diabetes insipidus?
What is another renal problem via outdated preparations?
demeclocyclin
Fanconi syndrome
What are two adverse effects of tetracyclines?
Phototoxicity and Pseudomembranous colitis (super infections, higher with tetracyclines)
What two tetracyclines cause Hepatotoxicity?
Oxytetracycline and tetracycline
What tetracycline drugs cause vestibular toxicity (reversible)?
Minocycline and doxycycline
Is tetracycline a bacterial-static or bacterialsidic?
Bacterial-static
What type of drugs are the -thromycin? What type of drugs are -mycin?
Macrolides
Aminoglycosides
What two drug classes bind to the 30 ribosomal subunit?
Aminoglycosides (-mycin), tetracyclines (-cyclines)
What drug is called a ketolide? What drugs are called macrolides?
Telithromycin
Erythromycin, Clarithomycin, Roxithromycin, Azithromycin
Erythromycin was what shortcomings?
Replaced by what drugs?
Poor bio-availability, frequent dosing, poor GI tolerability, not that great with H. influenzae
Clathiromycin and Azthyromicin
What is the mechanism of action with macrolides?
inhibits aminoacyl translocation and the formation of initiation complexes
What macrolide inhibits Gram positive, Gram negative, and other typical organisms?
Erythromycin
What macrolide fights M. avium, H. pylori?
Clarithromycin
Diptheria (over 14 days), Bordetella Pertussis, Mycoplasma pneumonia, chlamydial infections, and syphilis are treated by what macrolide?
Binds to what receptors in the GI, increases GI motility?
Erythromyicn
Motilin Receptors
What macrolide is used to fight community acquired pneumonia, pharynigitis, skin infections, and chlamyidal infections?
Azithromycin, really like single dose here
Macrolides are really good for patients that have what allergy?
Penicillin allergy
What are the adverse effects of macrolides?
Epigastric distress, cholestatic jaundice (estolate), and prolong QT interval and arrhythmias
Erythromycin and Clarithromycin inhibit what enzymes?
CYP450
Theophylline, Warfarin, Terfenadine, Astemizole, Carbamazepine, cyclosporine are inhibited via the metabolism of what drugs?
What drug levels are increased via these drug breakdowns?
Erythromycin and Clarithromycin
Digoxin, increasing the reabsorption via enterohepatic circulation
What drug has Pseudomembranous colitis as a severe drug reaction?
Clindamycin
What drug works against anaerobes, not a macrolide, with bacteroides fragilis, toxoplasmosis, and fighting osteomyelitis?
Clindamycin, narrow spectrum
What drug binds to 50S ribosomal subunit and blocks the action of peptidyl transferase and thus prevents amino acid incorporation into newly formed peptides?
Chloramphenicol
What drug treats meningococcal meningitis, bacterocide infections in combination with penicillin (brain infection),
Rickettsial diseases, Typhoid fever - Salmonella,
Haemophilus infections, Mycoplasma infections?
What are the bad side effects?
Chloramphenicol
Bone marrow suppression (aplastic anemia) and Gray Baby syndrome
Linezolid binds to what? What are the main reasons to use this drug?
50S subunit and prevents the 70S subunit formation
VRSA and VRE, drug resistant pneumococci, Myobacterium Tuberculosis
What are the adverse effects of Linezolid?
Thrombocytopenia and inhibits MAO (dont eat tyramine food) a derivative of tyrosine foods
What are drug has two subunits that is reserved for VRE, MRSA, and multi-drug resistant streptococci? Bind to what part?
Bactericidal long what _____________
post-antibiotic effect
Q/D is available through what route? Inhibits what? Has what adverse effects
Parenteral route
Inhibits cytochrome P450
Thrombophlebitis, hyperbilirubinemia, arthralgia, and myalgia
(joint pain and muscle pain)
What medication is a direct inhibitor of nucleic acid synthesis? What is the mechanism of action? What type of species does the medication work against?
Quinolones
Gyrase (Topoisomerase II)
Gram negative
What is the primary quinolone medication?
What are the adverse medications?
Nalidixic Acid
Neurological Toxicity: Seizures
Hemolysis in Glucose 6-phosphate deficiency patients
What ending do Fluroquinolones have?
What fluroquinolone is not used due to hepatic toxicity?
-Floxacin
Trovafloxacin
Fluroquinolones are concentration dependent killing and rely on what kind of an effect?
Post antibiotic effect
What do fluroquinolones inhibit?
DNA gyrase
Typhoid fever, UTI (resistant to cotrimoxazole), Gastroenteritis, skin, soft tissues, bone infections, upper/lower respiratory tract infections?
Fluroquinolones, ciprofloxacin and levofloxacin
What three therapeutic uses are there for ciprofloxacin?
Anthrax, Gonorrhea, and TB
What ADR are there for Fluoroquinolones?
Cartilage damage, tendonitis, photoxicity, CNS, Liver Failure, and long QT interval
