Chloramphenicol/Clindamycin Mupirocin/Spectinomycin

Question 1

Chloramphenicol

Answer 1

• Broad Spectrum 50S inhibitor
• Both Gram+/-: H-Flu, Neis Men, Bacteroides, Rickettsia, Psittacosis, Pneum/Meningococcal
• 3rd one for other serious infections
• NOT chlamydia
• Pharm: Cross BBB; Glucuronidated in Liver (inhibits function)
• AE: Bone Marrow Supression, Type IV HS, GI Distrubance, Hemolytic/aplastic/reversible anemia, Fatal pancytopenia, GRAYH BABY SYNDROME;
• Toxicity: affari, Coumarin, Phenytoin, Tolbutamide, + Chlorpromide

Question 2

Clindamycin

Answer 2

• Binds 50S subunit just like macrolide
• Gram + Aerobes/Anaerobes
• Gram - Aerobes + Bacteroides
• C.Diff is Resitant
• Topical, Oral, or IV
• AE: C.Dif, Type IV HS, GI disturba banche, Impaired hepatic function

Question 3

Mupirocin

Answer 3

• Inhibits t-RNA synthetase
• Primarily Gram + Cocci
• Traumatic skin lesions, Impetigo, Nasal MRSA
• Topical
• AE: Allergic RXN, Burning/stinging, Itching

Question 4

Spectinomycin

Answer 4

• Like aminoglycoside; Binds 30S subunit
• Wide spectrum Gram +/-
• Third line for Gonorrhea
• IM Injection
• AE: Pain/irritation, nausea, fever, Nephrotoxicity, Anemia

Question 5

Sulfonamides General

Answer 5

• Analogs of PABA -> Inhibits Folic acid synthesis
• Broad spectrum Bacteriostatic against against many Garm +/-
• Strp Pyo, strp pneum, Bac Anth, H-Flu, H-Duc, Proteus, Kleb, actin, Nocardia, Chlam, Pneumocystic
• USES: UTI, Toxoplasmosis, IBS, Burn infx, Inclusion conjunctivitis, Trachoma, Pneumonia, Nocardiosis
• AE: Nephrotoxicity; Hypersensitivity; Hemopoeitic disturbance; Kernicterus
• Contra: Warfarin, Tolbutamide, Methotrexate, Pregnancy

Question 6

Sulfisoxazole

Answer 6

• Highly water soluble - rapid absorption
• Lass chance of Nephrotoxicity
• Used for UTIs
• E.S.P. (W. Erythromycin) for Otitis Media

Question 7

Sulfamethoxazole

Answer 7

• Used for UTIs
• Also SMX-TMP therapy
• Crystalluria due to insoluble metabolite

Question 8

Sulfadiazine

Answer 8

• Rapidly absorbed P{.O.
• Distributes to C.S.F
• **Sulfadiazine/ Pyrimethamine + Leucovorin -> Toxoplasmosis

Question 9

Sulfasalazine

Answer 9

• Poor P.O. Absorption
• Treatment for IBS
• Azulfidine EN-tabs for RA and JRA
• 5-Aminosalicylate is intiinflammatory produced once metabolized

Question 10

Sulfacetamide

Answer 10

Topical for ophthalmic, skin, and acne infections

Question 11

Silver Sulfadiazone

Mafenide

Answer 11

Prevent Burn infections

Question 12

Resistance to Sulfa

Answer 12

INC synthesis of PABA

Question 13

Trimethoprim

Answer 13

• DHF analog
• Identical spectrum to Sulfonamides
• Specifically - Otitis Media, UTIs, and prostatitis
• AE: MEgaloblastic anemia, leukopenia, granulocytopenia

Question 14

SMX/TMP Therapy

Answer 14

• RIs, Gastroenteritis, UTIs, prostatitis, genital infections, DOC for Nocardiosis and Pneumocystis
• P.O; Sometimes IV