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Year2 GI Exam II > Drugs for GI infections II > Flashcards

Drugs for GI infections II Flashcards

1
Q

MOA bismuth subsalicaylate

A

bismuth coats ulcers and erosions forming protective barrier
atimulates PG, mucus, and HCO3
salicylate inhibites intestinal PG and Cl secretion (reduce stool frequency and liquidity in infecitous diarrhea)

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2
Q

therapeutic use bismuth subsalicylate

A

dyspepsia and acute diarrhea
travelers diarrhea
H pylor infection

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3
Q

adverse reactions from bismuth subsalicylate

A

harmless blackening of stool, liwuid could cause blackening of tongue
high doses: slaicylate toxicity, Reyes syndrome in kids
avoid in renal impairment

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4
Q

MOA fluoroquinolones

A

[ ] dep killing

targets bacterial DNA gyrase and topoisomerase IV

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5
Q

bacterial R to fluoroquinolones

A

mutation in bacterial chromosome genes encoding DNA gyrase or topoisomerase IV or by active trasnport out of the cell

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6
Q

fluoroquinolones work on what bacteria

A

E coli, salmonella, shigella, enterobacter, campylobacter, neisseria, pseudomonas, aeruginosa, S aureus

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7
Q

which fluoroquinolones work on strep spp

A

levofloxacin, gatifloxacin and moxifloxacin

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8
Q

therapeutic uses of fluoroquinolones

A

UTI, prostatisi, STI, travelers diarrhea, shigellosis, joint STTI infeciotns, DM foot infections

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9
Q

adverse effects fluoroquinolones

A

GI (nausea, vomiting, abdominal discomfort)
CNS(mild HA, dizziness, delirium, rare hallucinations)
rash, photosensitivity, Achilles tendon rupture

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10
Q

contraindications to fluoroquinolones

A

children because of achilles tendon rupture

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11
Q

MOA aminoglycosides

A

[ ] dependent, binds 30s ribosomeal subunit and disrupts normal cycle ribosomal funciton by interfering with initiation protein synthesis

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12
Q

bacterial R to aminoglycosides

A

AG metabolizing enzymes, impaired transport of drug into cell, altered ribosom

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13
Q

what microbesn are aminoglycosdes used against

A

aerobic gram - bacteria, limited action against gram +, produces synergistic bactericidal effects in gram + when combine with a cell wall active agent

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14
Q

GI uses aminoglycosides

A

UTI, peritonitis with peritoneal dialysis

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15
Q

adverse effects aminoglycosdes

A

ototoxicity, nephrotoxicity, neuromuscular block and apnea

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16
Q

what are the aminoglycosides

A

amikacin
tobramycin
gentamicin

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17
Q

MOA tetracycline

A

bacteriostatic, inhibits bacterial protein synthesis by binding 30s bacterial ribosome and preventing access of aminoacyl tRNA to acceptro A site on mRNA ribosome complex

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18
Q

bacterial R to tetracyline

A

decreased influx acquisition of energy dependent efflux, ribosomal protection proteins, enzymatic inactivation

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19
Q

spectrum tetracycline covers

A

aerobic and anaerobic gram + and gram -
also rickettsie, coxiella, mycoplasma, borrelia, treponema
Pseudomonas resistant

20
Q

therapeutic use tetracyline

A

MRSA, rickettsial, CAP, Q fever, anthrax

21
Q

adverse effects tetracycline

A

GI (epigastric burining, abdominal discomfort, nausea, vomiting, diarrhea, superinfecitons like C diff, photosensiticity, teeth discoloration

22
Q

what are macrolides

A

azithromycin erythromycin

23
Q

MOA macrolides

A

bacteriostatic, binds reversibly to 50s ribosomal subunit, inhibits translocation where a newly synthesized peptidyl tRNA molecule moves from acceptor site on ribosome to peptidyl donor site

24
Q

bacterial R with macrolids

A

drug efflux, ribosomal protection proteins, hydrolysis, ribosomal mutaitons

25
Q

spectrum covered by macrolides

A

aerobic gram + cocci, bacilli

clostridium , listeria monocytogenes

26
Q

therapeutic use of macrolides

A 
respiratory tract infections
alternative otitis media,s inusitis, bronchitis and SSTIs
pertussis, gastroenteritis
H pylori
mycobacterial infecitons
27
Q

MOa metronidazole

A

prodrug that requires reductive activation by susceptible organisms

28
Q

bacterial resistance to metronidazole

A

decreased formation of nitro radicals

29
Q

spectrum metronidazole

A

anaerobic coccie and both anaerobic gram - bacilli and anaerobic spore forming gram + bacilli, trichomoniasis, amebiasis, giardiasis, Helicobacter and Campylobacter

30
Q

Therapeutic use of metronidazole

A

bacterial vaginosis, amebic liver abscess, Tx anaerobic bacterial infections
part of regimen prophylazis coloretal surgery, C difficile, Crohns

31
Q

adverse effects metronidazole

A

HA, nausea, dry mouth, metallic taste, vomiting, diarrhea, abdominal distress!! esp with alcohol!!!
dizziness, vertigo, encephalopathy

32
Q

drug interactions metronisazole

A

induced metabolism of phenobarbital, prednisone, rifampin, prolongs prothrombin time with those on warfarin
metabolism is inhibited by cimetidine

33
Q

MOA TMP-SMX (bactrim)

A

sulfonamide: bacteristatic and competetive inhibitors dihyropteroate synthase (needed for precursot to folic acid)
trimethoprim: inhibits microbial dihydrofolate reductase

34
Q

bacterial R to TMP-SMX

A

lower affinity of enzymes to drug binding, decreased bacterial permeability or active efflux, alternative pathway for essential metabolites synthesis, increased production of essential metabolie

35
Q

spectrum of TMP-SMX

A 
chlamydia, N meningitis S aureus
S epidermidis and pygoesns
viridans
E coli
Proteus
Enterobacter
Salmonella
Shigella
Serratia
Klebsiella
Brucella
Pasteurella
Yersinia
36
Q

therapeutic use of TMP-SMX

A

UTI, bacterial prostatitis, bronchitis, shigellosis, travelers diarrhea, salmonella, pneumocysitis jiroveci prophylaxis in neutropenia,

37
Q

adverse effects tMP-SMX

A

allergic skin rashes, nausea, comtiing, CNS, photosensitivity, renal dysfunction, Stevens-Johnson syndrome

38
Q

drug interactions of TMP-SMX

A

potentiate effects of warfarin

39
Q

what is the glycopeptide antibiotic

A

vancomycin

40
Q

MOA vancmoycin

A

inhibits cell wasll synthesis binding with high affinity to D alanyl D alanine terminal cell wall unites

41
Q

bacterial R to vancomycin

A

alteration to D alanyl D to D alanyl D lactate or serine

42
Q

spectrum covered by vancomycin

A

gram + S aureus, S epidermidis, Strep, Bacillus, Corynebacterium, actinomyces, clostriudum, all gram - and mycobacterium

43
Q

therapeutic uses vancomycin

A

osteomyelitis, endocarditis, MRSA< strep, enterococci, CNS infections, bacteremia, orally for C difficle

44
Q

adverse effects vancomycin

A

macular skin rash, chills, fever, red man syndrome from rapid infusion
direct toxicity from vanco on mast cells causing release histamine
ototoxicity, nephrotoxicity

45
Q

MOA loperamide

A

inhibit presynaptic cholinergic nerves in submucals and myenteric plexuses, increase transit time, increase fecal water absorption, decrease mass colonic movements

46
Q

therapeutic use loperamide

A

nonspecific Tx diarrhea
moderate- severe diarrhea
loperamide useful in travelers diarrhea

47
Q

side effects loperamide

A

may cause toxic megacolon in patients with active IBD
should not be used in those with UC or acute bacillary or amoebic dysentery
dixcontinued if clinical improvement does not occur within 48 hours

Year2 GI Exam II (18 decks)

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