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2 - CPR (renal) > Drugs for UTIs > Flashcards

Drugs for UTIs Flashcards

1
Q

What does TMP-SMX stand for?

A

Trimethoprim - Sulfamethoxazole

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2
Q

MOA for TMP?

A

(-) bacterial dihydrofolate reductase needed to make tetrahydrofolic acid for DNA replication

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3
Q

MOA for SMX?

A

Competes with PABA binding to dihydropteroate synthetase needed to make tetrahydrofolic acid for DNA replication

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4
Q

TMP-SMX is active against?

A

MRSA and pathogens seen in immunocompromised patients

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5
Q

What are possible adverse effects of TMP-SMX?

A

N/V, rash, pruritus, resistance has developed

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6
Q

MOA for Fosfomycin?

A

Inactivates Pyruvyl Transferase to (-) cell wall synthesis

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7
Q

When is Fosfomycin used and what kind of resistance does it have?

A

Acute uncomplicated cystitis

- Low resistance

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8
Q

MOA for Nitrofurantoin?

A

Becomes reactive intermediates that alter bacterial ribosomal proteins

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9
Q

When is Nitrofurantoin used?

A

Acute uncomplicated cystitis

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10
Q

What are the possible side effects of Nitrofurantoin?

A

C. Difficile superinfection
Pulmonary and liver toxicity
Sensorimotor polyneuropathy

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11
Q

MOA for Ciprofloxacin/Levofloxacin?

A

(-) DNA gyrase and/or Topoisomerase IV

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12
Q

Adverse effects of Ciprofloxacin, but mostly Levofloxacin?

A

Tendonitis/Tendon rupture

– Peripheral neuropathy, CNS issues, myasthenia gravis exacerbation

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13
Q

What is the most common side effect with Cephalosporins?

A

Allergic reactions

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14
Q

What generations of Cephalosporins are usually used with UTIs?

A

Gen 1 and 3

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15
Q

What Gen 1 Cephalosporins are used with uncomplicated UTIs?

A

Cephalexin

Cefadroxil

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16
Q

What Gen 1 Cephalosporins are used with Uncomplicated UTIs?

A

Cephalexin

Cefadroxil

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17
Q

What Gen 3 Cephalosporins are used with UTIs?

A

Ceftriaxone
Cefpodoxime
Cefdinir

18
Q

Which Gen 3 Cephalosporin is used for Complicated UTIs and what is a possible side effect?

A

Ceftriaxone

– Bleeding

19
Q

What is special about Ceftriaxone?

A

It is eliminated by both the kidney and liver so one of those organ dysfunctions does not mean the drug needs a dosage alteration

20
Q

Which Gen 3 Cephalosporins are used for Uncomplicated UTIs?

A

Cefpodoxime

Cefdinir

21
Q

Piperacillin + Tazobactam are active against?

A

Gram (+) and (-) and Pseudomonas Aeruginosa

22
Q

Piperacillin + Tazobactam are used when?

A

Complicated UTI

23
Q

What is Vancomycin active against?

A

MRSA

24
Q

MOA for Linezolid?

A

(-) protein synthesis initiation

25
Q

What is linezolid active against and what is a con about it?

A

Gram (+) and VRE

– (-) MAO which causes drug interactions

26
Q

What is Imipenem active against?

A

Many multiresistant strains

27
Q

MOA for Daptomycin?

A

Cyclic lipopeptide that binds cell membrane to cause depolarization
=> (-) synthesis of DNA, RNA, proteins

28
Q

What is Daptomycin active against and what is weird about its usage?

A

Gram (+) only

- Lacks approval for VRE but still a 1st line agent for UTI even due to VRE

29
Q

What are some side effects of Daptomycin?

A

Bloating, swelling, weight gain

30
Q

MOA for Chloramphenicol?

A

(-) 50s subunit to prevent growing peptide chains

31
Q

When is Chloramphenicol used?

A

When less toxic agents are ineffective/contraindicated

32
Q

Possible adverse effects with Chloramphenicol?

A 
Blood diseases:
- Aplastic/hypoplastic anemia
- Thrombocytopenia
- Granulocytopenia
Grey baby syndrome
33
Q

MOA for Gentamicin?

A

(-) 30s subunit to prevent growing peptide chains

34
Q

What are the adverse effects associated with Gentamicin?

A

Neurotoxicity, Nephrotoxicity, Ototoxicity

35
Q

If acute cystitis is due to MDR gram (-), what 2 agent should be considered?

A

Nitrofurantoin

Fosfomycin

36
Q

Otherwise for acute cystitis, what are 3 1st line agents?

A

Nitrofurantoin
TMP-SMX
Fosfomycin

37
Q

Otherwise for acute cystitis, what are the 2nd and 3rd line agents?

A
  • Cephalosporins gen 3 or 1

- Fluoroquinolones

38
Q

For uncomplicated pyelonephritis, what are first line agents?

A

Fluoroquinolones – ciprofloxacin/levofloxacin

39
Q

With uncomplicated pyelonephritis, if resistance is > 10% what should be added?

A

Initial dose of ceftriaxone or 24 hour dose of aminoglycoside

40
Q

For uncomplicated pyelonephritis, what is a second line agent?

A

TMP-SMX

2 - CPR (renal) (27 decks)

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