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Infectious Disease > Drugs two last time > Flashcards

Drugs two last time Flashcards

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1
Q

Bacteriostatic Inhibitors of protein synthesis function, and 8 classes included

A

Inhibit growth and replication, do not kill bacteria, include

  • tetracyclines
  • macrolides
  • clindamycin
  • chloramphenicol
  • dalfopristin/quinipristin
  • Linezolid
  • Retamulin/mupirocin
  • Tigecycline
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2
Q

Tetracyclines spectrum (including 9 specific ones)

A

Broad speectrum including

1) rickettsia
2) spirochettes
3) brucella
4) chlamydia
5) mycoplasma
6) vibrio cholerae
7) helicobacter pylori
8) borrelia burgdorferi
9) bacillus anthracu

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3
Q

3 common uses of tetracyclines

A

1) acne
2) peptic ulcers
3) peridontal disease

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4
Q

3Tetracycline ADRs

A

Photosensitivty, bone and teeth discoloration, suprainfection

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5
Q

Tetracycline mech of action

A

Bind 30s ribosome preventing protein synthesis, actively transported into cell via energy dependent process only present in bacterial cells

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6
Q

Tetracycline resistance

A

Decreased uptake, increased exclusion of tetracyclines

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7
Q

Tetracycline absorption

A

GI absorption limited because of chelates (with any metal ion), topical use too

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8
Q

4 tetracyclines available

A

1) tetracycline (short acting, no food)
2) denecocycline (medium acting, no food)
3) doxyxcline(long acting, no food)
4) minocycline (long acting, food okay)

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9
Q

Fanconi syndrome

A

Ingestion of outdated tetracycline can cause renal tubular dysfunction leading to renal failure

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10
Q

Macrolides spectrum

A

Broad spectrum

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11
Q

Macrolides include 3 drugs

A

1) erythromycin
2) azithromycin
3) clarithromycin

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12
Q

Macrolides resistance

A

Pumping out macrolides or modifying target ribosomes

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13
Q

Macrolide mechanism of action

A

Bind 50S ribosome subunit to prevent protein synthesis

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14
Q

Erythromycin spectrum

A

Most gram + and few gram -, first choice for bordatella pertussis and cornybacterium diptheria

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15
Q

Erythromycin is often seen as an alternative for ____ in those with an allergy

A

PCN G

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16
Q

Erythromycin ADRs

A
  • suprainfection

- QT prolongation and sudden cardiac death (torsades de pointes)

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17
Q

Clarithromycin spectrum

A

Most gram + and few gram -, more active than erythromycin in certain situations

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18
Q

Clarithromycin ADRs

A
  • Very few

- Potential QT prolongation

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19
Q

Clarithromycin and azithromycin are often prescribed over erythromcyin because of one distinct advantage

A

They do not typically cause nausea and diarrhea

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20
Q

Azithromycin spectrum

A

Less active than erythromycin on strep/staph, more active on gram - bacterium

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21
Q

Azithromycin ADR’s

A
  • Cannot be taken with food

- Increased risk of heart arrhythmias

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22
Q

Clindamycin mechanism of action

A

Inhibition of the 50S ribosome to prevent protein synthesis

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23
Q

Clindamycin absorption

A

-Parenterally/IV, topical, oral

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24
Q

Clindamycin excretion

A

Mostly hepatic metabolism

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25
Q

Clindamycin treats

A

Gram + and -, DOC for Bacteroides

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26
Q

Clindamycin ADR

A

Can cause psudomembranous colitis from Cdiff

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27
Q

Chloramphenicol mechanism of action

A

Inhibit protein synthesis through binding the 50s ribosomal subunit

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28
Q

Chloramphenicol spectrum

A

Broad spectrum but often last resort, DOC for typhoid fever and effective against bacterial meningitis

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29
Q

Chloramphenicol absorption

A

GI route

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30
Q

Chloramphenicol ADRs

A
  • Pancytopenia (aplastic anemia)

- Gray baby syndrome

31
Q

Dalflopristin/Quinipristin mechanism of action

A

Streptogamins, together become bactericidal

32
Q

Dalflopristin/Quinipristin treats…

A

VRE and MRSA

33
Q

Dalfopristin/Qunipristin ADR’s

A
  • Hepatotoxicity

- Thrombophlebitis

34
Q

Linezolid mechanism of action

A

Binds 23s portion of 50s subuinit of ribosome, cross resistance therefore unlikely

35
Q

Linezolid treats

A

VRE and MRSA

36
Q

Linezolid ADR

A

Myelosuppression

37
Q

Tigecycline spectrum

A

Gram + and -, drug resistant strains, no pseudomonas

38
Q

Tigecycline mechanism of action

A

Binds to 30s ribosome

39
Q

Tigecycline absorption

A

IV antibiotic

40
Q

Tigecycline ADRs

A

Stained teeth in children and photosensitivity

41
Q

Retapamulin/mupirocin function

A

Topical antibiotics indicated for impetigo

42
Q

Fluoroquinolones are designated not to be used…

A

…in simple and acute infections

43
Q

Fluoroquinolones spectrum

A

Broad spectrum, most gram neg and some gram pos including MRSA

44
Q

Fluorquinolones abosrption

A

PO administration

45
Q

Fluoroquinolones ADRs

A

Tendon rupture/peripheral neuropathy/hypogllycemia/mental illness

46
Q

Fluoroquinolones include these 8

A

1) ciprofloxacin
2) norfloxacin
3) ofloxacin
4) Levofloxacin
5) Moxifloxacin
6) gemifloxacin
7) gatifloxacin
8) delafloxacin

47
Q

Fluoroquinolones mech of action

A

Enter bacterium by passive diffusion and inhibit replication of baterial DNA by inhibiting bacterial DNA gyrase and toposiomerase IV

48
Q

Fluorquinolones have a poor activity against….

A

…anaerobes

49
Q

Fluorquinolone resistance (2)

A

1) alterations in DNA gyrase

2) reduced ability of drug to cross bacterial membranes

50
Q

Cipro is often given prophylactically for patients exposed to these 2 pathogens

A

1) anthrax exposure

2) meningococcal disease

51
Q

Cipro ADR

A

Phototoxicity

52
Q

Cipro absorption

A

Gut, must be taken apart from food to prevent chelate formation

53
Q

Norfloxacin indication

A

UTI caused by P aeruginosa

54
Q

Ofloxacin indication

A

Less effective against P. aeruginosa

55
Q

Levofloxacin

A

More effective against gram +

56
Q

Moxifloxacin

A

CAP

57
Q

Gemifloxacin

A

CAP

58
Q

Gatifloxacin

A

Topical use only

59
Q

Delafloxacin

A

Acute bacterial skin infection from MRSA

60
Q

Metronidazole spectrum

A

Protozoa or anaerobic bacteria, DOC for Cdiff, amoeba, and trichomonas vaginalis

61
Q

Metronidazole mechanism of action

A

Taken up passively, converted to active form in anaerobic bacteria, break up DNA helical structure

62
Q

Metronidazole ADRs

A

Neurologic effect, urine darkening

63
Q

Rifampin spectrum

A

Broad, often for myobacterial infection

64
Q

Rifampin mech of action

A

Inhibit RNA poly

65
Q

Rifampin ADR

A

Hepatotoxicity, body fluid discoloration

66
Q

Bacitracin absorption

A

Topical only (unless life threatening)

67
Q

Bacitracin mech of action

A

Inhibit synthesis of cell wall

68
Q

Bacitracin spectrum

A

Gram pos

69
Q

Sulfonamides mech of action

A

Inhibition of synthesis of folic acid by binding where PABA does to be bacteriostatic

70
Q

Sulfonamide resistance (3 methods)

A

R factor

1) Increase synthesis of PABA
2) Prevent sulfonamide binding
3) Reduce uptake of sulfonamide

71
Q

Sulfonamide spectrum

A

Broad, gram + including MRSA and some gram neg, DOC for acute UTI

72
Q

Sulfonamide ADRs

A
  • Photosensitivity
  • drug fever
  • Steven Johnson syndrome (widespread lesions)
  • acute hemolytic anemia
  • Kernicterus (bilirubin buildup in newborn brain
73
Q

Trimethoprim spectrum

A

Gram - bacilli, some gram +, some protozoa, DOC for uncomplicated UTI

74
Q

Trimethoprim-Sulfamethoxazole (bactrim) spectrum

A

UTI, pneumocytis pneumonia, others

Infectious Disease (24 decks)

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