Exam 1 drugs and targets Flashcards
What’s the class of SMX-TMP
Sulfonamide
What bacterias the SMX-TMP covers?
MSSA, CA-MRSA, PEK
What’s the class of Nitrofurantoin?
Nitrofurans
What Bacterias does Nitrofurans cover?
+VRE, PEK
What is the class of Fosfomycin?
Phosphonic acid
What is the class of Metronidazole?
Nitroimidazoles
What bacteria are covered by Metronidazole?
Anaerobes and Clostridium (Not C.Diff)
What bacteria are covered by Fosfomycin?
MSSA, MRSA, +VRE, PEK
What is the cell target for fosfomycin?
NAM Synthesis
What process is affected by Fosfomycin?
Cell wall synthesis
What’s is the cell target of SMX-TMP?
Dihydropteroate Synthesis
What is the Process affected by Sulfamethoxazole?
Folic acid synthesis
Toxicities of SMX-TMP?
Steven-Johnsons Syndrome, Crystalluria, Anemia
What is the drug target in cell for Trimethoprim?
Dihydrofolate reductase
What is the process affected by Trimethoprim?
Folic acid synthesis
what are some toxicities associated with Trimethoprim?
Photo toxicity, Rash, pruritus
What are the Drugs Group I?
Fosfomycin, SMX-TMP, Nitrofurantoin, and Metronidazole
What drug causes brown color urine?
Nitrofurans
Whats the example of Fluoroquinolones?
Nalidixic acid, Ciprofloxacin, Levofloxacin, Moxifloxacin, gemifloxacin, delafloxacin
What groups are covered by Nalidixic acid?
Gram (-) UTIs only
What bacteria are covered by Ciprofloxacin?
MSSA, PEK, PIDDLY, SPACE, atypicals
What bacteria are covered by Levofloxacin?
MSSA, Strep/Pneumonia, PEK, PIDDLY, SPACE, atypicals
What bacteria are covered by Moxifloxacin?
MSSA, Strep/Pneumonia, PEK, PIDDLY, SACE, atypicals, anaerobes.
What bacteria are covered by Gemifloxacin?
MSSA, Strep/Pneumonia, PEK, PIDDLY, SACE, atypicals
What bacteria are covered by Delafloxacin?
MRSA, Strep/Pneumonia, PEK, PIDDLY, SPACE
What are some of the antibiotics that inhibit enzymes of the folate metabolite biosynthesis.
Sulfonylanilines (Dapsone), Sulfonamides (Sulfamethoxazole), diaminopyrimidines (trimethoprim)
what antibiotic is good against Mycobaterium leprae?
Dapson
Whats one of the blood related side effects of sulfonamides?
Anemia
What are some of the contraindications for sulfonamides?
Megaloblastic anemia due to folate deficiency.
What is Sulfadiazine used for?
Topical skin infections
Sulfadiazine (Ag) is a bacteriastatic (T/F)
True
Sulfacetamide is used for what?
Conjunctivitis (Pink eye)
What are some of the examples of Sulfamethoxazole (Fixed dose) in US?
Co-trimazole or TMP-SMX with Trimethoprim
What are some of the examples of Sulfamethoxazole (Ratio dose) in US?
Bactrim and Septra (1:5 TMP:SMX)
SMX should not be used for Strep throat (T/F)
True
What’s an example of Diaminopyrimidines?
Trimethoprim
What’s the MOA of Diaminopyrimidines?
Inhibit the dihydrofolate reductase in the folic acid biosynthesis pathway.
Whats the contraindication of Diaminopyrimidines?
Patients with megaloblastic anemia due to folate deficiency.
What is Trimethoprim used for?
Rash, pruritus
What is the mechanism of action for Quinolone antibiotics?
Inhibit DNA gyrase
What are some of the toxicologies related to Quinolones?
Diarrhea, Tendon rupture, CDAD, Phototoxicity, QT interval prolongation, Hyperglycemia/hypoglycemia effects. Muscular weakness
Whats the Black box warning for FQs?
Tendonitis and tendon rupture, exacerbated muscle weakness in patients with myasthenia gravis.
FQs are okay to be used for patients under 16 year old (T/F)
False
Why are FQs contra indicated in teenagers?
Risk to injury to the musculoskeletal system
What are the directions to take FQs?
Do not eat 2hrs before or after taking the medication
Why should you not take probenecid with FQs?
It interferes with elimination of all renally-excreted antibiotics increasing plasma levels
Why FQs are contraindicated in children?
May cause Cartilage lesions
How are FQs are excreted?
Renally except Moxifloxacin (Hepatic route)
First generation of FQs are confined to which Bacteria group?
PEK
List the First generational FQs
Nalidixic Acid
What are the list of Second generational FQs?
Cipro, Norfloxacin, Oflaxacin
What does Fluorine atom adds to the medication?
Adds lipophilicty aiding in outer membrane penetration.
What does Piperazine ring does to the medication?
Increases bioactivity spectrum, also increases half-life
How is Cipro eliminated?
Renally
How many time of day you should take Cipro?
QD
What All does Cipro covers?
MSSA, PEK, PIDDLY, SPACE, atypicals
What are Third generations FQs?
Levofloxacin, Gatifloxacin
What are the bacterias covered by Levofloxacin?
MSSA,Strep/Pneu, PEK, PIDDLY, SPACE and atypicals
What bacteria is specifically covered by 3rd generation FQs?
S. pneumonia
What’s the Levofloxacin geometry?
S-enantiomers and is 2x more potent
How is Levofloxacin given?
Empirically
What is Gatifloxacin used for?
Conjunctivitis
Brand name of Gatifloxacin
Zymar
What is the list of fourth generational quinolones.
Moxifloxacin, Gemifloxacin
List the coverage of Moxifloxacin
MSSA, Strep/Pnue, PEK, PIDDLY, SACE, Anaerobes, Atypicals
Whats the name of only FQ that covers anaerobes?
Moxifloxacin
Is Gemifloxacin resistant to S.pneumonia
No, it is actually very effective
List of the coverage of Delafloxacin
MSSA, MRSA, Strep/Pneumonia, PEK, PIDDLY, SPACE
List 2 things that cause resistance of FQs
Efflux pumps, Mutates topoisomerases
What type of drug is nitrofurans?
Prodrug
What are the toxicities of Nitrofurantoin?
GI irritant, Dark urine
Brand name for Nitrofurantoin
Macrobid
What is the activity spectrum of Nitroimidazole?
Anaerobic bacteria
What type of drugs are Nitroimidazoles?
Prodrug
MOA for Nitroimidazoles
It requires Bacterial nitroreductase to be activiated (prodrug) and nitro radical interacts with DNA causing the strand break
List the Nitroimidazole drugs
Metronidazole, Tinidazole
What type of infections does Metronidazole treats?
”Below the diaphragm” infections due to anaerobic bacteria (Bacteroids)
What normal recreational drink contraindicated with metronidazole’s?
Alcohol
What type of reaction Metronidazole causes if taken with alcohol?
Disulfram-like reaction
what may be an after effect of taking Metronidazole?
Vaginal Candidiasis requiring anti fungal tx
Whats the activity spectrum of Tinidazole?
anaerobes
what may be an after effect of taking Tinidazole?
can induce vaginal candidiasis requiring antifungal tx
What Bacteria do Nitrofurantoin?
+VRE, +ESBL
What Bacteria do Fosfomycin?
MSSA, MRSA, +VRE, +ESBL
Where (In body) is the highest concentration of Fosfomycin (Post admin)?
It have very high Urinary concentration
