Exam 2 Flashcards
Metronidazole? And Tinidazole
How does it work?
What is it good at fighting against?
AE?
What are its three functions of killing?
Amebicide
Does a ton of things, it kills trophozoites but not cysts by causeing DNA damage.
Good for kill Clostridium
Kills: Amebiasis, Giardiasis, Trichomoniasis
Dry mouth, nausea, metallic taste
Amebicidal, bactericidal, Trichomonicidal
What does daptomycin do?
Effects against? can cause?
- Binds to the cell wall of gram positive causing death
- Effective againsts MRSA, VRE (Vanco-resistant)
- Allergic pneumonitis
Entecavir and Lamivudine are?
Nucleoside RTI Treat HBV
Telaprevir, Simeprevir and Boceprevir are all? What do they so?
HCV NS3/4A protease inhibitors Inhibit replication by blocking the proteolytic activity of HCV protease NS3/4A
Immunocompromised patients?
Pneumonia
P. Jiroveci
Vancomycin is only active against?
Binds to d-___d-___
Drug of choice for?
Can cause?
- Gram positive
- Binds to d-Ala-d-Ala preventing elongation
- Drug of choice for MRSA
- Time dependent killing
- Redman syndrome
Block dihydropteroate synthase
Sulfonamides
STDs there are 5 bacterial STDs and diseases to go with them
Why are mycobacteria (like TB) difficult to treat?
- Slow growth or become dormant to evade
- intracellular pathogens cannot be reached by immune factors (Ab,C) and drugs
- lipid rich cell wall of the bacteria is impermeable to many agents
- Incredibly good at aquiring resistance to drugs
Macrolides?
Clari, Azithro, Erythro
Using ABXs can cause?
Medical devices can also cause _____ invasion
_____ is a major cause of fungal sepsis and septic shock (HTN, tachycardia)
Thrush
candidiasis invasion
Candidemia
How is gonorrhea transmitted?
- Transmission generally requires contact of epithelial surfaces
- Gonorrhea also crosses amniotic membranes
- Humans are the only natural hosts
WHAT IS THIS?
Yeast
Oxazolidinones?
MOA
GOOD for?
AE?
Resistnace?
Linezolid
- Inhibits proteins synth by preventing formation of the ribosome complex
- Good for MSSA, MRSA, VRE entero faecium
- Hematologic AE: Thrombocytopenia myelosuppression
- Different from other protein synth inhibitors
Hepatitis B is a ____ virus _____
dsDNA virus hepadnavirus
Cyclic Lipopeptide?
Daptomycin
Respiratory Infections: Acute bronchitis
What is it?
Bronchitis causes similar symptoms as? But doesnt demonstrate what?
- Acute inflammation or infection of the airways or bronchi
- Symptoms like pneumonia but doesnt demonstrate pulmonary consolidation and chest infiltrates
Interferon alfa-2a
Interferon alfa-2a or 2b act similarly to endogenous IFN-α to inhibit viral replication and cleave single-stranded viral RNA.
Name the quinolines
What are there adverse effects and how do they work?
Chloroquine, Mefloquine, Quinine, Primaquine
- Hematologic abnormalities, hemolysis, prolonged QT, hypotension
- Quinine can cause cinchonism, tinnitus, headache, nausea, dizziness, flushing, visual disturbances
B-lactams consist of Penicillin, Lactamase inhibitors, cephalosporins and Cephamycins, Carbapenems, Monobactams
What is there MOA?
Cross link is usually formed by transpeptidase but B-lactams inhibit this
Also known as PBP
What are the 6 bacteria types?
- True Bacteria
- Filamentous Bacteria
- Spirochetes
- Mycoplasmas
- Rickettsia
- Chlamydia
Tenofovir and Adefovir are both?
Nucleotide reverse transcriptase inhibitors
Scabies?
Carcoptes scabei
Entecavir is the most ___ so far?
potent
What are other pathogens associated with urethritis?
- Trichomonas vaginalis, herpes simplex virus, Ureaplasma urealyticum, and Mycoplasma
Kill sexual stages and prevent transmission to mosquitos?
Gametocides
What are the common side effects of Entecavir?
Diarrhea, Headache, Fatigue, chills, vomit, anorexia
Ribavirin?
IMP dehydrogenase inhibitor, crucial in making RNA including viral RNA
Amino glycosides. 3 main things
- Irreversible inhbitors of protein synthesis, Block the initiation complex
- Miscoding of amino acids
- Block of translocation on mRNA
Bacterial Sepsis? Associated with?
ARDS, DIC, Hemodynamic effects and renal failure.
Miroorganism/human relationship
Mutual relationship - Normal Flora - Relationship can be breached by injury + Leave their normal sites and cause infection elsewhere
Hepatitis can be A-?
G
Lincosamides?
Derivative of the?
Good for?
what type of bacteria
Resistance?
Clindamycin
- Of Lincomycin
- skin and soft tissue infections cause by strep and staph
- Same as macrolides
- Impaired influx or increase efflux
Production of esterases that hydrolyze macrolide lincosamide and streptogramin, MLS type B
Modification of the ribosomal binding site by mutation or by macrolide inducible or constitutive methylase
Flatworms examples?
- Neuro Cysticerosis
- Schistosomiasis blood flukes?
What is the oldest and highly effective antimalarial blood schizonticide?
Quinolines
Problems and adverse effects of HCV protease inhibitors?
Resistance to both drugs has been demonstrated in HCV isolated from cell cultures and during clinical studies • Skin rash (in some case systemic symptoms-> fatal)
B-lactams are _____ dependent and they are not active against?
Time dependent, not active against MRSA
Eliminate developing or dormant liver forms?
Tissue schizonticides
Act as erythrocytic parasites?
Blood schizonticides
Telaprevir, Simeprevir and Boceprevir should always be used in combination with?
Ribavirin and Interferon alfa-2b
Respiratory infections: Pneumonia
Community acquired
Pneumococcal pneumonia (strepto pneumoniae)
Mycoplasm in young
Bacteremia or septicemia
- Presence of bacteria in the blood due to a failure of the body’s defense mechanisms
- Usually caused by gram-negative bacteria
- Toxins released in the blood cause the release of vasoactive peptides and cytokines that produce widespread vasodilation
What is a UTI ?
what are the 3 type?
- UTI is inflammation of the urinary epithelium following invasion and colonization by some pathogen within the urinary tract
- Complicated
- Uncomplicated
- Persistent
Blocks Dihydrofolate reductase
Pyrimidines
Macrolides are used for?
Check for interactions with?
Respiratory infection, Avium, Chlamydia
P450 interaction
Nongonococcal or nonspecific urethritis
- Nonreportable STI
- Syndrome caused most commonly by Chlamydia trachomatis
What are the common pathogens that cause UTIs?
- E.Coli
- Staphylococcus saprophyticus
- Enterobacter spp
Isoniazid is responsible for?
MOA?
Cell wall inhibition of mycobacteria it inhibits mycolic acid synthesis
Oral fungistatic used for dermatophytosis
Griseofulvin
Explain how Pneumococcal Pneumonia gets in and infects the body?
Disease caused by fungi?
Fungi that invade the skin, hair, or nails? They are specifically called?
Deep fungal infections are ____ threatening
mycoses
dermatophytes, tineas (ringworm)
life threatening
Oral and topical fungicidal that blocks ergosterol synthesis at an earlier step than azoles
Terbinafine
What is pentamidine?
What is it used in?
Whats else?
- Used in african Trypanosomiasis - Sleeping sickness
- Leishmaniasis
- Its highly toxic
Staphylococcus aureus is?
Gram positive bacterial sepsis.
How to Entecavir work?
It slows the progression of chronic hepatitis B infection and improves liver inflammation and fibrosis caused by HBV
HBV causes?
Cirrhosis and hepatocellular carcinoma
Sexually transmitted parasitic infection?
Only one gone over in class
What does it stick to and damage?
Trichomoniasis
- Adheres to and damages squamous epithelial cells
- coexists with gonorrhea
Sulfonamides are good for?
Generally use as?
Adverse effects?
- Uncomplicated UTIs
- Hematopoietic disturbances
- interacts with warfarin
HBV relies on what type of transcription?
Reverse transcription RNA—>DNA
Tetracyclines?
Tetra, Doxy, Tige all cycline
First, Second, Third, Fourth generation cephalosporins gone over in class?
- Cephalexin, Cefazolin
- Cefprozil, Cefuroxime
- Ceftriaxone, Cefotaxime
- Cefepime
Bacterial virulence and infectivity.
Bacteria must have iron to multiply (Siderophores) - Presence of polysaccharide capsules - Supression of complement activation - Bacterial proliforation rates can surpass protective response.
Sexually transmitted Urogenital Infections
Gonorrhea
Cause by what species?
What type of bacteria are they?
- Caused by microorganisms of the species Neisseria gonorrhoeae
- Aerobic, non–spore-forming, gram-negative, diplococcus
- Presence of pili helps the microorganisms attach themselves to the epithelial cells of mucous membranes
Sofosbuvir is?
HCV RNA polymerase NtRTI inhibitor
A fungal infection is also referred to as?
Mycosis
Artemisinin is a?
How does it work?
Antimalarial medication
- Its a sesquinterpene lactone endoperoxide
GI infections?
_____ seen with dysentery
One other pathogen
- Shigellosis
- Campylobacter enteriris (Travelers Di)
HBV is spread by?
Sexual contact, perinatal
Ivermectin?
MOA?
Used in?
Antihelminthic
- Causes paralysis by intensifying GABA-mediated transmission of signals in peripheral nerves crazy
- Onchocerciasis: River blindness
- Microfilaria
- Ectoparasites such as scabies
What is sofosbuvirs MOA?
Sofosbuvir blocks the NS5B RNA-dependent RNA polymerase of HCV
Albendazole?
MOA?
Used for?
Antihelminthic
- Inhibits the polymerization of microtubules
- Intestinal parasites: Cysticercosis, Acariasis, Enterobiasis (pinworm)
- Hydatid disease (Echinococcus via dogs)
- Neurocysticercosis
Examples of Nematodes?
- Hookworm disease
- Ascariasis
- Enterobiasis
- Filariasis-Riverblindness, Loa loa, Lymphatic (can live there)
Streptogramins?
Rapidly ____ for most susceptible organisms ____ , _____ and ____ but not?
Resistance?
- Quinupristin-dalfopristin in 30:70
- bactericidal for MSSA, MRSA, and VRE
- but not Entero Faecalis
- slow with Entero Faesium
- Same as macrolide
Types of lice?
- Pediculus Humanus Capitis
- Corporis
- pubis crabs bro
Cephalosporin and Cephamycin what is their purpose?
What are some adverse rxns?
Increase gram negative coverage
Allergy, methylthiotetrazole containing cephs can cause bleeding and disulfiram like rxns
What can lice transmit?
As a result causes?
Rickettsia promazekii
Louseborne typhus
Fosfomycin?
MOA?
Used to treat?
Same as?
- Inhibits the bacterial wall synthesis by inhibiting the synthesis of the cell wall building blocks
- Primarily used for uncomplicated lower UTI
- Same as Nitrofurantoin
What is cystitis? Pertaining to UTIs
What are the symptoms?
How do you treat?
- Cystitis is an inflammation of the bladder
- Frequency, dysuria(hurts to pee), urgency, and lower abdominal and/or suprapubic pain
- Antimicrobial therapy, increased fluid intake, avoidance of bladder irritants, and urinary analgesics
How to fungal infections invade and evade destruction
- Intracellular survival (switch from yeast to more virulent)
- Inhibit phagocytosis
- Antigenic Variation
- Immune suppression
- Tissue damage by triggering inflammatory response
Viral Hepatitis
Is a viral disease that causes inflammation of the liver
Pneumonia Port of Entry
- Aspiration of oropharyngeal secretions
- Inhalation of aerosols
- From blood bacteremia
Nosocomial Infection?
Pneumonia
Staph aureus, Kleb pneumoniae, P. Aeroginosa
Hepatitis?
An inflammation of the liver from any cause
Interactions of HCV protease inhibitor drugs?
Act as inhibitors and substrates of CYP3A4 (boceprevir>telaprevir>simeprevir) • Also inhibitors and substrates of efflux transporter P-glycoprotein • Watch for interactions with other drugs that undergo same metabolism
How can bacteria be resistant to B-lactams and their derivatives? Theres 4
- Inactivation by amidases, B-lactamase, or carbapenamases
- Modification of PBP
- Imparied drug penetration to target PBPs
- Anitbiotic Efflux
Filamentous fungi growth as multinucleate, branching hyphae (branching), ringworm is a common one. Also these are more pathogenic
MOLds
Respiratory Infections TB or Mycobacterium Avium complex
TB has the ___ death toll of any infectious pathogen
POA:?
TB—?
MAC in what type of patient?
How to detect TB?
- Highest death toll
- Airborne transmission
- Mycobacterium tuberculosis
- MAC in immunocompromised patients
Detected
- Tubercle formation
- Caseous necrosis
- Positive tuberculin skin test (PPD)
Infections from species Neisseria gonorrhoeae can result in?
- Disseminated gonococcal infection (CGI)
- Perihepatitis
- Ophthalmia neonatorum
Macrolide resistance? 3 ways
- Impaired influx or increase efflux
- Production of esterases that hydrolyze macrolide lincosamide and streptogramin, MLS type B
- Modification of the ribosomal binding site by mutation or by macrolide inducible or constitutive methylase
Binds to ergosterol in the fungal cell membrane forming pores
- Broad spectrum with good activity against candida, cryptococcus
Adverse effects?
Amphotericin B
AE: Infusion related rxns, nephrotoxicity.
Carbapenems are not active against?
Impenem is administered with?
Good choice for?
- Klebsiella pneumoniae
- And carbapenemase producing strains
- administered with a renal dehydropeptidase, cilastatin
- Good for nosocomial infections and B-lactamase producing GN strains
What is the life cycle of HCV?
- Viral entry into the cells - Replication of the HCV genome depends on NS5B RNA replicase which subsequently converts genomic (t) RNA into (-) and back to (+) RNA - The messenger RNAs formed during the replicative cycle of HCV are translated to viral precursor proteins that are then cleaved by virus-encoded protease NS3/4A into mature structural and functional protein
Chlamydial infections
Trachoma?
Leading cause of preventable blindness
Monobactams?
Limited to?
No activity againsts? _____ and _____
- Aztreonam
- Limited to aerobic GN rods (including P aeruginosa)
- No activity against GP, or anaerobes
What are the B-lactam inhibitors?
What do they do?
Clavulanic Acid, Sulbactam, Tazobactam
Protected hydrolyzed penicillins from inactivation. Extend Spectrum of the penicillin to strains that would otherwise be inactive.
Adverse effects of Fluoroquinolones?
How do they work?
- Prolonged QT
- Neuropathy
- Cartilage degradation, Achilles tendon
- Should be avoided during pregnancy
They block bacterial DNA synthesis by inhibiting bacterial topoisomerase II (DNA gyrase) and Topo IV
Amebiasis
Most important?
Causes?
Can cause what type of liver disease?
- most important parasitic disease
- Causes dysentary as a result of cytotox. on colonic epithelial
- Can also cause amebic liver disease
Rifamycin is a?
What is its MOA?
Antimycobacterial Drug that inhibits the synthesis of RNA by targeting RNA polymerase
What generation cephalosporin/cephamycin can cross the BBB?
3rd and 4th
- Ceftriaxone, Cefotaxime
- Cefepime
Respiratory Infection: Acute epiglottitis
Most common in?
WHat happens how serious?
What bacteria causes it?
Symptoms?
Treatment?
- Children
- Severe rapid progressive, life threatening infection of the epiglottis and surrounding area
- Usually cause by Haemophilus influenzae type B
- Incidence decreased by HIB vaccine
- High fever, sore throat, inspiratory stridor, sever respiratory distress
- Emergency airway and antibiotics
Fluoroquinolones?
One is specific for upper and lower respiratory tract infections?
Ciprofloxacin, Levofloxacin, floxacin
Levofloxacin
Fungal Infections
- Eukaryotic Cells with _____ walls
- Can grow as molds or yeasts
- ______ can be both
- Resistant to ________ wall
- Pathogenicity?
- Rigid cell walls
- Candida albicans
- bacterial cell wall inhibitors
- Can adapt to a wide variety of temperatures, digest keratin, low oxygen, they also suppress the immune systems defense
HCV virus type
Single stranded RNA flaviviridae (Like dengue, yellow fever)
Inhibition of protein synthesis by targeting the 30S ribosomal subunit.
Used as an Anti what?
Antimycobacterial
Streptomycin
Combination of sulfonamide with timethoprim is?
Synergistic becasue it blocks the process in two different steps.
Polyene macrolide like amphotericin B
is too toxic for parenternal admin and only used topically
Nystatin
Nucleoside Analog
Blocks DNA and RNA polymerization
Treats Cryptococcus associated meningitis
AE?
Flucytosine
Bone marrow toxicity with anemia, leukopenia, and thrombocytopenia
Acute viral Hepatitis?
Inflammation of the liver that begins suddenly and lasts a few weeks
HCV can cause chronic?
Infection, cirrhosis and carcinoma
Syphillis
Primary ___
Secondary ___
Tertiary ____
Latent ____
Congenital____
- primary: appearance of a chancre (painless ulcers on genitals)
- secondary: mucocutaneous eruptions widespread hematogenous and lymphatic spread
- tertiary: cardiovascular syphilis, neurosyphilis
- latent syphilis: asymptomatic but potential recurrent infections
- congenital
Maturatio of TB
Cellular ______?
-
_____ granuloma
-
______
Granuloma
Necrotic Granuloma
Cavity
Inhibits fungal wall synthesis, good for invasive candidiasis
Fungin
Grow as ovoid or spherical, single cells multiply by budding and division
(Histoplasma)
Yeast
Complications of chronic HBV include?
Cirrhosis- scarring of the liver 2) Decompensated cirrhosis - Increase in portal HTN - Splenomegaly - Encephalopathy - Jaundice 3) Hepatic Carcinoma
Block ergosterol synthesis from lanosterol
broad spectrum for candida, C neoformans, endemic mycoses
Metabolized by CYP3A4
Azoles
Tetracyclines are good for treating?
Resistance? 3 ways
- Rickettsia Mycoplasma, Chlamydia, Plasmodium
- Impaired influx or increased efflux
- Productin of proteins that interfere with tetracylcine
- Enzymatic inactivation
The most common cause of water borne disease in the US?
Giardiasis
Terbinafine and Azoles both block synthesis of?
Ergosterol
Aminoglycosides?
______ dependent killing?
_____ killing with cell wall ___ in endocarditis
Good for?
AE?
Amikacin, Gentamicin, Tobramycin
- Cocentration dependent killing
- Synergisitc with cell wall inhibitors
- Nephro and ototoxicity
Staphylococcus aureus infections
Commensal bacteria and _____ pathogen?
Super antigens?
Children? SSSS? others?
Hospital?
SOFT PAINS?
- Opportunistic pathogen
- Enterotoxin and toxic shock syndrome toxin 1 (TSST-1)
- Cause immune overactivation —> Toxic shock and food poisoning
- Impetigo and Staph scalded skin syndrome (SSSS)
- Most common cause of food borne outbreaks
- Skin infection, Osteomyelitis, Food poisoning, Toxic shock syndrome, Pneumonia, Acute Endocarditis, Infective arthritis, Necrotizing fasciitis, Sepsis
Bacteria can produce endotoxins and exotoxins whats the difference?
Endo- lipopolysaccharides contained in the cell walls of gram negative organisms. Pyrogenic effects Exo- Enzymes released during growth causing specific responses - Immunogenic - Antitoxin production.
Chronic viral hepatitis?
Irreversible inflammatory disease of the liver a leading cause of death
What are the antimilarial drugs?
How are these administered?
- Quinolines
- Atovaquone
- Artemisinins
Either prophylactically or as definite therapy
