immunology Flashcards
Ciproflaxin
antibacterial
Fluoroquinolone
use: PLUGS from GM Pseudomonal infections Legionella pneumonia UTI (first line) GI infections (first line) S. aureus, S. pneumonia (gram positive cocci) Gonorrhea (gram neg) Meningococcal meningitis Mycobacteria (2nd line choice for TB)
how: promotes breakage of double stranded DNA and inhibits bacterial replication, highly active against aerobic gram negative bacteria
ci: children, myasthenia gravis
interactions: decreased absorption by cations: antacids, zinc, iron, bismuth; increases serum levels of warfarin and theophylline
Se: A PLACE forbidden for anyone under 18 years old
Arthropathy in children under 18 years old, except for anthrax and complicated UTI
Adult tendinitis and rupture
Peripheral neuropathy, worsening myasthenia gravis
Agitated GI tract
C. diff
Cardiac QT interval prolongation
Exfoliative dermatitis, photosensitive
Nitrofurantoin
Antibacterial
5 nitrofuran derivative
use: acute and uncomplicated UTI and prophylaxis
how: interferes with cell metabolism and cell wall synthesis, inactivates bacterial ribosomes and is bactericidal in urine at therapeutic doses, most gram negative and positive urinary tract pathogens
DO NOT USE FOR PSEUDOMONAS- ALL STRAINS RESISTANT
Se: PAIN
Pulmonary toxicity - rare but be aware
Anemia in G6PD
Irritated GI
Neurotoxicity
nausea, headache, discolored urine
ci: G6PD, elevated serum Cr., nearing delivery, lactation
interactions: antagonistic effects with Ciproflaxin
Doxycycline
Bacteriostatic antibiotic, protein synthesis inhibitor
use: Rickettsia, Chlamydia, Mycoplasma, Lyme, acne, cholera, gonorrhea, syphilis in penicillin allergy patients
NOT FOR STAPHYLOCOCCAL INFECTIONS
how: binds to 30S and 50S ribosomal subunits causing alterations on the cytoplasmic membrane of susceptible organisms,
se: photosensitivity and tooth discoloration in children younger than 8, nausea, vomitin, diarrhea, black tongue, hepatotoxicity, renal toxicity, decreased growth in children
interactions: antacids, calcium, magnesium, iron reduce absorption, decrease effects of penicillin, increased risk of intracranial pressure with vitamin A derivatives
ci: under 8 years old, pregnancy, lactation, sever liver disease, vitamin A derivatives
Azithromycin
Macrolide antibiotic
Protein synthesis inhibitor
use: RTI caused by streptococci, pneumococci, H. influenza, legionella
single dose for chlamydial urethritis, chancroid, Mycobacterium avid complex
How: binding 50s ribosomal subunit and disrupts RNA dependent protein synthesis
se: MAACrolide Motility enhanced GI upset Allergic reaction Arrhythmia- rare but severe Cholestatic hepatitis - rare
ci: liver disease, pregnancy
interactions: together with statins increase risk of rhabdomyolysis , increased digoxin toxicity, inhibits warfarin metabolism, DO NOT MIX WTIH ERGOT ALKALOIDS!
don’t use with magnesium or aluminum antacids
Trimethoprim sulfamethoxazole
sulfonamide antibiotic
folate antagonist
use: Pneumocystitis carinii pneumonia in AIDS patients
RTI- alternative to beta lactams for OM and sinusitis caused by SMZ -S. pneumonia, Moraxella catarrhalis and H. influenZa
UTI PEEKS: proteus, e coli, enterobacter, klebsiella, serratia
GI infections: Salmonella, Shigella
thrombocytopenia and leukopenia, megaloblastic anemia
how: folate antagonist
Ci; severe renal and hepatic impairment, megaloblastic anemia or folate deficiency anemia, SULFA drug, under 2 months, pregnancy, lactation, G6PD
interactions: additive folate deficiency with phenytoin and methotrexate, also may potentiate sulfonylureas, increase thiazide diuretic induced thrombocytopenia, warfarin
Mupirocin
topical antibiotic
protein synthesis inhibitor
use: impetigo, eradication of nasal colonization with staph aureus, infected skin lesions
prophylaxis in MRSA carriers
how: binds isoleucyl transfer RNA synthetase, gram positive bacteria including MRSA and certain gram negs
se: burning, stinging, pain, itching, erythema, dryness, tenderness, dermatitis and rash
ci: burn patients
Triple antibiotic
Neomycin, Polymyxin B and Bacitracin
used for minor cuts, scrapes and burns
se: Allergic contact dermatitis
not in eyes or large areas of body
Amantadine
anticholinergic
antiVIRAL, antiparkinson
use: herpes zoster in immunocompromised patients, parkinsons, not the flu anymore
how: weak dopamine agonist with antimuscarinic properties, alters dopamine release and uptake
non competitive antagonist of N methyl d aspirate
prevents the release of infections viral nucleic acid
ci: pregnancy and lactation, closed angle glaucoma, epilepsy or seizure disorders, severe renal impairment, PUD
interactions: enhances the adverse effect of antimuscarinics, anticholinergics and levodopa- do not take with CNS stimulants
se: dry mouth, confusion, seizures, psychosis, hallucination, blurred vision
Oseltamivir
Tamiflu
antiviral
neuraminidase inhibitor
use: prevention and treatment of flu a and b, active agains H3N2 and type b, resistant to H1N1
how: selective competitive inhibitor of neuraminidase, enzyme required for viral replication of the flu virus, prevents release of virus from host cell
ci: severe renal impairment
interactions: decreases flu vaccine effectiveness, vaccinate 2 weeks before or 48hrs after
se: nausea vomiting abdominal pain
Valacyclovir
Antiviral
nucleoside analog
use: herpes zoster, genital herpes, prophylaxis of herpes and CMV in immunocompromised
how: converted to acyclovir in the intestines and liver, inhibits DNA synthesis and viral replication mainly with herpes
ci: not under 2 yo
interactions: decreased effectiveness of vaccines
se: headache nausea diarrhea, elevated AST, ALT, neutropenia, nasopharyngitis
Zidovudine
antiretroviral agent
nucleoside analoge
use: HIV, PEP
how: thymidine analogue, interferes with DNA synthesis of retroviruses by inhibiting DNA replication
Reverse transcriptase inhibitor)
ci: lactation, Pregnancy
interactions: increase headache with benzo, increase serum levels with methadone, myelosuppression.
se: headache, nausea, vomiting, weakness, rash, diarrhea, anemia
Interferon alpha and beta
Antineoplastic, antiviral
use:
Interferon alpha: chronic hepatitis B and C, condyloma ccuminatum, tumors: leukemia, aids related kaposi, malignant melanoma
Interferon B: MS
how: bind sell surface receptors and activate the cascade to block viral protein synthesis
Interactions: reduces clearance of theophylline (fatal), myelosuppresion
ci: autoimmune hepatitis, hepatic decompensation, autoimmune disease, immunosuppressed transplant recipients, infants, pregnancy
se: IFN ALPHA
Inhibition of bone marrow leading to leukopenia and anemia
Flu like sx
Neurotoxicity - depression, psychosis
Liver enzyme elevations
Proteinuria
Hypotension, tachycardia
Alopecia
Fluconazole
anti fungal
synthetic azole
use: Oropharyngeal, esophageal, systemic candida; cryptococcal meningitis, candida UTI, balantis, Onychomycosis due to dermatophyte
how: decreases ergosterol synthesis by interfering with CYp450, inhibits cell membrane formation and leads to cell death
ci: pregnancy, liver and kidney disease
interactions: potentiates warfarin, oral hypoglycemic, may increase serum levels of phenytoin, cyclosporine, zidovudine, sulonylureas, carbamazepine, thiazides increase levels, increased risk with statins or rhabdo
se: headache, LFT, arrhythmias, seizures
Nystatin
anti fungal
polyene anti fungal
use: topical treatment of cutaneous or mucocutaneous candida infections
how: acts by binding sterols int he cell membrane- changes permeability and leakage of intracellular components
se: uncommon
Hydroxychloroquine
antimalarial, anti rheumatic, anti inflammatory
aminoquinoline
use: SLE, RA, malaria prophylaxis, acute malaria
how: interferes with digestive vacuole function
ci: retinal or visual field changes, long term use in kids
interactions: avoid digoxin, increases risk of gallstones with fibrates
se: hair loss, photosensitivity, visual disturbances, tinnitus, myopathy, psychosis, seizures, cardiomyopathy and retinopathy
