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Pharm Midterm 2 > Inhibitors of DNA Synthesis > Flashcards

Inhibitors of DNA Synthesis Flashcards

1
Q

What are the Fluoroquinolones

A 
Nalidixic acid (1st)
Ciprofloxacin (2nd)
Levofloxacin (3rd)
Moxifloxacin (4th)
Gemifloxacin (4th)
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2
Q

What are the Sulfonamides

A 
Sulfacetamide
Sulfadiazine
Sulfamethoxazole
Sulfasalazine
Sulfisoxazole
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3
Q

What are the Misc inhibitors of DNA synth

A

Trimethoprim
Co-trimoxazole
Metronidazole

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4
Q

What is the Urinary Antiseptic

A

Nitrofurantoin

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5
Q

Relationship between Fluoroquinolone generation and gram

A

Low gen = More G-

High gen = More G+

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6
Q

Which Fluoroquinolone is good against S. pneumoniae

A

Levofloxacin

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7
Q

Which Fluoroquinolone is synergistic with beta-lactams

A

Ciprofloxacin

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8
Q

What are 1st gen Fluoroquinolones for

A

Uncomplicated UTIs

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9
Q

What are 2nd gen Fluoroquinolones for

A

Traveler’s Diarrhea (ETEC)
P. aeruginosa in CF
Meningitis prophylaxis

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10
Q

What are 3rd gen Fluoroquinolones for

A

Prostatitis (E. coli)
STIs (not syphillis)
Acute sinusitis, bronchitis, TB

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11
Q

What are 4th gen Fluoroquinolones for

A

Monotherapy Community acquired PNA

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12
Q

S. pneumoniae 2nd line outpt, 1rd line inpt

A

Respiratory quinolones (3rd, 4th)

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13
Q

How do Fluoroquinolones act

A

Enter bacteria via porins

Inhibit Topo II, IV

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14
Q

What inpt infections can Fluoroquinolones be used for

A

S. pneumoniae
H. influenza
M. catarrhalis
Atypical pathogens

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15
Q

Don’t give with milk or acid

A

Fluoroquinolones

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16
Q

What messes with Fluoroquinolone absorption

A

Divalent cations (Fe, Zn, Ca)

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17
Q

For which Fluoroquinolone do you not have to adjust the dose for in renal dysfunction

A

Moxifloxacin

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18
Q

Which Fluoroquinolones can cause QT prolongation

A

3rd, 4th

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19
Q

What can enhance toxicity of Fluoroquinolones

A

Theophylline
NSAIDS
Corticosteroids

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20
Q

3rd and 4th Fluoroquinolone AE

A

Increase warfarin, caffeine and cyclosporine levels

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21
Q

Main Fluoroquinolone AE

A

Tendon rupture

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22
Q

When are Fluoroquinolones contraindicated

A

Pregnant
Nursing mothers
Everyone <18

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23
Q

General Fluoroquinolone AE

A

Photosensitivity
GI distress
CNS
Rash

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24
Q

Fluoroquinolone Resistance

A

Chromosomal mutation in gyrase and topo IV

Expression of efflux pumps

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25
Q

Why are Sulfonamides given in triple therapy

A

Resistance with alone

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26
Q

How do Sulfonamides work

A

Inhibit Dihydropteroate Synthase

Decreases folate

27
Q

Which Sulfonamide can you give for IBD

A

Sulfasalazine

28
Q

When can you give Sulfonamides topically

A

Eyes

Burns

29
Q

When can you give Sulfonamides orally

A

Simple UTI

30
Q

What is the structure of Sulfonamides

A

PABA analog

31
Q

When can Sulfonamides accumulate

A

Renal failure

32
Q

What can increase Sulfonamide plasma levels

A

Warfarin
Phenytoin
MTX

33
Q

Main Sulfonamide AE

A

Hypersensitivity

Crystalluria

34
Q

Sulfonamide Contraindications

A

Infants, newborns (Kernicterus)

35
Q

Who gets hemolytic anemia with Sulfonamides

A

G6PD deficiency

36
Q

General Sulfonamide AE

A

Photosensitivity
GI distress
Fever, Rash

37
Q

Sulfonamides Resistance

A

Altered enzyme
Decreased permeability
Enhanced PABA production
Decreased accumulation

38
Q

How do Sulfonamides cause kidney damage

A

Acetylation in liver causes metabolite precipitation at neutral/acid pH

39
Q

What is TMP used for clinically

A

UTIs
Bacterial prostatitis (after cipro)
BV

40
Q

What does TMP do

A

Inhibit DHF reductase

41
Q

What goes well with TMP

A

SMX

42
Q

Where does TMP hit high conc

A

Prostate

Vagina

43
Q

When is TMP contraindicated

A

Pregnancy

44
Q

TMP AE

A

Megaloblastic anemia
Leukopenia
Rash, pruritis

45
Q

What do you give for TMP leukopenia

A

Leucovorin

46
Q

DOC PCP, Uncomplicated UTIs, Nocardiosis, Toxoplasmosis

A

Co-trimoxazole

47
Q

What is Co-trimoxazole

A

TMP + SMX

48
Q

When is Co-trimoxazole contraindicated

A

Pregnancy

49
Q

Co-trimoxazole AE

A

Stevens-Johnson
GI
Hemolytic anemia
More AE in AIDS

50
Q

DOC C. Diff

A

Metronidazole

51
Q

Aside from C. diff, what’s Metro good for

A

Anaerobic/mixed intra-abdominal infections
T. vaginalis, BV, Gardnerella vaginalis
Brain abscess
Triple therapy for H. pylori

52
Q

How does Metro work

A

Reductive bioactivation of nitro group by ferredoxin
Cytotoxic product
Interfere with nucleic acid synth

53
Q

How is Metro eliminated

A

Liver

54
Q

What are the general Metro AE

A 
GI stomatitis
Peripheral neuropathy, HA
Dark urine
Leukopenia, dizziness, ataxia
Opportunistic fungal infections
55
Q

What is the most notable Metro AE

A

Disulfiram-like reaction

56
Q

Can you give Metro in pregnancy

A

Avoid in 1st trim

57
Q

Prophylaxis and Tx of lower UTI

A

Nitrofurantoin

58
Q

When is Nitrofurantoin contraindicated

A

Renal failure
Pregnancy at term
Infants

59
Q

What should you give to at-term pregnancy instead of Nitrofurantoin

A

Amoxicillin

60
Q

Where is the only place therapeutic levels of Nitrofurantoin are found

A

Urine

61
Q

Nitrofurantoin AE

A

Anorexia
N/V
Neuropathy

62
Q

Does Nitrofurantoin have cross reactivity

A

No

63
Q

How does Nitrofurantoin act

A

Reduced by bacteria

Damage DNA

Pharm Midterm 2 (52 decks)

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