Intro to ABX (Clinical Pearls) - Block 1 Flashcards
1
Q
Penicillin MOA
A
Inhibits the cross-linking of peptidoglycan in cell wall, causing autolysis & cell death
2
Q
Types of penicillins?
A
- Natural
- ANti-staph
- AMinopenicillins
- Aminopenicillisn + BLI
- Extend spec + BLIs
3
Q
Natural penicillins?
A
Penicillin G and V
Pen G benzathine
4
Q
Natural penicillin indication?
A
- Pharyngitis
- Syphillis
5
Q
BBW of penicillins?
A
Pen G benzathine should not be given IV -> fatal
6
Q
What is Pen G benzathine specifically used for?
A
Bicillin LA -> drug ofchoice for syphillis
7
Q
Types of anti-staph pens?
A
- Nafcillin
- Oxacillin
- Dicloxacillin
8
Q
Indications for anti-staph pens?
A
MSSA: ABX are therapeutically interchangeable
9
Q
Because of the short half-life and frequent dosing what do you need to consider about anti-staphs?
A
Increased risk for phlebitis -> consider using 1st gen cephs for better tolerability
10
Q
CP of anti-staphs?
A
- Metabolized by liver -> no renal dose adj
- Consider sodium content in CHF on Na restriction
- ABXs are interchangeable for MSSA
11
Q
Types of aminopenicillins?
A
- Amoxicillin
- Ampicillin
12
Q
Indications for aminopenicillins?
A
- URTIs
- Otisi media
- Strep throat
- H. pylori
- enterococci
13
Q
CP of aminopenicillins?
A
- Diarrheas as PO
- Amoxicillin»_space; ampicillin
- Alternative for UTIs in pregnant women
14
Q
When would ampicillin be considered over amoxicillin?
A
Suspectible enterococci infections
* E. faecalis = S
* E. faecium = R
15
Q
Types of Aminopenicillins + Beta-Lactamase Inhibitors?
A
Amoxicillin/clavulanate (PO)
Ampicillin/sulbactam (IV)
16
Q
Indication for Aminopenicillins + Beta-Lactamase Inhibitors?
A
- URTIs
- LRTIs
- Animal and human bites
17
Q
CP for Augmentin?
A
Causes diarrhea -> take with food
18
Q
Do Beta-lactamase inhibitors cause complete inactivation of all BL enzymes?
A
No
19
Q
CP of ampicillin/sulbactam?
A
active against Acinetobacter baumannii associated with nosocomial infections
20
Q
Types of extended spec + BLI?
A
Zosyn
21
Q
Indication for ZOsyn?
A
- Empiric coverage of nosocomial infections
- Susceptible P. aeruginosa infection
22
Q
CP of Zosyn?
A
- Broad spec activity against G- and G+ anaerobes
- COnsider sodium content in BHF on Na restriction
23
Q
ADRs of penicillins?
A
Hypersensitivity
C. diff colitis
24
Q
Monitoring parametrs of penicillins?
A
Hypersensitivity reactions
25
Cephalosporins MOA?
Inhibits the cross-linking of peptidoglycan in cell wall, causing autolysis & cell death
26
Types of 1st gen cephalosporins?
1. Cefazolin
2. Cephalexin
3. Cefadroxil
27
Indication of 1st gen cephs
1. SSTI
2. surigical prophylaxis
3. MSSA bacteremia and endocarditis
28
CP of 1st gen cephs?
1. Alt agent for anti-staph
2. Cephalexin and cefadroxil -> high cross reactivity to beta-lactams
3. Ceffazolin: low cross reactivity to beta-lactams
29
Types of 2nd gen cephs?
1. Cefuroxime
2. Ceprozil
3. Cefoxitin
4. Cefotetan
30
Indication for 2nd gen ceph?
1. URTIs
2. CAP
3. Surgical prophylaxis (Cefoxitin and cefotetan)
31
How does 2nd gen compare to 1st gen?
Less strep and staph activity
32
2nds gen cephs that have anaerobic coverage?
Cefoxitin and cefotetan
33
ADR of cefotetan?
MTT side chain -> inhibits Vit K production and causes prolonged bleeding
34
Which 2nd gen has a high cross reactivity with beta lactams
Cefprozil
35
Types of 3rd gen cephs?
1. Cefdinir
2. Cefpodoxime
3. Cefotaxime
4. Ceftriaxone
5. Seftazidime
36
Indication for 3rd gen?
1. URTIs
2. LRTIs
3. gonorrhea
4. SSTIs
5. Bacteremia
6. Osteomylitis
7. Menigitis and Lyme (ceftriaxone)
8. Nosocomial and febrile neuropenia (Ceftazidime)
37
ADR of 3rd gen?
1. C. diff infection
2. Increased risk of GNR resistance
3. Cefpodoxime -> MMT side chain inhibits Vit K production -> prolonged bleeding
38
How does ceftazidime coverage differ from other 3rd gens?
Only has Pseudomonas activity, poor strep and staph coverage
39
#rd gens that are used for CNS infection?
1. Ceftriaxone (meningitis and Lyme)
2. Cefotaxime
3. Ceftazidime (febrile neutropenia)
40
Ceftriaxone
| Dosing, DDI, ADR, CI
**Dosing:** QD, menigitis BID
* No renal adjustment
**DDI:** intercts with calcium-containing meds (forms crystals in lungs and kidneys)
**ADR:** biliary sludging -> hyperbilirubemia
**CI:** Neonates (cefotaxime is safer)
41
Types of forth gen cephs?
Cefepime
42
Indication cefepime?
1. Empiric therapy for nosocomial infection
2. Febrile neutropenia
3. Intra ab infction
4. SSTIs
5. UTI
| Pseudomonas activity (permanent charge)
43
Caution with cefepim?
1. Neurotoxicity
2. Renal dose adjustment
44
Types of 5th gen cephs?
Ceftaroline
45
Indication of ceftaroline?
1. CAP
2. MRSA
3. Complicating SSRI
46
ADR of ceftaroline?
Neutropenia
47
Types of sideophor ceph? MOA
Cefiderocol (Fetroja): contains a sideophore side chain that allows it to be taken up into the abcteria bypassing resistance mechanisms
48
Indication for Cefiderocol?
1. Complicated UTI
2. HAP
3. P. aeruginosa, ESBL- and carbapenemase producing organisms)
* Only used in patients with resistance of common ABX for the inidcation
49
Types of Cephalosporin + Beta-Lactamase Inhibitors?
ceftazidime/avibactam (IV), ceftolozane/tazobactam (IV), cefepime/enmetazobactam (IV)
50
Indication for Cephs + BLI?
1. MDR P. aeruginosa
2. ESBL-producign organsims
* ONLY in patients with bacterial infections which are resistant to other commonly-used antibiotics for the indication
51
What ceph combo has activity against carbapenem resistant enterobacterales?
Ceftazidime/avibactam
52
What can be added to ceph +BLI therapies if resistance is observed?
Metronidazole
53
ADR of Cephs?
1. Hypersensitivity rx
2. C diff colitis
54
Monitoring parameters of cephs?
1. Hypersensitivity rx
2. Renal function
55
MOA of carbapenems?
Inhibits the cross-linking of peptidoglycan in cell wall, causing autolysis & cell death
56
Types of cabapenems?
1. Imipenem/cilastatin
2. Meropenem
3. Ertapenem
57
Indications for carbapenems?
1. Nosocomial
2. Febrile neutropeia
3. Intra ab infection
4. ESBL infections
58
ABX with the broadest spec? Caution?
Imipenem/cilastatin and meropenum -> should not be used as empiric therapy for CA infections
59
ADRs of imipenem/cilastatin?
Seizures
* Renal adjustment to minimize sz
60
DDI with carbapenems?
Valproic acid
* carbapenems induce VPA -> sub therapeutic VA [C] and breakthrough sz
61
How does ertapenen differ from other carbapenems?
1. QD (more convenient)
2. Weaker spec
* Pooractivity against Pseudmonas, acinetobacter, enterococci
62
63
Types of Carbapenems + Beta-Lactamase Inhibitors?
imipenem/cilastatin/relebactam (IV)
meropenem/vaborbactam (IV)
64
Indication for carbapenems + BLI?
1. Complicated UTI
2. Intra ab infection
3. HAP
4. VAP
65
ADR of carbapenems?
1. Hypersensitvity
2. C diff colitis
65
CP of carbapenems + BLI?
1. Activity against carbapenemase-producing Enterobacterales and ESBL
2. Imipenem/cilastatin/relebactam has . carbapenem-resistant Pseudomonas coverage
3. Vaborbactam has no CR-pseudomonas coverage
66
Monitoring paratmeters of carbapenems?
1. Hypersensitivity rx
2. Renal function
67
Cautions when using carbapenems?
SZ higher in elderly with hx of sz or renal dysfunction
68
69
MOA of monobactams?
Inhibits the cross-linking of peptidoglycan in cell wall, causing autolysis & cell death
70
Types of monobactams?
Aztreonam
71
Indication for manobactams?
1. G- infections including Pseudomonas (especially hx of beta-lactam allergy)
72
ADR of monobactams?
C diff colitis
Anaphylactic penicillin allergy
Avoid if patient has a ceftazidime allergy
73
Monitoring parameters of aztreonam?
Renal function
74
Macrolides MOA?
Binds to 50S subuntis on bac ribosome -> inhibits it from adding new aa to elongate protein chain
75
Types of macrolides?
1. Azithromycin
2. Clarithromycin
3. Erythromycin
76
Indication of macrolides?
1. RIs
2. Atypical infection
3. Travelers diarrhea (Azitrhomycin)
4. H pylori PUD (clarithromycin)
5. CAP butnot as a monotherapy due to increasing resistance
77
DDI of Macrolides?
Not Azithromycin: potent CYP3A4 inhibits
78
ADRs of macrolides?
1. GI intolerance
2. Diarrhea (Erythromycin -> prokinetic and GI stimulating)
3. QTc prolongation
79
MOA of fluroquinolones?
Inhibits DNA topoisomerase -> DNA breakage and cell death
80
Types of fluroquinolones?
1. Ciprofloxacin
2. Levofloxacin
3. Moxifloxacin
4. Delafloxacin
81
Quinolones indicated for MRSA?
Delafloxacin
82
Quinolone not for respiratory?
Ciprofloxacin: poor S. pneumoniae coverage)
83
What is not an indication for moxifloxacin?
UTI -> poor urinary concntration
84
All quinolones reque renal adjustment?
Except for moxifloxacin
85
CI of quinolones?
Pregnancy and children -> imparied bone and cartilage development
86
BBW of quinolones?
1. Tendon rupture
2. Peripheral neuropathy
3. CNS effect
4. Myasthenia gravis
87
Precaution of quinolones?
1. Aortic aneurysm and dissection
2. Hyperglycemia
3. Hypoglycemia
88
Quinolones with P. aeruginosa coverage?
Levofloxacin and ciprofloxacine must be given in higher doses when treating infection
89
______ is necessary due to increasing resistance of P. aeruginosa?
Susceptibility testing
90
Compare bioavailabilties of quinolone formulations?
**Levofloxacin and moxifloxacin:** PO=IV
**Cipro and delafloxacin:** PO
91
DDIs with qinolones?
Mulivalent cations -> separate by at least 2 hrs
92
ADRs of fluoroquinolones?
1. GI intolerance
2. Photosensitivity
3. QTc prolongation
4. Tendon rupture
5. Peripheral neuropathy
6. SZ
7. C diff colitis
93
Monitoring parameters of fluoroquinolones?
Renal function
94
MOA of tetracyclines?
Binds to 30S subunit of bacterial ribosome -> preventing the docking of tRNA with new amino acids from adding to elongating protein chain
95
TYpes of tetracyclines?
1. Doxycycline
1. Minocycline
1. Tetracycline
96
Indication of tetracyclines?
1. URTIs
2. LRTIs
3. SSTIs
4. Atypicals
97
What is a con for tetracyclines have a large Vd?
Good tissue penetration -> not good for bacteremia
98
Doing of doxycycline and minocycline?
PO andIV are equivalent
99
DDI of tetracycline?
Multivalent cations -> separate for at least 2 hrs
100
Types of modified tetracyclines?
1. Tigecyclne
2. Eravacycline
3. Omadacycline
101
Why is tigecycle not used?
BBW -> increased risk of mortality
102
Tetracyclines that don't require renal dosing?
Eravacycline and omadacycline
103
How should omadacycline be dosed?
1. Empty stomach
2. 2 hrs before or 4 hrs after meals
3. DDI with multivalent cations
104
Modified tetras have better activity against ___ than normal tetras?
VRE and MRSA
105
ADR of tetras?
1. Esophageal ulcerations
2. Photosensitivity
3. Pseudotumor cerebri
4. C diff colitis
106
Counseling points fr Tetras?
1. Takewith 8 oz of water and sit upright for 30 minutes
2. Avoid in pregnancy
3. Doxycycline can be used in pediatrics <21 days
107
MOA of pleuromutilins?
Inhibits protein synthesis through various interaction with A and P sites of PTC (peptidyl transferase center) in domain V of 23S rRNA of the 50S ribosomal subunity
108
Types of pleuromutilins?
Lefamulin
109
Indication for lefamulin?
CAP (G+, G-, MRSA, Atypicals)
110
How is lefamulin metabolized?
CYP3A4 -> avoid CYP3A4 inhibitors -> QTc prolongation
111
ADr of pleuromutilins?
1. Gi intolerance
2. QT prolongation
3. C diff colitis
112
Monitoring parameters of pleuromutilins?
Pregnancy testing -> teratogenic
113
Counseling points for Lefamulin?
1. Take 1 hr before or 2 hr after meals
2. Swallow whole with 6-8oz of water
3. Don't crush or divide tablets
114
MOA of AGs?
Binds to 30S subunit of bacterial ribosome -> misreading of genetic code, incorrect protein
115
What are the types of AG?
1. Gentamicin
2. Tobramycin
3. AMikacin
4. Plazomicin
5. Streptomycin
116
What is plazomicin used for?
Complicated UTIs from MDR enterobacterales (ESBL and cabapenem resistant strains)
117
How is AG dosed?
IBW or AdjBW, but not TBW
118
Can AG be used has a monotherapy?
No, due to poor concnetrations achieved in the lungs and CNS
119
What are types of dosing strategies for AG?
1. Traditional
2. Extended interval
120
What is traditional dosing?
**Before 4th dose:** draw trough level wihin 30 min before next dose
**After 4th dose:** draw a peak level 30 min after infusion
121
What is the difference between peak and trough?
**Peak:** measures efficacy
**Trough:** measures toxicity
122
How do we fix peak?
Adjust dose
123
How do we fix trough?
Adjust dosing intervals
124
Who should not get extendd interval dosing?
1. Pregnancy
2. Critcally ill
3. Renal dysfunction
4. Morbidly obese
125
Dosing for extended interval?
Draw a random level after 1st dose based on **Hartford nomagram**
126
ADR of AG?
1. Tubular necrois (nephrotox)
2. Renal failure (nephrotox)
3. Vestibulr and cochlear toxicity (ototox)
127
Monitoring paramters for AG?
1. Renal function
2. Serum drug concentration
128
MOA of glycopeptides
Binds to terminal D-ala D-ala chains on PG in the cell wall preventing elongation of PG chains
129
Types of glycopeptides?
Vancomycin
130
What is the preferred option for MSSA infections starting out?
b-lactams
131
What is vanc for?
1. MRSA
2. C diff (PO only)
132
PK/PD of vanc?
Time dependent, bactericidal
133
Dosing of vancomycin?
SHould not exceed 5 mg/mL by IV infusion over >60minutes
* Infusion period of 30 minutes for every 500 mg administered
134
Goal range for vanc?
**Normal:** 10-20 mcg/mL
**Severe infection:** 15-20 mcg/mL
135
Monitoring of vanc levels should include?
Trough taken 30 minutes before next dose
* before 4th dose
136
Ho should we adjust vanc?
**Trough > goal range:** increasing the interval or decreasing the dose
**Trough < goal range:** decreasing the interval or increasing the dose
137
What is the the target AUC value?
400-600
138
ADR of glycopeptides?
Vanc flushing syndrome
* Prolonging vanc infusions -> premedicate antihistamines
139
Monitoring paraemters of vancs?
1. Renal function
2. Serum drug concentration
140
MOA of lipoglycopeptides?
1. Binds to D-al D-ala chains on PG in the cell wall, preventing elongation of PG chains
2. Interferes with cell membrane disrupting membrane function
141
Types of lipogycopeptides?
1. Telavancin
2. Dalbavancin
3. Oritavancin
142
Indications of lipoglycopeptides?
1. SSTIs
2. HAP (telavancin)
143
Describe the efficacy of telavancin over vanc?
Bactericidal effects more rapidly than vanc
144
DOA for lipoglycopeptides?
Oritavancin and dalbavancin: >1 week t1/2
145
DDI of lipoglycopeptids?
Heparin and warfarin: Oritavancin alters PT and activated pTT
146
Scope of activity of lipoglycopeptides?
1. MRSA
2. VRE (oritavancin)
147
ADR of lipoglycopeptides?
1. C. diff colitis
2. Infusion related rx
3. Nephrotox
4. Metallic taste disturbances (telavancin)
5. Foamy urine (telavancin)
148
Monitoring parameters of lipoglycopeptides?
1. Renal function
2. Pregnancy test -> telavancin is teratogenic
149
MOA of cyclic lipopeptides?
Binds to cell membrane of G+ -> causing leakage of intracellular cations that maintain membrane polarization -> rapid depolarization and cell death
150
Types of cyclic lipopeptides?
Daptomycin
151
Indication of daptomycin?
MRSA, VRE
152
CI of cyclic lipopetides?
Pneumonia -> inacitivation by lung surfactant
153
ADR of daptomycin?
1. Elevated cr phosphokinase (CPK)
2. Rhabdomyolysis
154
Monitoring parameters of cyclic lipopetides?
1. Renal function
2. CPK (patients with prior or concomitant statin therapy)
155
Dosing of daptomycin?
1. Elevated CPK >5 times ULN in patients with sx of rabdomyolysis
2. Elevated CPK > 10 times ULN in asymptomatic patients
156
MOA of oxazolidinones?
Binds to 50S subunit -> blocks the formation of the 70S initiation complex resulting in the inhibition of protein synthesis
157
Types of oxazolidinones?
1. Linezolid
2. Tedizolid
158
Indication for Oxazolidinones?
MRSA, VRE
159
Dosing of oxazolidinones?
Linezolid and tedizolid: IV-PO (1:1)
Linezolid: No dose adjustment, not eliminated kidneys and liver
160
DDI of oxazolidones?
Linezolid -> serotonergic agents due to MOAI activity -> Serotonin syndrome
161
ADR of oxazolidinones?
1. Myelosuppression (thrombocytopenia, leukopenia, anemia) - >2 weeks
2. Peripheral neuropathy
3. Serotonin syndrome
162
Monitoring parameters of oxazolidinones?
1. CBC with differential
2. Serotnin syndrome in patients on concomitant therapy with other serotonergic agents
163
MOA of folate antagonists?
Inhibits folate biosynthesis causing the depletion of the nucleotde pool -> inhibition of DNA synthesis in susceptible organisms
164
Types of folate antagonists?
1. Bactrim
2. Dapsone
3. Pyrimethamine
4. Sulfadiazine
165
Fixed ratio of Bactrim?
5:1
166
Indication of Bactrim?
1. First line for uncomplicated UTIs
2. ALt: nitrofurantoin if local E. coli >15-20%
3. Avoid for empiric tx of complicated UTIs
167
CI of Bactrim?
1. DDI wit warfarin -> increased bleeding risk -> monitor INR
2. Infants <2 months old
3. Pregnancy (inhibits folate)
168
ADR of folate antagonists?
1. GI intolerance
2. Rash
3. Hyperkalemia
4. Photosensitivity
5. Crystalluria with azotemia
6. SJS/TEN
7. Sulfa allergy
8. Methemoglobinemia in patients with G6PD def
169
MOA of streptogramins?
Bnds to different sites on the 5S subunit of the bacterial ribosome -> preventing of bacterial protein synthesis
170
Types of streptogramins?
Quinupristin - dalfopristin (Synercid)
171
Synercid scope of activity?
1. No activity against E. faecalis
2. Definitive therapy
3. Only used for MRSA, VRE (E. faecium)
| Bacteriostatic alone, bactericidal together
172
ADR of streptogramins?
1. Myalgia
2. Arthralgia
173
Dosing of Synercid?
* Mixed and administered with D5W
* 100% F
174
MOA of lincosamides?
Binds to 50S subunit inhibitng them from adding new aa to elongate protein chain (similar to macrolides)
175
Types of lincosamids?
Clindamycin
176
How do we test for lincosamide resistance?
D-test for erythromycin-resistant, clindamycin-susceptible strains:
* Positive D-test: inducible clindamycin resistance -> avoid clindamycin
177
ADR of lincosamides?
Diarrhea, C. diff colitis
178
MOA of nitromidazoles?
Forms free radicals can damage DNA and result in cell death of anaerobic bacteria and protozoa
179
Types of nitromidazoles?
1. Metronidazole
2. Tinidazole
180
DDI of nitromidazoles?
1. Metronidazole inhibits aldehyde dehydrogenase -> concomitant use of alcohol -> disulfurim like rx
2. CYP3A4 inhibition -> warfarin increased risk for bleeding
181
Bioavailability of metronidazole?
PO:IV -> 1:1
182
ADR of nitromidazole?
1. Metallic taste
2. Peripheral neuropathy -> reversible
3. Disulfirm rx with alcohol
183
MOA of Nitrofurans & Fosfomycin
**Nitrofurantoin:** redued by bacterial flavoproteins into reactive species that alters ribosomal proteins inhibitngprotein synthesis
**Fosfomycin:** inhibits bacterial cell wall synthesis by preventing the production of building blocks of PG
184
Indication of nitrofurantoin? Fosfomycin?
Uncomplicated UTIs
Both: acute cystitis from VRE
185
CI of nitrofurantoin?
CrCl < 60 mL/min
Short term use: >30 mL/min
186
ADR of nitrofurans and fosfomycin?
Nitrofurantoin:
1. Peripheral neuropathy
2. Hemolytic anemia
3. Urine discoloration
4. C. diff colitis
Fosfomycin:
1. GI intolerance
2. C. diff colitis
187
Monitoring parameters of nitrofurans and fosfomycin?
G6PD activity
188
Formulations of nitrofurans and fosfomycin?
**Nitrofurantoin:** Macrobid and Macrofantin
**Fosfomycin:** PO powder mixed with waters prior to admin as one-dase regimen
189
MOA of polymyxins?
Binds to outer membrane of G- causing disruption of membrane stability and leakage of cellular contents
190
Types of polymyxins?
1. Colistin
2. Polymyxin B
191
Indication for polymixins?
Last line by MDR G- (A. baumannii, P. aeruginosa, and carbapenem-resistant Enterobacterales (K. pneumoniae))
192
Dosing of colistin?
400 mg colistimethate = 150 mg colistin base activity
193
ADR of polymyxins?
1. Nephrotox -> dose-dependent effect
2. Neurotox
3. Neuromuscular blockade
194
MOA of anti-c diff?
Inhibits RNA polymerase resulting in the inhibition of protein synthesis and cell death
195
Types of anti-c diff agents?
Fidaxomicin
196
Indication of fidaxomicin?
1. Non-absorbble in narrow spec activity specifically C. diff
2. First line agent for C diff treatment and prophylaxis
197
ADR of anti-c. diff agents?
1. GI tolerance
2. Hypersensitivyt reactions
198
Cons of fidaxomicin?
1. Very expensive
2. Avoid: PO vanc or metronidazole
199
Types of tubercular agents?
1. Rifamycins
2. Isoniazid
3. Pyrazinamide
4. Ethambutol
200
MOA of rifamycins?
Inhibits RNA polymerase, which prevents transcription by blocking mRNA production & protein synthesis
201
Spectrum of activity of rifamycns?
MRSA
202
ADR of rifamycins?
1. Red orange discoloration of bodily fluids
2. Hepatotox
203
Monitoring paramters of rifampin?
Hepatic function (LFTs)
204
CP of rifampin?
Poten CYP450 enzyme inducers
* Rifabutin is less potent
205
MOA of isoniazid?
Inhibits enzymes that catalyze the synthesis of mycolic acids in the cell wall
206
Spectrum of activity of isoniazid?
Mycobacterium tuberculosis & Mycobacterium kansasii ONLY
207
ADR of isoniazid?
1. GI effects
2. Hepatotox
3. Peripheral neuropathy
208
Monitoring parameters?
Hepativ function (LFTs)
209
CP of isoniazid
Administer pyridoxine (B2) to prevent peripheral neuropathy
* Avoid use of alcohol or APA -> hepatotox
* Avoid serotonergic agents -> MAOI activity
210
MOA of pyrazinamide?
Inhibits fatty acid synthetase I, which prevents the production of mycolic acids in the cell wall
211
Soectrum of activity for pyrazinamide?
Mycobacterium tuberculosis ONLY
212
ADR of pyrazinamide?
Hepatotx (dose dependent)
Hyperuricemia
| Pyrazinamide is only used in combo
213
Monitoring parameters of pyrazinamide?
1. Hepatic function (LFTs)
2. Serum urate
214
MOA of ethambutol?
Inhibits arabinosyl transferase III, which prevents the production of arabinogalactan, a key component of the mycobacterial cell wall
215
Spectrum of activity of ethambutol?
Mycobacterium
216
ADR of ethambutol?
Optic neuritis
217
Monitoring parameters of ethambutol?
eye exam
218
What is the only med that is not associated with hepatotox?
Ethambutol
* first line agent for MAC infections
