L5. Other Microbials Flashcards
-floxacin
Floroquinolones
Prevent DNA synthesis
(Inhibit DNA topoisomerase (DNA gyrase -ve and topoisomerase +ve)
Nalidixic acid
Fluoroquinolone
1st gen
Gram -ve (include pseudomonas)
Ciprofloxacin
Fluoroquinolone
2nd gen, CYP inhibitor
Passes BBB (so does levofloxacin and other flouroquinolones?)
Extended spectrum
Delafloxacin
Fluoroquinolone
Only 4th generation drug that treats pseudomonas
Flouroquinolones spectrum change over generations?
1st gen gram neg
2nd gen extended spec
3rd gen +atypical and improved gram pos
4th gen +anaerobic
Overall: gram neg to broad spec
Fluoroquinolone SE?
Tendinitis, peripheral neuropath, seizure, photosens and prolonged QT
CI: preg, breast feeding and children
Don’t give with milk!
Resistance: primarily topoisomerase mutations (altered target binding)
Sulfasalazine, sulfamethoxazole
ES, Folate synthetase inhibitors (dihydropteroate)
Sulfonamide derivatives
Synthetic analogs of PABA
Less potent than trimethoprim
Penetrate CSF!!!
Trimethoprim
ES, folate reductase inhibitors (dihydrofolate)
More potent than sulfa
SE: potassium sparing effect which may cause hyperkalemia)
Sulfonamide SE
Crystal uria
Allergy
Hemolytic anemia (w/ G6PD deficiency)
CI: kernicterus (bilirubin associated brain damage) - sulfa drugs displace bilirubin from albumin which can freely pass into CNS (in new borns!) and cause damage
Newborns and preg woman
Cotrimoxazole
BS, Folate reductase + synthetase inhibitor
(Sulfamethoxazole + trimethoprim)
Synergy effect
Metronidazole
Oxidizes DNA causing cell death
Treatment of anaerobic bacteria (g-ve and g+ve —> including C diff)
SE: metallic taste
CI: disulfiram like reaction (when taken with alcohol)
Nitrofurantoin
DNA RNA synthesis inhibitor, treats cystitis
SE: N and V and diarrhea
Methenamine
Prophylaxis or suppression of Recurrent urinary tract infections
Converted to formaldehyde in acidic urine!
Whats special about sulfonamide resistance?
Organisms resistant to one member of sulfonamides are resistant to all!
