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CPRS > L78: Drugs used in UTI > Flashcards

L78: Drugs used in UTI Flashcards

1
Q

Common causative agent for catheter-associated UTI

A
  1. E. coli

2. Candida spp.

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2
Q

Common causative agent for urethritis

A
  1. Chlamydia trachomatis

2. Neisseria Gonorrhea

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3
Q

General principles of UTI treatment

A
  1. Quantitative culture (optional)
  2. Urine culture (upper, complicated UTI / treatment failure)
  3. Susceptibility testing (recurrent + complicated UTI)
  4. Identify + Correct risk factors
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4
Q

Treatment for Uncomplicated Cystitis in women

A
  1. Nitrofurantoin OR

2. Amoxicillin-clavulanate

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6
Q

Treatment for Uncomplicated UTI in children

A
  1. Cefuroxime OR
  2. Co-trimoxazole (sulfamethoxazole + trimethoprim)

<3 years: antibiotic prophylaxis after treatment

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7
Q

Treatment for Acute Pyelonephritis

A

IV amoxicillin-clavulanate

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8
Q

*Treatment for Enterobacter cloacae complex

A
  1. Levofloxacin/Ciprofloxacin OR
  2. Cefepime (IV) OR
  3. Piperacillin-tazobactam (IV)
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9
Q

Treatment for ESBL-positive E. coli / K. pneumoniae

extended spectrum beta-lactamase

A
  1. Nitrofurantoin OR
  2. Amoxicillin-clavulanate
  3. Fosfomycin trometamol
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10
Q

Treatment for

  • Candida spp. UTI
  • Asymptomatic Candiduria
  • Candida spp. Pyelonephritis
  • Fungal balls
A

Candida spp. UTI

  1. Fluconazole OR
  2. Amphoteracin B deoxycholate OR
  3. Flucytosine

Asymptomatic Candiduria:
- NO treatment unless high risk for dissemination (neutropenic)

Candida spp. Pyelonephritis:

  1. Fluconazole OR
  2. Amphoteracin B deoxycholate OR
  3. Flucytosine

Fungal balls:
- Surgery

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11
Q

Mechanism for azole, polyene, flucytosine and echinocandins

A

Azole: inhibit lanosterol —> ergosterol
Polyene: bind to ergosterol —> making cell membrane more crystalline, less fluid
Flucytosine: fluorinated pyrimidine analog —> stop DNA replication
Echinocandins: inhibit beta-glucan synthesis in fungal cell wall

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12
Q

Treatment for Chlamydial infections (urethritis + cervicitis)

A
  1. Azithromycin single dose OR
  2. Doxycycline OR
  3. Tetracycline/erythromycin/ofloxacin

Adverse effects:
- GI disturbance

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13
Q

Treatment for Gonococcal infections (urethritis + cervicitis)

A

IM Ceftriaxone / Cefixime + Azithromycin single dose

Oral cephalosporin not recommended due to increased resistance

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14
Q

Treatment for Prostatitis

A

Quinolones due to good pharmacokinetics, anti-inflammatory and anti-neuropathic effects

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15
Q

Members of Beta-lactams

A
  1. Penicillins
  2. Cephalosporins
  3. Monobactams
  4. Carbapenems
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16
Q

2nd generation + 3rd generation cephalosporin

A

2nd gen:
1. Cefuroxime

3rd gen:

  1. Ceftriaxone
  2. Cefotaxime
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17
Q

Members of non-beta lactams which inhibit cell wall synthesis

A
  1. Glycopeptide (Vancomycin)

2. Bacitracin

17
Q

Antibiotics which inhibits DNA and RNA synthesis

A

DNA synthesis: Metronidazole, Quinolone
RNA synthesis: Rifampicin

Metronidazole:
- metabolised in body to become active drug
—> Form unstable molecule with DNA causing DNA breaks
- Bactericidal against anaerobes

Quinolone:
- Inhibit DNA Topoisomerase II (gyrase) and IV
—> Inhibit DNA unwinding and replication

18
Q

Antibiotics that inhibit 30s, 50s ribosome

A

30s:

  1. Tetracycline
  2. Aminoglycosides

50s:

  1. Macrolides
  2. Linezolid
  3. Chloramphenicol
  4. Clindamycin
  5. Streptogramins
19
Q

Antibiotics that inhibit folate synthesis

A

Co-trimoxazole

  1. Sulfamethoxazole (sulfonamide: PABA analog: PABA —X—> Dihydrofolate)
  2. Trimethoprim (Dihydrofolate analog: Dihydrofolate —X—> Tetrahydrofolate)

Tetrahydrofolate is a precursor for DNA, RNA and proteins.

***Bacteriostatic

Adverse effects:

  1. Skin rash
  2. Haemolytic anaemia in G6PD
  3. Megaloblastic anaemia
20
Q

Nitrofurantoin

A

Formation of reactive intermediates by nitrofuran reductase
—> bacterial cells activate drug more rapidly
—> attack DNA, ribosomal protein, respiration and macromolecules in bacteria

  • Concentrated in urine / low in blood
  • **- LOW rate of resistance (due to many potential mechanisms)

Adverse effects:
- Brown urine

21
Q

Mechanism of Fosfomycin

A

Phosphoenolpyruvate analog
—> Irreversibly inhibit enolpyruvate transferase
—> Inhibit synthesis of N-acetylmuramic acid (NAM) in cell wall

CPRS (75 decks)

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