Micro Drugs Flashcards
1
Q
Indications for penicillins (1st generation)
A
Gram(+) organisms + N. meningitidis and T. pallidum
2
Q
Side effects of penicillins
A
Hypersensitivity; hemolytic anemia
3
Q
2nd generation penicillins (2)
A
Ampicillin, amoxicillin
4
Q
Indications for 2nd generation penicillins
A
Same as penicillin + H. flu, E.coli, Listeria, Proteus, Salmonella, shigella, and enterococci (HELPSS)
5
Q
3rd generation penicillins (3)
A
oxacillin, nafcillin, dicloxacillin
6
Q
Indications for 3rd generation penicillins
A
“Naf for Staph” - MRSA
7
Q
4th generation penicillins (2)
A
Ticarcillin, piperacillin
8
Q
Beta-lactamase inhibitors (3)
A
Clavulanic acid, sulbactam, tazobactam
9
Q
Organisms not covered by cephalosporins (4)
A
LAME - Listeria, atypicals, MRSA, enterococci
10
Q
1st generation cephalosporins (2)
A
Cefazolin, cephalexin
11
Q
Indications for 1st generation cephalosporins
A
PEcK - gram + cocci, Proteus, E. coli, and KLebsiella
12
Q
2nd generation cephalosporins (3)
A
cefoxitin, cefaclor, cefuroxime
13
Q
Indications for 2nd generation cephalosporins
A
HEN PEcKs - gram + cocci, H. flu, Enterobacter, Neisseria, PEcK
14
Q
3rd generation cephalosporins (3)
A
Ceftriaxone, cefotaxime, ceftazidime
15
Q
4th generation cephalosporin (1)
A
cefepime (for pseudomonas)
16
Q
5th generation cephalosporin (1)
A
ceftaroline (broad including MRSA, does not cover pseudomonas)
17
Q
Aztreonam is synergistic with ____
A
Aminoglycosides
18
Q
Indications for aztreonam
A
Gram - rods only (no gram pos, anaerobes)
19
Q
Carbapenems must always be administered with ____
A
Cilastatin (inhibitor of renal dehydropeptidase I)
20
Q
Indications for carbapenems
A
Gram + cocci, gram - rods, anaerobes
21
Q
Side effects of vancomycin
A
nephrotoxicity, ototoxicity, thrombophlebitis, red man syndrome
22
Q
Mechanism of linezolid
A
Inhibits 23s rRNA of 50S subunit
23
Q
Side effects of linezolid
A
Optic neuritis, thrombocytopenia, serotonin syndrome
24
Q
Aminoglycosides (5)
A
GNATS - gentamicin, neomycin, amikacin, tobramycin, streptomycin
25
Mechanism of aminoglycosides
Inhibit formation of initiation complex on 30S and cause misreading of mRNA; require O2 for uptake
26
Indications for aminoglycosides
Severe gram - rods; synergistic with beta-lactams
27
Toxicity of aminoglycosides
Nephrotoxicity (esp. with cephalosporins), NMJ blockade, ototoxicity, teratogen
28
Resistance to aminoglycosides
Bacterial transferase enzymes (esp. acetylation)
29
Tetracyclines (3)
Tetracycline, doxycycline, minocycline
30
Mechanism of tetracyclines
Block attachment of aminoacyl-tRNA on 30S subunit
31
What can't you take with doxycycline?
Divalent cations (Mg, Ca)
32
Indications for tetracyclines
Borrelia, mycoplasma, rickettsia, chlamydia, acne
33
Toxicity of tetracyclines
GI distress, discolored teeth, inhibition of bone growth, photosensitivity
34
Resistance to tetracyclines
Decreased uptake or increased efflux
35
Macrolides (3)
Azithromycin, clarithomycin, erythromycin
36
Mechanism of macrolides
Block translocation by binding 23 rRNa on 50S subunit
37
Indications for macrolides
Atypical pneumonia, STDs (chlamydia), gram+ cocci
38
Toxicity of macrolides
MACRO - motility problems, arrhythmia (prolonged QT), cholestatic hepatis, rash, eosinophiilia
39
Resistance to macrolides
Methylation of 23S rRNA binding site
40
Mechanism of chloramphenicol
Blocks peptidyltransferase at 50S subunit
41
Indications for chloramphenicol
Meningitis, RMSF
42
Toxicities of chloramphenicol
Aplastic anemia, gray baby syndrome, anemia
43
Resistance to chloramphenicol
Plasmid-encoded acetyltransferase inactivation
44
MEchanism of clindamycin
Blocks peptide transfer at 50S subunit
45
Indications for clindamycin
Anaerobes above the diaphragm (Bacteroides, C. perf in aspiration pneumo, lung abscesses, GAS)
46
Drugs causing pseudomembranous colitis
Clindamycin, 2nd generation penicillins
47
Sulfonamides (3)
SUlfamethoxazole (SMX), sulfisoxazole, sulfadizine
48
Indications for sulfonamides
Gram +, gram -, Nocardia, Chlamydia, simple UTI
49
Toxicity of sulfonamides
SJS, TEN, hemolysis in G6PD, nephrotox, photosensitivity, kernicterus (infants), displace other drugs from warfarin
50
Indications for trimethoprim
Combined with SMX for UTI, shigella, salmonella, PCP, toxo
51
Toxicities of TMP
Granulocytopenia, leukopenia, megaloblastic anemia
52
Fluroquinolones
Ciprofloxacin, norfloxacin, levofloxacin, nalidixic acid (and more. . . )
53
Mechanism of fluroquinolones
Inhibit DNA gyrase (topoisomerase II) and topo-IV
54
Do not take fluroquinolones with ____
Antacids
55
Indications for fluroquinolones
Gram - rods of urinary/GI (inc. pseudomonas), Neisseria; no MRSA
56
Toxicities of fluroquinolones
GI upset, superinfection, skin rash, tendonitis, myalgias
57
Mechanism of metronidazole
Free radical toxic metabolites
58
Indications for metronidazole
Giardia, entamoeba, trichomonas, gardnerella, anaerobes, H. pylori
59
Toxicities of metronidazole
Metallic taste, disulfiram-like rxn
60
Drugs for TB
RIPE - rifampin, isoniazid, pyrazinamide, ethambutol
61
Drugs for MAI
Azithromycin, rifabutin
62
Drugs for M. leprae
Dapsone and rifampin (+ clofazimine for lepromatous form)
63
Mechanism of INH
Reduced synthesis of mycolic acids, activated by bacterial catalase peroxidase (encoded by KatG)
64
Toxicity of INH
B6 deficiency, neurotoxicity, hepatotoxicity
65
4 Rs of Rifampin
RNA poly inhibitor, ramps up p450, red/orange body fluids, rapid resistance
66
Mechanism of pyrazinamide
Unknown; accumulates in acidic pH of phagolysosomes
67
Toxicities of pyrazinamide
Hyperuricemia, hepatotoxicity
68
Mechanism of ethambutol
Reduced carbohydrate polymerization (blocks arabinosyltransferase)
69
Toxicity of ethambutol
Optic neuritis (red-green color blindness)
70
Choice prophylaxis for meningococcal infection
Ciprofloxacin (rifampin for peds)
71
MRSA treatments (5)
Linezolid, daptomycin, vancomycin, tigecycline, ceftaroline
72
VRE treatments (2)
Linezolid, steptogamins (quinupristin/dalfopristin)
73
Mechanism of amphotericin B
Binds ergosterol and punches holes in cell membrane
74
Indications for amphoterrible
Cryptococcus, blastomyces, coccidioides, histoplasma, candida, mucor; supplement K+/Mg+
75
Toxicities for amphoterrible
Fever/chills, hypotension, nephrotox, arrhythmias, anemia, IV phlebitis
76
Nystatin
Same as amphiterrible; used for oral candida (swish and spit) and diaper rash/vaginal candidiasis
77
Mechanism of azoles
Block conversion of lamosterol to ergosterol
78
Use of azoles
Local and less serious systemic mycoses; fluconazole for suppression of crypto meningitis in compromised patients
79
Toxicities of azoles
Testosterone synthesis inhibitors, inhibition of p450
80
Mechanism of flucytosine
Inhibits DNA/RNA biosynthesis (conversion to 5-FU by cytosine deaminase)
81
Indication for flucytosine
Systemic fungal infxns in combo with amphoterrible
82
Mechanism of echinocandins (-fungins)
Inhibit cell wall synthesis by inhibiting synthesis of beta-glucan
83
Indication for echinocandins
Invasive aspergillosis, Candida
84
Toxicities of echinocandins
Flushing (histamine release), GI upset
85
Mechanism of terbafine
Inhibition of squalene epoxidase
86
Indication of terbafine
Dermatophytoses
87
Toxicities of terbafine
Gi upset, headaches, hepatotox, taste problems
88
Mechanism of griseofulvin
Accumulates in keratin; interferes with microtubule function
89
Toxicities of griseofulvin
Teratogenic, carinogenic, confusion, headaches, induces p450
90
Therapy for toxoplasmosis
Pyrimethamine
91
Therapy for t. brucei
suramin and melarsoprol
92
Therapy for T. cruzi
Nifurtimox
93
Therapy for leishmaniasis
Sodium stibogluconate
94
Mechanism of chloroquine
Blocks detoxification of heme into hemozoin
95
Toxicities of chloroquine
Retinopathy, pruritus
96
Therapy for flukes
Praziquantel
97
Mechanism of zanamivir/oseltamivir
Inhibit influenza NA
98
Mechanism of ribavarin
Inhibit synthesis of guanine nucleotides by inhibiting inosine monophosphate dehydrogenase
99
Indications for ribavarin
RSV, chronic Hep C
100
Toxicities of ribavarin
Teratogenic, hemolytic anemia
101
Mechanism of acyclovir/famciclovir/valacyclovir
Monophosphorylated by HSV/VSV thymidine kinase; guanosine analog; preferentially inhibits viral DNA poly by chain termination
102
Toxicity of acyclovir/famciclovir/valacyclovir
Crystalline nephrotoxicity, acute renal failure
103
Indication for acyclovir/famciclovir/valacyclovir
HSV/VSV, some EBV (not CMV)
104
Mechanism of gancyclovir
5' monophosphate formed by CMV viral kinase
105
Toxicity of gancyclovir
Leukopenia, neutropenia, thrombocytopenia, renal tox
106
Mechanism of foscarnet, cidofovir
Viral DNA poly inhibitor that binds to pyrophosphate-binding site (no activation required)
107
Indication for foscarent, cidofovir
CMV retinitis; acyclovir-resistant HSV
108
Toxicity of foscarnet, cidofovir
Renal tox
109
HAART initiated with CD4 counts below ___
500
110
HAART consists of _____
2 NRTIs and [ 1 NNRTI oooor 1 protease inhibitor ooor 1 integrase inhibitor ]
111
HIV protease inhibitors all end in ____
-navir
112
Special property of ritonavir issss ___
Inhibition of p450, raises amts of other drugs
113
Toxicity of protease inhibitors
Hyperglycemia, GI intolerance, lipdystrophy, hematuria, renal tox
114
NRTIs (7)
Zidovudine (ZDV/AZT), tenofovir (TDF), stavudine (d4T), lamivudine (3TC), emtricitabine (FTC), didanosine (ddI), abacavir (ABC)
115
Mechanism of NRTIs
Competitive inhibition of nucleotide binding to RT, terminate DNA chain (lack 3' OH group); must be phosphorylated to be active (ex. tenofovir, nucleotide already!)
116
Toxicity of NRTIs
BM suppression (give GM-CSF, epo), peripheral neuropathy, lactic acidosis, rash, anemia, pancreatitis
117
NNRTIs (3)
Efavirenz, nevirapine, delavirdine
118
Mechanism of NNRTIs
Bind to RT on different site than NRTIs; do not require phosphorylation for activity
119
Toxicity of NNRTIs
Rash, hepatotox, vivid dreams, SJS/TEN
120
Raltegravir
Inhibits integrase in HIV
121
Tox of raltegravir
Hypercholesterolemia
122
Fusion inhibitors (2)
Enfuvirtide (gp41), maraviroc (CCR5, blocks gp120)
123
IFNa used in ____
chronic hep B/C, kaposi's sarcoma, hairy cell leukemia, condyloma acuiminatum, RCC, malignant melanoma
124
IFNb used in ___
MS
125
IFN-gamma used in ___
CGD
126
Anti-pseudomonals (6)
4th gen penicillins, 3rd/4th generation cephalosporins, aminoglycosides, ciproflox/levoflox, aztreonam, imipenem + cilastatin
