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Pharm > micro3 > Flashcards

micro3 Flashcards

1
Q

fluoroquinolones

A

ciproflaxin, forfloxacin, levofloxacin, ofloxacin, moxifloxacin, gemifloxacin, enoxacin

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2
Q

mechanism of fluoroquinolones

A

inhibit prokaryotic enzymes topoisomerase II (DNA gyrase) and toposisomerase IV. Bactericidal. must not be taken w antacids

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3
Q

use of fluoroquinolones

A

gram - rods of urinary and GI tracts (including pseudomonas), some gram + organisms, otitiis externa

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4
Q

SE of fluoroquinolones

A

GI upset, superinfectiosn, skin rashes, headache, dizziness;
less commonly, can cause leg cramps and myalgias
prolong QT
tendonitis or tendon reupture in people > 60 yo and in pt’s taking prednisone. ciprofloxacin inhibits cytochrome p450

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5
Q

contranidnicsatsion for fluoroquinolones

A

pregnant women, nursing motehrs, and children <18 yo due to possible damage to cartialge.

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6
Q

resistance in fluoroquinolones

A

chromosome encoded mutation in DNA gyrase; plasmid mediated resistance; efflux pumps

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7
Q

daptomycin mechanism

A

lipopeptide that disrupts cell membranes of gram + cocci by creating transmembrane channels
cannot permeate outer membrane of gram - bcteria = ineffectiev

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8
Q

use of daptomycin

A

S. aureus skin infections (esp MRSA), bacteremia, endocarditis, VRE

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9
Q

not used for pneunomia bc avidly binds to and is ianctivated by surfactant

A

daptomycin

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10
Q

SE of daptomycin

A

myopathy, rhabdomyolysis

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11
Q

metronidazole

A

forms toxic free radical metabolites in bacterial cell that damage DNA. bactericidal, antiprotozoal

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12
Q

Use of metronidazole

A

treats Giardia, entamoeba, trichomonas, gardnerella vaginalis, anaerobes (bacterioides, C. difficile)
can be used in place of amoxiclilin in H. pylori thripple therapy in case of penicillin allergy
GET GAP on the Metro with metronidazole

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13
Q

SE of metronidzole

A

disulfiram like reaction (severe flushing, tachycardia, hypotension) with alcohol, headache, metallic taste
inhibits acetaldehyde hedhyraogenase

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14
Q

prophylaxis for m. tuberculosis

A

isoniazid

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15
Q

treatmetn of TB

A

Rifampin, isoniazid, pyrazinamide, ethambutol (RIPE) for treatment

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16
Q

M. avium - intracellulare prophylaxis

A

azithromycin, rifabutin

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17
Q

treatment of M. avium - intracellulare

A

more drug resistant than M. tuberculosis
azitrhomcyin or clarithromycin + ethambutol
can add rifabutin or ciproflaxin

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18
Q

M. leprae prophylaxis

A

n.a.
long term treatmtn with dapsone and rifampin for tuberculoid form
add clofazimine for lepromatous form

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19
Q

Rifamycins

A

rifampin, rifabutin

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20
Q

rifampin mechanism:

A

inhibit dna dependent rna polymerase

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21
Q

use of rifampin

A

mycobacterium tuberculosis; delay resistance to dapsone when used for leprosy.

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22
Q

used for post exposure prophylaxis for meningococcal

A

rifampin

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23
Q

chemoprophylaxis in contacts of children with H. influenzae type B

A

rifampin

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24
Q

SE of rifampin

A

minor hepatoxicity with drug interactiosn (cytochrome p450; oragne body fluids (nonhazardous side effect)
rifabutin favored over rifampin in pt’s w HIV infection due to less cytochrome p450 stimulation

25
Q

rifampin 4R’s

A

RNA polymerase inihbitor
ramps up microsomal cytochrome p450
Red/orange body fluids
Rapid resistance if used alone

26
Q

why is rifabutin favored over rinfampin in pt’s with HIV infection

A

due to less cytochrome p450 stimulation

27
Q

mechanisms of resistance to rifampin

A

mutations reduce drug binding to RNA polymerase. monotherapy rapidly leads to resistance

28
Q

Isoniazid mechanism

A

decrease syntehsis of mycolic acids;

bacterial catalase peroxidase (encoded by KatG) needed to convert INH to active metabolite

29
Q

use of isoniazid

A

mycobacterium tuberculosis; the only agent used as solo prophylaxis against TB. also used as monotherpay for latent TB

30
Q

different INH half lives in fast vs slow acetylators

A

true

31
Q

what forms long branched chain FA’s in outer portion of mycobbacterial peptidoglycan cell wall

A

mycolic acids

32
Q

SE of isoniazid

A 
hepatotoxcity
p450 inhibition
drug induced SLE
anion gap metabolic acidosis
vitamin B6 deficiency (peripheral neuropathy), sideroblastic anemia)
33
Q

INH Injures Neurons and Hepatocytes

A

hepatoxicity, vit b6 deficiency

34
Q

administer what with isoniazid

A

b6;
inh is strucutarlly similar to b6 ; thus this antibiotic increase urinary excretion of pyridoxine causing deficiency of vit B6 and competes for Vit B6 leading to defective syntehsis of neurotransmitters like GABA

35
Q

resistance to isioniazid

A

mutations leading to expression of KatG
occurs by 2 selective gene mutaionts
1. decrease in bacterial expression of catalase peroxidase enzyme required for isoniaizd activation once drug enters bacterial cell
2. modfiication of protein target bidnign for isoniaizd

36
Q

pyrazinamide mechanism

A

mechanism uncertain; pyrazinamide is a produgr that converted to active compound pyrazinoic acid
works best at acidic pH (in host phagolysosomes)

37
Q

use of pyrazinamide

A

mycobacterium tuberculosis

38
Q

SE of pyrazinamide

A

hyperuricemia, hepatotoxcity

39
Q

ethambutol mechanism

A

decrease carbohydrate polyemraization of mycobacterium cell wall by blocking arabinosyltransferase

40
Q

SE of ethambutol

A 
optic neuropathy (red green color blindness)
pronounce eyethambutol
41
Q

ressitance of ethambutol

A

increase acitivty of enzymes (arabisonyl transferase) invovled in cell wall by blocking arabinosyltransferase

42
Q

Streptomycin mechanism

A

inteferes with 30S components of ribosome

43
Q

use of streptomycin

A

mycobacterium tuberculosis (2nd line)

44
Q

SE of streptomycin

A

tinnitus, vertigo, ataxia, nephrotoxciicty

45
Q

high risk for endocarditis and undergoing surgical or dental procedures

A

amoxicilin

46
Q

exposure to gonnorrhea

A

ceftriaxon

47
Q

history of recurrent UTI

A

tmp-smx

48
Q

exposure to meningococal infection

A

ceftriaxone, ciproflaxin, or rifampin

49
Q

pregnant women carrying group B strep

A

intrapartum penicillin G or ampicillin

50
Q

prevention of gonococcal conjunctivitis in newborn

A

erythromycin ointment on eyes

51
Q

prevention of post surgical infection due to s. aureus

A

cefazolin

52
Q

prophylaxis of strep pharyngitis in child with prior rheumatic fever

A

benzathine penicillin G or oral penicillin V

53
Q

exposure to syphilis

A

benzathine penicllin G

54
Q

Cd4 <200 HIV in fection: pjp

A

tmp-smx

55
Q

cd4 <100 pjp, toxoplasmosis

A

tmp-smx

56
Q

cd4 <50 cells/mm mycobacterium avium complex

A

azitrhomycin or clarithromycin

57
Q

MRSA treamten

A

vancomycin, daptomycin, linezolid, tigecycline, ceftaroline, doxycycline

58
Q

VRE treatment

A

linezolid, streptogramins (quinupristin, dalfopristin)

59
Q

multidrug resistant P. aeruginosa, multidrug resistant Acinetobacter baumannii:

A

polymyxins B and E (colistin)

Pharm (13 decks)

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