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IDIT Final Pharm > Miscellaneous > Flashcards

Miscellaneous Flashcards

1
Q

What do chloramphenicol target?

A

IV for aerobic/anaerobic G+/G- microbes

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2
Q

What sort of infections will chloramphenicol be used for?

A

Serious & fatal blood dycrasias (only seriously resistant infections)

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3
Q

What is the mechanism of chloramphenicol?

A

Inhibits binding of ammoniacal-tRNA to acceptor site

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4
Q

What is the main problem with using chloramphenicol?

A

Inhibits human mitochondrial peptidyl-transferase

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5
Q

What cells are most sensitive to chloramphenicol?

A 
Erythropoietic cells (leukopenia, thrombocytopenia, fatal aplastic anemia)
Causes a decrease in G6PD which predisposes you to hemolytic anemia
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6
Q

What is gray baby syndrome caused by?

A

1) insufficient glucuronyl transferase (can’t conjugate)

2) underdeveloped renal function (can’t eliminate)

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7
Q

What does chloramphenicol inhibit?

A

cytochrome P450

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8
Q

Levels of chloramphenicol increase and interfere with mitochondrial ribosomes resulting in what?

A

Depressed respiration
CV Collapse
Cyanosis

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9
Q

What do quinupristin/dalfopristin treat?

A

IV for MRSA and vancomycin-resistant infections

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10
Q

What is the mechanism of quinupristin?

A

Releases peptidyl-tRNA from donor site

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11
Q

What is the mechanism of Dalfopristin?

A

Inhibits binding of ammoniacal-tRNA to acceptor site & of peptidyl-tRNA to donor site

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12
Q

Quinupristin/dalfopristin inhibits CYP3A which causes what?

A

Decreased metabolism of warfarin

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13
Q

What are the side effects of quinupristin/dalfopristin?

A 
Arthralgias/myalgias (30-40%)
Superinfection (colitis)
Hyperbilirubinemia (25%)
Severe venous irritation
Vancomycin-resistant E. faecium
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14
Q

What is linezolid?

A

An oxazolidinone

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15
Q

What is linezolid used for?

A

Vancomycin resistant E. faecium, MSSA & MRSA, skin infections (static or cidal)

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16
Q

How can linezolid be administered?

A

Oral and IV

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17
Q

What are the risks of linezolid?

A

Colitis and thrombocytopenia

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18
Q

Is there a limit to how much you should use linezolid?

A

Do not use for more than 28 days

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19
Q

What is the mechanism of linezolid?

A

Inhibits formation of the initiation complex

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20
Q

What does linezolid inhibit and what might that cause?

A

Inhibits MAO-A which may cause 5HT syndrome if with other Rss that have increased 5HT activity

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21
Q

What happens if you use linezolid chronically?

A

Reversible optic neuropathy
Irreversible peripheral neuropathy
Lactic acidosis

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22
Q

What is tedizolid?

A

An oxazolidinone Pro-Rx

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23
Q

How is tedizolid administered and what for?

A

Oral or IV for ABSSSI, including MRSA

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24
Q

What is the mechanism of tedizolid?

A

Binds 50S ribosomal subunit resulting in inhibited protein synthesis

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25
Q

What are the side effects of tedizolid?

A

Nausea, Vomiting, Diarrhea, Headache

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26
Q

What are you at risk for when taking clindamycin?

A

Pseudomembranous colitis caused by opportunistic C. difficile

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27
Q

What tissues does clindamycin penetrate well?

A

Everything except the CNS

28
Q

What is the mechanism of clindamycin?

A

Inhibits translocation

29
Q

What can clindamycin be used with to treat group A strep?

A

A high dose PCN

30
Q

What does polymyxin target and how?

A

G- microbes, it is a cidal cationic detergent

31
Q

What is polymyxin used for?

A

Common infections of the conjunctiva and lids (topical; rarely IV)

32
Q

What are the side effects of polymyxin?

A

Nephrotoxic and neurotoxic (neuromuscular block)

33
Q

What is colistimethate?

A

polymyxin E

A cidal cationic detergent

34
Q

What is colistimethate used for?

A

IV/IM for G- rods

35
Q

What are the side effects of colistimethate?

A

Nephrotoxic and possibly neurotoxic

36
Q

What is something interesting about rifaximin?

A

No significant systemic absorption

37
Q

What are the uses of rifaximin?

A

Travelers diarrhea from noninvasive strains of E. coli

Reduce risk hepatic encephalopathy in patients w/ advanced liver disease

38
Q

What is the rationale behind rifaximins effect of reducing hepatic encephalopathy?

A

Reduces ammonia producing bacteria

39
Q

What is the mechanism of rifaximin?

A

Binds DNA-dependent RNA polymerase

40
Q

What are the side effects of rifaximin?

A

Flatulence, abdominal pain, urgency to defecate

41
Q

What infection has developed cross resistance to rifaximin?

42
Q

What forms does mupirocin come in?

A

Ointment and cream

43
Q

What is the mechanism of mupirocin?

A

Inhibits bacterial isoleucyl t-RNA synthetase

44
Q

What is mupirocin used for?

A

Used for impetigo from group A strep or S. aureus (high resistance)

45
Q

What forms does retapamulin come in?

A

Topical ointment

46
Q

What does retapamulin do to impegito?

A

It is a pleuromutilin meaning it blocks protein synthesis

47
Q

What is the mechanism of retapamulin?

A

Blocks acceptor and donor sites of peptidyl-transferase

48
Q

What is nitrofurantoin used for?

A

Treatment and prevent G+/G- UTIs

Has poor systemic levels but lots of local action in tubules

49
Q

What is the mechanism of nitrofurantoin?

A

Reduced by urinary bacteria to receive intermediates that damage DNA, ribosomes, cell wall

50
Q

What are the acute symptoms of nitrofurantoin?

A

fever, chills, cough, infiltrates

51
Q

What are the chronic symptoms of nitrofurantoin?

A

Malaise, DOE, altered PFTs, pneumonitis, fibrosis

52
Q

What color might nitrofurantoin turn urine?

53
Q

What should you not use nitrofurantoin?

A

If patient has cholestatic jaundice or hepatic dysfunction w/ prior use > might lead to hepatic necrosis and death

54
Q

How is daptomycin administered?

A

Parenteral

It is a tidal lipopeptide 1x/day injection for G+ and MRSA skin infections

55
Q

What can’t you use daptomycin for pneumonia?

A

It is inactivated by surfactant

56
Q

What is the mechanism of daptomycin?

A

Creates pore in membrane > K+ loss > depolarization > inhibits DNA, RNA and protein synthesis

57
Q

What are the side effects of daptomycin?

A

Increases creatine kinase

58
Q

How is daptomycin excreted?

A

By the kidneys unchanged

59
Q

What is quinidine used for?

A

IV for life-threatening Plasmodium falciparum

60
Q

What does rifampin target?

A

Penetrates tissues and biofilm to target most G+ and many G-; staph & MRSA; intracellular and extracellular organisms
Penetrates lung cavities and abscesses
Used only with other Rxs

61
Q

What is the mechanism of rifampin?

A

inhibits DNA-dependen RNA polymerase

62
Q

What is rifampin excreted by?

A

Through the enterohepatic circulation so through bile

63
Q

What happens if you give rifampin for more than 2 weeks?

A

Flu like symptoms

64
Q

What are the side effects of rifampin?

A

Rd/orange color to urine, feces, saliva, sweat and tears
Rash, fever, nausea, vomiting
Jaundice
Hepatitis (rare if normal liver)

65
Q

What increases your chances of hepatitis when using rifampin?

A

Liver Disease
Alcohol
Increased Age

IDIT Final Pharm (7 decks)

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