other abc classes Flashcards
MOA of FQs
inhibit protein synthesis by binding to DNA gyrase (topoisomerase II) and topoisomerase IV
bacteriocidal
MOA of daptomycin ( cubicin)
uses calcium and inserts itself into bacterial membranes-causes lysis of permeability to intracellular ions
MOA of TMP/SMX
inhibits bacterial synthesis of dihydrofolic acid therefore bacterial cell division is stopped/slowed
bacteriocidal & synergistic
inhibits CYP2C9-CAUTION WITH WARFIN
MOA of metronidazole (Flagyl)
in presence of anaerobic bacteria that chemically reduce the nitro group creating an unstable intermediate compound (free radical)-toxic
-binds to DNA and inhibits synthesis
bacteriocidal
used for UTI’s
MAO of Macrobid, Macrodantin
interferes with metabolism & cell wall synthesis by inhibiting several bacteria enzymes systems
IV/PO uses for FQs
CAP complicated/uncomplicated UTI prostatitis soft tissue infection Crohn's disease Bone penetration (i.e. osteomyelitits) intracellular concentration
3 FQ’s for corneal ulcers
Cipro
levofloxacin
Ofloxacin
Otic use of FQs
acute otitis media
otitis externa
chronic supporative otitis media
SE of Fq’s
QT prolongation
seizure risk if coadministered with NSAIDS
Tendon injury/rupture
All preg C and Lactation L3
do not mix with di- & trivalent cations (Al, Ca, Fe, Mg) within 2hrs
issues with Cipro
CYP1A2 inhibitor
not good for strep pneumonia
dosage of Cipro
PO/IV Adults: 500 mg PO BID or 400mg IV BID
Peds: 20-30mg/kg PO BID or
Cystic fibrosis patients: 6-10 mg/kg BID IV
Norfloxacin (Noroxin) dosage
adults only 400mg PO BID
ofloxacin (Floxin)
adults only 200-400 PO BID
levofloxacin (Levaquin) dosage
PO/IV 250-750 mg QD
CAP 750 QD
moxifloxacin (Avelox) dosage and issues
PO/IV 400 mg QD
not for UTI’s
possible QT prolongation
Gemifloxacin (Factive) dosage and issues
Adults: 320-640 mg PO QD
Peds: 5-10 mg/kg QD; not recommended
not for UTI
Cipro HC Otic issue
**not sterile-not to use if tympanic membrane ruptured!
otitis externa
Ciprofloxacin Otic (Cetraxal)
acute otitis media externe due to p. aeruginosa, staph aureus
Daptomycin (cubicin) dosage and issues
Adults IV only
- used for complicated skin structure infections (MRSA, vanco-sensitive enter faecalis, s.aureus, r-sided endocarditis)
- monitor CK levels and s/s of myopathy
Daptomycin does not provide coverage for
gram negative bacteria
CAP-lung surfactant inactivates drug
Issues with Flagyl
Contraindicated 1st trimester
avoid alcohol-disulfiram-like reaction
interaction with warfarin
SE of TMP/SMX
-TMP-Treats Marrow Poorly-bone marrow suppression
-avoid 1st trimester or Breastfeeding bc sulfa can displace bilirubin=kernicterus
-avoid in G6PD deficiency
drink fluids-can precipitate
pancreatitis, avoid sun
uses of Bactrim
UTI, otitis media, PJP, travelers diarrhea, shigella, chronic prostatitis, nocadiosis,
DOC for VAP caused by stenotrophomas
Uses of Daptsone and issues
alternative for Bactrim allergy for PJP and T. gonadii
M. leprae: uses 400-600 QD
CI for G6PD deficiency-cause hemolysis and methemoglobinemia
issues with Macrobid/Macrodantin
- Caution with G6PD deficiency-cause hemolytic anemia
- Avoid if CrCl <60 ml/min
- longer than 6 month associated with pulmonary toxicity
- severe/irreversible neuropathy
- avoid in pregnancy-38-42 wks, during labor, & delivery bc may cause hemolytic anemia in infants
first line anti tubercular drugs
Isoniazid Rifampin Pyrazinamide Ethambutol Streptomycin
Second line anti-TB drugs
*mainly MDR-Tb
Ethinamide Para-aminosalicyclic acid Cycloserine capreomycin kanamycin
issues with Isoniazid
- INH=Injures Neurons & Hepatocytes
- hepatitis-not for alcoholics, pregnant women, elderly
- penetrates CNS and depletes pyridoxine (Vit B6)-can cause neuropathies therefore replace
“R” for Rifampin
RNA polymerase inhibitor
red urine/fluids
ramps or revs up enzymes
rapid resistance when used alone
issues with rifampin
potent CYP3A4 inhibitor (warfarin, oral contraceptives, anti-convulsants)-increase these meds while on RIF
issues of Ethambutol
optic neuritis-need slit lamp and red/green discrimination
hyperuricemia
rash
anaphylaxis
Meds associated with the development of hemolytic anemia in patients with G6PD deficiency
- chloroquine
- dapsone
- nitrofurantoin (macrobid, macrodantin)
- primaquine phosphate
- rasburicase (elitek)
- Bactrim