Pharmacology Flashcards
Chloramphenicol MOA
- blocks peptidyltransferase at 50S bacterial ribosomal subunit
- bacteriostatic
3 adverse effects of Chloramphenicol
- anemia ( dose dependent)
- aplastic anemia ( dose independent)
- gray baby syndrome ( in premature infants, because they lack liver UDP- glucuronyl transferase)
What are 2 clinical uses for Chloramphenicol? causing agents?
- Meningitis
- Haemophilus influenzae
- Niesseria meningitidis
- Streptococcus pneumoniae - Mountain spotted fever
- Rickettsia rickettsii
what is a mechanism of resistance for Chloramphenicol
Plasmid-encoded acetyltransferase inactivates the drug
What class of drug is Azithromycin
Macrolide
MOA for Azithromycin
- Inhibit protein synthesis by blocking translocation (macroSLIDES)
- bind to 23S rRNA of 50S ribosomal subunit
- bacteriostatic
Clinical use for Azithromycin (4)
- atypical pneumonias
- mycoplasma
- chlamydia
- legionella - STI - chlamydia
- gram + cocci
- streptococcal infection in patients allergic to penicillin - B. pertussis
Adverse effects of Azithromyocin
MACRO
- gastrointestinal Motility issues
- Arrhythmia caused by prolonged QT interval
- acute Cholestatic hepatitis
- Rash
- eOsinophilia
drug interaction of Azithromyocin
increase serum concentration of theophylline and oral anticoagulants
what is a MOA of Clarithromycin and Erythromycin
inhibit cytochrome P450
what is a mechanism of resistance for Macrolides
methylation of 23S rRNA-binding site, prevents binding of drug
What is the class of drug for Ciprofloxacin
Fluoroquinolones
MOA of Ciprofloxacin
- Inhibit prokaryotic enzymes topoisomerase II ( DNA gyrase) and topoisomerase IV
- bactericidal
Fluoroquinolones can not be mixed with what
antacids
clinical use for Ciprofloxacin
gram - rods of urinary and GI tracts
- Pseudomonas
- Neisseria
some gram +
adverse effects of fluoroquinolones
GI upset superinfections skin rashes headache dizziness
are are less common side effects of fluoroquinolones
leg cramps and myalgias
Fluoroquinolones are contraindicated in who
pregnant women
nursing mothers
less than 18 years due to cartilage damage
older than 60 also taking Prednisone : tendontitis or tendon rupture irks
impact on other organs of Flurorquinolones
prolong QT interval
MOA of tetracyclines
- bind 30S and prevent attachment of aminoacyl-tRNA
- bacteriostatic
- limited CNS penetration
what can you not take tetracyclines with
- milk (Ca2+) and antacids (Ca2+ or Mg2+)
- iron-containing preparations b/c divalent cations inhibit drugs’ absorption in the gut
Renal failure patients can take what tetracycline and why
Doxycycline b/c fecally eliminated
clinical use for tetracycline
Borrelia burgdorferi
M. penumoniae
Rickettsia
Chlamydia
Adverse effects of tetracycline
GI distress
discoloration of teeth
inhibition of bone growth in children
photosensitivity
tetracycline is contraindicated in who
pregnant women
what is a mechanism of resistance for tetracyclines
- increase uptake
- decrease efflux out of bacterial cells by plasmid-encoded transport pumps
MOA of cephalosporins
- Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases
- bactericidal
Name organisms not covered by 1st-4th generation cephalosporins ? any exceptions
LAME Listeria Atypicals ( chlamydia, mycoplasma) MRSA ( Ceftraline, 5th) Enterococci
Name 1st generation cephalosporins
Cefazolin
cephalexin
what cephalosporin is sued prior to surgery to prevent S. aureus wound infections
Cefazolin
1st generation cephalosporins treat against what
Proteus Mirablils
E.Coli
Klebsiella
name 2nd generation cephalosporins
Cefaclor
Cefoxtin
Cefuroxime
FAke FOX FUR
what organisms do 2nd generation cephalosporins cover
HENS PEcK H influenzae Enterobacter aerogenes Neisseria spp Serratia Proteus E coli Klebsiella pneumoniae
Name 3rd generation cephalosporins
ceftriaxone
cefotaxime
ceftazidime
what organisms do 3rd generation cephalosporins cover
serious gram (-) infections resistant to other beta lactams
what does Ceftriaxone used to treat
meningitis
gonorrhea
disseminated Lyme disease
what does Ceftazidime treat
pseudomonas
name 4th generation cephalosporins
cefepime
what organisms do cefepime cover
gram (-) organisms with increased activity against pseudomonas and gram (+) organisms
name 5th generation cephalosporin
Ceftaroline
what does Ceftaroline cover
broad gram (+) and gram (-) organism coverage including MRSA - not pseudomonas
adverse effects of cephalosporins
hypersensitivity reactions
autoimmune hemolytic anemia
disulfiram-like reaction
vitamin K deficiency
what are drug interaction with cephalosporins?
- cross-reactivity with penicillins
- increases nephrotoxicity in aminoglycosides
what is mechanism of resistance for cephalosporins
Structural change in penicillin-binding proteins ( transpeptidase)
