Pharmacology of LUT and STIs - Kinder Flashcards
DOC for enterococci
ampicillin
DOC for uncomplicated cystitis
TMP/SMX
if E. coli resistant area:
nitrofurantoin
fosomycin
ceftriazone
3rd gen cephalosporin
MOA TMP/SMX
bacteriostatic
cimpetitive inhibitor of dihydropteroate synthase
inhibit dihydrofolate reductase
inhibit steps in folic acid pathway
-prevent bacterial use of PABA
potentiate effect of warfarin
TMP/SMX
nitrofurantoin MOA
form highly reactive imtermediates that damage DNA
MOA fosfomycin
bactericidal
inhibit cell wall synthesis
reduced formation of N-acetylmuramic acid
MOA fluoroquinolones
target bacterial DNA gyrase
concentration dependent killing
azithromycin MOA
bacteriostatic
-reversible binding to 50S subunit
metrondiazole MOA
prodrug
-single electron transfer in anaerobic bacteria firms highly reactive nitro radical anion - kill orgamism DNA
uncomplicated cystitis
individuals lacing structural or functional abnormalities of urinary tract
pre-menopausal females of child bearing age otherwise healthy
male UTI
not considered uncomplicated
recurrent UTI
2 or more UTI 6 months
3 or more UTI 1 year
cause of uncomplicated infection
E. Coli - 1
staph sapro - 2
cause of complicated infection
E. coli
enterococci
FQ
risk of resistance
-so use TMP/SMX
DOC for acute pyelonephritis
FQ - 1st line
TMP/SMX
or IV ceftriaxone
warfarin enantionmers
R - CYP3A4 metabolism
S - CYP2C9 metabolism
CYP2C9 - inhibited by bactrim
tx failure FQs
if take with calcium carbonate - impair absorption of FQ
tx neisseria gonorrhea
ceftriaxone IM
PCN allergy - azithromycin
tx chlamydia trachomatis
azithromycin
macrolide - binds 50S subunit
doxycycline
-pregnant - azithromycin and amoxicillin DOC
aminoglycosides and tetracyclines
bind 30S subunits
adverse azithromycin
nausea - 18%
low chance - arrhythmia, hepatotoxicity, QT prolonged, skin rash
tx syphilis
PCN G - 26 day effect
-treponema pallidum multiplies slowly
PCN allergy - doxycycline
if pregnant w/ allergy - PCN desensitization
