Pharmocology Flashcards
Well absorb drugs (oral)
Anti-folate
FQ
Nitrofurantoin
Metronidazole
Tetracycline
Lincosamide
Linezolid
Poor absorption oral
Carbapenams
Monobactam
Glycopeptide
Not absorb orally
Daptomycin
Polymyxin
Aminoglycoside
Penicillin oral absorption
Penicillin V 60%
Amoxicillin 75%
Cloxacillin 50%
Cephalosporin oral absorption
Cephalexin 90%
Cefuroxime 52%
Tetracycline and doxycycline oral absorption
Tetra 60-80%
Doxy 90-100%
Macrolide oral absorption
Azithromycin 40%
Clarithromyxin 50%
Erythromycin 15-45%
Good CSF penetration
Gen 3&4 cephalosporins and cefuroxime
Meropenem
Imipenem
Anti-folate
Metronidazole
FQ(m>I>c)
Abscess distribution
Glycopeptide
Lincosamide
Bile distribution
Tetracycline
Lincosamide
Metabolism liver
Tetracycline Tigecycline (minimal) Macrolide Lincosamide Linezolid (not cyp 450) Anti folate Macrolide (partly; inhibit liver also) Metronidazole
Not metabolize in liver
Penicillin Cephalosporin Carbapenams Monobactam Glycopeptide
Excrete in kidney
Penicillin anti staphy (bile and renal) Cephalosporin (except ceftriaxone)
Carbapenans
Monobactam
Glycopeptide
Daptomycin
Polymyxin(?) Aminoglycoside Tetracycline (and bile) Tigercycline (mainly bile) Macrolide (4-30%) Lincosamide (and bile) Linezolid (and non renal)
Anti folate
Nitrofurantoin
Metronidazole
FQ (except mo and nalidixic )
Excreted in bile
Nafcillin
Antistaph
Ceftriaxone
Tetracycline
Tigecycline
Lincosamide
Time dependent killings
Penicillin (40-50%) Cephalosporin (40-50%) Carbapenams (40-50%) Monobactam (50-60%) Glycopeptide Tetracycline Lincosamide Linezolid
Concentration killing
Daptomycin Polymyxin Aminoglycoside FQ Metronidazole
Daptomycin should not be use to treat
Pneumonia
Vancomycin is not as effective as _______________ for treatment of serious infections such as endocarditis caused by MSS strain.
Anti staphylococcus penicillin
MSSA choices of drugs
1st
Nafcillin
2nd
Cefazolin (1gen)
Vancomycin (if allergic to pcn)
Oral
Dicloxacillin
Cephalexin (1gen)
FQ
CONS DOC
Nafcillin
Vancomycin
Daptomycin
Carbapenams
Strep grp a / b DOC
Pcn g + clindamycin
Any BL
Vancomycin (pcn allergy)
Clindamycin
Amoxicillin
Tmp/smx
Viridans strep doc
Pcn g
Ceftriaxone
Vancomycin
Amoxicillin
Faecalis doc
Ampicillin
Pcn g
vancomycin
Amoxicillin
Pseudomonal aeruginosa is resistant to
Tetracycline inc tigecycline
And
Sulfonamide
Static or cidal
Beta lactam AG Tetracycline Macrolide Linezolid
Cidal
Cidal
Cidal at high conc
Static but cidal against streptococci
Macrolide activity is enhanced at
Alkaline ph
Sulphonamide may ppt in Urine esp at _______ producing crystalluria, hematuria or even obstruction
Neutral or acid pH
Sulphonamide
Trimethoprim
Co trimoxazole
Cidal or static
Static
Static
Cidal
Co-trimoxazole ratio
Trimethoprim :
Sulfamethoxazole 1:5
FQ cidal or static
Cidal (broad spectrum)
FQ block DNA synthesis by _______
Inhibiting bacterial. Topoisomerase II (DNA gyrase)
And topoisomerase IV.
Nitrofurantoin is cidal or static
Cidal at right dose
Nitrofurantoin antagonizes action of ____
Nalidixic acid
It is desirable to keep urine ph __________ when using nitrofurantoin to treat Chronic UTI
Below 5.5
Metronidazole Moa
Non enzymatically reduced by reacting with reduced ferrodoxin.
This result in production of toxic product.
Fosfomyxin MOA
An analogue of phosphoenolopyruvate.
It inhibits the cytoplasmic enzyme enolpyruvate transferase by covalently binding to the cysteine residue of the active site and blocking the addition of phosphoenolpyruvate to UDP-N-acetylglucosamine.
Uptake of fosfomycin require
___
Glycerophosphate or glucose 6 phosphate transport system.
Protein binding penicillin
Penicillin 80%
Amoxicillin 25%
Cloxacillin 95%
Protein binding cephalosporins
Cefepime 20%
Ceftriaxone 90%
Protein binding carbapenams
Meropenem 2%
Ertapenam 95%
Monobactam protein binding
56%
Vancomycin
Teicoplanin
Protein binding
Vanco 30-55%
Teicoplanin 90%
Daptomycin protein binding
90%
Polymyxin protein binding
80-90%
Aminoglycoside protein binding
10%
Tetracycline BP
T: 20-67%
D: 82-93%
Tigecycline BP
79-81%
Macrolide BP
A 7-50%
C 65%
E 70%
Lincosamide BP
85-94%
Linezolid BP
13%