PPP Final Flashcards
Penecillin G
1st gen
Gram positive
best for syphilis, strep and cali
oxac, dicox, naf
2nd gen
gram postive
best for MSSA and beta lactam resitant
Amox, ampicillin ( Clav)
3rd gen
postive and negative bacteria, cali
HELP
add Clav - HNPEK
HELP - cherry, shake, santa, triton HNPEK - cherry, mac, triton, dino
Pipercillin
4th gen
Postive and negative
HNPEK, CaPES and cali
HNPEK - cherry, mac, triton, shake, dino CAPES - citro, acter, mona, di
Cefazolin, Cephalexin
1st gen cephalosporins
Kinectics - long duration
Use - Staph, strep and PEK
AD- Nephrotoxic
Special - MSSA
Cefuroxine, Cefoxitin, Cefotetan
2nd Gen
Stap and stre, HNPEK
FOX 10 - B. Frags
Cefuroxine - crosses BBB for menigitis
AD - Cefotetan - alchohol toxic
Ceftriaxone, Ceftotaxime, Ceftazidime
3rd gen
emperical menigitis and sepsis, CaPES
Ceftazidine - only one that can treat mona
Triaxone - nisseria vikings
cefepime
4th gen
Ceftazdines cousin
Ceftaroline
5th gen
treates MRSA only in the family
Aztreonam
Penecillin like
USE - negative bc smol, HNPEK and CaPES
used for pen and cep allergic rxn
Meropenam
Penecillin like
THE KING for positives and negative (no atypicals or MRSA or cali)
Treat for mengitis and sepsis
Vancomycin
MOA- Prevents crosslinking of peptides
Postive only, strep, cali cdiff
MRSA first line
AD - Vancomycin flushing, Ototoxic, Nephrotoxic
Daptomycin
Postive only
MRSA, cali, VRE
cant treat pneumonia bc of mucus
AD - muscle weakness, statins X
Gentamicin, Tobramycin, Amikacin
Type - Animoglycoside
MOA- Bind to LPS (-) and crack membrane but requires OXYGEN blocks 30s BACTERIACIDAL
Use- Gram (-) aeorbes, Psedomonas, Used in combo with gram postive to gain entry
AD - Nephro, Ototosic, Neruomuscular,
Contra - Renal, hearing, pregnacy
Special - NEEDS TO BE MONITORED
Linezolid, Tedizolid
Type - Oxazolidinones
MOA- 50s subunit type P
Use- Gram (+), gram neg pumps out, USE ON VRE, VRSA, MRSA
AD - GI, Thrombocytopenia, optic and peropheral neuropathy ( long term)
Contra -
Special - LINEZOLID HTN WITH CHEESE AND WINE, SERITONIN SYNDOME WITH MAO
Doxycycline
Type - Tetracycline
MOA-reversible 30s bind to A site
Use- Board Specturm ( +, -, atypicals, MRSA, Rickettsia), + acne, - Brucella
AD - GI, Bone and teeth deposit, phototoxic
Contra - Cations, BWW kids and pregnacy
Special -
Tigecycline
Type - Tetracycline
MOA-reversible 30s bind to A site
Use- Board Specturm ( +, -, anaerobes, atypicals, MRSA, Rickettsia), + acne, - Brucella
AD - GI, Bone and teeth deposit, phototoxic
Contra - Cations, BWW kids and pregnacy
Special - ANAEROBES, FAECALIS, VRE, MRSA
Azithromycin, Clarithromycin
Type - Macrolides
MOA- Binds 50s subunits and block translocation
Use- Broad specturm (+, -, Anaerobes, atypicals) + Strep pneimoniae, - camp jejuni, Chlamydia
AD - SEVERE GI due to increased motility, Hep, QT PROLONG
Contra -
Special - DOC FOR PNEUMONIA
Clindamycin
Type - Lincosamide
MOA-50s blocker of translocation
Use- Gram +, Anearobes, MRSA
AD - GI, HIGHEST CHANCE FOR PSUDOMEMBRANOUS COLITIS from C. DIFF
Contra -
Special - ANEAROBES above THE DIAPRAGM
What does a positve or negative test of MEC A mean
MEC A determines Methicillin resistant staph aureus
Trimethoprim/Sulfamethozale
Type - Bactrim
MOA- inhibit folic acid and DHFR, Berteiostatic alone, bactericidal together
Use- Broad specturm (+, - , MRSA), HPEK, good for UTI
AD - GI, hypersensitivity, Leukopenia, Hemolytic Anemia (G6P testing), Kernicterus neonates, Hyperkalemia
Contra - CYP, hyperkalemia, BBW pregnacy and infants
Special - Fungi pneumocystis
Ciprofloxacin
Type - Fluoroquinolones
MOA- inhibit top II, do it can glue back DNA rep Bacteriocidal
Use- +, - (BETTER) HNPEK CaPES, Psudomonas (BEST), Antharacis
AD - GI, Neurotoxic, dermatologic, musculoskeletal, QT prolong
Contra - Pregnacy, children, BBW TENDINITIS Peripheal neuropathy
Special - Respitory quinolones, 2hr before or 4 hrs after cations
Levofloxacin
Type - Fluoroquinolones
MOA- inhibit top II, do it can glue back DNA rep Bacteriocidal
Use- + (BETTER), -, Psudomona
AD - GI, Neurotoxic, dermatologic, musculoskeletal, QT prolong
Contra - Pregnacy, children, BBW TENDINITIS Peripheal neuropathy
Special - Respitory quinolones, 2hr before or 4 hrs after cations
Moxifloxacin
Type - Fluoroquinolones
MOA- inhibit top II, do it can glue back DNA rep Bacteriocidal
Use- + (BETTER), -, Anaerobes, atypicals
AD - GI, Neurotoxic, dermatologic, musculoskeletal, QT prolong
Contra - Pregnacy, children, BBW TENDINITIS Peripheal neuropathy
Special - Respitory quinolones, B. FRAG, 2hr before or 4 hrs after cations
Metronidazole
MOA- Prodrug actived by anerobic conditions, breaks double stand DNA
Use- +, -, anaerobes, protozoa
AD - GI metalic taste, Disulfram rxn, CNS
Contra - pregnacy, malignacny, seizures, alcohol
Special - DOC for below diaphram Anaerobes
Rifampin
Type -
MOA- Inhibit RNA sysnthesis
Use- Tuberculosis, leprosy, menigococcal prophylaxis, cherry bacteria
AD - hepa, red/oragne urine, cyp inducer
Contra -
Special -
Quinine, Quinidine
MOA- Prevnets Heme stacking of malaria
Kinetics - Oral TID bc short HL
Use- Reistant P. Falciparium
AD - GI, QT prolong, Cinchonism (ears, eyes , CNS), G6P hematologic effects
Contra - CYP inhibit, P-Glycoprotien
Special -
Chloroquine, Hydroxychloroquine
MOA- blocks heme stacking
Kinetics -
Use- P. Falc, P. malariae, (COMBO WITH PRIMAQUINE for P. Vivax, P. Ovale bc has liver domant)
AD - GI, QT
Contra - psoriasis, ocular disease
Special - Itchign and visuals
Mefloquine
MOA- blocks heme stacking
Kinetics - LONG HF
Use- Prophlaxis
AD - GI, QT
Contra - CNS problems BBW ( epli, schitz, depression, anxiety)
Special -CNS and Crossed BBB (VIVID DREAMSSSSS) very very common
Primaquine
MOA- unknown
Kinetics -
Use- only hepatic stage malaria ( P. Vivax, P. ovale)
AD - GI QT
Contra - Pregnacy CYP inducer
Special - Hematologic w/ G6P def NEED TO DO TESTING, have dark urine
Artesunate, Artermether, Dihydroartemisnin
Type - Artemisinin derivative
MOA- Binds to iron and makes free radicals
Kinetics - rapid absorption and short HL
Use- uncomplicated (dihydroartemisinin), Complicated (Artesunate, Artermether) Falci Malaria
AD - GI, CNS, Overall well tolerated
Contra - first trimester of pregnacy, childer under 5kg
Special -
Atovaquone + proguanil
Type - Antifolates
MOA- Ato - disrupts mito ETC, Proguanil DHFR inhitor
Kinetics -
Use- treatment and prophylaxis of chloroquine resitance P. falciparum
AD - GI, liver enzyme rise
Contra - PREG
Special -
Antibiotics for malaria
tetracycline, doxycycline, clindamycin
MOA - inhibit apucoplase in parasite
kinetics - Slow acting
Malaria Treatment
- Complicated ( only IV) or not complicated ( oral or IV)
-
Complicated - give artesunate until can be sent home with oral meds
3.** Uncomplicated ** - **Falciparum **
- Cholorquine senstive - give cholorquine
- Cholorquine resistance - give Ato + prag, artemether + lumefantrine, Quinine + antibiotic, Mefloquine
- Mefloquine resitance - give Ato + prag, artemether + lumefantrine, Quinine + antibiotic,
- **Non-falciparum **
- Give choloroquine - malaria
- Add primaquine - P. Ovale, P. Vivax
Protezoal Amebiasis Treatment
Asystematic - Lodoquinol or paromoycin
Intestial diseas - metronidazole followed by asystematic drug
Extrainstestianl - metronidazole followed by asystematic drug
Tinidazole
MOA- like metronidazole with everything
Kinetics - QD
Contra - Pregnacy
Paromomycin
MOA- binds to 30s subunit
Kinetics - only oral
Use- asymptomatic amebiasis (unless with metro) Giadiasis
AD - GI and rash
Iodoquinol
MOA- Unknown
Kinetics - oral
Use- Amebiasis
AD - GI eat with food,
Special - Enlargement of thyroid
Protezoal Giardiasis treatment
Metro, Tinidazole, nitazoxanide, paromomycin ( low effic but can use with pregnacy)
Nitazoxanide
MOA- unknown
Kinetics - well absorbed
Use- Giardiasis
AD - Gi
Albendazole
MOA- blocks micotubles systhesis and cause glucose block starvation \
Kinetics - poor absorption but okay cause in GI system, meta liver
Use- Nematodes ( GI best), Cycsticerosis ( give with food if used for this), Invasive Cestode
AD - mild liver
Contra - pregnacy and hepatic disease
Pyrantel Pamoate
MOA- Ach realse to paralyze worm ( common treatment)
Kinetics - poor absorption
Use- Intestial round worms
AD - GI dizzy
Ivermectin
MOA- Bind Cl- channels and paralyze ( dont not pass BBB)
Use- all round worms execpt hookworms
AD - GI and itching
Contra - PREGNACY
Special - DOC for strongyloidiasis and Oncheoceriasis
Praziquantel
MOA- Increase Ca permeability to cause paralysis
Use- DOC schistosomiasism, Cycticercosis, other tape worms
AD - GI and itching
Zanamivir
MOA- Block the Neuraminidase ( the budding of the virus)
Use- Influenza but only 1-2 days for first symptoms bc viral load gets to high
AD - cough, headache
Contra-milk protein, COPD, Asthma
special - inhalation
Oseltamivir
MOA- Block the Neuraminadas ( the budding of the virus)
Use- Influenza but only 1-2 days for first symptoms bc viral load gets to high
AD - Headace NV
Special - DOC, PO
Peramivir
MOA- Block the Neuraminadas ( the budding of the virus)
Use- Influenza but only 1-2 days for first symptoms bc viral load gets to high
AD - diarrhea
Special - PO
Amantadine
MOA- M2 protine inhibitor ( less acid to break down outerlayer and delay RNA release
Use- Influenza
AD - CNS GI
Special - a lot of resistance so barely used
Didanosine, Zidovudine, Lamivudine, abacvir, [Tenofovir and Emtricitiabine QD]
-dine, -bine
Type - NRIT
MOA- Inhibit nucleotide binding to reverse transcriptase, prodrug that lacks hydorxyl group to elongation cant occur
Use-HIV R step
AD - MItocondria activity (PLAN) pancreatitis, Lactic Acidosis, Anemia, Neuropathy. DZ more - later less mito effects
Contra-
Specail-
Abacavir
Drug type - nucleoside
Special - HLA-B hypersensitivity (rash and peaks at day 11)
Tenofovir
Drug type - nucleoside
Special - Renal and Bone toxic
TAF - lower renal toxic
Zidovudine
Drug Type - Nucleoside
Special - liopatrophy ( losing fat in arms,legs and face)
What drug is used to treat Hep B and HIV
lamivudine, tenofovir and emtricitabine
new to watch out discontinue theses meds as it can cause hep b flare if they have
Didanosine
pancreatitis, hepatoxic
severe side effects
Efavirenz, Nevirapine, Etravirine, Rilpivirine
Vir in the middle
Type - NNRTIS
MOA - binds directly to RT and cause conformation change of catalytic center
AD - Rash can lead to Steven Johnson, Hepatotoxic
Contra- CYP interaction (not Rilpivirine)
Special - Food matters, Efaz need empty, Etravirine and Rilpivirine need food, NEvirapine depends on diet
Efavirenz
NNRTI
timing dependent day = stoned night = nightmares
Needs empty stomach
MOST TERATOGENIC
Raltegravir, Elvitegravir, Dolutegravir
Tegravir
Type - INSTI
MOA - Interfere with viral into host DNA at I in RIP
AD - well tolerated but some GI
Special - Elvitegravir - need booster (CYP inhibitor)
Atazanavir, Darumavir, Ritonavir, Nefinavir, Indinavir
Navir
Type - PI
MOA - blocks proteolytic of proteins precoursors that are used for production (ONLY A BOOSTER NEVER MONO)
AD - Metabolic problems, liver toxic, protease pouch (human primodial pouch)
Atazanavir least side effects but hyperbilirubinemia
contra - CAD, Diabetes
Special - INHIBIT CYP so can combo with drugs meta by CYP
HIV treatment
will ask on test if valid regiment
3 drugs - 2 NRTIS +INSTI, NNRTI or PI
new pt usually NRTIS and 3 drug
Biktary - TAF, FTC/ emtricatabine and Bictegravir
Triumeq - Aba, lam, dolutegravir (NEED HYPER TESTING)
ALL NEED TO TEST CD4 T and VIRAL LOAD
Maraviroc
Type - Fusion
MOA - CCR-5 antagonist
Kinetic - PO
AD - increased infection
Contra - Cyp inducer/ inhibior
Enfuvirtide
type - fusion
MOA - binds GP41 and blocks fusion and viral entry
Kinetics - SQ
AD - injection site and rash
Ibalizumab
type - fusion
MOA - agonist of CD4 and inhibt entry
USE - Drug resistance HIV
AD - diarrhea, dizzy , opportunistic infections
Rendesivir
MOA - Monophosphate - inhibitor of RNA dependent RNA polymerase
AD - liver toxic, infusion rxn
Nirmatrelvir + Ritonovir
Type - paxloid
MOA - Nir protease inhibitor block replication, Rit booster block cyp
USE - >12 with a high risk of develping severe covid
AD - Diarrhea, Dysgeusia (taste disorder)
Molnupiravir
MOA - prodrug blocks eloongation
ONLY IF PAX NO AVAILABLE
AD - dizziness, Diarrhea
Amphotericin
MOA - interact with membranes to form pores and poke holes
USE - DOC for aspergillosis, candida cryptococcus, histoplasma
AD - BAD infusioon rxn, super nephro toxic (needs saline), hypokalemia, hypomagnesia
5-FC
MOA - Penetrates cell well, to delaminat cystosine to 5-FU
AD hematelogic effects ( anemia, leukopenia, throbocytopenia)
-azole
MOA - blocks lanosterol 14 alpha demethylase
AD - NV, hepatotoxic
Contra - CYP
Fluconazole
GI and chapped lips
Voriconazole
Visual distrub
Pasaconazole
well tolerated some GI
Isaruconazole
GI
Micafungin, Caspofungin, Anidulafungin
MOA - inhibit glucan synthase
AD - some minor histamine release
Terbinafine
MOA - inhibit squalene-epoxidase
USE - fungal fingernails and toenails
AD - taste distrubacnes, GI, Hepatoxic, Headache
Antifungal useage
