Respiratory Drugs Flashcards
Isoniazid
Inhibits synthesis of mycolic acid needed for cell wall
Resistance if used alone to treat (can use alone for prophylactic)
Isoniazid side effects
peripheral neuropathy if not administered with pyridoxine, hepatotoxicity
rifampin
inhibits RNA polymerase,
induces metabolism of drugs by cytochrome P450
amphotericin B
hydrophobic face binds to ergosterol in fungal cell wall, forms pore leading to osmotic lysis
side effects: fever, chills, nephrotoxicity
caspofungin / echinocandins
inhibit cell wall synthesis
triazole mechanism of action
inhibits fungal cyp450 needed for ergosterol synthesis
ketoconazole
inhibits human cyp450 which decreases steroid hormone, can lead to gynecomastia
itraconazole
inhibition of cyp3A4 can lead to increased levels of macrolides, risk of prolonged QT, and warfarin,
drug of choice for histoplasmosis or blastomycosis
voriconazole
drug of choice for invasive aspergillus
inhibits cyp450, transient visual disturbances, and photosensitivity
fluconazole
wide therapeutic window, fewer drug interactions
oseltamivir, zanamivir
treatment and prophylaxis of flu virus,
inhibits viral neuraminidase needed for release,
resistance through neuraminidase mutations
oseltamivir side effects
high oral bioavailablity,
rare psychiatric effects
zanamivir
low oral bioavailability,
airway brochospasm or fatal lung deterioration in patients with airway disease
B-lactams
penicillin, amoxicillin, ampicillin
transpeptidase inhibitors (cell wall)
side effect: hypersensitivity rxns
vancomycin
inhibits transgylcosylase and chain elongation by binding to cell wall precursors attached to lipid carriers,
effective only for gram (+)
vancomycin use and side effects
MRSA, penicillin resistant pneumococcal infections
flushing, “red man syndrome”
aminoglycosides
gentamicin, tobramycin - bactericidal
binds 30S subunit inhibiting translation,
aerobic gram (-) bacteria, but not Legionella because will not penetrate macrophages
aminoglycoside side effects
narrow therapeutic window
nephrotoxicity, tinnitus, hearing loss, vertigo
tetracyclines
doxycycline - bacteristatic
binds 30S subunit inhibiting translation, blocks binding of aminoacyl tRNA
tetracycline use and side effects
Rickettsia (RMSF, lyme disease), spirochetes
dental staining in kids, photosensitivity
macrolides
erythromycin, azithromycin, clarithromycin
binds to 50S subunit inhibiting translation, blocks translocation of peptidyl tRNA
macrolide use and side effects
aerobic gram (+), mycoplasma, mycobacteria prolonged QT interval
drug of choice for pertussis or diphtheria
erythromycin
drug of choice for Legionnaire’s
azithromycin
fluoroquinolones
ciprofloxacin, levofloxacin - bactericidal
inhibit DNA gyrase (topo IV)
fluoroquinolone side effects
cartilage damage, tendon rupture, photosensitivity, prolonged QT interval
trimethoprim-sulfamethoxazole
bactrim
inhibits folate synthesis
useful in treatment and prophylaxis of Pneumocystis jjrovecii or nocardia asteroides infection
empiric therapy for community acquired pneumonia
macrolides or doxycycline
treatment of strep pneumoniae related pneumonia
pneumonia: ceftriaxone
characterisitics of atypical pneumonia
nonproductive cough, low fever, does not appear very sick
community acquired pneumonia
S. pneumoniae
M. catarrhalis
H. influenzae
M. pneumoniae
hospital acquired pneumonia
S. aureus
E. coli
K. pneumoniae
P. aeruginosa
