Sulfanomides Flashcards
DHFR reductase is 1) inhibited by and 2) converts what to what?
TMP (Trimethoprim)
2) dihydrofolic acid to tetrahydrofolic acid (then to DNA/RNA -> stops protein synthesis)
DHFR synthase 1) converts what to what and 2) is inhibited by what?
1) PABA to dihydrofolic acid
2) inh by SMX/sulfanomides
Bactrim/TMP-SMX is DOC for
UTI
Spectrum of bactrim/TMP-SMX
G+/G-
crosses placenta and BBB
excreted in breast milk so avoid near term and in nursing prematures or jaundiced infants
bactrim/TMP-SMX
bactrim/TMP-SMX is excreted through
kidney
sulfazaline is
a prodrug:
ulcerative colitis and RA
Steven-Johnsons is SE in
bactrim/TMP-SMX
cross sensitivity with other sulfa drugs
bactrim/TMP-SMX
kernicterus (what is it?) with
bactrim/TMP-SMX
void pregs and <2 months
photosensitivity is with
bactrim/TMP-SMX
which drug is an alternative to Vanco (txs serious G+) and has no resistance?
Daptomycin
lipopeptide
Daptomycin is a
lypopeptide
Binds to bacterial membrane, forms channels: leakage of ion depolazises membrane and inhibits protein, DNA and RNA synthesis
Daptomycin
treats G+: MRSA, MSSA, aerobs and unaerobs
Daptomycin
IV once daily
daptomycin
excreted kidney
Mupirocin (Bactroban) spectrum:
good G+/some G-
static at low [ ]/cidal at high [ ]
Impetigo by S Aureus or strep pyogenes
MRSA - intranasal
no cross sensitivity with
Mupirocin/Bactroban
which drug treats impetigo
bactroban/mupirocin
MOA of bactroban/mupirocin:
inhibits protein and RNA synthesis by irreversably binding to iso…tRNA synthase
Binds to G- bacterial cell membrane phospolipids (LIPID A of endotoxin): increases permiability and decreases metabolites, cell doesn’t survive
Polymyxin B
Lipid A is only found in what type of bacteria
G-
What binds to Lipid A of G- bacteria
Polymyxin B
cidal against most G- bacilli except Proteus and Neisseria
no effect on G+
Polymyxin B
