Sulfas Flashcards
DOC of UTI
Sulfamethoxazole
- slow excretion, high urine concetration
2nd choice is ciproflocacine
Sulfamethoxazole
Oral admin
- crosses the placenta and BBB so avoid in near term or nursing infants and is excreted in breast mild
Sulfas mechanism
bacteria make their own folic acid
- sulfas compete with PABA in bacteria for incorporation of folic acid
Sulfas resistance
increased production of metabolite PABA
- active efflux or decreased perm
- alt metabolic pathwayfor synthesis
Sulfa uses
UTI infections DOC c trimoxazole ( bactrim)
urine concentration is higher
met in the liver and excreted in kidney
Sulfa toxicities
Aplastic anemia G6PD > high risk near preg
- photosensitivity
- hypersensitivity
- SJS associated with it
Sulfa toxicity
Drug sensitivites
Kernicterus- compete with the binding of bilirubin to plasma
* sulfa drugs should not be given to infants less than 2mo
Daptomycin mech
Mech: binds to bac mebranes and causes rapid depol of membrane pot
> leads to inhib of protein DNA and RNA synthesis > cell death
Daptomycin mech spect
IV administration cidal against G+ bacteria (MSSA MRSA) aerobic and anarobic given once a day becuase long t1/2 -resistance is rare - sutible alternate to Vanco in serious G+ infections if wont work
Mupirocin mech
protein and RNA sysnthesis are inhibited when binds to isoleucyl-tRNA synthestas
Mupirocin use
G+ and some G- bacteriostatic and cidal at high doses * adminitered topically Tx: of impetigo intrasnasal application to patients who carry MRSA
Polypeptide Abx type
Polymyxin B
Colistin
*use tipically**
Polypeptide Abx Mech
G- infections
- polymyxin binds to g- cell mmbrane phopholipids increasing permiability of membrane
-cidal against more G- bacilli ecept proteus or neiseria
no G+
Polymyxin Colstin
no GI absorption bound well to plasma proteins excretion through kidney is slow Tox: Nephrotoxic!!! why use topically Use: topical in combo with neomycin and bactracin
