sulfonamides and miscellaneous

Question 1

What is the brand name of sulfamethoxazole + Trimethoprim

Answer 1

co-trimaxazole, TMP-SMX (Bactrim)

Question 2

What is the route of administration of sulfamethoxazole + Trimethroprim (Bactrim)

Answer 2

• oral
• IV only in extreme situations

Question 3

List the sulfonamides

Answer 3

• sulfamethoxazole + trimethoprim (Bactrim)
• sulfamethoxazole (Gantanol)
• Sulfasalazine
• silver sulfadiazine

Question 4

route of administration of sulfamethoxazole (Gantanol)

Answer 4

oral

Question 5

route of administration of Sulfasalazine

Answer 5

oral

Question 6

route of administration of silver sulfadiazine

Answer 6

topical

Question 7

sulfamethoxazole (Gantanol) has a high concentration where

Answer 7

high urine concentration

Question 8

what is a major different between the sulfonamides

Answer 8

rate of absorption, excretion and solubility in the urine

Question 9

MOA of sulfamethoxazole. static or cidal?

Answer 9

competes with PABA in the synthesis of bacterial folic acid

• generally bacteriostatic
• bactericidal in the urinary tract

Question 10

MOA of trimethoprim

Answer 10

prevents the reduction of dihydrofolate to tetrahydrofolate

Question 11

spectrum of coverage of Sulfamethoxazole

Answer 11

inhibit G+ and G- organisms

Question 12

DOC UTI infections (first attack)

Answer 12

Co-trimoxazole (Bactrim)

Question 13

contraindications of Bactrim

Answer 13

• avoid use near term or in nursing premature or jaundiced infants
  
  • sulfa can cross placenta and blood brain barrier

Question 14

How much higher is Bactrim’s concentration in the urine than in the plasma

Answer 14

urine concentration is 10-20 times higher

Question 15

Toxicities of sulfa drugs

Answer 15

• drug sensitivity (allergy 6%)
• Steven-Johnson Syndrome
• Kernicterus (sulfa compete with binding of bilirubin to plasma proteins)

Question 16

contraindications of sulfa drugs

Answer 16

should not be given to infants < 2 months old

Question 17

What is the one Lipopeptide Abx

Answer 17

Daptomycin (Cubicin)

Question 18

MOA of Daptomycin (Cubicin)? static or cidal?

Answer 18

binds to bacterial membrane and causes a rapid depolarization of membrane potential

• bactericidal

Question 19

spectrum of coverage of Daptomycin (Cubicin)

Answer 19

G+ aerobic and anaerobic

Question 20

route of administration of Daptomycin (Cubicin)

Answer 20

IV

Question 21

what abx can be used as an alternate to vancomycin to treat serious G+ infections

Answer 21

Daptomycin (Cubicin)

Question 22

MOA of Mupirocin (Bactroban)

Answer 22

bacterial protein and RNA synthesis are inhibited

Question 23

spectrum of coverage of Mupirocin (Bactroban)? Static or cidal?

Answer 23

good against G+ and some G-

• bacteriostatic at low concentrations
• bactericidal at high concentrations

Question 24

route of administration of Mupirocin (Bactroban)

Answer 24

topical; intranasal

Question 25

what abx is used to treat impetigo caused by S.aureus and/or streptococcus pyogenes

Answer 25

Mupirocin (Bactroban)

Question 26

Name the two polypeptide Abx

Answer 26

• Polymyxin B
• Colistin

Question 27

MOA of polypeptide Abx

Answer 27

G- infections

Question 28

MOA of polymyxin B

Answer 28

binds to G- bacterial cell membrane phospholipids (lipid A of endotoxin)

Question 29

spectrum of coverage of polypeptide abx

Answer 29

• G- infections
• No effect in G+

Question 30

toxicity of polypeptide abx

Answer 30

nephrotoxicity

Question 31

route of administration of polypeptide abx

Answer 31

topical