Sulfonamides And Miscellaneous

Question 1

What is mupirocin’s mechanism of action?

Answer 1

It prevents tRNA syntheses from inserting isoleucine into the protein strand

Question 2

Is trimethroprim a sulfa?

Answer 2

No, but it is commonly given with one in the form of Bactrim (sulfamethoxazole+trimethoprim)

Question 3

Is Bactrim an example of synergy?

Answer 3

Yes, it is a combo of sulfamethoxazole and trimethoprim

Question 4

What is sulfasalazine used for?

Answer 4

Anti-inflammatory

Question 5

How old does the patient need to be to give them a sulfa drug? Why?

Answer 5

2 months or older.

Due to risk of kernicterus

Question 6

Is daptomycin’s mechanism of action the same thing as cell lysis?

Answer 6

No, daptomycin just makes all the cell contents leak out

Question 7

If baby is jaundiced, is Bactrim a good idea?

Answer 7

No, no sulfa drugs in jaundiced babies or babies under 2 months

Question 8

Is TMP-SMX static or cidal?

Answer 8

It is generally static, but in the urine, it gets concentrated 10-20x to become cidal

Question 9

What is an alternate to vancomycin that is suitable for empiric therapy in patients with serious G+ infections

Answer 9

Daptomycin

Question 10

What is the spectrum of polymyxin B and E?

Answer 10

Gram negative infections

G-
G-
G-

Question 11

What are the main toxicities of sulfa drugs?

Answer 11

Aplastic anemia- especially if they have G6PDase deficiency

Photosensitivity

Hypersensitivity

Stevens-Johnson syndrome

Question 12

What is the spectrum of daptomycin?

Answer 12

Gram +
Gram +
++++++++++
Drug resistant gram + infections

Question 13

How do bacteria develop resistance to TMP-SMX/Bactrim?

Answer 13

Increase their production of PABA

Make folic acid another way

Efflux/decreased permeability

Question 14

What is the 2nd highest drug class after PCNs to cause sensitivity?

Answer 14

Sulfa

Cross reacts with some diuretics, celecoxib, diabetes drugs

Question 15

What about sulfamethoxazole+trimethoprim makes it the DOC for UTI?

Answer 15

Sulfamethoxazole is slowly excreted and achieves a high urine concentration

Question 16

Is Bactrim a sulfa drug?

Answer 16

Yes

Question 17

If someone has recurrent UTIs, do we give them TMP-SMX/Bactrim?

Answer 17

No.

Ciprofloxacin, Fosfomycin, nitrofurantoin, or methenamine would be better

Question 18

How does daptomycin kill bacteria?

Answer 18

It binds to their membrane causing a rapid depolarization of the membrane, and all the ions leak out.

Question 19

What drug class is associated with kernicterus

Answer 19

Sulfa drugs

Question 20

What is silver sulfadiazine used for?

Answer 20

Burns

Question 21

What is the DOC for first attack UTIs?

Answer 21

TMP-SMX / Bactrim

Question 22

What drug class commonly causes Steven Johnson syndrome

Answer 22

Sulfa

Question 23

Why do we give TMP-SMX (Bactrim) together?

Answer 23

They have a synergistic effect

Question 24

How is mupirocin administered?

Answer 24

Topically

Question 25

Why do TMP and SMX have a synergistic effect?

Answer 25

They both work in the same pathway to synthesize folic acid

SMX- competes with PABA enzyme

TMP

Question 26

What are the 3 drugs in Neosporin?

Answer 26

Neomycin

Bacitracin

Polymyxin B

Question 27

How are polymyxin B and Polymyxin E administered?

Answer 27

Topically only

Highly nephrotoxic

Question 28

Do sulfa drugs cause photosensitivity?

Answer 28

Yes

Question 29

What are the polypeptide antibiotics

Answer 29

Polymyxin B

Polymyxin E

Question 30

What do we use mupirocin for?t

Answer 30

Impetigo

Intranasally for MRSA carriers