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PoD Test 2 > Sulfonamides etc. > Flashcards

Sulfonamides etc. Flashcards

1
Q

What is the strucutre of sulfonamides?

A

Similar to PABA, a precursor required by bacteria for folic acid synthesis

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2
Q

What is the MoA for sulfonamides?

A

Stop bacteria from synthesizing folic acid

Bacteriostatic

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3
Q

How are sulfonamides excreted?

A

Renal

Extent varies with each agent

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4
Q

What are the ADRs for sulfonamides?

A

Anaphylaxis

Cutaneous reactions

Hematologic

Hypersensitivity

Nephrotoxicity

Kernicterus

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5
Q

What are the mechanisms of resistant against sulfonamides?

A

Over production of PABA (Neisseria, Staph)

Structureal change in dihydropteroate synthetase

Decreased permeability of the bacteria to the drug

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6
Q

What are the indications for sulfonamides?

A

Acute, uncomplicated UTI

Pneumocystis carinii

Nocardosis

Toxoplasmosis

Malaria

Rheumatic fever

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7
Q

What is the MoA for trimethoprim?

A

Inhibits dihydrofolate reductase, preventing THF formation

Bacteriostatic or bactericidal depending on the growth conditions

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8
Q

How is trimethoprim excreted?

A

80% unchanged via glomerular filtration and tubular secretion

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9
Q

What are the ADRs of trimethoprim?

A

Cutaneous rxns

GI rxns

Hematologic rxns

Caution in patients with foalte deficiency

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10
Q

What are the indications for trimethoprim?

A

Acute uncomplicated UTI

Recurrent UTI prophylaxis

Traveler’s diarrhea

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11
Q

What is the MoA of bactrim?

A

Trimethoprim/sulfamethoxazole

Combined mechanisms of both agents, usually bactericidal

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12
Q

What are the indications for bactrim?

A

UTI

RTI - COPD, Pneumonia, Sinusitis

GI infections - Slmonella/shigella, traveler’s diarrhea, cholera

STDs

Stenotrophomonas maltophilia

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13
Q

What are the drug interactions associated with bactrim?

A

Warfarin - potentiation

Methorexate - increase free fraction

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14
Q

What is the MoA for Nitrofurantoin?

A

Possibly interferes with early stages of bacterial carb metabolism

Possibly production of free radicals

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15
Q

What is the distribution and excretion for Nitrofurantoin?

A

Distribution - High urine concentrations

Excretion - rate is linearly related to GFR

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16
Q

What are the ADRs of Nitrofurantoin?

A

Hypersensitivity

Hematologic

Hepatotoxicity

Peripheral neuropathy

GI

17
Q

What are the pulmonary ADRs of nitrofurantoin?

A

Acute - hypersensitivity

Subacute - after 1 month, cough, dyspnea, interstitial infiltrate

Chronic - cough, dyspnea, interstitial infiltrate

Often reversible, but not necessarily and can be fatal

18
Q

What is nitrofurantoin indicated for?

A

Acute uncomplicated UTI

UTI prophylaxis

19
Q

What is the MoA for methenamine?

A

At adequate urine pH (<5.5), its hydrolyzed to formaldehyde, which kills bacteria by denaturing proteins

20
Q

What is the absorption and excretion of methenamine?

A

Absorption - rapidly absorbed in GI tract, excellant bioavailability

Excretion - Renal clearance is 95% of total, half life = 3-4hrs

21
Q

What are the ADRs for methenamine?

A

Hypersensitivity

Hemorrhagic Cystitis

GI

Avoid in hepatic insufficiency

Renal failure

22
Q

What is the spectrum of methenamine?

A

Virtually all bacteria and fungi

Certain urease positive bacteria can alkalinize the urine

23
Q

What are the indications for methenamine?

A

UTI prophylaxis only

PoD Test 2 (23 decks)

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