Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology Exam 2 > Sulfonamides & Misc Abx > Flashcards

Sulfonamides & Misc Abx Flashcards

1
Q

Sulfonamide Drugs

A

Sulfamethoxazole+Trimethoprim, Co-trimoxazole, TMP-SMX (Bactrim) - oral and parenteral
Sulfamethoxazole - oral
Sulfasalazine - oral
Silver Sulfadiazine - topical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

DOC for UTI

A

Bactrim - slow excretion and high urine concentration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sulfasalazine Use

A

Ulcerative Colitis (GI action)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Silver Sulfadiazine Use

A

Burns - topical application

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Sulfonamide MOA

A

Antimetabolite, competes with para-aminobenzoic acid (PABA) for incorporation into folic acid:
PREVENTS FOLIC ACID SYNTHESIS
Bacteriostatic, but becomes cidal in the urinary tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

TMP-SMX MOA

A

SULFAMETHOXAZOLE inhibits folic acid synthesis
TRIMETHOPRIM prevents reduction of dihydrofolate to tetrahydrofolate essential for one carbon transfer
This is a SYNERGISTIC relationship when coadministered as in Bactrim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sulfonamide Resistance

A

Increased production of an essential metabolite or drug antagonist (PABA)
Efflux pumps
Decreased permeability
Alternative metabolic pathway for synthesis of essential metabolite (plasmid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Sulfonamide Spectrum

A

G+ and G- (generally static unless in the urinary tract)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sulfonamide Uses

A

UTI (first attacks) - DOC is Co-trimoxazole (Bactrim)
Chlamydia (second line) - DOC is azythro or tetracycline
Moraxella, E. Coli, Klebsiella, Proteus, Salmonella, Vibrio sp, Burkholderia, Nocardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Bactrim Administration

A

Oral - absorption is adequately rapid

Cotrimoxazole is available IV, but is RARELY used!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Sulfa metabolism

A

Liver primarily as acetylated products and excreted through the kidney.
Urine concentration is 10-20x that of plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sulfa contraindications

A

Near term pregnancies (crosses placenta and bbb)
Nursing mothers (excreted in breast milk)
Premature or jaundiced infants (immature liver)
Infants <2 months (displaces bilirubin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Sulfa Toxicities

A

Aplastic anemia (G6PD deficient - avoid at end of preggo)
Photosensitivity
Hypersensitivity (2nd to PCNs)
SJS and TEN
Kidney and Liver damage, microscopic hematuria
Peripheral nerve damage
KERNICTERUS (bilirubin displacement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Daptomycin MOA

A

Binds bacterial membranes and causes rapid depolarization of membrane potential.
Bactericidal against G+ bacteria (MRSA, MSSA) - concentration dependent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Daptomycin Spectrim

A

Aerobic and Anaerobic G+ bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Daptomycin Resistance

A

Exceedingly rare, but does exist. Unsure mechanism

17
Q

Daptomycin administration

A

IV

18
Q

Daptomycin Metabolism

A

Half life is 8-9 hrs: once daily dosing

Excreted unchanged by the kidneys

19
Q

Daptomycin Use

A

Suitable for EMPIRIC therapy in patients with SERIOUS G+ infections; alternate to Vancomycin
Very little is known about this drug!

20
Q

Mupirocin MOA

A

Binds bacterial isoleucyl-tRNA synthetase - every isoleucine that needs to be added, can’t! Protein and RNA synthesis are inhibited.
Bacteriostatic at LOW concentrations
Bacteriocidal at HIGH concentrations

21
Q

Mupirocin Spectrum

A

Good against G+ and some G-

22
Q

Mupirocin Administration

A

Topical (to skin or nares)

23
Q

Mupirocin Use

A

Impetigo (DOC) caused by S. aureus

Intranasal application of carriers of MRSA

24
Q

Mupirocin cross-resistance

A

Practically none b/c of its unique MOA

25
Q

Polypeptide Antibiotics

A

Polymyxin B

Colistin

26
Q

Polypeptide Spectrum

A

Mostly G- infections. No effect in G+ (lack endotoxin which is the binding site)

27
Q

Polymyxin B MOA

A

Binds to G- bacterial cell membrane phospholipids (lipid A of endotoxin), increasing permeability of the cell membrane.
Bactericidal against most G- bacilli, except PROTEUS and NEISSERIA

28
Q

Polypeptide Administration

A

Topical - NO GI absorption (can’t be oral)

Binds well to plasma proteins (distribution after parenteral use is poor)

29
Q

Polypeptide Metabolism

A

Slow excretion through the kidney (can cause nephrotoxicity especially if not topical)

30
Q

Polypeptide Toxicity

A

NEPHROTOXICITY - use topically
Paresthesia, ataxia, dizziness
Visual/speech disturbances, leukopenia, granulocytopenia

31
Q

Polypeptide Use

A

Topical in combination with neomycin and bacitracin.

Topical application to wounds, burns, and the eye (pseudomonas infections).

32
Q

Neosporin Abx

A

Bacitracin (G+)
Neomycin (G-)
Polymyxin B (G-)

Pharmacology Exam 2 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions