SYNTHETIC ANTIBACTERIALS Flashcards
Synthetic antibacterial agents are antibiotics.
True or False
False
Antibiotics are from natural origin.
QUINOLONES
Quinolones are patterned after ____, which is a ____ derivative.
- Nalidixic acid
- Naphthyridine
QUINOLONES
Prototype quinolone
Nalidixic Acid
QUINOLONES
Nalidixic Acid
Identify the isosteric heterocyclic grouping.
Napthyridines
QUINOLONES
Enoxacin
Identify the isosteric heterocyclic grouping.
Napthyridines
QUINOLONES
Cinoxacin
Identify the isosteric heterocyclic grouping.
Cinnolines
QUINOLONES
Norfloxacin
Identify the isosteric heterocyclic grouping.
Quinolones/Fluoroquinolones
QUINOLONES
Ciprofloxacin
Identify the isosteric heterocyclic grouping.
Quinolones/Fluoroquinolones
QUINOLONES
Ofloxacin
Identify the isosteric heterocyclic grouping.
Quinolones/Fluoroquinolones
QUINOLONES
Lomefloxacin
Identify the isosteric heterocyclic grouping.
Quinolones/Fluoroquinolones
QUINOLONES
Sparfloxacin
Identify the isosteric heterocyclic grouping.
Quinolones/Fluoroquinolones
QUINOLONES
Mechanism of action of quinolones
- DNA Topoisomerase IV inhibitor
- DNA gyrase inhibitor (TP II) -> Supercoiling -> -Cidal
QUINOLONES
Nalidixic Acid
Identify the generation.
1st
QUINOLONES
Cinoxacin
Identify the generation.
1st
QUINOLONES
Norfloxacin
Identify the generation.
2nd
QUINOLONES
Ciprofloxacin
Identify the generation.
2nd
QUINOLONES
Enoxacin
Identify the generation.
2nd
QUINOLONES
Ofloxacin
Identify the generation.
2nd
QUINOLONES
Levofloxacin
Identify the generation.
3rd
QUINOLONES
Sparfloxacin
Identify the generation.
3rd
QUINOLONES
Moxifloxacin
Identify the generation.
3rd
QUINOLONES
Gemifloxacin
Identify the generation.
3rd
QUINOLONES
Trovafloxacin
Identify the generation.
4th
QUINOLONES
- Gram (-)
- Not Pseudomonas species
Identify the generation based on the spectrum described.
1st
QUINOLONES
- Gram (-) + Pseudomonas species
- Gram (+) (S. aureus)
- Atypical microorganisms
Identify the generation based on the spectrum described.
2nd
QUINOLONES
- Gram (-) + Pseudomonas species
- Extended Gram (+) and atypical microorganisms coverage
Identify the generation based on the spectrum described.
3rd
QUINOLONES
- Gram (-) + Pseudomonas species
- Extended Gram (+) and atypical microorganisms coverage
- Broad anaerobic coverage
Identify the generation based on the spectrum described.
4th
QUINOLONES
Gastroenteritis caused by G. bacilli
Ciprofloxacin
QUINOLONES
This quinolone increases the effect of warfarin due to its enzyme inhibitor nature.
Ciprofloxacin
QUINOLONES
A quinolone that binds divalent cations, which decreases its absorption. Food also delays its absorption.
Ciprofloxacin
QUINOLONES
Ciprofloxacin is contraindicated with milk and ____ due to binding of divalent cations.
- Antacids
- Calcium supplements
QUINOLONES
This drug can lead to ruptured tendons in patients under 18 years old.
Moxifloxacin
QUINOLONES
The only quinolone that is taken once daily. It is the most phototoxic.
Lomefloxacin
NITROFURANS
First nitro heterocyclic compounds to be introduced into chemotherapy.
Nitrofurans
NITROFURANS
Nitrofurans are derivatives of ____, formed on reaction with the appropriate hydrazine or amine derivative.
5-nitro-2-furaldehyde
NITROFURANS
One of the earliest prototype nitrofurans
Nifurtimox
NITROFURANS
Tx of trypanosomiasis and leishmaniasis
Nifurtimox
Anti-protozoal
NITROFURANS
Adverse effects of nitrofurans
Mutagenic and Carcinogenic
NITROFURANS
Antimicrobial activity is present only when the nitro group is in the ____-position of Furan ring
5
NITROFURANS
Amebicide nitrofuran
Metronidazole
NITROFURANS
MOA: Reduction (nitrofuran reductase) of the nitro
group -> ____ (reactive intermediates) -> ____ damage -> inhibition of DNA, RNA, protein, and cell wall synthesis
- Free radicals
- Ribosomal proteins
NITROFURANS
The overall effect of nitrofurans to bacterial growth
Bactericidal
NITROFURANS
Topical tx of burns and prevention of bacterial infection associated with skin grafts
Nitrofurazone
NITROFURANS
Oral treatment of bacterial or protozoal diarrhea
Furazolidone
NITROFURANS
Nitrofuran that can inhibit aldehyde dehydrogenase
D/I: Alcohol
Furazolidone
NITROFURANS
Oral tx of UTI
Nitrofurantoin
NITROFURANS
Administered in a microcrystalline form to improve GI tolerance without inferring oral absorption
Nitrofurantoin
METHENAMINE & ITS SALTS
Methenamine is prepared by evaporating a solution of ____ and ____ to dryness.
- Formaldehyde
- Strong ammonia water
METHENAMINE & ITS SALTS
Methenamine is used for the treatment of ____.
Chronic UTI
METHENAMINE & ITS SALTS
To liberate the formaldehyde, the pH of the solution must be ____ (weakly acidic).
5.5
METHENAMINE & ITS SALTS
MOA: Liberation of ____ and enhanced by ____ with sodium bisphosphate or ammonium chloride
- Formaldehyde
- Acidifying
URINARY ANALGESIC
Former use: Urinary antiseptic
Current use: Urinary analgesic on the UT
Phenazopyridine HCl
Pyridium
URINARY ANALGESIC
Phenazopyridine HCl may tint the urine ____.
Red-orange
URINARY ANALGESIC
The stain by Phenazopyridine HCl may be removed by ____.
0.25% sodium dithionite
URINARY ANALGESIC
Phenazopyridine HCl is used in combination in ____ and ____.
- Azo-Gantrisin (+ Sulfisoxazole)
- Urobiotic (+ Oxytetracycline + Sulfamethizole)
ANTI-TUBERCULOSIS
Causative organism of tuberculosis
Mycobacterium tuberculosis
Koch Bacillus
ANTI-TUBERCULOSIS
Mycobacterium tuberculosis is a gram __ __ bacillus that live inside macrophages and lysosomes.
(+), acid-fast
ANTI-TUBERCULOSIS
Therapy for the management of TB
Shotgun Therapy
Use of multiple drug regimen
ANTI-TUBERCULOSIS
1st line single agent for TB
Streptomycin
ANTI-TUBERCULOSIS
1st line combination for TB
- Rifampicin
- Isoniazid
- Pyrazinamide
- Ethambutol
RIPE
ANTI-TUBERCULOSIS
MOA of rifampicin
RNA polymerase inhibitor
ANTI-TUBERCULOSIS
MOA of isoniazid
Mycolid acid inhibitor
ANTI-TUBERCULOSIS
MOA of pyrazinamide
Production of pyrazinoic acid -> low pH
ANTI-TUBERCULOSIS
MOA of streptomycin
30s ribosome inhibitor
ANTI-TUBERCULOSIS
MOA of ethambutol
Arabinogalactan synthesis and mycolic acid inhibition
Cell wall synthesis inhibition
ANTI-TUBERCULOSIS
Type of TB wherein the bacteria is resistant to 1-2 of the anti-TB drugs
Resistance to Isoniazid and Rifampin
Multidrug-resistant TB (MDR TB)
ANTI-TUBERCULOSIS
DOTS
Directly Observed Treatment Short-course
ANTI-TUBERCULOSIS
Type of TB wherein the bacteria is resistant to first-line and second-line anti-TB drugs
Extensively drug-resistant (XDR) TB
ANTI-TUBERCULOSIS
Recommended regimen for pulmonary TB that is virtually 100% effective but expensive
6-Month Regimen
ANTI-TUBERCULOSIS
Drugs included in the first two of 6-month TB regimen
- Rifampicin
- Isoniazid
- Pyrazinamide
- Ethambutol
RIPE
ANTI-TUBERCULOSIS
Drugs included in the next 4 months of 6-month TB regimen
- Rifampicin
- Isoniazid
- Pyrazinamide
RIP
ANTI-TUBERCULOSIS
Adverse effect of ethambutol
Retinobulbar Optic Neuritis
(Colorblindness)
ANTI-TUBERCULOSIS
Rifampicin is produced by ____.
Streptomyces mediterranei
ANTI-TUBERCULOSIS
The most active first line agent against TB
Rifampicin
ANTI-TUBERCULOSIS
Rifampicin is an enzyme ____, which ____ the effect of paracetamol when taken concomitantly. This can lead to ____.
- Inducer
- Decreases
- Hepatotoxicity
ANTI-TUBERCULOSIS
Rifampicin can tint the urine, stool, saliva, tears, and skin ____.
Red-orange
ANTI-TUBERCULOSIS
1st choice for TB prophylaxis
Isoniazid
ANTI-TUBERCULOSIS
2nd choice for TB prophylaxis
Rifampicin
ANTI-TUBERCULOSIS
Safest, most potent and effective against all forms of M. tuberculosis
Isoniazid
ANTI-TUBERCULOSIS
Adverse effects of isoniazid
- Hepatotoxicity
- Insomnia
- Peripheral Neuropathy
HIP
ANTI-TUBERCULOSIS
Peripheral neuropathy associated with isoniazid can be managed by ____.
Vitamin B6 Pyridoxine
ANTI-TUBERCULOSIS
1st line agent for short term TB
Pyrazinamide
ANTI-TUBERCULOSIS
Synthetic analogue of Nicotinamide that penetrates inflamed meninges
Pyrazinamide
ANTI-TUBERCULOSIS
Active against dividing mycobacteria
Ethambutol
ANTI-TUBERCULOSIS
Basic red dye that exerts slow bactericidal effects on M. leprae
Clofazimine
ANTI-TUBERCULOSIS
3 Secondary drugs treatment for TB
- Ethionamide
- Aminosalicylic Acid
- Aminosalicylate sodium
ANTI-TUBERCULOSIS
Prophylaxis of disseminated MAC in AIDS patients
Rifabutin
ANTI-TUBERCULOSIS
Isolated from S. orchidaceus, S. garyphalus, S. lavendulus
Cycloserine
ANTI-TUBERCULOSIS
Strongly basic cyclic peptide (aminoglycoside) isolated from S. capreolus that is used as an alternative to streptomycin
Sterile capreomycin sulfate
ANTI-TUBERCULOSIS
Adverse effect of rifampicin
- Cholestatic jaundice
- Renal toxicity
- Flu-like symptom
ANTI-TUBERCULOSIS
Adverse effect of pyrazinamide
- Hepatotoxicity
- Hyperuricemia
ANTIPROTOZOAL
Triad of features for metronidazole
- Trichomoniasis
- Amebiasis
- Giardiasis
TAG
ANTIPROTOZOAL
Alternative for Vancomycin in the treatment of pseudomembranous colitis, anti-biotic induced diarrhea, and Clostridium difficile infection
Metronidazole
Flagyl
ANTIPROTOZOAL
Tx of asymptomatic carriers of E. histolytica
Diloxanide
ANTIPROTOZOAL
Parent compound that is an antibacterial and antifungal
8-Hydroxyquinoline
ANTIPROTOZOAL
Tx of acute and chronic intestinal amebiasis
Iodoquinol
ANTIPROTOZOAL
Adverse effect of iodoquinol
Neuropathy
Management: Vitamin B6 Pyridoxine
ANTIPROTOZOAL
Tx of for balantidial dysentery, fluke infestations, and liver diseases
Emetine
From Ipecac
ANTIPROTOZOAL
Tx for:
* P. carinii pneumonia
* African trypanosomiasis (Prophylaxis)
* Visceral leishmaniasis
PAV
Pentamidine isethionate
ANTIPROTOZOAL
Originally an antimalarial drug, but Plasmodium falciparum developed tolerance
Atovaquone
ANTIPROTOZOAL
Alternative to pentamidine isethionate for the treatment of P. carinii pneumonia (PCP)
Atovaquone
ANTIPROTOZOAL
MOA of eflornithine
Ornithine decarboxylase inhibition
ANTIPROTOZOAL
Tx of West African sleeping sickness, caused by Trypanosoma gambiense
Eflornithine
ANTIPROTOZOAL
Drug of choice for acute and chronic Chaga’s disease
Nifurtimox
ANTIPROTOZOAL
Alternative to nifurtimox for Chaga’s disease
Benznidazole
ANTIPROTOZOAL
2 Adverse effects of benznidazole
- Peripheral neuropathy
- Bone marrow suppression
ANTIPROTOZOAL
Drug of choice for later stages of African trypanosomiasis
Melarsoprol
ANTIPROTOZOAL
Melarsoprol is known to cause ____ toxicity.
Arsenic
ANTIPROTOZOAL
Drug of choice for various leishmaniasis
Sodium Stibogluconate
ANTIPROTOZOAL
MOA of Dimercaprol
British Anti-Lewisite (BAL)
Chelation
ANTIPROTOZOAL
Drug of choice for long term prophylactic agent for African trypanosomiasis
Suramin Sodium
ANTHELMINTHICS
Platyhelminthes
- Tapeworms
- Flukes
ANTHELMINTHICS
Nemathelminthes
Nematodes or true round worms
ANTHELMINTHICS
Alternative treatment for pinworm (Enterobius vermicularis) and roundworm (Ascaris lumbricoides) infestations.
Piperazine
ANTHELMINTHICS
Selective anthemintic activity against filariasis and ascariasis
Diethylcarbamazepine Citrate
ANTHELMINTHICS
Depolarizing neuromuscular blocking agent for the treatment of pinworms and ascaris
spastic paralysis in susceptible helminths
Pyrantel Pamoate
ANTHELMINTHICS
Pyrantel Pamoate has an antagonistic effect against ____.
Piperazine
ANTHELMINTHICS
Broad-spectrum anthelmintic activity in human and livestock
Thiabendazole
ANTHELMINTHICS
Broad-spectrum anthelmintic activity similar with thiabendazole
Mebendazole
ANTHELMINTHICS
Broad-spectrum anthelmintic against intestinal nematodes
Albendazole
ANTHELMINTHICS
Active against blood trematodes
Niridazole
ANTHELMINTHICS
A potent taenicide; Saline purge 1 to 2 hours after ingestion to remove scolex and worm segments
Niclosamide
ANTHELMINTHICS
- Chlorinated bisphenol that is formerly used in soaps and cosmetics due to antimicrobial activity
- Fasciolicide and taeniacide
Bithionol
ANTHELMINTHICS
Tx of Schistosoma mansoni (intestinal schistosomiasis)
Oxamniquine
ANTHELMINTHICS
MOA of praziquantel
Tetanic-like contraction of the fluke due alteration in the influx of calcium ions
ANTHELMINTHICS
Drug of choice for blood flukes
Praziquantel
ANTHELMINTHICS
Obtained from Streptomyces avermitilis
Ivermectin
ANTHELMINTHICS
Controls endo and ecto parasites in domestic animals
Ivermectin
ANTHELMINTHICS
Use of ivermectin in humans
Onchocerciasis (river blindness)
Oncocerca vovulus
SCABICIDE AND PEDICULICIDE
Compounds used to control mites (Sarcoptes scabiei)
Scabicide
SCABICIDE AND PEDICULICIDE
Used to eliminate head, body, crab lice, and fleas
Pediculicide
SCABICIDE AND PEDICULICIDE
Benzyl alcohol + Benzoyl chloride
Benzoyl benzoate
SCABICIDE AND PEDICULICIDE
Ester topical scabicide from peru balsam
Benzoyl benzoate
SCABICIDE AND PEDICULICIDE
Halogenated hydrocarbon with insecticidal activity
Lindane
SCABICIDE AND PEDICULICIDE
Direct contact poison: fumigant effect and acts as stomach poison
Lindane
SCABICIDE AND PEDICULICIDE
Topical treatment for scabies that has an antipruritic effect and local anesthetic action
Crotamiton
Eurax
SCABICIDE AND PEDICULICIDE
Lethal action against lice, ticks, mites, and fleas and pediculicide treatment of head lice
Permethrin
SULFONAMIDES
Brilliant azo red dye which was found to protect against and cure Streptococcal infections in mice
Prontosil
SULFONAMIDES
Active metablite of prontosil
Sulfanilamide
SULFONAMIDES
Non-aniline sulfonamide
Mafenide Acetate
for burn therapy
SULFONAMIDES
Sulfonamides are derived from ____.
p-amino-benzenesulfonamide
SULFONAMIDES
MOA of sulfonamides
Dihydropteroate Synthetase inhibition
No DNA synthesis
SULFONAMIDES
Mechanism of resistance of pathogen against sulfonamides
Increase production of PABA
SULFONAMIDES
5 Adverse effects of sulfonamides
- Crystalluria
- Rashes
- Anemia
- Nausea
- Kernicterus
CRANK
SULFONAMIDES: ORAL ABSORBABLE SINGLE
Prodrug of sulfisoxazole
Sulfisoxazole Acetyl
SULFONAMIDES: ORAL ABSORBABLE SINGLE
Diethanolamine + Sulfisoxazole solution
Sulfisoxazole Diolamine
SULFONAMIDES: ORAL ABSORBABLE SINGLE
More soluble in acidic urine
Sulfamethazine
SULFONAMIDES: ORAL ABSORBABLE MIX
3 Components of trisulfapyrimidines
- Sulfadiazine
- Sulfamerazine
- Sulfamethazine
SULFONAMIDES: ORAL ABSORBABLE SINGLE
First agent for the tx of pneumonia
Sulfapyridine
SULFONAMIDES: ORAL ABSORBABLE MIX
Tx for pateints with malaria (Plasmodium falcifarum) and with chloroquine resistance
Sulfadoxine + Pyrimethamine
SULFONAMIDES: ORAL ABSORBABLE MIX
Used for malaria prophylaxis for traveller’s where chloroquine resistant malaria is endemic
Sulfadoxine + Pyrimethamine
SULFONAMIDES: TOPICAL
Used as eye drops in ophthalmic infections and very soluble in water
Sulfacetamide sodium
SULFONAMIDES: TOPICAL
Short to intermediate acting sulfonamide IM, IV
Sulfisoxazole diolamine
SULFONAMIDES: TOPICAL
3 Components of TriSulfa
- Sulfabenzamide
- Sulfacetamide
- Sulfathiozole
SULFONAMIDES: TOPICAL
Vaginal cream for Haemophilus vaginalis
TriSulfa
SULFONAMIDES: TOPICAL NON-ABSORBABLE
Non-absorbable topical sulfonamides are used for ____.
Burn Therapy
SULFONAMIDES: TOPICAL NON-ABSORBABLE
Homologue of the sulfanilamide molecule that is not inhibited by PABA
Mafenide Acetate
SULFAMYLON
SULFONAMIDES: TOPICAL NON-ABSORBABLE
Adverse effect of mafenide acetate (Sulfamylon)
Systemic Acidosis
SULFONAMIDES: TOPICAL NON-ABSORBABLE
Tx of Pseudomonas spp. infections
Silver sulfadiazine + Zinc Salt
SULFONAMIDES: TOPICAL NON-ABSORBABLE
Very potent antimicrobial for burns, scald, and wound infections with better patient acceptance than mafenide
Silver sulfadiazine + Zinc Salt
SULFONAMIDES
Effective in treating ulcerative colitis
Sulfasalazine
Colon specific
SULFONAMIDES
Sulfasalazine is a prodrug metabolized into ____ and ____.
p/m-aminosalicylic acid and
sulfapyridine
DIHYDROFOLATE REDUCTASE INHIBITORS
For uncomplicated UTI
Trimethoprim
DIHYDROFOLATE REDUCTASE INHIBITORS
Potent antibacterial that is closely related to several anti-malarials but does not have good antimalarial activity
Trimethoprim
DIHYDROFOLATE REDUCTASE INHIBITORS
For chronic UTI and the drug of choice for complicated and uncomplicated UTI especially caused by entero-bacteria
Sulfamethoxazole + Trimethoprim
SMX + TMP = CO-TRIMOXAZOLE
DIHYDROFOLATE REDUCTASE INHIBITORS
Co-trimoxazole is a combination of ____ and ____.
Sulfamethoxazole + Trimethoprim
SMX + TMP
SULFONES
Sulfones are mainly used for treating ____ (Leprosy) caused by Mycobacterium leprae
Hansen’s Disease
SULFONES
Test animals to culture M. Leprae.
Mice and Armadillo
SULFONES
Parent sulfone and protype
Dapsone, DDS
Avlosulfone
SULFONES
For both lepromatous and tuberculoid leprosy
Dapsone, DDS
Avlosulfone
SULFONES
Dapsone is the drug of choice for ____.
Dermatitis Herpetiformis
SULFONES
Dapsone is sometimes used with ____ for the tx of malaria with TMP for PCP.
Pyrimethamine
SULFONES
Adverse effects of dapsone
- Hemolytic anemia (G6PCD)
- Methemoglobinemia
- Hepatotoxicity
SULFONES
Reported to be effective against malaria and rickettsia infections
Sulfones
