TMP-SMX FQs Metronidazole

Question 1

What are the Sulfonamides?

Answer 1

Sulfamethoxazole (SMX), sulfisoxazole, sulfadiazine

Question 2

MOA sulfonamides

Answer 2

Inhibit folate synthesis via dihydropteroate synthase

Question 3

Sulfonamide coverage?

Answer 3

G+, G- Nocardia, Chlamydia

Question 4

SE of Sulfonamides?

Answer 4

Hypersensitivity (allergy), hemolysis if G6PD

Question 5

Trimethoprim class?

Answer 5

Trimethoprim

Question 6

MOA Trimethoprim?

Answer 6

Inhibits bacterial DHF reductase

Question 7

What is Trimethoprim commonly combined with?

Answer 7

SMX

Question 8

What is TMP/SMX typically used for?

Answer 8

UTIs, Shigella, Salmonella, Pneumocystis jirovecii prophylaxis in immunocomp, toxo prophylaxis

Question 9

Toxicity of TMP?

Answer 9

Megaloblastic anemia, leukopenia, granulocytopenia

Question 10

What are the FQs?

Answer 10

Ciprofloxacin (Cipro), norfloxacin (Noroxin), levofloxacin (Levaquin), ofloxacin (Floxin), sparfloxacin, moxifloxacin (Avelox)

Question 11

MOA FQs?

Answer 11

Inhibit DNA gyrase (topoisomerase II) and topo IV

Question 12

FQ coverage?

Answer 12

G- rods of UT and GIT (include Pseudomonas), Neisseria, some G+

Question 13

FQ SE?

Answer 13

GI upset, skin rashes, HA, dizziness; Tendonitis, tendon rupture, leg cramps, myalgias, may prolong QT interval

Question 14

FQ contraindications?

Answer 14

Pregnant women, nursing mothers, children under 18 yrs (damage to cartilage), > 60yo (tendon rupture)

Question 15

FQ MOR?

Answer 15

Chromosome encoded mutation inDNA gyrase, plasmid-mediated resistance, efflux pumps

Question 16

Class of metronidazole (Flagyl)?

Answer 16

Metronidazole

Question 17

Coverage of Metronidazole (Flagyl)?

Answer 17

Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (Bacteroides, C. diff), H. pylori (GET GAP); anaerobes below diaphragm

Question 18

Metronidazole SE?

Answer 18

Disulfiram-like rxn with alcohol