Urinary Antiseptics and Metronidazole Flashcards
indications for the use of ciprofloxacin
- active against pen/cephalo/AG resistant strains
- oral option for pseudomonas
- traveller’s diarrhoea (E coli, salmonella, shigella, campylobacter jejuni)
- complicated UTI
- anthrax caused by bacillus anthracis
Prostatitis
what are the 3rd gen FQ?
levofloxacin, moxifloxacin
why 3rd gen are used for, and their advantages?
better coverage against gram + bacteria (esp against s.pneumoniae), atypicals (MCL), used as second line for TB
DDI with FQ?
increase levels of warfarin and cyclosporine
3rd gen FQs are also known as?
respiratory quinolones as they trat resp infection caused by s.pneumoniae and atypicals
use of cotrimethazole
- uncomplicated UTI
- pneumocystis pneumonia caused by Pneumocystis jiroveci
- MRSA
- resp tract infections caused by haemophilius sp and klebsiella spp
Nitrofurantoin used to treat
lower UTI
- e coli, enterococci
polymyxins moa?
disrupts the phospholipid bilayer by increasing cell permeability with a detergent-like action
polymyxins indication?
for multidrug resistant gram -ve bacteria
colistin (CMS); lung infection caused by Pseudomonas
polymyxin B: UTI, blood infections due to P.aeruginosa
fosfomycin MOA?
inhibits the action of phosphoenolpyruvate synthetase -> blocks formation of NAM
fosfomycin indication
UTI, synergistic effect with B lactam ABx
active against gram +ve: s.aureous, entercoccus
gram -ve : P.aeruginosa, Klebisella pneumoniae
metronidazole indication
- Anaerobic organisms (Bacteroides species and CD [CDAD])
- 2nd line for CDAD
- H pylori
- Protozoa infection: E. histolytica, trichomonas vaginalis (vaginitis), giardia lambia (Giardiasis)
- Surgical prophylaxis (30-60min before incision)
metronidazole MOA?
MD acts an as electron acceptor, forming cytotoxic free radicals -> resulting in protein and DNA damage
reducing potential more in anaerobic organisms
Which drugs must be taken on an empty stomach?
Tetracycline and FQs and Fosfomycin
Which drug has an adverse effect of prolonged QT interval?
Macrolides and FQs
Which drug’s adv effect is peripheral neuropathies?
FQs and Linezolid
Which drugs’ adv effect is haemolytic anaemia caused by G6PD def?
Nitrofurantoin, Sulfonamides, Cotrimoxazole
Which drugs must be avoided for pts with myasthenia gravis?
Ciprofloxacin (actually FQ), Polymyxin, AGs
Which drugs are used as part of the triple therapy for H.pylori?
Metronidazole, Clarithromycin (Macrolides)
Which drugs are bacteriostatic?
Sulfonamides, Tetracyclines, Clindamycin, Linezolid, Macrolides
http://pharmwarthegame.blogspot.com/2019/06/bactericidal-vs-bacteriostatic-mnemonics.html
Which drugs are bactericidal?
Polymyxin, Quinolones, Vancomycin, Metronidazole, AGs, b-lactams
http://pharmwarthegame.blogspot.com/2019/06/bactericidal-vs-bacteriostatic-mnemonics.html
What is the difference between bacteriostatic and bactericidal?
Bacteriostatic: Arrest the cell growth, stop growing
“bacteriostatic” means that the agent prevents the growth of bacteria (i.e., it keeps them in the stationary phase of growth), and “bactericidal” means that it kills bacteria.
drugs used to treat CDAD
first line: vancomycin
second line: metronidazole
which drugs effective against pseudomonas?
FQ, polymyxin, fosfomycin,
- anti-pseudomonal (piperacillin + tazobactam)
- cephalosporins: third gen = cefezidime, 4th gen = cefepine, 5th gen = ceftabiprole
- carbpenem: imipenem, etrapenem
- monobactam: aztreonam
- AG
what is similar to the DNA gyrase in eukaryotic cells?
DNA topoisomerase II
adverse effect of FQ
- C.D colitis (esp with cipro)
- Aortic aneurysm
- QT interval prolongation
- risk of dysglycaemia in diabetic patients
- Anthropathy (joint problem)
- peripheral neuropathy
- GI distress
- Phototoxicity
- Tendinitis or tendon rupture
counselling for cotrimoxazole?
drink full cup of water
which drug has more bacterial resistance than FQ and Co-TS
nitrofurantoin
