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Renal Pharm > UTI > Flashcards

UTI Flashcards

1
Q

(1) Nausea, vomiting
(2) Rash
(3) Hepatitis (rare but fatal), elevated liver enzymes
(4) Endocrinologic abnormalities, e.g., women, menstrual
irregularities; men, gynecomastia; due to inhibition of steroid
biosynthesis; more important for ?

A

Azoles

ketoconazole

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2
Q

(1) Nausea, vomiting and diarrhea (take with meals to decrease adverse effects)
(2) Hemolytic anemia associated with G6PD deficiency
(3) Colors the urine brown

A

Nitrofurantoin

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3
Q

a. GI: nausea, vomiting, abdominal discomfort
b. CNS: headache, dizziness
c. Have been shown to cause arthropathy in immature animals of a variety of species

A

Fluoroquinolones

ciprofloxacin, levofloxacin

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4
Q

Acute hemolytic anemia (G6P deficiency)
Steven Johnson Syndrome
Crystalluria
Kernicterus in newborns

A

Trimethoprim-Sulfamethoxazole

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5
Q

Administration of what can overcome the neuromuscular blockade associated with aminoglycosides?

A

calcium salt

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6
Q

Contraindications: Anesthetics and neuromuscular blockers due to neuromuscular blockade; overcome by calcium salt administration

A

Aminoglycosides

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7
Q

are cell wall synthesizing enzymes

which are the binding sites for the β-lactam antibiotics

A

Penicillin Binding Proteins (PBPs)

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8
Q

Bacterial enzymes reduce the drug to reactive intermediates which are responsible for damaging DNA.

Bacteria reduce the drug more
than mammalian cells which accounts for its selectivity

A

Nitrofurantoin

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9
Q

Bacteriostatic agents (e.g., TCN) are antagonistic

A

Penicillins - Piperacillin-tazobactam; 3rd Generation Cephalosporin - Ceftriaxone

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10
Q

bind to the 30S ribosome inhibiting protein synthesis by interfering with the initiation complex

Cause misreading of the mRNA template leading to incorrect amino acids
incorporated into the protein

Aberrant proteins inserted into cell membrane leading to altered
permeability and cell death

A

Aminoglycosides

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11
Q

block the enzyme lanosterol 14-α-demethylase inhibiting the conversion of lanosterol to ergosterol. There is an
accumulation of 14-α-methylsterols which disrupt cell membranes
or inhibit cell functions

A

Azoles

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12
Q

Candidiasis pyelonephritis

A

Azoles (fluconazole)

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13
Q

characterized by blistering of the mucous membranes (mouth, eyes, vagina) with patchy rashes over most of the body. Patients may also experience fever,
headache, and cough

A

Stevens-Johnson Syndrome; a/e of SMX-TMP

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14
Q

Complicated pyelonephritis

A

Penicillins - Piperacillin-tazobactam; 3rd Generation Cephalosporin - Ceftriaxone; Aminoglycosides

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15
Q

Concurrent use with methotrexate, 6-mercaptopurine, and azathioprine–> bone marrow suppression

PREGNANCY (can cross placenta)

A

Trimethoprim-Sulfamethoxazole

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16
Q

Contraindicated in pregnant patients at term, during labor and delivery, or when
onset of labor is imminent; this is due to the possibility of hemolytic anemia in the neonate

A

Nitrofurantoin

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17
Q

Diarrhea, nausea

A

Fosfomycin

18
Q

effective only against aerobic gram-negative organisms

A

Ciprofloxacin

19
Q

Hypersensitivity reactions
GI distress and diarrhea
Neurotoxicity (myoclonus or seizures, agitation, confusion and hallucinations, or lethargy and stupor progressing to coma)
Ampicillin rash

A

Penicillins - Piperacillin-tazobactam

20
Q

Hypersensitivty
Local reactions at injection site
Nephropathy (Risk of tubular necrosis in patients with underlying renal disease or who are taking potentially nephrotoxic drugs)

A

3rd Generation Cephalosporin - Ceftriaxone

21
Q

In a cell in which cell wall synthesis is inhibited, (1) degrade the cell wall forming weak points through which
the cell membrane can extrude and eventually rupture killing the cell.

A
  1. autolysins (murein

hydrolases)

22
Q

Inactivates the enzyme pyruvyl transferase, which is responsible for transformation of N-acetylglucosamine into N-acetyl-muraminic acid;
the latter is required for synthesis of the cell wall peptidoglycan by bacteria

A

Fosfomycin

23
Q

inhibit incorporation of PABA into dihydropteroic acid interfering with folate metabolism (1); competitive inhibitor of dihydrofolate reductase (2)

A
  1. SMX
  2. TMP
    Trimethoprim-Sulfamethoxazole
24
Q

Inhibition of DNA gyrase (primary target in many gram-negative organisms) which is responsible for formation of negative DNA supercoils

Inhibition of topoisomerase IV (primary target in many gram-positive organisms) which is responsible for separating the interlinked daughter DNA molecules that are a product of DNA replication

Bactericidal

A

Fluoroquinolones

ciprofloxacin, levofloxacin

25
Q

Inhibition of transpeptidase causes

rapid cell lysis

A

Penicillins - Piperacillin-tazobactam;

3rd Generation Cephalosporin - Ceftriaxone

26
Q

inhibits DNA synthesis

converted to 5-fluoruracil, an antimetabolite, by fungi; selectively toxic as well because mammalian cells do not convert (1) to 5-fluoruracil

A
  1. Flucytosine
27
Q

inhibits fungal mitosis by interacting with

polymerized microtubules

A

Griseofulvin

28
Q

inhibits squalene epoxidase, inhibiting conversion of squalene to lanosterol

A

Terbinafine

29
Q

inhibits β-(1,3)-glucan synthase

selectively toxic because
human cells do not contain β-(1,3)-D-glucan

A

Echinocandins: Caspofungin

30
Q

Irreversible ototoxicity: high-pitched tinnitus; high frequency loss followed by loss of low frequency (cochlear); N/V, vertigo (vestibular)
Reversible nephrotoxicity
Neuromuscular blockade (inhibit ACh release; Administration of a calcium salt can overcome this effect)

A

Aminoglycosides

31
Q

is a PBP which is a lethal target for the
action of the β-lactam antibiotics. Inhibition causes
rapid cell lysis.

A

The transpeptidase enzyme

32
Q

should not be used as first-line agents during pregnancy

A

Fluoroquinolones

ciprofloxacin, levofloxacin

33
Q

single oral dose is effective in the

treatment of uncomplicated urinary tract infections (cystitis) in women

A

Fosfomycin

34
Q

sulfonamides displace bilirubin from plasma
albumin. The free bilirubin deposits in basal ganglia and subthalamic
nuclei of the brain causing encephalopathy

A

Kernicterus in newborns; a/e of SMX-TMP

35
Q

Treatment for candidiasis pyelonephrititis

A

Fluconazole

36
Q

Treatment for complicated cystitis

A

Fluoroquinolone

37
Q

Treatment for complicated pyelonephritis

A

3rd gen Cephalosporin
Fluoroquinolone
Piperacillin-tazobactam
Aminoglycoside

38
Q

Treatment for prostatitis

A

TMP-SMX

Fluoroquinolone

39
Q

Treatment for uncomplicated cystitis

A

TMP-SMX
Nitrofurantoin
Fosfomycin

40
Q

Treatment for uncomplicated pyelonephritis

A

Fluoroquinolone

TMP-SMX

41
Q

Uncomplicated cystitis
Prostatitis
Uncomplicated pyelonephritis

A

Trimethoprim-Sulfamethoxazole

42
Q

Uncomplicated cystitis

A

Nitrofurantoin

Renal Pharm (14 decks)

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