UTI antibiotics Flashcards
Sulfonamides and trimethoprim
Prototype
Trimethoprim-sulfamethoxazole
Sulfadiazine
Trimethoprim
Sulfonamides and trimethoprim
Pharmacologic action
Prevent synthesis of folic acid derivative (tetrahydrofolate), which is neded for producing RNA, DNA, and proteins
Sulfonamides and trimethoprim
Therapeutic uses
- UTI (Usually E. coli)
- Otitis media
- Chancroid
- Pertussis
- Shigellosis
- pneumonia
Sulfonamides and trimethoprim
Complications
- Hypersensitivity (includingn Stevens-Johnson Syndrome)
- Blood dyscrasias (anemia, leukopenia, thrombocytopenia, agranulocytosis)
- Crystalluria
- Kernicterus: brain damage from high levels of bilirubin in newborns
- Hyperkalemia
Sulfonamides and trimethoprim
Contraindications
- Folate deficiency
- Pregnancy
Sulfonamides and trimethoprim
Precautions
- Impaired kidney function
- Older than 65 and take ACE inhibitors or angiotensin II receptor blockers due to risk for hyperkalemia
Sulfonamides and trimethoprim
Interactions
- Increased effects of warfarin, phenytoin, and sulfonylurea oral hypoglycemics
Fluoroquinolones
Prototype
Ciprofloxacin
Fluoroquinolones
Expected pharmacologic action
Bactericidal due to inhibition of DNA gyrase and topoisomerase IV, which are needed for DNA replication
Fluoroquinolones
Therapeutic use
- Broad spectrum for gram negative and positive bacteria
- Treats urinary, respiratory, and GI tract infections
- Prevents anthrax
Fluoroquinolones
Complications
- C. difficile-associated diarrhea
- Achilles tendon rupture if younger than 18
- Suprainfection
- Phototoxicity
Fluoroquinolones
Contraindications
- Younger than 18, except for E. coli
- pregnancy risk cateogry C
Fluoroquinolones
Precautions
- Older adults
- Cardiovascular disorders due to CNS effects (dizziness, headache, confusion)
Fluoroquinolones
Interactions
- Dairy, iron, aluminum and magnesium decrease absorption
- Warfarin increases with use
