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IDIT Test #3 > Walters - Misc. Antibiotics > Flashcards

Walters - Misc. Antibiotics Flashcards

1
Q

What is Chloramphenicol used for?

A

Used for resistant and serious aerobic/anaerobic G+/G- infections (meningitis)

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2
Q

What is the mechanism for Chloramphenicol?

A

(same as tetracyclines) inhibits binding of aminoacyl-tRNA to acceptor site

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3
Q

Why is Chloramphenicol problematic in humans?

A

it also inhibits mammalian mitochondrial peptidyltransferase (Erythropoietic cells are most sensitive), decreases G6PD and inhibits P450

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4
Q

what causes Gray Baby Syndrome in infants?

A

caused by Chloramphenicol - insufficient glucoronyl transferase to conjugate drug for elimination and underdeveloped renal function

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5
Q

What are the side effects of Chloramphenicol?

A

fatal blood dyscrasias, depressed respiration, cardiovascular collapse and cyanosis (gray baby)

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6
Q

When is Quinupristin/Dalfopristin used?

A

given IV for MRSA and vancomycin resistant infections (synergistic medications = cidal)

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7
Q

what is the mechanism for Quinupristin/Dalfopristin?

A

Quinupristin releases peptidyl-tRNA from donor site of peptidyltransferase, and Dalfopristin inhibits binding of aminoacyl-tRNA to acceptor site and of peptidyl-tRNA to donor site of peptidyltransferase

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8
Q

what do both Quinupristin and Dalfopristin inhibit?

A

CYP3A = decreases metabolism of warfarin and diazepam

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9
Q

what are the side effects of Quinupristin/Dalfopristin?

A

Superinfection, venous irritation, arthralgias/myalgias, and hyperbilirubinemia

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10
Q

what is Linezolid used for?

A

for Enterococcus faecium, MSSA, MRSA and other vancomycin-resistant infections (can be static or cidal)

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11
Q

what is a risk with using Linezolid?

A

myelosuppression - blood dyscrasias and colitits (weekly complete blood counts recommended)

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12
Q

what is the mechanism for Linezolid?

A

inhibits formation of the initiation complex on the ribosome

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13
Q

what does Linezolid weakly inhibit and what might it cause?

A

MAO-A and may cause 5-HT syndrome when used with other Rxs that enhance 5-HT activity (antidepressants)

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14
Q

what can chronic use of Linezolid cause?

A

reversible optic neuropathy, irreversible peripheral neuropathy, and lactic acidosis (do not use longer than 28 days)

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15
Q

what is Clindamycin used for?

A

topical for acne or suppository for bacterial vaginosis (has been used with high dose PCN for group A strep)

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16
Q

what are the side effects with Clindamycin?

A

risk of pseudomembranous colitis (C.diff)

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17
Q

what is the mechanism for Clindamycin?

A

inhibits translocation from A site to P site on ribosome

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18
Q

what is Polymyxin B used for?

A

effective against G- organisms = bacterial infections of conjunctiva and lids (only used topical)

19
Q

what are the side effects of Polymyxin B?

A

very nephrotoxic and neurotoxic (neuromuscular block)

20
Q

what is the mechanism for Polymyxin B?

A

it is a cidal cationic detergent and has a postantibiotic effect

21
Q

what is Colistimethate?

A

Polymyxin E - cidal cationic detergent, IV/IM for G- rods (neurotoxic and nephrotoxic)

22
Q

what is Rifaximin used for?

A

travelers diarrhea from non-invasive strains of E.coli and decreases risk of hepatic encephalopathy in patients with advanced liver disease by decreasing number of ammonia-producing bacteria

23
Q

what is the mechanism for Rifaximin?

A

binds DNA-dependent RNA polymerase

24
Q

what are the side effects of Rifaximin?

A

flatulence, abdominal pain and urgency to defecate

25
Q

what may occur due to the structural similarity of Rifaximin and Rifampin?

A

may lead to cross-resistance and emergence of rifampin-resistant staph

26
Q

what two drugs are used to treat IMPETIGO?

A

Mupirocin and Retapamulin

27
Q

what is the mechanism of Mupirocin?

A

inhibits bacterial isoleuyl t-RNA synthetase

28
Q

what is the mechanism of Retapamulin?

A

blocks acceptor and donor sites of peptidyl transferase

29
Q

what is Nitrofurantonin used for?

A

prevention and treatment of G+/G- UTIs

30
Q

what is the mechanism for Nitrofurantonin?

A

concentrates in renal tubules for local effect and is reduced by urinary tract bacteria to reactive intermediate that damage DNA, ribosomes, cell wall, etc. (non-specific mechanism)

31
Q

what are the acute symptoms of using Nitrofurantonin?

A

fever, chills, cough, pulmonary infiltrates during 1st week of treatment (reversible)

32
Q

what are the chronic symptoms (6 months) of using Nitrofurantonin?

A

malaise, DOE, cough, altered PFTs, pneumonitis, fibrosis

33
Q

when should you avoid using Nitrofurantonin?

A

if patient has a history of cholestatic jaundice or hepatic dysfunction with prior use

34
Q

what is the caution with using Nitrofurantonin?

A

discolors the urine brown and pulmonary reactions have been reported

35
Q

when is Daptomycin used?

A

it is a cidal parenteral lipopeptide for G+ and MRSA skin and systemic infections (NOT for pneumonia)

36
Q

what is the mechanism for Daptomycin?

A

forms pores in cytoplasmic membrane - loss of K+ - depolarization and inhibition of DNA, RNA, and protein synthesis

37
Q

what is a side effect of Daptomycin?

A

increases creatine kinase (CK) and is excreted by kidneys unchanged

38
Q

what is Quinidine used for?

A

IV for life-threatening Plasmodium falciparum (parasite)

39
Q

what is a side effect of using Quinidine?

A

can cause arrhythmias - monitor ECG

40
Q

what is Rifampin used for?

A

effective against most G+ and many G- organisms - good against staph and MRSA

41
Q

what is the mechanism for Rifampin?

A

inhibits DNA-dependent RNA polymerase thus inhibiting RNA synthesis (kills intracellular and extracellular organisms)

42
Q

how is Rifampin excreted?

A

mostly through bile - enterohepatic recirculation

43
Q

what are some side effects of Rifampin?

A

rash, fever, nausea, vomiting, re-orange color to urine, feces, saliva, sweat, tears, jaundice, and hepatitis

44
Q

how is Rifampin an enzyme reducer?

A

it decreases activity of digoxin, anticoagulants, quinidine, and oral contraceptives

IDIT Test #3 (19 decks)

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