Term
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Definition
synthetic form of human ACTH
It is employed in diagnostic tests.
To diagnose congenital adrenal hyperplasia.
To diagnose adrenal insufficiency in a test that measures cortisol before and after cosyntropin injection. |
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Term
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Definition
| a glucocorticoid with a low degree of protein binding, is given to the pregnant women in premature labor to hasten maturation of the lungs. |
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Term
| GLUCOCORTICOIDS : Anti-inflammatory action |
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Definition
Inhibition of prostaglandin synthesis by inhibiting phospholipase A2.
Inhibit neutrophil and macrophage migration.
It suppress the activation of T lymphocytes and ↓ production of cytokines.
It prevents the mast cells, basophils and eosinophils from degranulation. |
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Term
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Definition
| is an orally active, potent, commonly used mineralocorticoid. |
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Term
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Definition
Sequential blockade (TMP-Sulfa)*
Block drug inactivating enzyme (clavulanic acid)*
Enhance uptake or action of a second antimicrobial (Ampicillin-Aminoglycoside)* |
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Term
| penicillin mechanism of action |
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Definition
| CIDAL antibiotics; 1: Binds to specific receptors(PBP) located in bacterial cytoplasmic membrane and inhibits transpeptidase enzymes that act to cross-link linear peptidoglycan chains; 2: Activation of autolytic enzymes that cause lesions in the bacterial cell wall |
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Term
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Definition
Variable oral absorption; minimally metabolized; Excretion blocked by Probenecid; Only crosses minimally into CNS, prostate, eye
-short t ½ |
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Term
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Definition
1: Formation of Beta Lactamases (penicillinases) that destroy the antimicrobial agents
2: Mutation of PBP targets
3: Alter porins to decrease penetrations of antimicrobial agents |
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Term
| Penicillin seqeula/interactions |
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Definition
| Allergic Hypersensitivity: anaphylactic reactions, rash, uticaria; Diarrhea, Seizures(high dose penicillin); Haematologic (penias, hemolytic anemia), Nephritis (esp. methicillin), Drug fever (follow w/ ESR), Elevated hepatic transaminases |
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Term
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Definition
natural penicillin,
Parenteral distribution
coverage: Group A Strep (S. pyogenes)
Pneumococci (S. Pneumonia)
Some Gram + anaerobes
Syphilis (Treponema pallidum
Short comings: SE: Phlebitis, short ½ life, not well absorbed |
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Term
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Definition
Natural penicillin
Distribution : oral
Clincal use: Group A Strep (S. pyogenes)
Pneumococci (S. Pneumonia)
Some Gram + anaerobes
Syphilis (Treponema pallidum) |
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Term
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Definition
| Best results for prophylactic Rheumatic Fever treatment |
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Term
| Penicillinase-resistant Penicillin |
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Definition
Developed b/c Staph developed resistance
Tx: Staphylococcal infections |
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Term
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Definition
Penicillinase-Resistant Penicillins
given parenteral
used against: S. aureus, S. Epidermitis
Most Staphylococcus is resistant to methicillin d/t change in target penicillin binding protein (MecA)
comolications: Moderately Renal Toxic |
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Term
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Definition
penicilinase-resistant
adminstered:Parenteral,Oral
Used for:S. aureus, S. epidermitis MOSTLY excreted in biliary tract (so, use to tx. hepatic abscess or cholaginits) |
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Term
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Definition
penicilanse-resistant
adminstered:Parenteral, Oral
Given for: S. aureus, S. epidermitis |
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Term
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Definition
Penicilinase resistant
administered: Oral
used against : S. aureus, S. epidermitis |
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Term
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Definition
Penicillinase-resistant
Adminstered: oral
used against S. aureus, S. epidermitis |
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Term
| Extended-spectrum Penicillins |
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Definition
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Term
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Definition
extended spectrum Penicillin
Adminstered: Parenteral, oral
Given for:For a while, had excellent Gram – coverage, but MO developed resistance
Clinical Use: Otitis media, Sinusitis, Pneumonia, Urinary tract infections |
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Term
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Definition
Extended-spectrum Penicillin
Administered: oral
Treats: For a while, had excellent Gram – coverage, but MO developed resistance; MOSTLY excreted in biliary tract (so, use to tx. hepatic abscess or cholaginits)
Clinical Use: Otitis media, Sinusitis, Pneumonia, Urinary tract infections; DOC for Listeria Monocytogenes |
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Term
| Piperacillin and ticarcillin |
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Definition
Both antipsuedomonal penicillin
Piperacillin is more effective
Used for:Gram – Microbes, especially Psuedomonas
Clinical Use: Pseudomonas infections, Mixed intra-abdominal infections |
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Term
| Cephalosporins mechanism of action |
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Definition
| 1:Bind to PBP & inhibit cell wall synthesis by blocking the transpeptidase step of peptidoglycan synthesis; 2: Activation of Autolytic enzymes |
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Term
| Cephalosporins adminsitration |
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Definition
| Variable oral absorption; Renal eliminiation |
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Term
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Definition
As go from 1st to 4th Generation, the agents have ↓ Gram + coverage, ↑ Gram – Coverage, ↑ CNS Penetration, ↑ in resistance to β-lactamases
None are good for Enterococci, Listeria or MRSA |
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Term
| Cephalosporins resistance |
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Definition
| 1: Degrading enzyme III (Beta lactamase) |
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Term
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Definition
| Allergic Hypersensitivity, Phlebitis at infusion site, Biliary obstruction (Ceftriaxone) Cefamandole & Cefoperazone have bleeding diathesis & a Disulfiram-like reaction (ingestion with alcohol produced headache, nausea, vomiting, abdominal pain) |
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Term
| Cefazolin (Ancef), Cephalexin (Keflex), Cefadroxil (Duricef) |
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Definition
| 1st generation Cephalosporins adminstered:Usually dose Q6hr b/c short half-life Used for: Developed mostly for Gram + Coverage Clinical Use: Surgical prophylaxis, soft tissue infections |
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Term
| Cefuroxime, Cefoxitin, Cefotetan, Cefaclor, Cefprozil |
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Definition
| 2nd Generation Cephalosporins used for:Cefoxitin & Cefotetan have excellent anaerobe coverage, they are drugs of choice for Anaerobic abdominal and obstetric infections Clinical Use: Intra-abdominal infections |
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Term
| Cefotaxime, Ceftriaxone (Rocephin), Ceftazidime, Cefidinir(Omnicef), Cefpodoxime |
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Definition
3rd Generation Cephalosporins
Used for Ceftazidime is used to treat Pseudomonas
Cefoperazone & Ceftriaxone are well excreted into bilary tract; Cefotaxime is metabolized in the liver (all good for treating liver abscess & cholecystitis
Ceftriaxone & Cefotaxime: Serious pediatric infections especially meningitis (Except: Anaerobes, pseudomonas, enterococci, listeria MRSA)
extra: Ceftriaxone is highly efficacious b/c it has a long t ½
NB: Only 3rd generation Cephalosporins reach adequate CNS levels |
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Term
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Definition
4th Generation Cephalosporins
has renal exrection
Used for Broad Spectrum, Good coverage against Pseudomonas
Not active against anaerobes: enterococci, listeria, MRSA |
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Term
| Glucocorticoids immune system action |
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Definition
| Immunosuppression: Suppresses the T lymphocytes & production of cytokines; Actively lymphocytic in nature; delays the rejection reactions in organ transplantation |
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Term
| Glucocorticoids inflammatory action |
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Definition
| Anti-inflammatory Action: Inhibition of prostaglandin synthesis by inhibiting Phospholipase A2; Inhibits neutrophil & macrophage migration; Prevents degranulation of mast cells, basophils & eosinophils |
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Term
| Glucocorticoids fetal effects |
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Definition
| Fetal Effects: Increases the production of surfactant in the fetal lung & also helps in the development of fetal lung |
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Term
| Glucocorticoids metabolic actions |
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Definition
| Metabolic Effects – Stimulate gluconeogenesis, lipolysis & lipogenesis (↑ BS);Cause catabolism of muscle, bone, lymphoid, skin, and fat |
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Term
| Glucocorticoids other effects |
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Definition
| Other: Antagonizes the effect of Vitamin D on Calcium absorption; Catabolic effect on the bone (causing Osteoporosis); Stimulates gastric acid & pepsin production |
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Term
| Glucocorticoids are used for |
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Definition
| Tx: Fetal Lung Maturation; Inflammation, Allergy, Immunosuppression, Bronchial asthma, Addison’s Disease, Myasthenia Gravis, Cancer (Lymphoma), Organ graft rejection reactions, Psoriasis, hypercalcemia, CAH |
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Term
| Glucocorticoids adverse effects and other stuff |
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Definition
SE: Adrenal suppression may occur when used for more than 2 weeks, Cushingoid syndrome features: like moon faces, muscle wasting, thinning skin & hyperglycemia, Osteoporosis
Contraindications: Hypertension, Peptic Ulcer, Infection, Diabetes Mellitus |
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Term
| Dexamethasone/Betamethasone |
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Definition
Glucocorticoid
effect:Increases production of surfactant in the fetal lung
Tx: Fetal Lung Maturation |
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Term
| Hydrocortisone/Fludrocortisone |
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Definition
Glucocorticoid
used for :Replacement therapy
Tx: Addison’s Disease
adverse effect: Hypokalemia |
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Term
| Beclomethasone, Budesonide, Flunisolide, Fluticasone |
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Definition
Glucocorticoid
effect:Prevents degranulation of mast cells, basophils & eosinophils; ↓ Mucus secretion, ↓ endothelial leak & ↑ β-2 adrenoreceptor (Bronchial dilation)
Tx: Bronchial asthma |
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Term
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Definition
Adrenal steroid synthesis inhibitor
Action: Blocks the conversion of cholesterol to pregnenolone; Inhibits Aromatase (which converts androgens to estrogens- Low Dose)
Tx: Breast cancer & Cushing’s Syndrome
SE: GIT, Maculopapular rash |
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Term
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Definition
Adrenal steroid synthesis inhibitor
Action:Inhibits 17-20 lyase & side chain cleavage enzymes required for the adrenal steroid synthesis; (Inhibitor of adrenal steroid synthesis at Low Dose);(Inhibitor of BOTH adrenal & gonadal steroid synthesis at High Dose)
Tx: Cushing’s Syndrome |
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Term
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Definition
Adrenal steroid synthesis inhibitor (Selective for glucocorticoid synthesis)
Action:Inhibits 11-β hydroxylation (the final step in glucocorticoid pathway)
Used to diagnose adrenal insufficiency; Used to treat Cushing’s Syndrome
SE: Salt & Water retention and hirsutism |
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Term
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Definition
Targets the Adrenal gland
Has adrenolytic properties specific to the adrenal cortex; Destroys the adrenal gland
Tx: Adrenal Carcinoma |
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Term
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Definition
Adrenal Steroid Antagonist
Action: Anti-progesterone activity by blocking the receptor; High Doses exert anti-glucocorticoid activity
Used for adrenal carcinoma & to induce early abortion (Progesterone normally maintains pregnancy) |
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Term
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Definition
Mineralcorticoid Antagonist (K+ sparing diuretic)
action: Competes w/aldosterone binding site & decreases its effect
Tx: Hyperaldosteronism (Conn’s Syndrome); Used in Hirsutism (Androgen Antagonist)
SE: Gynecomastia |
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Term
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Definition
Mineralcorticoid Antagonist
action: Aldosterone Antagonist; More specific for Mineralcorticoid Receptor
Used as an adjunct in the management of chronic heart failure
NB: It does NOT block androgen receptors |
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Term
| Other Beta Lactam Antibiotics |
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Definition
Renal excretion
Clinical Uses: Often used as empiric treatment of hospitalized patients that “crash” secondary to suspect infection; Also used for mixed infections
GI, Allergic/ Hypersensitivity, Renal, Hepatic, Hematologic (Eosinophilia, Neutropenia), Drug Fever, Overgrowth |
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Term
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Definition
Other beta lactam
Most effective against Gram – organisms including pseudomonas but NOT anaerobes |
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Term
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Definition
Other beta lactam
Administered with Cilastatin which inhibits renal inactivation( by dehydropeptidase1) (So, Cilastatin allows Imipenem to be used to treat UTI’s)
Very broad spectrum( Gram +, - & Anaerobic), often drugs of last resort for resistant organisms, NOT effective against: Listeria, MRSA, Enterococci (VRE, C-diff), Pseudomonas
Rare Neurologic reactions (seizures), especially in high doses or with renal failure |
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Term
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Definition
other beta lactam
Very broad spectrum( Gram +, - & Anaerobic), often drugs of last resort for resistant organisms, NOT effective against: Listeria, MRSA, Enterococci (VRE, C-diff), Pseudomonas |
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Term
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Definition
other beta lactam
Very broad spectrum( Gram +, - & Anaerobic), often drugs of last resort for resistant organisms, NOT effective against: Listeria, MRSA, Enterococci (VRE, C-diff), Pseudomonas |
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Term
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Definition
| Blocks cell wall synthesis by irreversibly inhibiting biosynthesis of peptidoglycan polymers in cell wall of dividing gram positive organisms |
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Term
| Vancomycin administration |
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Definition
Not absorbed orally, Renal excretion, Inadequate CNS, prostate & eye penetration -t ½ ~6 hrs
It's usually given IV |
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Term
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Definition
Narrow spectrum: All Gram + organisms including MRSA & enterococci
Clinical Use: Drug of choice for serious infection with resistant gram positive organism MRSA, PCN-Resistant pneumococci(2nd DOC), Drug of second choice for Pseudomembranous colitis caused by clostridium dificile; NOT effective for Lung infections |
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Term
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Definition
| 1: Mutation of antibiotic binding site (↓ binding of Vanco to Receptor site on MO) |
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Term
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Definition
NB: T ½ 6 hrs
SE: *“Red Man” Syndrome histamine release (need to slow infusion down); Renal Toxicity, Auditory (dose related), |
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Term
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Definition
| Lipopeptide antiobiotic; Bacteriocidal; Disrupts multiple aspects of bacterial plasma membrane function including peptidoglycan synthesis, lipoteichoic acid synthesis and bacterial membrane potential |
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Term
| daptomycin administration |
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Definition
IV administration ONLY, Rapid concentration-dependent activity; prolonged and concentration dependent post-antibiotic effect
Excretion primarily via kidney
-t ½ ~9 hrs. |
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Term
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Definition
Coverage against Gram + organisms including MRSA, VRE & Linazolide resistant; MIC’s tend to be LOW (very sensitive)
Clinical Uses: Skin & soft tissue infections, Sepsis, Endocarditis |
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Term
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Definition
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Term
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Definition
SE: (Unique) Transient Muscle weakness, myalgias after 6-11 days of tx. (CPK levels are elevated initially, but normal at 1 week); Once daily dosing ↑ the therapeutic-toxicity ratio by ↑ efficacy & ↓ skeletal muscle adverse effects associated w/2X daily
NB: Not yet approved for Children |
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