Term
| what is the functions of folates (5) |
|
Definition
make purines and primidines
growth
replication
cell division |
|
|
Term
|
Definition
|
|
Term
| how do bacteria get folate (3) |
|
Definition
| make it from PABA, pteridine, glutamine |
|
|
Term
| what are the 6 antifolate drugs |
|
Definition
sulfonamide/trimethoprim
silver sulfadizine
sulfacetamidine
pyrimetnamine
dapsone
methotraxate |
|
|
Term
| what does pyrimetnamine treat |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what does methotrexate treat (2) |
|
Definition
|
|
Term
| what are the 3 DNA antibiotics |
|
Definition
metronidazole
daptomycin
floroquinolones |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| what are the 1st gen floroquinolones |
|
Definition
|
|
Term
| what are the 2st gen floroquinolones (2) |
|
Definition
|
|
Term
| what are the 3st gen floroquinolones (2) |
|
Definition
|
|
Term
| what are the 4st gen floroquinolones |
|
Definition
|
|
Term
| is sulfonamide bacteriostatic or cidial |
|
Definition
|
|
Term
| is metronidazole bacteriostatic or cidial |
|
Definition
|
|
Term
| is nitrofurantoin bacteriostatic or cidial |
|
Definition
|
|
Term
| what is the MOA of trimethoprim sulfamethoxazole |
|
Definition
| competitive inhibitor for dihydrofolate reductase in conversion of folic acid to nucleotides |
|
|
Term
| why is TMP/SMX in the combo (2) |
|
Definition
prevents formation of tetrahydrofolic acid
have greater activity together |
|
|
Term
| what can cause resistance to TMP/SMX (2) |
|
Definition
not common with two drugs
over use
alteration of dihydrofolate reductase |
|
|
Term
| how is TMP/SMX administered (2) |
|
Definition
|
|
Term
| where does TMP/SMX distribute to |
|
Definition
| trimethloprim part concentrates in prostatic and vaginal fluid |
|
|
Term
| what are 4 adverse effects of TMP/SMX |
|
Definition
all the sulfonamide side effects
in G6PDH deficiency it causes anemia
rash: commonly in elderly and HIV
marrow supression |
|
|
Term
| what types of marrow suppression occur with TMP/SMX (3), how can you fix it |
|
Definition
megaloblastic aemia
leukopenia
thrombocytopenia
give folic A |
|
|
Term
| in general what does TMP/SMX work on (5) |
|
Definition
broad spectrum - but lots resistant
gram positive, negative, rod, cocci |
|
|
Term
| what is TMP/SMX the drug of choice for |
|
Definition
| prevention and tx of PJ pneumonia |
|
|
Term
| what is TMP/SMX the second in line for drug of choice for |
|
Definition
|
|
Term
| what specific microbes does TMP/SMX treat (5) |
|
Definition
listeria
CA-MRSA
moraxella
E. coli (UTI)
PJ pneumonia |
|
|
Term
| what is the MOA of sulfonamides |
|
Definition
compete with PABA for dihydroperoate synthase
stop folic A synthesis |
|
|
Term
| how do you get resistance to sulfonamides (3) |
|
Definition
altered dihydroperoate synthesis via mutation or plasmid transfer
decreased sulfonamide uptake
increased PABA |
|
|
Term
| what are the type types of sulfonamides, how are they administered |
|
Definition
sulfacetamide: ointment, drops
silver sulfadiazine: cream |
|
|
Term
| what are the side effects of sulfonamides (6) |
|
Definition
burning brown gray discoloration
blurred vision
hypersensitivity - oral rash, angioedema, steven johnson syndrome |
|
|
Term
| what are three symptoms of steven johnson syndrome |
|
Definition
| erythema, hemorrhages, crust on lips |
|
|
Term
| what has cross allergenicity with sulfonamides (4) |
|
Definition
carbonic anhydase inhibitors
thiazide diruetics
loop duiruetics
sulfonyl urea hypoglycemia drugs |
|
|
Term
| what in general are sulfanomides used for (5 conditions, 3 organisms) |
|
Definition
gram negative and positive
yeast
sepsis prevention in burns
conjunctivitis
corneal infection
UTI |
|
|
Term
| what is the MOA of maternidazole (2) |
|
Definition
activated by ferrdoxin in anaerobes via reduction
messes with DNA |
|
|
Term
| how is metronidazole administered |
|
Definition
|
|
Term
| how is metronidazole metabolized |
|
Definition
|
|
Term
| what are the adverse effects of metronidazole (4) |
|
Definition
gi upset
metalic taste
red brown urine
disulfrum reaction |
|
|
Term
| what causes resistance to metronidazole/what is it not good against (3) |
|
Definition
oxygen inhibits
no aerobic activity
no pesudomonas |
|
|
Term
| explain the disulfrim reaction |
|
Definition
| blocks acetylaldehyde DH and acid aldehyde builds up |
|
|
Term
| what in general does metronidazole kill (5) |
|
Definition
| anaerobes, parasites, protozoa, empiric for anaerobic and mixed infections |
|
|
Term
| what are specific organisms matronidazole kills (6) |
|
Definition
giardia
etenobea
trichomonas
bacteroides
anaerobes
clostridium
on the
metronidazole
gardenela (bacterial vaginosis) |
|
|
Term
|
Definition
| binds bacterial cell membrane and depolarizes it causing loss of potential and inhibiting DnA/RNA synthesis |
|
|
Term
| how is daptomycin administered, how long |
|
Definition
| IV over 30 minutes once a day for 1-2 weeks |
|
|
Term
| what are the 5 adverse effects of daptomycin |
|
Definition
constipation
nausea
abnormal LFT
muscle pain
weakness |
|
|
Term
| what is daptomycin used for (5) |
|
Definition
complicated skin and skin structure infections
staph
MRSA
gram positive cocci |
|
|
Term
| what is the MOA of flouroquinolones |
|
Definition
inhibit DNA gyrase (topoisomerase II) preventing relaxation of supercoils stipping transcription
prevents joining of gyrase |
|
|
Term
| what does DNA gyrase normally do |
|
Definition
| changes DNA configuration by nicking, pass through, and resealing |
|
|
Term
| what can cause resistance to flouroquinolones (3) |
|
Definition
mutation of DNA gyrase
eflux of the drug
prevention of drug penetration |
|
|
Term
| how are flouroquinolones administered |
|
Definition
|
|
Term
| where do flouroquinolones distribute to (6) |
|
Definition
| tissue, bone, urine, kidney, prostate, lung |
|
|
Term
| where are foluroquinolones excreted |
|
Definition
|
|
Term
| what are the adverse effects of foluroquinolones (6) |
|
Definition
generally well tolerated
gi upset
phototoxicity
tendinitis
rupture
affects collagen metabolism
affects cartiladge development |
|
|
Term
| what interacts with foluroquinolones |
|
Definition
avoid antacidsL Mg, Al, Zn, Fe
cipro inhibits P450 and interferes with theophylline metabolism |
|
|
Term
| what can foluroquinolone generations 1 and 2 kill that the others cant (2) |
|
Definition
| cipro can kill bacillus anthracis, pseudomonas |
|
|
Term
| what can gen 3 and 4 fouroquinolones kill that the others cant(5) |
|
Definition
strep, enterococcus, fecalis
anaerobes: c not diff, bacteroides |
|
|
Term
| what general categories can foluroquinolones kill |
|
Definition
gram negative first choice except pseudomonas
atypicals
newer drugs gram positives |
|
|
Term
| what are flouroquinolones first choice for |
|
Definition
|
|
Term
| what atypicals can fouroquinolones kill (3) |
|
Definition
| candidia, mycoplasma, legionalla |
|
|
Term
| what do you use when a pneumonia is resistant to macrolides and penicillins |
|
Definition
|
|
Term
| what random microbes can all foluroquinolones kill that are not atypical (6) |
|
Definition
listeria
strep pneumonia
neisseria
moraxella
chylamydia
MSSA |
|
|
Term
|
Definition
boys <6yo without circumcision
girls 1-5yo, teens, puberty, and sexually active women
eldery |
|
|
Term
|
Definition
| e. coli, staph saphrophiticus, klevsiella, proteus, pseudomonas aeruginosa |
|
|
Term
| what are the symptoms of UTI (5) |
|
Definition
| asymptomatic, urgency, frequency, nocturia, suprapubic heaviness |
|
|
Term
| what are the symptoms of UTI in the elderly (2) |
|
Definition
| altered mental status, changes in eating |
|
|
Term
| what is used to treat a complicated UTI (2) |
|
Definition
| TMP/SMX, foluroquinolones |
|
|
Term
| what is used to treat a uncomplicated UTI (3) |
|
Definition
| gentamycin, anti-pseudomonal penicillin, nitrofurantoin |
|
|
Term
| what is the MOA of nitrofurantoin (3) |
|
Definition
bacteria activate the drug
it inhibits enzymes and damaes DNA |
|
|
Term
| how do you get resistance to nitrofurantoin |
|
Definition
|
|
Term
| how is nitrofurantoin administered |
|
Definition
|
|
Term
| is nitrofurantoin teratogenic |
|
Definition
|
|
Term
| what are the adverse effects of nitrofurantoin (4) |
|
Definition
GI upset- take with food
pulmonary: pneumonitis, fibrosis with chronic treatment
turns urine brown |
|
|
Term
| what does nitrofurantoin kill ((4) |
|
Definition
e. coli
gonorrhea
MSSA
strep |
|
|
Term
| what is hte MOA of probencid |
|
Definition
| inhibit tubular reabsorption of uric acid and increase excretion |
|
|
Term
| what does probencid interact with (4) |
|
Definition
inhibits secretion of penicillins, cephalosporins, and foluroquinolones
increases half life of WA antibiotics |
|
|
Term
| what is the number one and two choice of tx for gonorrhea |
|
Definition
1. ceftriaxone
2. flouroquinolone |
|
|
Term
| what is the treatment for syphilos |
|
Definition
|
|
Term
| what is the number 1 and 2 treatment for chalmydia trachomatis |
|
Definition
1. asithromycin
2. doxycycline |
|
|
Term
| what are the 5 antibiotics that are not excreted renal |
|
Definition
anti-staph penicillins
cephtriaxone
doxycycline
macrolides
clindamycin
metronidazole |
|
|
