| Term 
 
        | What drugs are in this Drug Class: Folic acid synthesis inhibition? |  | Definition 
 
        | Sulfonamides & Trimethoprim |  | 
        |  | 
        
        | Term 
 
        | What drugs are in this Drug Class: Inhibit DNA gyrase, DNA synthesis? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What drugs are in this Drug Class: DNA damage? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What drugs are in this Drug Class: Inhibit mRNA synthesis? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Sulfisoxazole is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Sulfamethoxazole is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Sulfonamides are Analogs of _____ |  | Definition 
 
        | PABA (para-amino benzoic acid) |  | 
        |  | 
        
        | Term 
 
        | Sulfonamides Compete with ____ in synthesis of folic acid a required precursor of ___ & ____ DNA bases |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Trimethoprim is what type of drug? |  | Definition 
 
        | An antibiotic that inhibits folic acid synthesis |  | 
        |  | 
        
        | Term 
 
        | Trimethoprim is a Competitive inhibitor of ______  and Inhibits ____ conversion to purines/pyrimidines |  | Definition 
 
        | dihydrofolate reductase folic acid
 |  | 
        |  | 
        
        | Term 
 
        | Sulfamethoxazole + Trimethoprim (Co-trimoxazole, SMZ/TMP or TMP-SMX, Bactrim, Septra)
 Combination produces a _____ inhibition because two sequential steps in folic acid pathway are blocked
 |  | Definition 
 
        | synergistic * know bactrim
 |  | 
        |  | 
        
        | Term 
 
        | Sulfonamides & Trimethoprim has ____ Toxicity |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Bacteria have no ____ transport for folate and must synthesize it.  ____ inhibit this synthesis. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Trimethoprim is 20,000 x more potent at inhibiting ______ dihydrofolate reductase than ____ enzyme. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Humans cannot synthesize folate – must obtain from diet via Active uptake. Human dietary folate deficiency causes ____. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | ____ is another folate antagonist (inhibits dihydrofolate reductase) used clinically at high does to treat cancer & at low doses to treat RA (rheumatoid arthritis) and severe psoriasis |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Sulfonamides & Trimethoprim: Bacterio____
 Very ____ spectrum
 Distribute to ___ body fluids including ___
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Sulfonamides & Trimethoprim Use: Wide use throughout world because cheap & effective
 USA: less use because many resistant strains, allergic reactions, penicillins and other drugs to use
 Most used is ____
 Resistance developed:
 (a) due to the ability of bacteria to ___ the drug
 (b) to produce more ___ to counteract sulfonamide drug
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | SMX-TMP is what type of drug? |  | Definition 
 
        | Sulfamethoxazole + Trimethoprim |  | 
        |  | 
        
        | Term 
 
        | Co-trimoxazole is what type of drug? |  | Definition 
 
        | Sulfamethoxazole + Trimethoprim |  | 
        |  | 
        
        | Term 
 
        | Bactrim is what type of drug? |  | Definition 
 
        | Sulfamethoxazole + Trimethoprim |  | 
        |  | 
        
        | Term 
 
        | Septra is what type of drug? |  | Definition 
 
        | Sulfamethoxazole + Trimethoprim |  | 
        |  | 
        
        | Term 
 
        | _____ is antibiotic used for Chronic and recurrent UTIs _____ first choice for acute, uncomplicated UTI
 |  | Definition 
 
        | SMX-TMP Fluoroquinolone (Cipro)
 |  | 
        |  | 
        
        | Term 
 
        | Trimethoprim concentrates in ____ & ____ |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | _______ is the antibiotic used for Acute gonococcal urethritis & oropharyngeal gonococcal inf. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | ________ is the antibiotic (drug of choice) for Pneumocystis carinii pneumonia ->Most common opportunistic fungus infections of AIDS |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | ____ is the antibiotic used for GI infections & prophylaxis for travelers’ diarrhea -> E. coli, Proteus mirabilis, Salmonella typhi, Shigella |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | _____ is the antibiotic used for Recurrent otitis media |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | ____ is the antibiotic used for Nocardiosis |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Sulfonamides & Trimethoprim Adverse Effects: Hypersensitivity - Rashes common, angioedema, ____ - Many drugs are derivatives of sulfonamides, all these   can cause hypersensitivity reactions, e.g., diuretics   and sulfonylurea oral hypoglycemic agents _____ in newborn - Displaces bilirubin from albumin - Contra-indicated if <__ months old, or __ at term ____________  - due to poor solubility of older sulfas _____________ - In patients with G6PD deficiency |  | Definition 
 
        | Steven’s-Johnson syndrome Kernicterus
 2
 pregnant
 Crystalluria
 Hemolytic anemia
 |  | 
        |  | 
        
        | Term 
 
        | Ciprofloxacin (Cipro) is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Norfloxacin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Ofloxacin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Levofloxacin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Enoxacin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Sparfloxacin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Lomefloxacin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Moxifloxacin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Trovafloxacin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Fluoroquinolones Mechanism: Inhibit _____ (_______)
 Induces cleavage of ___
 Bacterio____
 |  | Definition 
 
        | DNA gyrase (topoisomerase II) DNA
 cidal
 |  | 
        |  | 
        
        | Term 
 
        | Fluoroquinolones Use: Relatively non-toxic, well tolerated, ____ spectrum, excellent ____ bioavailability.
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Fluoroquinolone names all end in _____ |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Fluoroquinolones Resistance: Inappropriate overuse has led to increasing resistance. Don’t use for routine upper & lower ____ infections or ___ or ___ tissue infections
 Mechanism: Mutated ____ or decreased permeability through ____
 |  | Definition 
 
        | respiratory skin
 soft
 gyrase
 porins
 |  | 
        |  | 
        
        | Term 
 
        | Fluoroquinolones Spectrum: Very ___ spectrum but generally more active against gram (__) than gram (__) aerobes
 Not effective against ____
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Fluoroquinolones Pharmacokinetics: Widely distributed in ___
 Renal secretion of ____ drug in urine
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What antibiotic is used for Anthrax -> Bacillus anthracis? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Fluoroquinolones are used in ___ Tract & __ Tract Infections Gram (-) rods E. coli, Enterobacter, Klebsiella pneumoniae, Proteus mirabilis, Serratia marcescens, Shigella, H. influenzae, Legionella, Pseudomonas aeruginosa
 Gonorrhea Gram (-) cocci – alternate choice
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Fluoroquinolones have Good penetration into ____ |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What antibiotic is used for Resistant Respiratory Tract Infections -> Infections unresponsive to b-lactams? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Fluoroquinolones are Not 1st choice for pneumonia because only ___ active vs. Strep. pneumoniae |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Fluoroquinolones Adverse Effects: _____ tolerated
 Nausea, vomiting, diarrhea
 Occasionally, headache, dizziness, rash, abnormal LFTs
 May cause erosion of ____ leading to tendinitis and tendon rupture for older patients (>60 years old)
 Use not recommended if <___ yr old
 Contraindicated in ______ and nursing mothers
 |  | Definition 
 
        | Extremely well cartilage
 18
 pregnant
 |  | 
        |  | 
        
        | Term 
 
        | Metronidazole Forms cytotoxic compounds that damage ____ & ___ |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Metronidazole is what type of drug? |  | Definition 
 
        | antibiotic that damages DNA |  | 
        |  | 
        
        | Term 
 
        | Metronidazole is An anti-____ drug that also has potent antibacterial activity against ____, including Bacteroides & Clostridium |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Metronidazole is Well absorbed ___, well distributed including ___ |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Metronidazole Adverse effect: ____-like effect (if ingested with alcohol) , blocks conversion of ethanol, acetaldehyde accumulates, flushing, nausea&ventilation
 GI upsets, ____ taste
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which antibiotic doesn't have resistance issues except w/ H. Pylori? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What is the DOC for Amebiasis (E. histolytica)? |  | Definition 
 
        | Metronidazole b/c is Antiprotozoal |  | 
        |  | 
        
        | Term 
 
        | What is the DOC for Giardia? |  | Definition 
 
        | Metronidazole b/c is Antiprotozoal |  | 
        |  | 
        
        | Term 
 
        | What is the DOC for Trichomoniasis? |  | Definition 
 
        | Metronidazole b/c is Antiprotozoal |  | 
        |  | 
        
        | Term 
 
        | Metronidazole Bacterial Uses: 
 ____ or mixed intra-abdominal infections
 ____ (trichomonas, bacterial vaginosis)
 Antibiotic-associated _________________
 ____ abscess
 In combinations for ___________________
 |  | Definition 
 
        | Anaerobic Vaginitis
 enterocolitis
 Brain
 Helicobacter pylori
 |  | 
        |  | 
        
        | Term 
 
        | Rifampin is what type of drug? |  | Definition 
 
        | antibiotic that Inhibits mRNA synthesis |  | 
        |  | 
        
        | Term 
 
        | Rifampin Inhibits DNA-dependent __________ Specific for _________
 Resistance developed due to mutations in the ____ gene.
 |  | Definition 
 
        | RNA polymerase prokaryotes
 RNA polymerase
 |  | 
        |  | 
        
        | Term 
 
        | Rifampin is Bacteri____ for intra- & extracellular mycobacteria including M. tuberculosis, M. leprae, and atypical mycobacteria. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Rifampin is the 1st line drug for _____ In combination with isoniazid, pyrazinamide, others
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Triple therapy for leprosy? |  | Definition 
 
        | Rifampin, dapsone, clofazimine |  | 
        |  | 
        
        | Term 
 
        | What antibiotic Discolors urine, tears, contact lenses? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Mupirocin is what type of drug? |  | Definition 
 
        | antibiotic -> Natural product produced by Pseudomonas fluorescenes |  | 
        |  | 
        
        | Term 
 
        | Mupirocin  is Active against gram (__) cocci including ___ |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Mupirocin is available in an _______ for local application |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Mupirocin Inhbits Staph. Isoleucyl ____ synthetase |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Nitrofurantoin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Nitrofurantoin: ___ enzyme inhibitors
 Used P.O. to treat GI infection (no ___ absorption)
 Acts on ____ and ___ enteritis
 |  | Definition 
 
        | Multiple systemic
 bacterial
 protozoal
 |  | 
        |  | 
        
        | Term 
 
        | Antibiotics that are Protein Synthesis Inhibitors: (5) |  | Definition 
 
        | Tetracyclines Aminoglycosides
 Macrolides
 Chloramphenicol
 Clindamycin
 |  | 
        |  | 
        
        | Term 
 
        | Doxycycline is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Demeclocycline is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Minocycline is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Gentamicin is what type of drug? |  | Definition 
 
        | Aminoglycoside antibiotic |  | 
        |  | 
        
        | Term 
 
        | tobramycin is what type of drug? |  | Definition 
 
        | Aminoglycoside antibiotic |  | 
        |  | 
        
        | Term 
 
        | amikacin is what type of drug? |  | Definition 
 
        | Aminoglycoside antibiotic |  | 
        |  | 
        
        | Term 
 
        | Neomycin is what type of drug? |  | Definition 
 
        | Aminoglycoside antibiotic |  | 
        |  | 
        
        | Term 
 
        | Streptomycin is what type of drug? |  | Definition 
 
        | Aminoglycoside antibiotic |  | 
        |  | 
        
        | Term 
 
        | Netilmicin is what type of drug? |  | Definition 
 
        | Aminoglycoside antibiotic |  | 
        |  | 
        
        | Term 
 
        | Erythromycin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Clarithromycin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Azithromycin is what type of drug? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Chloramphenicol is what type of drug? |  | Definition 
 
        | Antibiotic -> Protein Synthesis Inhibitors |  | 
        |  | 
        
        | Term 
 
        | Clindamycin is what type of drug? |  | Definition 
 
        | Antibiotic -> Protein Synthesis Inhibitors |  | 
        |  | 
        
        | Term 
 
        | Bacterial ribosomes differ from eukaryotic Bacterial = __S with __S/__S subunits
 Mammalian = __S with __S/__S subunits
 Thus, antibiotics that bind and inhibit bacterial ribosome function have relatively selective toxicity for bacteria
 
 ____ ribosomes are more similar in bacteria and mammals
 Toxicity of some of these drugs is at ___ ribosome
 |  | Definition 
 
        | 70 50S/30S
 80
 60S/40S
 
 Mitochondrial
 mitochondrial
 |  | 
        |  | 
        
        | Term 
 
        | Tetracyclines (bacterio_____) Binds to __S, block access of ____
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Aminoglycosides (bacteri____; very toxic) Binds to __S , interferes with ____ of functional ribosome &/or ___
 |  | Definition 
 
        | cidal 30
 assembly
 misreading
 |  | 
        |  | 
        
        | Term 
 
        | Macrolides (bacterio_____) Bind irreversibly to __S, inhibits ____
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Chloramphenicol (bacterio_____) Binds __S, inhibits ____ transferase reaction
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Clindamycin (bacterio______) Bind irreversibly to ___S, inhibits ____
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Tetracyclines Pharmacokinetics:  Adequate but incomplete ___ absorption Absorption decreased by ....(4)      - Think antacids for PUD (Peptic ulcer disease), with        tetracycline for _____       - Concentrate in liver, kidney, spleen, skin & tissue        undergoing _____ (teeth, bone) or tumors with        high ____ (gastric carcinoma) Do not give to ____      - Chelation with calcium discolors developing teeth        - Can reduce growth of developing bone |  | Definition 
 
        | oral food, milk, cations, iron
 H.pylori
 calcification
 calcium
 children
 |  | 
        |  | 
        
        | Term 
 
        | Tetracyclines Clearance: _____ uniquely cleared as chelate in feces
 Others in ____ metabolism or ___
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Tetracyclines Spectrum: very ____ |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Tetracyclines Especially useful for ... (3) |  | Definition 
 
        | Chlamydia, Rickettsia, Mycoplasma |  | 
        |  | 
        
        | Term 
 
        | Tetracyclines Resistance: Sensitive bacteria have intake system to concentrate drug inside bacteria Resistant bacteria have both intake and ___  systems and could not accumulate drug inside bacteria
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Tetracyclines Side Effects: Do not give to _____ –> teeth, bone
 _____sensitivity
 Superinfections with ____ -> (causes diarrhea and other intestinal disease when competing bacteria in the gut flora are wiped out by antibiotics.) -> (can be treated with oral ____ or ____)
 Liver and kidney toxicity possible
 |  | Definition 
 
        | children Photo
 C. difficile
 vancomycin
 metronidazole
 |  | 
        |  | 
        
        | Term 
 
        | Tetracyclines Clinical Uses:  _____ infections      - Lymphogranuloma venereum – STD      - Psittacosis – pneumonia _____      - Rocky Mountain Spotted fever from ticks _____ - spirochete      - Lyme disease _____       - Also erythromycin (is a macrolide) _____ G(-) bacilli      - Vibrio cholerae – enterotoxin, diarrhea Doxycycline  _____ in combinations Actinomyces, Amoebae |  | Definition 
 
        | Chlamydial Rickettsia
 Borrelia
 Mycoplasma pneumonia (DOC)
 Cholera
 H. pylori
 |  | 
        |  | 
        
        | Term 
 
        | Aminoglycosides are For aerobic gram ___ bacteria only |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Aminoglycosides enter through ____ then through active transport by ____ -dependent process. Low ____ & ___ inhibit transport. Transport enhanced by ___ damage to wall = synergistic effect |  | Definition 
 
        | porins oxygen
 pH & anaerobic
 b-lactams
 |  | 
        |  | 
        
        | Term 
 
        | Aminoglycosides are Effective against serious infection due to ___ gram(__) bacteria |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Aminoglycosides Mechanism: bacteri____, irreversible binding
 Binds to ___S ribosomal subunit
 blocks formation of _____ complex
 ____ of mRNA
 Block ____ of mRNA chain
 |  | Definition 
 
        | cidal 30
 initiation
 Misreading
 translocation
 |  | 
        |  | 
        
        | Term 
 
        | Aminoglycosides Resistance: Bugs produce ___ that inactive drug
 Impaired entry – mutant porin, or pH, O2
 Mutant __S ribosomal protein
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Aminoglycosides Pharmacokinetics: Large, polar molecules
 Poor ___ absorption
 Must be given parenterally IM, IV, intrathecal if CSF
 Distribution limited to _______
 Do not reach ___
 Eliminated by ____ filtration
 Doses matched to creatinine clearance to avoid severe toxicity, blood levels monitored
 |  | Definition 
 
        | oral extracellular fluid
 CSF
 glomerular
 |  | 
        |  | 
        
        | Term 
 
        | Aminoglycosides Adverse Effects  Very ____ ___toxicity      - Loss of equilibrium      - Loss of hearing ____toxicity ____toxicity ____ blockade      - reduces respiratory function, esp. after surgery |  | Definition 
 
        | toxic Oto
 Nephro
 Neuro
 Neuromuscular
 |  | 
        |  | 
        
        | Term 
 
        | Aminoglycosides are used for Gram (__) ___ bacteria, esp. when isolate is drug-resistant or sepsis |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Aminoglycosides Used in combo with ____, synergistic, extends spectrum to gram (__) |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Aminoglycosides used against Pseudomonas aeruginosa In combo with antipseudomonal _____ |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Aminoglycosides used for Enterococcal _____, Viridans streptococcal, & staph ____ |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Aminoglycosides used for _____ UTI, Not for ___, uncomplicated UTI |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Aminoglycosides are used for E. coli or Klebsiella pneumonia along With ____ & ____ |  | Definition 
 
        | ampicillin & cephalosporin |  | 
        |  | 
        
        | Term 
 
        | What is the 2nd line drug for TB? |  | Definition 
 
        | Streptomycin (Aminoglycosides) |  | 
        |  | 
        
        | Term 
 
        | Gentamicin is Active against Staph, coliforms, pseudomonas, proteus, Enterobacter, Klebsiella, Serratia, & other gram (__) ___ It is Mainly employed for severe infections, often ___ patient with bugs resistant to other antibiotics |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Macrolides Mechanism: Inhibits ____ synthesis
 Binds irreversibly to __S, inhibits translocation of the peptidyl molecule from ”__” site to “__” site
 Bacterio_____
 Bacterio_____ at high concentrations
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Macrolides Pharmacokinetics: ____ base is destroyed by stomach acid, so either enteric-coated or esterified forms given
 ____ & ____ stable to acid
 All have adequate oral absorption
 Distribute well to all tissues except __
 Good levels in ___ and accumulates in ____
 |  | Definition 
 
        | Erythromycin Clarithromycin & azithromycin
 CSF
 prostate
 macrophages
 |  | 
        |  | 
        
        | Term 
 
        | Macrolides Spectrum  Erythromycin spectrum same as Penicillin G so used often when Pt ____ to penicillin Especially useful for (3) Gram (__) organisms      - Pneumococci, streptococci, staphylococci,          corynebacteria Aerobic Gram (__) & Others      - Mycoplasma, Legionella, Helicobacter, Chlamydia,        Listeria, Neisseria, Bordetella pertussis,        Treponema, some Rickettsia |  | Definition 
 
        | allergic Chlamydia, Mycoplasma, Legionella
 +
 -
 |  | 
        |  | 
        
        | Term 
 
        | Macrolides: Clinical Use: Erythromycin (or other macrolide) = Drug of Choice (DOC) for:    ______ pneumonia      - Spectrum includes pneumococcus, mycoplasma,        legionella      - Mycoplasma pneumonia “atypical pneumonia”      - Legionnaires’ Disease ______ infections during pregnancy      - Alternative to tetracycline for uncomplicated        urethral, endocervical, rectal or epididymal         Chlamydia infections      - Tetracyclines also effective ______      - Alternative if allergic to Penicillin G ______       - Erythromycin or Pen to eliminate carrier state ______      - UTI |  | Definition 
 
        | Community-acquired Chlamydial
 Syphilis
 Corynebacterium diphtheriae
 Ureaplasma
 |  | 
        |  | 
        
        | Term 
 
        | Clarithromycin is the DOC for ____ in combo with amoxicillin + PPI Also active vs ______
 Less GI upset than erythromycin
 ___ dosing vs. qid for erythromycin
 |  | Definition 
 
        | H. pylori Haemophilus influenzae
 BID
 |  | 
        |  | 
        
        | Term 
 
        | Azithromycin ___ dosing an advantage over other macrolides
 Slightly better tissue penetration
 Preferred for ___, also ___
 |  | Definition 
 
        | Once-per-day Chlamydia trachomatis
 Haemophilus influenzae
 |  | 
        |  | 
        
        | Term 
 
        | Macrolides Adverse Effects: ____ distress common
 Cholestatic _________
 ___toxicity – at high doses
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Macrolides Contraindication:  patients with ___ dysfunction since drug ___ in liver |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Drug-drug interactions of macrolides:  _____ & _____inhibit hepatic metabolism (by inhibiting cytochrome P450 enzymes) of theophylline, warfarin, and other drugs |  | Definition 
 
        | Erythromycin & clarithromycin |  | 
        |  | 
        
        | Term 
 
        | _____-____ is a combination of two streptogramins (30:70) for IV injection |  | Definition 
 
        | Quinupristin-dalfopristin |  | 
        |  | 
        
        | Term 
 
        | Streptogramins are Active against gram (__) ___including multidrug resistant Strep, pen resistant Strep. Pneuniae, methicillin- susceptible, and-resistant Staph, and vancomycin-resistant strain. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Streptogramins Resistance is due to modification of (_____) drug-binding site |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Chloramphenicol is what type of drug? |  | Definition 
 
        | antibiotic (protein synthesis inhibitor) |  | 
        |  | 
        
        | Term 
 
        | Chloramphenicol is ___ spectrum against G(+) & G(-) organisms Even ___
 but is ___ so use is restricted to life-threatening infections in which there are no alternatives
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Chloramphenicol Mechanism: Binds __S, inhibits ___ transferase reaction |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Chloramphenicol Resistance: Via increased metabolizing enzyme _______ |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Chloramphenicol IV or oral, enters CSF
 Serious _____ [Rarely used]
 Hemolytic anemia (G6PD deficiency)
 aplastic anemia (fatal)
 “___ baby syndrome” (cyanosis)
 overgrowth of Candida
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Chloramphenicol Use: Life-threatening ___ or ___ infections |  | Definition 
 
        | Salmonella typhi H. influenzae
 |  | 
        |  | 
        
        | Term 
 
        | Clindamycin Mechanism: Bactericidal inhibition of ___ synthesis
 Bind irreversibly to __S, inhibits translocation
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Clindamycin is used P.O. for treatment of ____ infections ex. Bacteroides fragilis |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Clostridium difficile is always resistant to ______ so for Incidences of pseudomembranous colitis (caused by C. difficile), treat with ____ or ____ |  | Definition 
 
        | Clindamycin metronidazole or vancomycin
 |  | 
        |  | 
        
        | Term 
 
        | _____ still the leading cause of death by infectious disease throughout the world |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Mycobacterium tuberculosis is Difficult to ___ & “____-___” |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Tuberculosis Grows ____, treat for _ years Many resistant strains so use multiple drug therapy
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Mycobacterium tuberculosis Treatment divided into:
 
 1. Treatment of ___ infection diagnosed by a positive PPD  or
 2. Treatment of ___ clinical TB
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Tuberculosis First Line Drugs
 1.
 2.
 3.
 4.
 5.
 
 Second Line Drugs
 Ethionamide, Aminosalicylic Acid, Capreomycin, Cycloserine
 |  | Definition 
 
        | 1.  Isoniazid 2.  Rifampin (or Rifabutin)
 3.  Ethambutol
 4.  Pyrazinamide
 5.  Streptomycin
 |  | 
        |  | 
        
        | Term 
 
        | Tuberculosis               FYI Empirical initial therapy until susceptibility reports are available (4 drugs regimen)
 1.  Isoniazid (INH)
 2.  Rifampin (or Rifabutin)
 3.  Ethambutol
 4.  Pyrazinamide
 
 Continuation phase: INH +rifampin for 4 months
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Isoniazid (INH) in treatment of Tuberculosis: Inhibits mycolic acid formation in outer membrane, this is unique to _____
 INH acetylated in liver, “fast” acetylators have lower levels, “slow” acetylators may reach ____ levels
 Side effects: peripheral neuritis, hepatitis, drug interactions
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Rifampin in treatment of Tuberculosis: Inhibits DNA-dep. ___ polymerase
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Pyrazinamide in treatment of ____: Drug targets and mechanism of action are unknown. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Ethambutol in treatment of tuberculosis: Inhibits ___ acid synthesis, can impair ___ vision
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Streptomycin in treatment of tuberculosis: Parenteral, bacterio____  _____ synthesis inhibitor
 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Mavium complex bacteremia in AIDS patients  can be treated with a single daily dose  of ____ (300 mg) 
 
 _____, 500 mg once daily or ____, 500 mg twice daily ca also be used
 |  | Definition 
 
        | rifabutin Azithromycin
 clarithromycin
 |  | 
        |  |