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Boards Review > Micro Drugs > Flashcards

Micro Drugs Flashcards

1
Q

Indications for penicillins (1st generation)

A

Gram(+) organisms + N. meningitidis and T. pallidum

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2
Q

Side effects of penicillins

A

Hypersensitivity; hemolytic anemia

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3
Q

2nd generation penicillins (2)

A

Ampicillin, amoxicillin

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4
Q

Indications for 2nd generation penicillins

A

Same as penicillin + H. flu, E.coli, Listeria, Proteus, Salmonella, shigella, and enterococci (HELPSS)

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5
Q

3rd generation penicillins (3)

A

oxacillin, nafcillin, dicloxacillin

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6
Q

Indications for 3rd generation penicillins

A

“Naf for Staph” - MRSA

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7
Q

4th generation penicillins (2)

A

Ticarcillin, piperacillin

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8
Q

Beta-lactamase inhibitors (3)

A

Clavulanic acid, sulbactam, tazobactam

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9
Q

Organisms not covered by cephalosporins (4)

A

LAME - Listeria, atypicals, MRSA, enterococci

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10
Q

1st generation cephalosporins (2)

A

Cefazolin, cephalexin

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11
Q

Indications for 1st generation cephalosporins

A

PEcK - gram + cocci, Proteus, E. coli, and KLebsiella

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12
Q

2nd generation cephalosporins (3)

A

cefoxitin, cefaclor, cefuroxime

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13
Q

Indications for 2nd generation cephalosporins

A

HEN PEcKs - gram + cocci, H. flu, Enterobacter, Neisseria, PEcK

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14
Q

3rd generation cephalosporins (3)

A

Ceftriaxone, cefotaxime, ceftazidime

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15
Q

4th generation cephalosporin (1)

A

cefepime (for pseudomonas)

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16
Q

5th generation cephalosporin (1)

A

ceftaroline (broad including MRSA, does not cover pseudomonas)

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17
Q

Aztreonam is synergistic with ____

A

Aminoglycosides

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18
Q

Indications for aztreonam

A

Gram - rods only (no gram pos, anaerobes)

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19
Q

Carbapenems must always be administered with ____

A

Cilastatin (inhibitor of renal dehydropeptidase I)

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20
Q

Indications for carbapenems

A

Gram + cocci, gram - rods, anaerobes

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21
Q

Side effects of vancomycin

A

nephrotoxicity, ototoxicity, thrombophlebitis, red man syndrome

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22
Q

Mechanism of linezolid

A

Inhibits 23s rRNA of 50S subunit

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23
Q

Side effects of linezolid

A

Optic neuritis, thrombocytopenia, serotonin syndrome

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24
Q

Aminoglycosides (5)

A

GNATS - gentamicin, neomycin, amikacin, tobramycin, streptomycin

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25
Q

Mechanism of aminoglycosides

A

Inhibit formation of initiation complex on 30S and cause misreading of mRNA; require O2 for uptake

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26
Q

Indications for aminoglycosides

A

Severe gram - rods; synergistic with beta-lactams

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27
Q

Toxicity of aminoglycosides

A

Nephrotoxicity (esp. with cephalosporins), NMJ blockade, ototoxicity, teratogen

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28
Q

Resistance to aminoglycosides

A

Bacterial transferase enzymes (esp. acetylation)

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29
Q

Tetracyclines (3)

A

Tetracycline, doxycycline, minocycline

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30
Q

Mechanism of tetracyclines

A

Block attachment of aminoacyl-tRNA on 30S subunit

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31
Q

What can’t you take with doxycycline?

A

Divalent cations (Mg, Ca)

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32
Q

Indications for tetracyclines

A

Borrelia, mycoplasma, rickettsia, chlamydia, acne

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33
Q

Toxicity of tetracyclines

A

GI distress, discolored teeth, inhibition of bone growth, photosensitivity

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34
Q

Resistance to tetracyclines

A

Decreased uptake or increased efflux

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35
Q

Macrolides (3)

A

Azithromycin, clarithomycin, erythromycin

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36
Q

Mechanism of macrolides

A

Block translocation by binding 23 rRNa on 50S subunit

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37
Q

Indications for macrolides

A

Atypical pneumonia, STDs (chlamydia), gram+ cocci

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38
Q

Toxicity of macrolides

A

MACRO - motility problems, arrhythmia (prolonged QT), cholestatic hepatis, rash, eosinophiilia

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39
Q

Resistance to macrolides

A

Methylation of 23S rRNA binding site

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40
Q

Mechanism of chloramphenicol

A

Blocks peptidyltransferase at 50S subunit

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41
Q

Indications for chloramphenicol

A

Meningitis, RMSF

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42
Q

Toxicities of chloramphenicol

A

Aplastic anemia, gray baby syndrome, anemia

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43
Q

Resistance to chloramphenicol

A

Plasmid-encoded acetyltransferase inactivation

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44
Q

MEchanism of clindamycin

A

Blocks peptide transfer at 50S subunit

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45
Q

Indications for clindamycin

A

Anaerobes above the diaphragm (Bacteroides, C. perf in aspiration pneumo, lung abscesses, GAS)

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46
Q

Drugs causing pseudomembranous colitis

A

Clindamycin, 2nd generation penicillins

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47
Q

Sulfonamides (3)

A

SUlfamethoxazole (SMX), sulfisoxazole, sulfadizine

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48
Q

Indications for sulfonamides

A

Gram +, gram -, Nocardia, Chlamydia, simple UTI

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49
Q

Toxicity of sulfonamides

A

SJS, TEN, hemolysis in G6PD, nephrotox, photosensitivity, kernicterus (infants), displace other drugs from warfarin

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50
Q

Indications for trimethoprim

A

Combined with SMX for UTI, shigella, salmonella, PCP, toxo

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51
Q

Toxicities of TMP

A

Granulocytopenia, leukopenia, megaloblastic anemia

52
Q

Fluroquinolones

A

Ciprofloxacin, norfloxacin, levofloxacin, nalidixic acid (and more. . . )

53
Q

Mechanism of fluroquinolones

A

Inhibit DNA gyrase (topoisomerase II) and topo-IV

54
Q

Do not take fluroquinolones with ____

A

Antacids

55
Q

Indications for fluroquinolones

A

Gram - rods of urinary/GI (inc. pseudomonas), Neisseria; no MRSA

56
Q

Toxicities of fluroquinolones

A

GI upset, superinfection, skin rash, tendonitis, myalgias

57
Q

Mechanism of metronidazole

A

Free radical toxic metabolites

58
Q

Indications for metronidazole

A

Giardia, entamoeba, trichomonas, gardnerella, anaerobes, H. pylori

59
Q

Toxicities of metronidazole

A

Metallic taste, disulfiram-like rxn

60
Q

Drugs for TB

A

RIPE - rifampin, isoniazid, pyrazinamide, ethambutol

61
Q

Drugs for MAI

A

Azithromycin, rifabutin

62
Q

Drugs for M. leprae

A

Dapsone and rifampin (+ clofazimine for lepromatous form)

63
Q

Mechanism of INH

A

Reduced synthesis of mycolic acids, activated by bacterial catalase peroxidase (encoded by KatG)

64
Q

Toxicity of INH

A

B6 deficiency, neurotoxicity, hepatotoxicity

65
Q

4 Rs of Rifampin

A

RNA poly inhibitor, ramps up p450, red/orange body fluids, rapid resistance

66
Q

Mechanism of pyrazinamide

A

Unknown; accumulates in acidic pH of phagolysosomes

67
Q

Toxicities of pyrazinamide

A

Hyperuricemia, hepatotoxicity

68
Q

Mechanism of ethambutol

A

Reduced carbohydrate polymerization (blocks arabinosyltransferase)

69
Q

Toxicity of ethambutol

A

Optic neuritis (red-green color blindness)

70
Q

Choice prophylaxis for meningococcal infection

A

Ciprofloxacin (rifampin for peds)

71
Q

MRSA treatments (5)

A

Linezolid, daptomycin, vancomycin, tigecycline, ceftaroline

72
Q

VRE treatments (2)

A

Linezolid, steptogamins (quinupristin/dalfopristin)

73
Q

Mechanism of amphotericin B

A

Binds ergosterol and punches holes in cell membrane

74
Q

Indications for amphoterrible

A

Cryptococcus, blastomyces, coccidioides, histoplasma, candida, mucor; supplement K+/Mg+

75
Q

Toxicities for amphoterrible

A

Fever/chills, hypotension, nephrotox, arrhythmias, anemia, IV phlebitis

76
Q

Nystatin

A

Same as amphiterrible; used for oral candida (swish and spit) and diaper rash/vaginal candidiasis

77
Q

Mechanism of azoles

A

Block conversion of lamosterol to ergosterol

78
Q

Use of azoles

A

Local and less serious systemic mycoses; fluconazole for suppression of crypto meningitis in compromised patients

79
Q

Toxicities of azoles

A

Testosterone synthesis inhibitors, inhibition of p450

80
Q

Mechanism of flucytosine

A

Inhibits DNA/RNA biosynthesis (conversion to 5-FU by cytosine deaminase)

81
Q

Indication for flucytosine

A

Systemic fungal infxns in combo with amphoterrible

82
Q

Mechanism of echinocandins (-fungins)

A

Inhibit cell wall synthesis by inhibiting synthesis of beta-glucan

83
Q

Indication for echinocandins

A

Invasive aspergillosis, Candida

84
Q

Toxicities of echinocandins

A

Flushing (histamine release), GI upset

85
Q

Mechanism of terbafine

A

Inhibition of squalene epoxidase

86
Q

Indication of terbafine

A

Dermatophytoses

87
Q

Toxicities of terbafine

A

Gi upset, headaches, hepatotox, taste problems

88
Q

Mechanism of griseofulvin

A

Accumulates in keratin; interferes with microtubule function

89
Q

Toxicities of griseofulvin

A

Teratogenic, carinogenic, confusion, headaches, induces p450

90
Q

Therapy for toxoplasmosis

A

Pyrimethamine

91
Q

Therapy for t. brucei

A

suramin and melarsoprol

92
Q

Therapy for T. cruzi

A

Nifurtimox

93
Q

Therapy for leishmaniasis

A

Sodium stibogluconate

94
Q

Mechanism of chloroquine

A

Blocks detoxification of heme into hemozoin

95
Q

Toxicities of chloroquine

A

Retinopathy, pruritus

96
Q

Therapy for flukes

A

Praziquantel

97
Q

Mechanism of zanamivir/oseltamivir

A

Inhibit influenza NA

98
Q

Mechanism of ribavarin

A

Inhibit synthesis of guanine nucleotides by inhibiting inosine monophosphate dehydrogenase

99
Q

Indications for ribavarin

A

RSV, chronic Hep C

100
Q

Toxicities of ribavarin

A

Teratogenic, hemolytic anemia

101
Q

Mechanism of acyclovir/famciclovir/valacyclovir

A

Monophosphorylated by HSV/VSV thymidine kinase; guanosine analog; preferentially inhibits viral DNA poly by chain termination

102
Q

Toxicity of acyclovir/famciclovir/valacyclovir

A

Crystalline nephrotoxicity, acute renal failure

103
Q

Indication for acyclovir/famciclovir/valacyclovir

A

HSV/VSV, some EBV (not CMV)

104
Q

Mechanism of gancyclovir

A

5’ monophosphate formed by CMV viral kinase

105
Q

Toxicity of gancyclovir

A

Leukopenia, neutropenia, thrombocytopenia, renal tox

106
Q

Mechanism of foscarnet, cidofovir

A

Viral DNA poly inhibitor that binds to pyrophosphate-binding site (no activation required)

107
Q

Indication for foscarent, cidofovir

A

CMV retinitis; acyclovir-resistant HSV

108
Q

Toxicity of foscarnet, cidofovir

A

Renal tox

109
Q

HAART initiated with CD4 counts below ___

A

500

110
Q

HAART consists of _____

A

2 NRTIs and [ 1 NNRTI oooor 1 protease inhibitor ooor 1 integrase inhibitor ]

111
Q

HIV protease inhibitors all end in ____

A

-navir

112
Q

Special property of ritonavir issss ___

A

Inhibition of p450, raises amts of other drugs

113
Q

Toxicity of protease inhibitors

A

Hyperglycemia, GI intolerance, lipdystrophy, hematuria, renal tox

114
Q

NRTIs (7)

A

Zidovudine (ZDV/AZT), tenofovir (TDF), stavudine (d4T), lamivudine (3TC), emtricitabine (FTC), didanosine (ddI), abacavir (ABC)

115
Q

Mechanism of NRTIs

A

Competitive inhibition of nucleotide binding to RT, terminate DNA chain (lack 3’ OH group); must be phosphorylated to be active (ex. tenofovir, nucleotide already!)

116
Q

Toxicity of NRTIs

A

BM suppression (give GM-CSF, epo), peripheral neuropathy, lactic acidosis, rash, anemia, pancreatitis

117
Q

NNRTIs (3)

A

Efavirenz, nevirapine, delavirdine

118
Q

Mechanism of NNRTIs

A

Bind to RT on different site than NRTIs; do not require phosphorylation for activity

119
Q

Toxicity of NNRTIs

A

Rash, hepatotox, vivid dreams, SJS/TEN

120
Q

Raltegravir

A

Inhibits integrase in HIV

121
Q

Tox of raltegravir

A

Hypercholesterolemia

122
Q

Fusion inhibitors (2)

A

Enfuvirtide (gp41), maraviroc (CCR5, blocks gp120)

123
Q

IFNa used in ____

A

chronic hep B/C, kaposi’s sarcoma, hairy cell leukemia, condyloma acuiminatum, RCC, malignant melanoma

124
Q

IFNb used in ___

A

MS

125
Q

IFN-gamma used in ___

A

CGD

126
Q

Anti-pseudomonals (6)

A

4th gen penicillins, 3rd/4th generation cephalosporins, aminoglycosides, ciproflox/levoflox, aztreonam, imipenem + cilastatin

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