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Flashcards in 8.6 Deck (14):
1

What is the clinical use of Mupirocin?

• Intranasal:
• Eradication of nasal colonization with MRSA in
adult patients and healthcare workers
• Topically:
• Treatment of impetigo or secondary infected traumatic skin lesions due to S.aureus or
S.pyogenes

2

What is the MOA of Mupirocin?

• Binds to bacterial isoleucyl transfer-RNA synthetase
resulting in the inhibition of protein synthesis

3

Which drugs affect Nucleic Acid Synthesis? (3)

• Fluoroquinolones
• Sulfonamides
• Trimethoprim

4

What is the MOA of fluoroquinolones?

• Enter bacterium via porins
• Inhibit bacterial DNA replication via interference with
topoisomerase II (DNA gyrase) & IV

5

What is Levofloxacin ideal for?

Excellent activity against
S.pneumoniae

6

Fluoroquinolones have their absorption affected by what?

Divalent cations:
- Iron
- Zinc
- Calcium

7

What are the adverse effects of Fluoroquinolones?

• GI distress

• CNS, rash, photosensitivity

• Connective tissue problems (avoid in pregnancy, nursing mother, under 18’s) – Black Box Warning! (Esp in ankle - can be irreversible)

• QT prolongation (moxifloxacin, gemifloxacin,
levofloxacin)

• High risk of causing superinfections (C.difficile, C
albicans, streptococci)

8

What are the Sulfonamides?

1) Sulfamethoxazole
2) Sulfadiazine
3) Sulfasalazine

9

What organisms are sulfonamides used for?

Bacteriostatic against gram + and gram -organisms?

10

Sulfonamides compete with what in it's MOA?

PABA
(inhibits Folic Acid synthesis)

11

What are the clinical applications of Sulfonamides?

Infrequently used as single agents (resistance)

• Topical agents (ocular,
burn infections)
• Oral agents (simple UTI’s)
• Sulfasalazine (oral) = ulcerative colitis, enteritis, IBD

12

What are the adverse effects of Sulfanomides?

• GI distress, fever, rashes, photosensitivity are common
• Crystalluria nephrotoxicity)
• Hypersensitivity reactions
• Hematopoietic disturbances (esp. patients with G6PD
deficiency)
• Kernicterus (in newborns and infants <2 months)

13

What are some drug reactions with Sulfonamides?

•Warfarin, phenytoin and methotrexate can lead to
increased plasma levels

14

What is the contraindication of Sulfonamide?

• Newborns & infants < 2 months (kernicterus) – drugs compete with bilirubin for binding sites on albumin