Flashcards in 8.7 Deck (13):
Where does Trimethoprim work?
Inhibits Dihydrofolate reductase.
(inhibits purine, pyrimidine, & amino acid synthesis)
What are the clinical applications of Trimethoprim?
• Bacterial prostatitis
• Bacterial vaginitis
What are the adverse effects of Trimethoprim?
• Antifolate effects (contraindicated in pregnancy)
• Skin rash, pruritus
What is the drug of choice for PCP
What are the clinical applications of Cotrimoxazole?
• Uncomplicated UTI’s (drug of choice)
• PCP (drug of choice)
• Nocardiosis (drug of choice)
• Toxoplasmosis (alternative drug)
• Respiratory, ear, sinus infections (H.influenzae,
What are the adverse effects of Cotrimoxazole?
• Dermatologic (common)
• Hematologic (hemolytic anemia)
• AIDS patients = higher incidence
• Contraindicated in pregnancy (esp. 1st trimester)
What does Metronidazole mainly affect?
Activity against anaerobic bacteria (including bacteroides & Clostridium)
What is needed for Metronidazole to be effective?
Aerobic conditions bc undergoes reductive bioactivation of nitro group by ferrodoxin.
What are the clinical applications of Metronidazole?
• C.difficile infections (drug of choice)
• Anaerobic or mixed intra-abdominal infections
• Vaginitis (trichomonas & bacterial vaginosis, G.vaginalis)
• Brain abscesses
• H.pylori eradication (in combination)
What are the adverse effects of Metronidazole?
• GI irritation, stomatitis, peripheral neuropathy (prolonged use)
• Headache, dark coloration of urine
• Leukopenia, dizziness, ataxia (rarer)
• Opportunistic fungal infections
• Disulfiram-like effect (avoid alcohol)
• Use generally not advised in 1st trimester
Which drug is a urinary antiseptic?
What are the adverse effects of Nirofurantoin?
• Anorexia, nausea & vomiting.
•Neuropathies, hemolytic anemia (G6PD deficient patients)