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Flashcards in 8.7 Deck (13):
1

Where does Trimethoprim work?

Inhibits Dihydrofolate reductase.

(inhibits purine, pyrimidine, & amino acid synthesis)

2

What are the clinical applications of Trimethoprim?

• UTI’s
• Bacterial prostatitis
• Bacterial vaginitis

3

What are the adverse effects of Trimethoprim?

• Antifolate effects (contraindicated in pregnancy)
• Skin rash, pruritus

4

What is the drug of choice for PCP

Cotrimoxazole

5

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,
M.catarrhalis)

6

What are the adverse effects of Cotrimoxazole?

• Dermatologic (common)
• GI
• Hematologic (hemolytic anemia)
• AIDS patients = higher incidence
• Contraindicated in pregnancy (esp. 1st trimester)

7

What does Metronidazole mainly affect?

Activity against anaerobic bacteria (including bacteroides & Clostridium)

(below diaphram)

8

What is needed for Metronidazole to be effective?

Aerobic conditions bc undergoes reductive bioactivation of nitro group by ferrodoxin.

9

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)

10

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

11

Which drug is a urinary antiseptic?

Nitrofurantoin

12

What are the adverse effects of Nirofurantoin?

• Anorexia, nausea & vomiting.
•Neuropathies, hemolytic anemia (G6PD deficient patients)

13

What are the contraindications of Nitrofurantoin?

• Significant renal insufficiency
• Pregnancy at term (38-42 weeks)
• Infants <1 month (risk of hemolytic anemia)