9.1 Sulfa II Flashcards Preview

270 S1 > 9.1 Sulfa II > Flashcards

Flashcards in 9.1 Sulfa II Deck (27):
1

What is the mechanism of Metronidazole/flagyl?

Small molecule diffuses into cells, once activated releases free radicals that break DNA.

2

What class of bacteria does Metronidazole target? Examples?

Anaerobes- they have the e- txp chain needed to activate free radicals

C. Diff, B. fragilis

3

Do bacteria become resistant to Metronidazole?

Rare-

4

What are the SA of metronidazole?

Nausea, Epigastric dyscomfort
Metallic taste
Furring of tongue
Headache, dizziness, neuropathy – high dose and long duration
Disulfiram – like reaction

5

What is the MOA of bacitracin?

Inhibits cell wall synthesis

6

What does bacitracin cover?

G+ cocci and bacilli
Neisseria; H. flu
Treponema pallidum; Actinomyces; Fusobacterium

7

What doesn't bacitracin cover?

Enterobacteriaceae; Pseudomonas; Candida; Norcardia

8

How is bacitracin prepared?

PO Only
IV- D/C'd due to nephrotoxicity

9

What is mupirocin?

Topical 2% med

10

What does mupirocin cover?

G+ (i.e. Strep pyogenes & MSSA & MRSA)
G- (i.e. H. Flu; Neisseria; B. Catarrhalis; Pasteurella Multocida)

11

What is the mechanism of mupirosin?

Reversibly inhibits Aminoacyl-tRNA synthetase Prevents AA attaching to tRNA (i.e. prevent “loading” or “charging”)  stop protein synthesis

12

What is the indication for mupirosin?

Nasal MRSA

13

What is the most important characteristics of mycobacterium?

4 layers of cell wall, outer made from mycelia acid
Many efflux pumps
Can hide INSIDE patient's own cells

14

What are the most common anti-mycobacterial agents?

Isoniazid- most common
Rifamycins- (RNA polymerase)
Some aminoglycosides (streptomycin)
Some macrolides (azithromycin)

15

What is the mechanism of Isoniazid (INH)?

Inhibits mycolic acid synthesis- which makes up the cell wall
Prodrug- diffuses into mycoplasma where activated by KatG that then interferes with mycolic acid

16

What is the indication for INH/Isoniazid?

TB

17

How do cells become resistant to INH?

Mutation of activating enzyme

18

What are the SE of INH?

Rash, fever, dry mouth
Methemoglobinemia
Hepatoxicity (esp. together with 2E1 inducers)
2E1 converts INH to hepatotoxic metabolite
Neuropathy – to prevent give with vit B6
Arthritic symptoms

19

What are special considerations with INH?

Monitor LFTs
Many DDI- induces 2E1 (same as ETOH, many other meds)

20

What is the indication for Pyrazinamide?

Given with INH for TB

21

What is the mechanism of Pyrazinamide

Not fully known
Targets enzymes for synthesis of mycolic acid
Reduction of intracellular pH
Disrupt membrane transport
** Only works at acidic pH

22

What are the SA of pyrazinamide?

Arthralgias, anorexia, N/V
Fever, malaise, dysuria
Hepatotoxicity
Increase uric acid higher risk for gout

23

What is Ethambutol?
MOA

TB drug
Target the synthesis of mycobacterial cell wall
Disrupt the assembly of cell wall

24

What are the SA of ethambutol?

Optic Neuritis --> decrease visual acuity and red-green color blindness
Rash, pruritus
Joint pain, GI upset, HA, dizziness

25

What is the tx for multi-drug resistant TB?

Bedaquiline

26

What is the mechanism of Bedaquiline?

Inhibits bacterial ATP synthase

27

What are the notable SA of bed aquiline?

QT prolongation
Hepatitis