Antibacterial drugs (12 Q's on the test) Flashcards Preview

Pharm Exam 4 SP2018 > Antibacterial drugs (12 Q's on the test) > Flashcards

Flashcards in Antibacterial drugs (12 Q's on the test) Deck (30):
1

Sulfonamides: -cidal or -static

-static

2

Sulfonamides MOA

inhibit Dihydropteroate synthase (inhibits folate synthesis and RNA/DNA/aa synthesis)

3

what are some dose unrelated toxicities of sulfonamides

hypersensitivity rxns (Stevens Johnson-mild to serious rashes)
photosensitivity
acute kidney injury (sulfamethoxazole)

4

what are dose related toxicities of sulfonamides?

crystalluria (if not well hydrated)
GI
anemia
Kernicterus (encephalopathy in neonates)

5

clinical uses of sulfonamides

UTIs
pneumocystis jirovecii in HIV/AIDS
prophylaxis: meningitis, burns, wounds

6

Trimethoprim: -static or -cidal

-static

7

Trimethoprim inhibits

Dihydrofolate reductase (we have this enzyme too but works better with prokaryotes)

8

What is a good drug to use in combination with trimethoprim (synergism)?

sulfamethoxazole (both are static but become cidal together)

9

clinical uses of trimethoprim

urinary, respiratory infections
prostatis
pneumocytis jarovecii in AIDS
MRSA***(know)

10

Which works better for pseudomonas aeruginosa? Sulfonamides or Trimethoprim?

Sulfonamides

11

Quinolones: -static or -cidal

-cidal

12

Quinolones MOA

Inhibit DNA gyrase and Topoisomerase IV

13

Quinolones inhibit DNA gyrase. What is DNA gyrase's function?

induces transient double strand breaks in DNA to relieve torsional stress in front of replication fork

14

Quinolones have a rapid excretion in the urine but what is the one exception?

Moxifloxacin

15

3 resistant mechanisms to quinolones?

1) DNA gyrase or Topo IV mutations
2) Increased efflux
3) altered porins

16

Quinolones are well absorbed orally but one can be inhibited by drinking with milk since it is inhibiting by cations++

Cipro

17

Nitrofurantoin MOA

nitro-reduction to form DNA damaging oxygen radicals

18

Nitrofurantoin: -static or -cidal

-static but can be -cidal with high doses

19

Clinical use of nitrofurantoin

UTI's (single dose usually)

20

Nitrofurantoin is well absorbed ... and has ... levels in the urine. One possible toxicity is ... which is reversible

orally
high
pulmonary fibrosis

21

T/F: Metronidazole is a pro-drug

true

22

Metronidazole: -static or -cidal

-cidal

23

Metronidazole requires ... ... activation

anaerobic reductive

24

Metronidazole MOA

anaerobic nitro-reduction to metabolites that bind to and perturb DNA function

25

Resistant mech. to metronidazole

reduced activation

26

Clinical uses of metronidazole

anaerobic infections- gram positive and gram negative; some protozoal infections

27

Toxicities of metronidazole

metallic taste

disulfiram-like effect (nausea,vomiting)

peripheral neuropathy

central neurotoxicity: dizziness, vertigo, convulsions, ataxia

28

4 important resistant mechanisms to beta-lactams

1) beta-lactamases (gram + and gram -)

2) Altered PBP's (MRSA->MecA->PBP2a)(lower affinity for beta-lactams)

3) Altered Porins (gram neg)

4) Increased efflux (gram neg)

29

Clinical uses of PCNs

Group A streptococcus
Streptococcus pneumoniae (pediatric)
Endocarditis, meningitis
STD's (+probenecid)
UTI's

30

Are Penicillins dose or time dependent?

Time-dependent