Antimicrobials Flashcards by William Pickering

Classic rare complication of fluoroquinolones

Achilles tendon rupture in patient over 60 or on steroids

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NRTI mechanism

competitive reverse transcriptase inhibition

requires phosphorylation (except tenofovir)

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Linezolid toxicities (name 3)

Thrombocytopenia, peripheral neuropathy, serotonin syndrome

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Ganciclovir toxicity

leukopenia

neutropenia

thrombocytopenia

renal toxicity

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Protease inhibitor mechanism

Protease cleaves polypeptide products of HIV mRNA into their functional parts

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Chronic granulomatous disease tx

IFN-gamma

Gamma for Granulomatous

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imipenem must be give with?

cilastatin

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Tetracyclines mechanism

30S

Prevent attachment of aminoacyl-tRNA

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Toxic side effects of carbapenems

GI, derm, seizures

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chloroquine mechanism

causes heme accumulation that’s toxin to plasmodia

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Macrolide Toxicities

MACRO

  GI **M**otility

** A**rrthythmia 2/2 long QT

Acute Cholestatic hepatitis

** R**ash

    e**O**sinophilia

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Enfuvirtide mechanism:

fusion inhibitor, binds gp41, inhibiting entry

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M. leprae treatment

tuberculoid form:

lepromatous form:

tuberculoid: dapsone, rifampin
lepromatous: clofazimine

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ziduvodine toxicity

general NRTI toxicities + anemia

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Interferons have what molecular structure

glycoproteins

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Antimicrobial mechanism of Vancomycin

Disrupts cell wall peptidoglycan synthesis

Modification of D-ala D-ala to D-ala D-lac

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What are the 3 components of HAART?

2 NRTI’s and 1 of the following:

NNRTI or protease inhibitor or integrase inhibitor

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Name 3 NNRTIs

Delaviridine

Efavirenz

Nevirapine

DEN

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Function of cilastatin

inhibits renal dehydropeptidase I

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Tx for resistant pseudomonas

colistin (polymixins b and e)

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PPX of strep pharyngitis in child with prior rheumatic fever

Benzathine PCN G or oral PCN V

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Mechanism of penicillins and cephalosporins

Inhibit peptidoglycan cross-linking

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Tetracyclines: don’t take with what?

Divalent cations: Milk, antacids, iron

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Chloramphenicol mechanism

Blocks peptidyltransferase at 50S

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Sulfonamides mechanism Cidal or static

Inhibits dihydropteroate synthase (part of folate synthesis) Static

Metronidazole mechanism Cidal or static

Forms free radicals that damage DNA Cidal

Aminoglycoside mechanism

30S Inhibits initiation complex

Aminoglycosides: cidal or static?

cidal

Linezolid mechanism

Binds to 50S and inhibits formation of initiation complex

-cyclovir mechanism

guanosine analog, inhibits viral DNA polymerase

-fungins aka echinocandins mechanism

inhibits cell wall synthesis by inhibiting synthesis of beta-glucan

Which has greater oral bioavailability: Amox or Amp?

Amox

Unique effect of ritonavir

boosts other drug concentrations by inhibiting P-450

PPX: High risk for endocarditis and undergoing dental procedure

Amox

Preggers with GBS

PCN G

Prevention of post-surgical infection 2/2 S. aureus

cefazolin

Trimethoprim mechanism? Cidal or static?

Inhibits bacterial dihydrofolate reductase Static

IFN beta use

MS treatment

Isoniazid toxicities

**INH** **I**njures **N**eurons and **H**epatocytes

TB Prophylaxis: Treatment:

Prophylaxis: Isoniazid Treatment: Rifampin, Isoniazid, Pyrazinamide, Ethambutol (RIPE)

Nystatin mechanism

binds to ergosterol and forms membrane pores (same as Amphotericin B)

Oseltamivir and zanamivir mechanism

inhibit influenza neuraminidase

NRTI toxicities

Bone marrow suppression Peripheral neuropathy lactic acidosis

Ethambutol mechanism

Blocks arabinoglycan synthesis

Terbinafine use

Dermatophytes especially onychomycosis

TMP toxicities

**T**reats **M**arrow **P**oorly Megaloblastic anemia, leukopenia, granulocytopenia

What can you not take with a fluoroquinolone

antacid

vivid dreams and CNS symptoms in patient on HAART

efavirenz

Griseofulvin mechanism

disrupts microtubule function

Maraviroc mechanism

fusion inhibitor -- binds CCR5, preventing interaction with gp120

these NNRTI's are contraindicated in pregnancy

efavirenz delavirdine

Clinical use for aztreonam

GNR only Useful in PCN allergies and renal insufficiency

IFN toxicity

neutropenia myopathy

Flucytosine mechanism

inhibits DNA and RNA synthesis by converting 5FU --\> cytosine deaminase

ribavirin toxicity

hemolytic anemia teratogenic

Clindamycin: cidal or static

static

Terbinafine mechanism

inhibits squalene epoxidase (enzyme involved in ergosterol synthesis)

Isoniazid mechanism

Decreases mycolic acid synthesis

simeprevir mechanism

HCV protease inhibitor

Azoles mechanism

Inhibits ergosterol synthesis by inhibiting cytochrome P450 enzyme

Clindamycin mechanism

Blocks peptide transer (translocation) at 50S subunit

Protease inhibitor toxicities

Nephropathy (indinavir) hematuria (indinavir) GI intolerance hyperglycemia lipodystrophy (protease inhibitors mess up pee and poop)

Chloramphenicol: cidal or static

static

-navir drugs are what class

protease inhibitor

raltegravir toxicity

increased CK

Macrolide mechanism

Binds 50S, blocks translocation

raltegravir mechanism

integrase inhibitor

Permethrin mechanism

blocks Na channels

Three toxicities of vancomycin

Nephro Oto Thrombophlebitis

Doxycycline route of elimination

Feces

treatment for CMV retinitis

ganciclovir try foscarnet or cidofovir if ganciclovir fails

Foscarnet and cidofovir mechanism

inhibits DNA polymerase

-cyclovir toxicity

obstructive crystalline nephropathy

Pyrazinamide toxicities

Hyperuricemia Hepatotoxicity

sofosbuvir mechanism

inhibits RNA polymerase in HCV

Aminoglycoside ineffective against

anaerobes

Foscarnet is a ___ analog?

pyro**fos**phate analog

Fluoroquinolone mechanism Cidal or static

Inhibit prokaryotic topoisomerase II (DNA gyrase) and topoisomerase IV Cidal

Rifampin 4 R's

**R**NA polymerase inhibitor **R**amps up cytochrome P-450 **R**ed/orange body fluids **R**apid resistance if used alone

didanosine toxicity

general NRTI toxicities + pancreatitis

Macrolide cidal or static

static

Amphotericin B mechanism

binds ergosterol and forms membrane pores "tears holes"

NNRTI toxicity

rash, hepatotoxic

Tetracyclines: cidal or static?

static

Ethambutol toxicity

Optic neuropathy (Eye-thambutol)

Ribavirin mechanism

blocks guanine nucleotide synthesis inosine monophosphate dehydrogenase inhibitor

What is needed to convert isoniazid to active metabolite? What encodes it?

bacterial catalase peroxidase KatG

Tx for ringworm, tinea

griseofulvin

Daptomycin mechanism

Lipopeptide disrupts cell membrane Cidal

Antimicrobials Flashcards

(89 cards)