Drugs for GI infections II Flashcards Preview

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Flashcards in Drugs for GI infections II Deck (47):
1

MOA bismuth subsalicaylate

bismuth coats ulcers and erosions forming protective barrier
atimulates PG, mucus, and HCO3
salicylate inhibites intestinal PG and Cl secretion (reduce stool frequency and liquidity in infecitous diarrhea)

2

therapeutic use bismuth subsalicylate

dyspepsia and acute diarrhea
travelers diarrhea
H pylor infection

3

adverse reactions from bismuth subsalicylate

harmless blackening of stool, liwuid could cause blackening of tongue
high doses: slaicylate toxicity, Reyes syndrome in kids
avoid in renal impairment

4

MOA fluoroquinolones

[ ] dep killing
targets bacterial DNA gyrase and topoisomerase IV

5

bacterial R to fluoroquinolones

mutation in bacterial chromosome genes encoding DNA gyrase or topoisomerase IV or by active trasnport out of the cell

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fluoroquinolones work on what bacteria

E coli, salmonella, shigella, enterobacter, campylobacter, neisseria, pseudomonas, aeruginosa, S aureus

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which fluoroquinolones work on strep spp

levofloxacin, gatifloxacin and moxifloxacin

8

therapeutic uses of fluoroquinolones

UTI, prostatisi, STI, travelers diarrhea, shigellosis, joint STTI infeciotns, DM foot infections

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adverse effects fluoroquinolones

GI (nausea, vomiting, abdominal discomfort)
CNS(mild HA, dizziness, delirium, rare hallucinations)
rash, photosensitivity, Achilles tendon rupture

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contraindications to fluoroquinolones

children because of achilles tendon rupture

11

MOA aminoglycosides

[ ] dependent, binds 30s ribosomeal subunit and disrupts normal cycle ribosomal funciton by interfering with initiation protein synthesis

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bacterial R to aminoglycosides

AG metabolizing enzymes, impaired transport of drug into cell, altered ribosom

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what microbesn are aminoglycosdes used against

aerobic gram - bacteria, limited action against gram +, produces synergistic bactericidal effects in gram + when combine with a cell wall active agent

14

GI uses aminoglycosides

UTI, peritonitis with peritoneal dialysis

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adverse effects aminoglycosdes

ototoxicity, nephrotoxicity, neuromuscular block and apnea

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what are the aminoglycosides

amikacin
tobramycin
gentamicin

17

MOA tetracycline

bacteriostatic, inhibits bacterial protein synthesis by binding 30s bacterial ribosome and preventing access of aminoacyl tRNA to acceptro A site on mRNA ribosome complex

18

bacterial R to tetracyline

decreased influx acquisition of energy dependent efflux, ribosomal protection proteins, enzymatic inactivation

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spectrum tetracycline covers

aerobic and anaerobic gram + and gram -
also rickettsie, coxiella, mycoplasma, borrelia, treponema
Pseudomonas resistant

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therapeutic use tetracyline

MRSA, rickettsial, CAP, Q fever, anthrax

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adverse effects tetracycline

GI (epigastric burining, abdominal discomfort, nausea, vomiting, diarrhea, superinfecitons like C diff, photosensiticity, teeth discoloration

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what are macrolides

azithromycin erythromycin

23

MOA macrolides

bacteriostatic, binds reversibly to 50s ribosomal subunit, inhibits translocation where a newly synthesized peptidyl tRNA molecule moves from acceptor site on ribosome to peptidyl donor site

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bacterial R with macrolids

drug efflux, ribosomal protection proteins, hydrolysis, ribosomal mutaitons

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spectrum covered by macrolides

aerobic gram + cocci, bacilli
clostridium , listeria monocytogenes

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therapeutic use of macrolides

respiratory tract infections
alternative otitis media,s inusitis, bronchitis and SSTIs
pertussis, gastroenteritis
H pylori
mycobacterial infecitons

27

MOa metronidazole

prodrug that requires reductive activation by susceptible organisms

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bacterial resistance to metronidazole

decreased formation of nitro radicals

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spectrum metronidazole

anaerobic coccie and both anaerobic gram - bacilli and anaerobic spore forming gram + bacilli, trichomoniasis, amebiasis, giardiasis, Helicobacter and Campylobacter

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Therapeutic use of metronidazole

bacterial vaginosis, amebic liver abscess, Tx anaerobic bacterial infections
part of regimen prophylazis coloretal surgery, C difficile, Crohns

31

adverse effects metronidazole

HA, nausea, dry mouth, metallic taste, vomiting, diarrhea, abdominal distress!! esp with alcohol!!!
dizziness, vertigo, encephalopathy

32

drug interactions metronisazole

induced metabolism of phenobarbital, prednisone, rifampin, prolongs prothrombin time with those on warfarin
metabolism is inhibited by cimetidine

33

MOA TMP-SMX (bactrim)

sulfonamide: bacteristatic and competetive inhibitors dihyropteroate synthase (needed for precursot to folic acid)
trimethoprim: inhibits microbial dihydrofolate reductase

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bacterial R to TMP-SMX

lower affinity of enzymes to drug binding, decreased bacterial permeability or active efflux, alternative pathway for essential metabolites synthesis, increased production of essential metabolie

35

spectrum of TMP-SMX

chlamydia, N meningitis S aureus
S epidermidis and pygoesns
viridans
E coli
Proteus
Enterobacter
Salmonella
Shigella
Serratia
Klebsiella
Brucella
Pasteurella
Yersinia

36

therapeutic use of TMP-SMX

UTI, bacterial prostatitis, bronchitis, shigellosis, travelers diarrhea, salmonella, pneumocysitis jiroveci prophylaxis in neutropenia,

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adverse effects tMP-SMX

allergic skin rashes, nausea, comtiing, CNS, photosensitivity, renal dysfunction, Stevens-Johnson syndrome

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drug interactions of TMP-SMX

potentiate effects of warfarin

39

what is the glycopeptide antibiotic

vancomycin

40

MOA vancmoycin

inhibits cell wasll synthesis binding with high affinity to D alanyl D alanine terminal cell wall unites

41

bacterial R to vancomycin

alteration to D alanyl D to D alanyl D lactate or serine

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spectrum covered by vancomycin

gram + S aureus, S epidermidis, Strep, Bacillus, Corynebacterium, actinomyces, clostriudum, all gram - and mycobacterium

43

therapeutic uses vancomycin

osteomyelitis, endocarditis, MRSA< strep, enterococci, CNS infections, bacteremia, orally for C difficle

44

adverse effects vancomycin

macular skin rash, chills, fever, red man syndrome from rapid infusion
direct toxicity from vanco on mast cells causing release histamine
ototoxicity, nephrotoxicity

45

MOA loperamide

inhibit presynaptic cholinergic nerves in submucals and myenteric plexuses, increase transit time, increase fecal water absorption, decrease mass colonic movements

46

therapeutic use loperamide

nonspecific Tx diarrhea
moderate- severe diarrhea
loperamide useful in travelers diarrhea

47

side effects loperamide

may cause toxic megacolon in patients with active IBD
should not be used in those with UC or acute bacillary or amoebic dysentery
dixcontinued if clinical improvement does not occur within 48 hours