French DNA Function Inhibitors

Question 1

Drugs that inhibit DNA function in bacteria?

Answer 1

Fuoroquinolones

Question 2

FQ mechanism?

Answer 2

CIDAL - inhibit bacterial DNA gyrase & topoisomerase

Question 3

Resistance to FQ?

Answer 3

plasmid-mediated: Qnr proteins that protect DNA gyrase & acetyltransferases that modify cipro

Question 4

FQ absorption?

Answer 4

PO (also IV)

Question 5

FQ distribution?

Answer 5

well - especially into lungs & high urinary levels

Question 6

FQ elimination

Answer 6

primarly by kidney

Question 7

Cipro Spectrum?

Answer 7

G- (Pseudomonas) good for UTIs

Question 8

Levo Spectrum?

Answer 8

G+/- (strep, MSSA, pseudo) good for lung infections

Question 9

ADRs to FQs?

Answer 9

GI (CDAD), CNS disturbance, tendon rupture, arthropathies

Question 10

DDIs w FQs?

Answer 10

Theophylline (decreased metabolism), antacids (reduced po absorption)

Question 11

Nitrofurantoin mechanism?

Answer 11

static/cidal - damage DNA (needs to be reduced in bacterial cell)

Question 12

Nitrofurantoin absorption?

Answer 12

PO (rapid GI abs)

Question 13

Nitrofurantoin metabolism?

Answer 13

rapid urine excretion (urinary antiseptic)

Question 14

Nitrofurantoin spectrum?

Answer 14

G- (E coli resistant to TMP/SMX) for UTIs

Question 15

ADRs to nitrofurantoin

Answer 15

GI upset, hypersensitivity rxns (hemolytic anemia, hepatocellular damage), neuropathies, Cat B in pregnancy

Question 16

Metronidazole mechanism?

Answer 16

CIDAL- radical-mediated DNA damage (only turns into prodrug in susceptible organisms)

Question 17

Resistance to Metronidazole?

Answer 17

nitroimidazole reductase stops prodrug formation

Question 18

Metronidazole Absorption?

Answer 18

PO

Question 19

Metronidazole Distribution?

Answer 19

CSF & Bone

Question 20

Metronidazole metabolism?

Answer 20

hepatic metabolism, excreted in breastmilk

Question 21

Metronidazole spectrum?

Answer 21

anaerobic bacteria (C diff, B fragilis), protozoa

Question 22

ADRs to Metronidazole?

Answer 22

Candidal superinfections, Cat b in pregnancy

Question 23

DDIs with Metronidazole?

Answer 23

Alcohol (aldehyde dehydrogenase), CYP450 inhibitors/inducers

Question 24

Sulfonamides mechanism?

Answer 24

anaologue of PABA, inhibits DHPS synthesizes folic acid in bacteria

Question 25

Resistance to sulfonamides?

Answer 25

increase PABA, altered DHPS, use DNA precursors from pus

Question 26

Sulfonamides and trimethoprim?

Answer 26

synergistic, CIDAL (together inhibit DNA synthesis pathway so much it kills)

Question 27

Sulfonamides Absorption?

Answer 27

PO (also IV)

Question 28

Sulfonamides distribution?

Answer 28

fluids (including CSF), fetus

Question 29

Sulfonamides metabolism?

Answer 29

metabolized to insoluble toxic compound excreted by urine

Question 30

Sulfonamides spectrum?

Answer 30

Broad (G+/-, chlamydia, protozoa)

Question 31

ADRs to sulfonamides?

Answer 31

fever, rashes, hematologic toxicity, stevens-johnson syndrome, renal damage, Cat C in pregnancy, hemolytic anemia

Question 32

DDI w sulfonamids?

Answer 32

kernicterus in infants, increased effect of oral anticoagulants