Metabolite Inhibitors And Others

Question 1

Sulfonamides
Mechanism
Cidal or Static?

Answer 1

Bacteriostatic
PABA anti metabolite
Inhibits dihydropteroate synthetase

Question 2

Sulfonamides

Clinical use

Answer 2

Gram + and -

Nocardia and Chlamidia

Question 3

Sulfonamides

Toxicity

Answer 3

Hypersensitivity
Hemolysis if G6PD deficient
Nephrotoxicity
Photo Sensitivity
Kernicterus in infants

Question 4

Trimethoprim

Mechanism

Answer 4

Bacteriostatic

Inhibits dihydrofolate reductase

Question 5

Trimethoprim

Clinical Use

Answer 5

Recurrent UTIs, Shigella, Salmonella, Pneumocystis jiroveci

Question 6

Trimethoprim

Toxicity

Answer 6

Pseudo membranous colitis
Hematological disorders
Fever
Diarrhea
Cellulitis

Question 7

How is silver Sulfadiazine used?

Answer 7

Topically for burn treatment

Question 8

TMP/SMX

AKA?

Answer 8

Cotrimoxazole, Bactrim, or Septra

Question 9

TMP/SMX

Clinical Use

Answer 9

Drug of Choice: Pneumocystis jiroveci (Carinii)

Recurrent UTIs

Question 10

Isoniazid

Mechanism

Answer 10

Bacteriocidal if rapidly dividing
Inhibits mycolic acid synthesis
Prodrug cleaved by bacterial catalase-peroxidase

Question 11

Isoniazid

Clinical Use

Answer 11

Monotherapy for prophylaxis of Latent TB

RIPE for active and recurrent TB

Question 12

Isoniazid

Toxicity

Answer 12

Hepatotoxicity
Neurotoxicity
Disulfiram like reaction with alcohol
*must give with vit b6 to prevent peripheral neuropathy

Question 13

Pyrazinamide

Mechanism

Answer 13

Inhibits mycolic acid synthesis
Prodrug with cleaved by bacterial pyrazinamidase
Accumulates at low pH of granule as

Question 14

Pyrazinamide

Clinical use

Answer 14

Active TB (RIPE)

Question 15

Pyrazinamide

Toxicity

Answer 15

Hepatotoxicity
Gout
Rash
DO NOT GIVE IN PREGNANCY

Question 16

Ethambutol

Mechanism

Answer 16

Crosses BBB

Decreases carb polymerization, inhibits arbanosol transferase = inhibits formation of Mycobacterial cell wall

Question 17

Ethambutol

Clinical Use

Answer 17

Active TB (RIPE)

Question 18

Ethambutol

Toxicity

Answer 18

Ocular Toxicity
Color Blindness
Ocular Neuritis
Blindness

Question 19

Bedaquiline

Mechanism

Answer 19

Inhibits Mycobacterial ATP synthase

Question 20

Treatment and Prophylaxis for leprosy

Answer 20

Rifampin for treatment, Dapsone for prophylaxis

Question 21

Dapsone

Mechanism

Answer 21

Competes with PABA (inhibits dihydrofolate synthesis)

Question 22

Dapsone

Clinical Use

Answer 22

Prophylaxis of leprosy and pneumocystis jiroveci

Question 23

Dapsone

Toxicity

Answer 23

Hepatotoxicity
Hemolysis
Cross sensitivity with sulfa drugs

Question 24

Rifaximin

Mechanism

Answer 24

Inhibits DNA dependent RNA polymerase

Question 25

Rifaximin | Clinical use

Answer 25

Prophy for travelers diarrhea Hepatic encephalopathy Chron's disease

Question 26

Rifaximin | Toxicity

Answer 26

Constipation

Question 27

Fidaxomicin | Mechanism

Answer 27

Inhibits bacterial RNA polymerase

Question 28

Fidaxomicin | Clinical Use

Answer 28

Resistant/recurrent C. Difficile (not absorbed well in gut)

Question 29

Fidaxomicin | Toxicity

Answer 29

GI hemorrhage | Neutropenia

Question 30

Six drugs that frequently cause pseudo membranous colitis

Answer 30

``` Ampicillin Amoxicillin Cephalosporins Clindamycin Other Penecillins Aztreonam ```

Question 31

Sulfonamide

Answer 31

Sulfamethoxazole | Sulfadiazine

Question 32

Bedaquiline | Clinical use

Answer 32

Multi drug resistant TB

Question 33

Bedaquiline | Toxicity

Answer 33

Nausea Vomiting Arthralgia