Block DNA topoisomerase
Patient with strep is allergic to pencillin; What do you treat her with?
Inhibits dehydropteroate synthase?
Obstructed crystalline nephropathy?
Acyclovir, Valacyclovir, famciclovir
MOA of fluoroquinolones?
Inhibit DNA gyrase
GET GAP on the Metro: Giardia; Entamoeba, Trichimonas; Garnderalla; Anaerobes (Cdiff and bacteroides); Hpylori (along with proton pump inhibitor; and clarithromycin)
Used for history of recurrent UTIs
Endocarditis with surgical or dental procedures?
Trypansoma brucei? What is trypansoma brucei?
suramin and melarsoprol; African sleeping sickness
4 main uses of tetracycline?
Borrelia; M. pneumoniae; Very effective against Chlamydia and Rickettsia for its ability to accumulate intracellularly
Pregnant woman with group B strep?
Ampicillin (may cause pseudomembranous colitis)
Prevention of gonoccocal or chlamydial conjunctivitis in newborn?
Inhibits DNA dependent RNA polymerase?
All drugs that end in "navir?"
Drug used for Staph Aureus?
Nafcillin (use Naf for Staph); Oxacillin, dicloxacillin
NRTI that is a nucleoTide and therefore does not need to be activated?
Inhibits D-ala D-ala portion of cell wall precursors?
This molecule converts Flucytosine to 5 FU
Protein synthesis inhibitor that requires O2 for uptake?
Patient presents with gynecomastia and liver dysfunction 1 week after starting a medication to treat his coccioides infection.
Azoles! cause gynecomastia
Inhibits bacterial dihydrofolate reducatase
MOA of caspofungin and micafungin?
inhibit synthesis of beta glucan; used for invasive aspergilossis and candida May cause flushing due to histamine release
treats trypanosoma cruzi
MOA of macrolides?
blocks translocation by binding to the 23S rRNA-- macroslides
Antibiotic that causes aplastic anemia?
Chloramphenicol (blocks peptidyl transferase)
Causes ototoxicity during preg?
Inhibits squalene epoxidase?
Drug with high risk of seizures; only used in life threatening situations?
Carbapenems (Imipenem/cilastatin, meropenem)-- cn also get skin rash and GI distress
Causes a disulfiram like reaction with alcohol?
MOA of macrolides?
Blocks 50S and protein synthesis by blocking translocation; thought to block peptidyl transferase
Patient is started on Isoniazid. How can she prevent neurotoxicity and lupus?
Treats dermatophytoses; what is side effect?
Terbinafine; may cause abnormal LFTs and visual disturbances
Toxicity and MOA of chloroquine
Retinopathy; blocks detoxification of heme into hemozoin
Inhibits influenza neuraminidase
Anaerobes above the diaphragm (metronidazole is anaerobes below the diaphragm)
Cipro for adults; Rifampin for children
Blocks 50s from binding during ribosomal assembly?
Blocks DNA topoisomerase?
Blocks mRNA synthesis?
Azithromycin; calrithromycin; erythromycin
Cause tendon rupture, leg cramps and myalgias?
FluoroquinoLONES hurt attachments to your BONES; also cause GI upset, skin rashes, headache and dizziness
CD4 count of
TMP-SMX-- to prevent pneumocystis pneumonia
everything that ends in "oxacin"; mostly floxacin (think ciprofloxacin)
Viral DNA polymerase inhibitor that binds pyrophosphate binding site of enzyme-- does not require viral kinase?
Foscarnet-- pyroFosphate analog
Inhibits influenza neuroaminidase?
Zanamivir and oseltamivir
Used to treat ringworm?
Girseoflvin; interferes with microtubule function; disrupts mitosis
Causes cartilage damage during pregnancy?
Antibiotic that causes discoloration of teeth?
Beta lactamase inhibitors?
CAST-- Clavulanic Acid; Sulbactam; Tazobactem
Sulbactem and Tazobactem?
Beta lactamase inhibitors (CAST)
Side effect of Ribavirin?
Azithromycin (mycobacterium avium complex)
Extended spectrum penicillin?
Amoxicillin and ampicillin (amoxocillin has greater oral bioavailability)
carbapenems-- only used for life threatening cases due to inc risk for seizures (except for meropenem which has reduced risk of seizure)
Treatment of pneumocystis?
Blocks peptide transfer
May cause pseudomembrouns colitis
Ampicillin or clindomycin
Meningitis (Haemophilus; Neisseria, Strep) in developing countries because of low cost; has lots of side effects including gray baby syndrome, aplastic anemia, anemia,
Drug for Borrelia?
Tetracycline and ceftriaxone
Treatment of legionella?
Blocks peptidoglycan synthesis
Pt. presents with hearing difficulties, pain and swelling of arm, with diffuse flushing
Red man syndrome-- caused by VancomycinOtoxoticity, nephrotoxicity, thrombophlebitis, diffush
Treatment of leprosy?
Dapsone+ rifampine (first 6 months) + (clofazimine for 2-5 years)
Where is pyrainamide most effective?
In acidic pH of phagolysosomes, where TB engulfed by macrophages is found
Used for pseudomonas; Cephalosporin
Nevirapine, Efavirenz, Delavirdine, zidovudine, tenofovir
Treats anaerobic infections below the diaphragm?
MOA of Sulfonamides?
PABA antimetabolites inhibit dihydropteroate synthase
Use of fluoroquinolones?
Mostly gram negative rods of urinary and gi tracts including pseudomonas
Uses of Acyclovir?
HSV and VZV-- no activity against EBV
Inhibits peptidoglycan cross linking?
Blocks peptidoglycan synthesis
Have low cross reactivity with penicillin?
Inhibits influenza neuroaminidase
Block peptidoglycan synthesis?
Bacitracin and vancomycin
Interferes with microtubule function; disrupts mitosis?
Girseofulvin; deposits in keratin containing tissues; used for superficial infections; tinea, ringworm
History of recurrent UTIs
Side effect of cephalosporins? 2
Vit K deficiency and increases nephrotoxicity of aminoglycosides
Penicillinase resistant penicillins?
Oxacillin, nafcillin, dicloxacillin (due to bulky R group that blocks access of Beta lactamase)
Block nucleotide synthesis by inhibiting folic acid synthesis
4 drugs used for TB?
Ethambutol Pyrazinamide Rifampin Isoniazid
May cause red-green color blindness?
Ethambutol (used for TB)
drug for haemophilus and proteus?
ampicillin and amoxicillin HELPSS
Mean GNATS caNNOT kill anaerobes
AMEANOglycosides: gentamicin; neomycin; amikacin; tobramycin; streptomycin) and CAuse nephrotoxicity; neuromuscular blockade; otoxocity; teratogen Require O2 for uptake
Antifungal that causes bone marrow suppression?
INH; Injures Neurons and Hepatocytes; Pyridoxine can prevent neurotoxicity
Do not take this antibiotic with Milk or iron containing products?
Tetracycline-- forms a divalent cation that cannot be absorbed by gut
Competitively inhibits IMP dehydrogenase leading to inhibition of guanine nucleotides?
Treatment for simple UTI?
Always used with imipenem to decrease inactivation of drug in renal tubules?
CD4 count of
TMP SMX-- to prevent pneumocystis and toxoplasmosis
MACRO: Motility issues, Arrhythmias (Torsades), Cholestatic hepatitis, Rash, eOsinophilia
Tetracycline toxicities: 5
Discoloration of teeth; inhibition of bone growth in children; photosensitivity; GI--- also teratogenic
Used for meningitis and gonorrhea?
Use for pseudomonas?
Ticarcillin/piparacillin--use with clavulanic acid AND Ceftazidime (celine has pseudomonas)
Patient presents with jaundice, fatigue, and upper left quadrant pain after being treated for an infection. Possible disease and medication?
Penicillin and Hemolyic anemia
Myopathy and neutropenia
increases nephrotoxicity of aminoglycosides?
Aztreonam: MOA? and Use?
Monobactem that prevents peptidoglycan cross linking by binding to PBP3; and used for gram negative rods only; for people with renal insufficiency who cannot tolerate aminoglycosides and people who are allergic to penicillin-- is synergistic with aminoglycosides
Drug for M. pneumoniae?
MOA of chloramphenicol?
Blocks peptidyl transferase at 50S
What does INH need in order to be converted to its active metabolite?
TB drug that causes hyperuricemia?
Increases warfarin metabolism?
Antibiotic causes gray baby syndrome?
Chloramphenicol-- babies lack UDP glucuronyl transferase
MOA of INH?
decreases synthesis of mycolic acids; Bacterial catalase peroxidase (KatG)
Gentamicin; neomycin; amikacin; tobramycin; streptomycin Inhibits initiation complex and causes misreading of mRNA
Block nucleotide synthesis by inhibiting folic acid synthesis?
Sulfonamides and Trimethoprim
May cause acute tubular necrosis?
Aminoglycosides (gentamicin, neomycin, amikacin, tobramycin, streptomycin)
MOA of chloromphenicol?
Block peptidyl transferase (50s)
MOA of ethambutol?
Used in TB; decrease carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase
Plasmodium other than falciparum
Prodrug of acyclovir?
Valacyclovir-- side effects are hallucinations and seizures
blocks initiation (blocks linitiation)
Inhibits viral dna polymerase-- does not require viral kinase?
Foscarnet and Cidofovir
Antibiotic that leaves metallic taste in mouth?
How is ganciclovir activated?
5' monophosphate formed by CMV viral kinase Triphosphate formed by cellular kinases---- Both inhibit viral dna polymerase
Block nucleotide synthesis by inhibiting folic acid synthesis
Uses for ampicillin amoxicillin?
ampcillin/amoxicillin HELPSS kill; (Hinfluenza; E.coli; listeria; Proteus; salmonella; shigella) enterococci
Forms free radical toxic metabolites?
Used for C. diff and multidrug resistant gram positives?
Drug for Ecoli and lIsteria?
Causes CMV retinitis in immunocompromised patients? and used for acyclovir resistant hsv?
Amphotericin B: MOA? toxicity?
Binds ergosterol forming pores that allow leakage of electrolytes Fever/chills; hypotension; nephrotoxicity, arrhythmias, anemia, IV phlebitis; Liposomal amphotericin reduces toxicity
4 R's of Rifampin?
Rna polymerase inhibitor Revs up microsomal p450 Red/orange body fluids Rapid resistance if used alone
Atypical pneumonia, STDs, gram positive cocci-- strep infections in patients allergic to penicillin
Can cause kernicterus?
Penicillin mostly used for?
Gram positive and N. meningitidis, Treponema and Syphilis
Vit K deficiency?
Blocks 30S ribosomal subunit?
Aminoglycoside and Tetracycline
Drug that causes pseudomembranous colitis?
TMP: Treats Marrow Poorly: megaloblastic anemia, leukopenia, granulocytopenia
Block 50S ribosomal subunit
Macrolides, Clindamycine, Streptogramins, linezolid, Chloramphenicol
Prevention of postsurgical infection due to S. aureus?
Blocks detoxification of heme into hemozoin?
Chloroquine-- resistance due to membrane pump that decreases intracellular concentration of drug
Blocks A site preventing binding of aminoacyl tRNA?
Tetracyclines 30s d
Block cell wall synthesis by inhibiting peptidoglycan cross linking-- by binding penicillin binding proteins (transpeptidases)
treatment of Vancomycin resistant bacteria?
Linezolid and streptogramins and tigecycline
Uses of Trimethoprim?
Pneumocystis, shigella, salmonella
Carbapenem-- Beta lactamase resistant
Inhibits IMP dehydrogenase
Binds 23S rRNa of 50S ribosomal subunit?
MOA of Rifampin?
Inhibit DNA dependent RNA polymerase
NRTI used during pregnancy to reduce risk of HIV transmission?
Inhibit DNA gyrase?
Treats lung abscesses
Prevents staph aureus wound infections prior to surgery?
Cefazolin-- 1st generation cephalosporin
ADH antagonist that is rarely used as an antibiotic
Demeclocycline-- used for SIADH; tetracycline (demeCLO will make you GO)
forms free radical toxic metabolites
Used for candida?
Caspofungin or micafungin; may cause flushing due to histamine release
Pt treated for staph aureus. Possible drug toxicity of the drug used to treat her?
Oxacillin, nafcillin, dicloxacillin-- interstitial nephritis
Drug for Chlamydia?
Inhibits DNA polymerase by chain termination?
Acyclovir-- needs to be phophorylated by thymidine kinase in order to work
Fluoroquinolones should not be taken with?
HIV drug that may cause hypercholesterolemia?
Prevents peptidoglycan cross linking by binding to PBP3
Tetracycline: MOA? Limits?
1) Bacteriostatic; binds to 30S and prevents attachment of aminoacyl-tRNA2) Limited CNS penetration3) Can be used in patients with renal failure--excreted fecally
Antiviral and antifungal that are teratogenic?
Griseofulvin and Ribavirin
Used for gram negative rods in patients who due to renal insufficiency cannot tolerate aminoglycosides or are penicillin allergic
Inhibits bacterial dihydrofolate reductase?
Block peptidyl transferase at 50S?
Macrolides and Chloramphenicol
Interferes with proofreading process of translation, initiation, and translocation?
Used for oral candidiasis?
Nystatin (same as amphotericin B; topical form; too toxic to swallow)
Block peptidyl transferase?
Inhibits squalene reductase
Causes kernicterus during preg?
Azoles: MOA? Toxicity?
Inhibits ergosterol synthesis Blocks testosterone synthesis (gynecomastia); and liver dysfunction
Binds CCR5 and inhibits interaction with gp120