Pharm antimicrobials 3 Flashcards Preview

ABBEY MSII U6 > Pharm antimicrobials 3 > Flashcards

Flashcards in Pharm antimicrobials 3 Deck (39):
1

what are the nucleic acid synthesis inhibitors?

fluoroquinolones, metronidazole, rifamycin

2

what are the fluoroquinolones

-floxacin
ciprofloxacin, levofloxacin, moxifloxacin

3

fluoroquinolones mechanism

FLOCK OF SINNERS
-gyrating (inhibit DNA gyrase - topoisomerase II and IV)
- bactericidal

4

what must fluoroquinolones not be taken with?

antacids (divalent cations chelate oral quinolones_

5

fluoroquinolones spectrum

gram - rods of urinary and GI tracts including pseudomonas, neisseria, intracellulars, also some gram + (bug that would ruin a party! bring the party inside!) STDs, UTIs, GI and ab infections

6

side effects of fluoroquinolones

GI irritibility - vomiting, diarrhea (hang over), superinfections, skin rashes, headache, dizziness, tendonitis, prolonged QT

7

who is fluoroquinolones contraindicated in? why?

children and pregnant - hurt attachments to bones - damage cartilage (CHILDREN AND PREGNANT CAN'T DRINK!)

8

what are the only oral agents effective against pseudomonas?

levofloxacin and ciprofloxacin

9

metronidazole mechanism

forms toxic free radicals in bacterial cell that damage DNA - bactericidal, antiprotozoal

10

metronidazole spectrum

anaerobes BELOW the diaphragm - excluding actinomycetes and peptostreptococcus (get on the METRO with METROnidazole!)
covers C difficile!
also covers the protozoa (trichomonas, giardia, entamoeba histolytica)

11

what are the two drugs that cover c difficile?

metronidazole or vancomycin

12

what is used in triple therapy against h pylori?

metronidazole, clarithromycin, proton pump inhibitor

13

metronidazole side effects

disulfiram-like reaction (severe flushing, tachycardia, hypotension) with alcohol; headache, metallic taste

14

what are the rifamycins?

RIF-
rifampin, rifabutin, rifaximin

15

rifamycins mechanism

inhibit DNA-dependent RNA polymerase (inhibit RNA synthesis)

16

rifamycin spectrum

mycobacterium mostly, also gram + and gram - as adjunctive therapy

17

what are the 4 Rs of rifamycins?

1. RNA polymerase inhibitor
2. Ramps up microsomal cytochrome P-450 (BUT rifaBUTin does not)
3. Red/orange body fluids
4. Rapid resistance if used alone

18

rifamycin side effects

minor hypatotoxicity and drug interaction, orange body fluids

19

which rifamycin is preferred in HIV infection?

rifabutin! (less P-450)

20

what are the antituberculosis drugs?

isoniazid, pyrazinamide, ethambutol, rifamycins

21

isoniazid mechanism

inhibition of mycolic acid synthesis (large fatty acid in cell wall of mycobacteria)

22

what is the only agent used as solor prophylaxis against TB? and monotherpay for latent TB?

isoniazid for both

23

isoniazid side effects

hepatotoxicity, p-450 inhibition, drug induced SLE, vitamine B6 deficiency

24

what needs to be administered with isoniazid?

vit B6

25

pyrazinamide mechanism

unknown - prodrug that works best at acidic pH

26

pyrazinamide side effects

hyperuricemia, hypatotoxicity

27

which TB drug works the quickest for killing?

pyrazinamide

28

ethambutol mechanism

decreased carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase

29

ethambutol side effects

neuropathy and optic neuritis (reversible)

30

what are the folic acid synthesis and reduction drugs?

sulfonamides and trimethoprim

31

sulfamethoxazole mechanism

inhibit dihydropteroate synthase which inhibits folate synthesis - bacteriostatic

32

when does sulfamethoxazole become bacteriocidal?

when combined with trimethoprim (act synergistically)

33

sulfamethoxazole spectrum

gram +, gram 0, nocardia, chlamydia - uncomplicated UTIs, pneumocystis pneumonia and toxoplasmosis

34

when is the trimethoprim/sulfamethoxazole combindation (bactrim) dangerous to give?

when taking warfarin because causes increased warfarin = increased risk of bleeding

35

sulfamethoxazole side effects

allergies,displace other drugs from albumin (warfarin)

36

trimethoprim mechanism

inhibits bacterial dihydrofolate reductase - bacteriostate

37

trimethoprim spectrum

UTIS, shigella, salmonella, pneumocystis jirovecii, pneumonia treatment and prophylaxis, toxoplasmosis

38

TMP/SMX bactrim use

TMPS:
T = resp tree; M = mouth, gram - GI tract; P = pee (UTI); S = syndrome - AIDS prevents PCP when CD4 under 200

39

trimethoprim side effects

megaloblastic anemia, leukopenia, granulocytopenia - TMP = treats marrow poorly
Hyperkalemia in patients with renal failure