Sulfonamides, Trimet, Quinolones Flashcards Preview

Pharmacology > Sulfonamides, Trimet, Quinolones > Flashcards

Flashcards in Sulfonamides, Trimet, Quinolones Deck (21):
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Silver sulfadiazine

Use: burns
MOA: competitively inhibit the conversion of PABA to folic acid mediated by the enzyme dihydropteroate synthase which ultimately inhibits DNA synthesis

Side effects: irritation, stinging or burning

1

Sulfacetamide

Use: conjunctivitis , corneal ulcer, and other superficial ocular infections
MOA: competitively inhibit the conversion of PABA to folic acid mediated by the enzyme dihydropteroate synthase which ultimately inhibits DNA synthesis

Side effects: irritation, stinging or burning

2

Triple sulfa

Use: for vaginitis caused by H. Vaginalis
MOA: competitively inhibit the conversion of PABA to folic acid mediated by the enzyme dihydropteroate synthase which ultimately inhibits DNA synthesis

Side effects: irritation, stinging or burning

3

Sulfisoxazole

Use: uncomplicated urinary tract infections
Usually used with phenazopyridine
MOA: competitively inhibit the conversion of PABA to folic acid mediated by the enzyme dihydropteroate synthase which ultimately inhibits DNA synthesis

Side effects: hypersensitivity -skin rash, fever, urticaria. Cross sensitivity with other sulfa drugs. N/v/d, crystalluria, allergic nephritis, hematopoietic disturbances, hemolytic anemia in pts with g6pd deficiency, kern icterus in newborns by displacement of serum albumin.

4

Sulfamethoxazole

Use: uncomplicated urinary tract infections
Usually used with trimethoprim

MOA: competitively inhibit the conversion of PABA to folic acid mediated by the enzyme dihydropteroate synthase which ultimately inhibits DNA synthesis

Side effects: hypersensitivity -skin rash, fever, urticaria. Cross sensitivity with other sulfa drugs. N/v/d, crystalluria, allergic nephritis, hematopoietic disturbances, hemolytic anemia in pts with g6pd deficiency, kern icterus in newborns by displacement of serum albumin.

5

Sulfadoxine

Use: malaria
Usually used with pyramethamine

Very long lasting

MOA: competitively inhibit the conversion of PABA to folic acid mediated by the enzyme dihydropteroate synthase which ultimately inhibits DNA synthesis

Side effects: hypersensitivity -skin rash, fever, urticaria. Cross sensitivity with other sulfa drugs. N/v/d, crystalluria, allergic nephritis, hematopoietic disturbances, hemolytic anemia in pts with g6pd deficiency, kern icterus in newborns by displacement of serum albumin.

6

Sulfadiazine

Use: used to treat toxoplasmosis
Usually used with pyramethamine

MOA: competitively inhibit the conversion of PABA to folic acid mediated by the enzyme dihydropteroate synthase which ultimately inhibits DNA synthesis

Side effects: hypersensitivity -skin rash, fever, urticaria. Cross sensitivity with other sulfa drugs. N/v/d, crystalluria, allergic nephritis, hematopoietic disturbances, hemolytic anemia in pts with g6pd deficiency, kern icterus in newborns by displacement of serum albumin.

7

Dapsone

Use: to treat leprosy

MOA: competitively inhibit the conversion of PABA to folic acid mediated by the enzyme dihydropteroate synthase which ultimately inhibits DNA synthesis

Side effects: hypersensitivity -skin rash, fever, urticaria. Cross sensitivity with other sulfa drugs. N/v/d, crystalluria, allergic nephritis, hematopoietic disturbances, hemolytic anemia in pts with g6pd deficiency, kern icterus in newborns by displacement of serum albumin.

8

Sulfasalazine

Use: to treat inflammatory bowel disorder

Not absorbed- active ingredient is 5-aminosalicylic acid

MOA: competitively inhibit the conversion of PABA to folic acid mediated by the enzyme dihydropteroate synthase which ultimately inhibits DNA synthesis

Side effects: hypersensitivity -skin rash, fever, urticaria. Cross sensitivity with other sulfa drugs. N/v/d, crystalluria, allergic nephritis, hematopoietic disturbances, hemolytic anemia in pts with g6pd deficiency, kern icterus in newborns by displacement of serum albumin.

9

Trimethoprim

MOA: inhibits dihydrofolate reductase of bacteria 10,000 times more efficiently than mammalian cells . Bacteriostatic.

Use: used alone for acute UTIs
Used in combo with sulfamethoxazole for other infections

Adverse effects: similar to sulfa drugs plus rare hematopoietic disturbances ( megalomaniac anemia, leukopenia) use folinic acid to prevent hematologic toxicity.

10

Uses for trimethoprim and sulfamethoxazole

Pneumonia - due to pneumocystis carinii (oral and IV)
GI infections - shigella enteritis
Systemic infections caused by norcardia and salmonella
UTIs and respiratory infections caused by h. Influenza or streptococcus pneumonae
Listeria meningitis

11

Quinolones (fluoroquinolones)

Synthetic fluoridated antimicrobial agents

Moa: block DNA synthesis by in hi biting topoisomerase II ( DNA gyrate) and topoisomerase IV . This prevents unwinding of supercooled DNA that is required for normal transcription and duplication . IV deals with the separation of replicated chromosomal DNA.

12

Ciprofloxacin

Gram - and some activity against gram + , h. Influenzae

13

Levofloxacin , gemifloxacin, moxifloxican

Improved activity against gram + particularly s. Pneumoniae

14

Quinolone Resistance occurs due to what.

Microbial modification of DNA gyrase or topoisomerase IV structure.

Alteration of members never me ability into the bacterial cell

15

Sulfonamides gain resistance how

Microbial overproduction of PABA

Structural changes that occur in bacterial dihydropteroate synthase

Decreased permeability

16

Use of Ciprofloxacin

Topical : eye- conjunctivitis, corneal ulcer, and other superficial ocular infections

Oral: resistant uti, infectious diarrhea( shigella, salmonella, e. Coli, campylobacter) typhoid fever, single dose to treat gonorrhea, pseudomonas , anthrax

17

Clinical use of levofloxacin

Oral: resistant uti, infectious diarrhea( shigella, salmonella, e. Coli, campylobacter) typhoid fever, single dose to treat gonorrhea, pseudomonas , anthrax , osteomyelitis and skin structure Infections

Respiratory tract infections including cap, reserved for pts with comorbidity or risk factors

18

Clinical uses of gemifloxacin

Oral: osteomyelitis and skin structure Infections

Respiratory tract infections including cap, reserved for pts with comorbidity or risk factors

19

Moxifloxican clinical uses

Oral: osteomyelitis and skin structure Infections and single dose for treatment of gonorrhea

Respiratory tract infections including cap, reserved for pts with comorbidity or risk factors

20

Sides effects of Quinolones

Topical - irritation, stinging or burning
Systemic effects
- n/v/d
-'photosensitivity, CNS disturbances : dizzy, confusion, hallucinations)
- damage growing cartilage : no children or preggers
- prolong qt interval : don't use in pts taking antiarrhythemiad and other drugs that prolong that qt ( erythromycin, tricyclic antidepressants)