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USMLE
Comprehensive Pharm 11
| Question | Answer |
|---|---|
| examples of macrolides | the MACRO WREATH's CLARity is EZ to see Erythromycin Clarithromycin Azithromycin |
| MOA macrolides cidal/static? | blocks protein transloation by binding to the 50S ribosomal subunit |
| clinical uses for macrolides | URIs pneumonia STDs gm + cocci (for pts allergic to penicillin) Mycoplasma Chlamydia Legionella Neisseria |
| toxicity of macrolides | GI discomfort acute cholestatic hepatitis eosinophilia skin rash increases serum [] theophylline and oral anti-coagulants |
| MOA chloramphenicol cidal/static? | binds 50S, inhibiting peptidyl transferase static |
| clinical uses for chloramphenicol | meningitis |
| toxicities associated with chloramphenicol | anemia aplastic anemia gray baby sndrome |
| what causes gray baby syndrome | premature infants lack UDP gluuronyl transferase |
| MOA clindamycin cidal/static? | blocks peptide bond formation at 50S ribosomal subunit static |
| clinical uses for clindamycin | treats anaerobic infections (above the diaphragm) |
| toxicity of clindamycin | c. diff overgrowth fever diarrhea |
| MOA sulfonamides cidal/static? | PABA antimetabolites inhibit dihydropterate synthase static |
| clinical uses for sulfonamides | gram +/- nocardia chlamydia |
| which sulfonamide can be used to treat simple uti's | triple sulfa |
| toxicity associated with sulfonamides | hypersensitivity hemolysis with G6PD deficiency tubulointerstitial nephritis kernicterus in infants displaces other drugs from albumin |
| MOA trimethoprim static/cidal? | inhibtits bacterial dihydrofolate reductase static |
| clinical use of trimethoprim | used in combo with sulfamethoxaole treats recurrent uti's, shigella, salmonella, PCP |
| toxicity of trimethoprim | megaloblastic anemia leukopenia granulocytopenia (TMP = treats marrow poorly) |
| examples of fluorquinolones | ___-floxacin (also nalidixic acid which is a quinolone) |
| MOA fluoroquinolones cidal/static? | inhibits topoisomerase II (DNA gyrase) cidal |
| toxicity associated with fluoroquinolones | gi upset superinfections skin rashes h/a dizziness cartilage damage bone pain tendonitis, tendon rupture (adults) myalgia and leg cramps in kids "fluoroquinolones hurt attachments to your bones" |
| contraindications of fluoroquinolones | pregnant women children |
| MOA metronidazole static/cidal? | forms toxic metabolites in bacterial cell cidal |
| clinical uses for metronidazole | anti-protazoal GET GAP on the METRO Giardia Entamoeba Trichomonas Gardnerella vaginalis Anaerobes H. PYLORI treats anaerobic infx below the diaphragm (as opposed to clindamycin, which treats them above the diaphragm) |
| toxocitiy of metronidazole | disulfiram like rxns with etoh h/a metallic taste |
| MOA polymyxins | bind to cell membranes of bacteria and disrupt osmotic properties act like detergents |
| clinical uses for polymyxins | resistant gram - infxs |
| toxicity associated with polymxyins | neurotoxicity acute renal tubular necrosis |
| 1st line anti-TB drugs | INH-SPIRE streptomycin pyrazinamide isoniazid rifampin ethambutol |
| 2nd line anti-tb drug | cycloserine |
| drugs for tb proph | INH alone |
| MOA INH | decreased synth of mycolic acid |
| toxicity of INH | hemolysis in G6PD deficiency neurotoxicity (prevent with B6) hepatotoxicity SLE-like syndrome INH = Injures Neurons and Hepatocytes |
| MOA rifampin | inhibits DN Adependent RNA polymerase (the rif-raf RAN around the block) |
| uses for rifampin | m. tb delays resistance to dapsone when treating leprosy meningococcal proph proph in contacts of children with HiB |
| 4Rs of rifampin | RNA polymerase inhibitor Revs up microsomal p450 Red/orange body fluids rapid resistance if used alone |
| meningococcal proph | rifampin (drug of choice) minocycline |
| gonorrhea proph | ceftriaxone |
| proph in a pt with h/o repeated uti's | tmp-smx |
| proph against PCP | tmx-smp (drug of choice) aerosolized pentamide |
| proph against endocarditis with surgical/dental procedures | penicillins |
Created by:
Asclepius
on 2008-10-22