antimicrobials

Description:	antimicrobials
Category:	USMLE
Created by:	ddecampo on 2009-05-10

Question	Answer
Toxicity of penicillin	Coombs + (hemolytic anemia)
Clinical use of penicillin G	Streptococcal, pneumococcal, meningococcal infections, syphillis
Probenicid interacts will all beta lactams except ___. It causes them to ____ levels of Beta lactams	aztreonam (monbactam). Causes increase in the serum level of the antibiotic
Naficillin is used to treat	MSSA (bone, joint, UTI, respiratory, endocarditis)
Other drugs in the same class as nafcillin are ___, ____. Oral forms that are similar include	Oxacillin, methicillin. Oral forms included cloxacillin, dicloxacillin
Methecillin is used rarely because of	interstitial nephritis
Ampicillin and amoxicillin are ___. Which one is given orally? What beta lactamase inhibitor is used for each?	aminopenicillins. Amoxillicin = oral, Ampicillin-sulbactam, piperacillin-tazobactam,
What beta lactam can decrease hormonal contraceptive effectiveness?	Amoxicillin
Clinical use of amoxicillin/ampicillin	"Amped penicillin" penicillin spectrum + gram negative: Respiratory tract infections (otitis, sinusitis, pneumonia), skin infections (bite wounds); HELPS kille enterococci (Hemophilus, e. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella
Ticarcillin (class) and Piperacillin (class). They need to use a beta lactamase inhibitor. What are they?	Ticaracillin = carboxypenicillin, Piperacillin = ureidopenicillin. Tircacillin = clavulanate, Piperacillin uses tazobactam.
Ticarcillin, carbenicillin, piperacillin are used for	antipseudomonal agents and gram negative rods, especially enterobacteria. (TCP = takes care of pseudomonas)
1st generation = , 2nd generation = , 3rd generation cephalosporins, 4th = cefepime	1st generation = (cefazolin, cephalexin), 2nd generation = cefotoxin, cefaclor, cefuroxime, 3rd generation = ceftriaxone, cefotaxime, ceftazidime, 4= cefepime
Side effects of cephalosporins:	penicillin allergy 10-15%, Bleeding or disulfiram reaction in those cephalosporins with methylthiotetrazole group (cefotetan, cefoperazone, cefamandole)
1st generation cephalosporin (name 2). Good for:	cefazolin, cephalexin. surgical prophylaxis, cellulitis. Good for staph/strep. 1st generations are first on the PEcKing order: Proteus, E. coli, Klebsiella
2nd generation cephalosporin (name 3). Good for:	Cefoxitin, cefaclor, cefuroxime. HENs are 2nd in the PEcKing order: Haemophilus, Enterobacter, Neisseria, proteus, E. coli, Klebsiella, Serratia
3rd generation cephalosporin (name 3). Good for	ceftriaxone, cefotaxime, ceftazidime. Serious gram-negative infections resistant to other B-lactams. (cross BBB).
For pseudomonas: use	Ceftazidime, cefepime
Hemolytic toxicity	Penicillin (Coombs + )
Clinical use of penicillin G	Streptococcal, pneumococcal, meningococcal infections, syphillis
Probenicid interacts will all beta lactams except ___. It causes them to ____ levels of Beta lactams	aztreonam (monbactam). Causes increase in the serum level of the antibiotic
Naficillin is used to treat	MSSA (bone, joint, UTI, respiratory, endocarditis)
Other drugs in the same class as nafcillin are ___, ____. Oral forms that are similar include	Oxacillin, methicillin. Oral forms included cloxacillin, dicloxacillin
Methecillin is used rarely because of	interstitial nephritis
Ampicillin and amoxicillin are ___. Which one is given orally? What beta lactamase inhibitor is used for each?	aminopenicillins. Amoxillicin = oral, Ampicillin-sulbactam, piperacillin-tazobactam,
What beta lactam can decrease hormonal contraceptive effectiveness?	Amoxicillin
Clinical use of amoxicillin/ampicillin	"Amped penicillin" penicillin spectrum + gram negative: Respiratory tract infections (otitis, sinusitis, pneumonia), skin infections (bite wounds); HELPS kille enterococci (Hemophilus, e. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella
Ticarcillin (class) and Piperacillin (class). They need to use a beta lactamase inhibitor. What are they?	Ticaracillin = carboxypenicillin, Piperacillin = ureidopenicillin. Tircacillin = clavulanate, Piperacillin uses tazobactam.
Ticarcillin, carbenicillin, piperacillin are used for	antipseudomonal agents and gram negative rods, especially enterobacteria. (TCP = takes care of pseudomonas)
1st generation = , 2nd generation = , 3rd generation cephalosporins, 4th = cefepime	1st generation = (cefazolin, cephalexin), 2nd generation = cefotoxin, cefaclor, cefuroxime, 3rd generation = ceftriaxone, cefotaxime, ceftazidime, 4= cefepime
Side effects of cephalosporins:	penicillin allergy 10-15%, Bleeding or disulfiram reaction in those cephalosporins with methylthiotetrazole group (cefotetan, cefoperazone, cefamandole)
1st generation cephalosporin (name 2). Good for:	cefazolin, cephalexin. surgical prophylaxis, cellulitis. Good for staph/strep. 1st generations are first on the PEcKing order: Proteus, E. coli, Klebsiella
2nd generation cephalosporin (name 3). Good for:	Cefoxitin, cefaclor, cefuroxime. HENs are 2nd in the PEcKing order: Haemophilus, Enterobacter, Neisseria, proteus, E. coli, Klebsiella, Serratia
3rd generation cephalosporin (name 3). Good for	ceftriaxone, cefotaxime, ceftazidime. Serious gram-negative infections resistant to other B-lactams. (cross BBB).
For pseudomonas: use	Ceftazidime, cefepime
Hemolytic toxicity	Penicillin (Coombs + )
Clinical use of penicillin G	Streptococcal, pneumococcal, meningococcal infections, syphillis
Probenicid interacts will all beta lactams except ___. It causes them to ____ levels of Beta lactams	aztreonam (monbactam). Causes increase in the serum level of the antibiotic
Naficillin is used to treat	MSSA (bone, joint, UTI, respiratory, endocarditis)
Other drugs in the same class as nafcillin are ___, ____. Oral forms that are similar include	Oxacillin, methicillin. Oral forms included cloxacillin, dicloxacillin
Methecillin is used rarely because of	interstitial nephritis
Ampicillin and amoxicillin are ___. Which one is given orally? What beta lactamase inhibitor is used for each?	aminopenicillins. Amoxillicin = oral, Ampicillin-sulbactam, piperacillin-tazobactam,
What beta lactam can decrease hormonal contraceptive effectiveness?	Amoxicillin
Clinical use of amoxicillin/ampicillin	"Amped penicillin" penicillin spectrum + gram negative: Respiratory tract infections (otitis, sinusitis, pneumonia), skin infections (bite wounds); HELPS kille enterococci (Hemophilus, e. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella
Ticarcillin (class) and Piperacillin (class). They need to use a beta lactamase inhibitor. What are they?	Ticaracillin = carboxypenicillin, Piperacillin = ureidopenicillin. Tircacillin = clavulanate, Piperacillin uses tazobactam.
Ticarcillin, carbenicillin, piperacillin are used for	antipseudomonal agents and gram negative rods, especially enterobacteria. (TCP = takes care of pseudomonas)
1st generation = , 2nd generation = , 3rd generation cephalosporins, 4th = cefepime	1st generation = (cefazolin, cephalexin), 2nd generation = cefotoxin, cefaclor, cefuroxime, 3rd generation = ceftriaxone, cefotaxime, ceftazidime, 4= cefepime
Side effects of cephalosporins:	penicillin allergy 10-15%, Bleeding or disulfiram reaction in those cephalosporins with methylthiotetrazole group (cefotetan, cefoperazone, cefamandole)
1st generation cephalosporin (name 2). Good for:	cefazolin, cephalexin. surgical prophylaxis, cellulitis. Good for staph/strep. 1st generations are first on the PEcKing order: Proteus, E. coli, Klebsiella
2nd generation cephalosporin (name 3). Good for:	Cefoxitin, cefaclor, cefuroxime. HENs are 2nd in the PEcKing order: Haemophilus, Enterobacter, Neisseria, proteus, E. coli, Klebsiella, Serratia
3rd generation cephalosporin (name 3). Good for	ceftriaxone, cefotaxime, ceftazidime. Serious gram-negative infections resistant to other B-lactams. (cross BBB).
For pseudomonas: use	Ceftazidime, cefepime
Beta lactams that display no cross-reactivity include	Monobactams (aztreonam) and some cephalosporins (10-15%)
For patients wtih renal insufficiency that can't tolerate aminoglycosides, use ___.	aztreonam
Aztreonam is used for:	Gram negative rods (enterobacter, pseudomonas); NO Gram positive/anaerobic activity
Impinem (class) is used with ___ because it is a dehydropeptidase inhibitor. Dehydropeptidase increases/decreases imipenim?	Carapenem. Use wtih cilastatin. Cilastatin inactivates renal tubules and prevents degradation of imipenem.
Clinical use of impenem:	gram-positive coci, gram negative rods, anaerobes. Drug of choice for enterobacter. use for life saveing (because of negative side effects)
Meropenem is unlike imipenem because	it is stable to dihydropeptidase and has less severe side effects
Toxicity of imipenem	GI distress, skin rash, CNS toxicity (seizures)
Which cephalosporin has the greatest gram negative coverage?	Generations 3,4
Which cephalosporin has the greatest gram + coverage?	Generations 1, 4
Which cephalosporin covers anaerobes	Generation 2
Protein synthesis inhibitors (30s)	TAG = Tetracyclines, Aminoglycosides
Protein syntheis inhibitors (50s)	CCLLEan =Clindomycin, Chloramphenicol, Erythromycin, Lincomycin, Linezolid
Inhibit formation of initiaion complex and cause misreading of mRNA.	aminoglycosides
Requires O2 for uptake, therefore ineffective against ____.	Aminoglycosides
Synergistic with B-lactam antibiotics	Aminoglycosides
Clinical use: aminoglycosides	Severe gram negative rods (pseudomonas, enterobacter, staph
Synergistic with beta lactams	aminoglycosides (Amp-gent)
Bowel surgery	Neomycin (aminoglycoside)
Toxicity: aminoglycosides	Nephrotoxicity (cephalosporins, Ototoxicity (loop diuretics), Teratogen
Aminoglycoside types	"GNATS" Gentomycin, Neomycin, amikacin, tobramycin, streptomycin
Aminoglycoside used for TB	Streptomycin
Mechanism: Vancomycin	Inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall. Bactericidal. Resistance occurs with amino acid change to D-ala
Vancomycin = BC/BS, Aminoglycosides BC/BS?	both BC
Tetracycline types	Tetracycline, doxycycline, demeclocycline, minocycline
Mechanism: tetracycline	Bacteriostatic; Bind to 30s and prevent attachment of aminoacyl-tRNA. limited CNS penetration
Limited CNS penetration	Tetracycline
Which tetracycline can be used in patients with renal failure?	doxycycline
What can't you take with tetracyclines?	Milke, antacids, iron-containng preparations (divalent cations inhibit absorption into gut
Clincal uses for tetracycline	VACUUM The BedRoom that looks like a cyclone- Vibrio, Acne, Chlamydia, Ureaplasma, Urealyticum, Mycoplasma pneumoniae, Tularemia, H. pylori, Borrelia burgdorferi, Rickettsia
Toxicity: Tetracylcines	GI distress, discoloration of teeth, inhibition of bone growth in children, photosensitivity, contraindicated in pregnancy
Macrolide types	erythromycin, azithromycin, clarithromycin
Mechanism: macrolides	Inhibit protein synthesis by blocking translocation (moving the peptide strand to the p site); it binds to 23S rRNA of teh 50s ribosomal unit; bacteriostatic
Clinical uses: macrolides	Atypical pneumonia (mycoplasma, legionella, chlamydia, Neisseria), typical (s. pneumoniae), gram positive cocci
Toxicity: macrolides	GI distress (motilin receptors), acute cholestatic hepatitis, eosinophila, skin rashes.
Increases serum concentration of theophyllines, anticoagulants, diazepam	Erythromycin
Mechanism:Chloramphenicol	Inhibits 50s peptidyltransferase activity; bacteriostatic (peptidyltransferase = adds peptide to amino acid in A site"
Clinical use: chloramphenicol	meningitis (H. influenzae, Neisseria, S. pneumoniae)
Toxicity: Chloramphenicol	Anemia (dose dependent), aplastic anemia, gray baby syndrome (lack UDP-glucoronyl transferase)
Mechanism: Clindamycin	Blocks peptide bond formation at 50S ribosomal subunit
Clinical use:clindamycin	treat anaerobic infections (bacteroides fragilis, clostridium perfringens) ==> aspiration, abcess
Toxicity: clindamycin	C. dificile, fever, diarrhea
Sulfonamide allergy: what not to give	furosemide, thiazides, acetazolamide
blocks dihydropteroate synthetase	sulfonamides (can't produce nucleotides)
blocks dihydrofolate reductase	trimethoprim
Sulfonamides: clinical use	Gram positive, gram negative, Nocardia, chlamydia
Sulfonamides: toxicity	Hypersensitivity reactions, hemolysis of G6PD, nephrotoxicity (tubulointerstitial nephritis, photosensitivity, kernicterus in infants, displace other drugs from albumin (warfin)
TMP-SMX: clinical use	recurrent UTIs, shigella, salmonella, PCP
TMP-SMX: toxicity	Megaloblastic anemia, leukopenia, granulocytopenia
INH: mechanism	Decreases synthesis of mycolic acid
INH: clinical use	TB prophylaxis, treatment
INH: toxicity	Neurotoxicity, hepatotoxicity (INH = injures neurons, hepatocytes), pyridoxine (B6) can prevent neurotoxicity
Rifampin: mechanism	Inhibits DNA dependent RNA polymerause
Rifampin: clinical use	TB, delays resistance to dapsone in leprosay, used for meningococcal prophylaxis in patients with Hib contact
Rifampin: toxicity	Hepatotoxicty, (increase p-450, orange body fluids)
4 R's of rifampin	RNA polymerase inhibitor, Revs up microsomeal P-450, Red/orange body fluids, Resistance if used alone
Treatment of MRSA, VRE	MRSA= vanco, VRE = linezoild, streptogramins (quiinupristin/dalfopristin)
Nalidixic acid is a___	quinolone
Fluoroquinolones: Mechanism	inhibit DNA gyrase (topoisomerase II).
Fluoroquinolones: Clinical use	Gram negative rods of urinary/GI tracts (pseudomonas, neisseria, gram positive)
Fluoroquinolones: toxicity	GI upset, superinfections, skin rash, headache dizziness. Contraindicated in pregnant women. Must not be taken with antacids, tendonitis, tendon rupture in adults, leg cramps, myalgias in kids.
Metronidazole: mechanism	forms toxic metabolites in the bacterial cell that damage DNA.
Metronidazole: clinical use	GET GAP on the Metro (Giardia, Entamoeba, trichomonas, Gardenerella, Anaerobes, H.Pylori
Metronidazole: toxicity	Disulfiram-like reaction, metallic taste
Polymyxins: mechanism	bind to cell membranes of bacteria and disrupt their osmotic properties. (positive; act like detergent)
Polymyxins: clinical use	resistant gram-negative infections
Polymyxins: toxicity	neurotoxicity, acute renal tubular necrosis
Prophylaxis: M. tuberculae, M. avium intracellulare	Isoniazid, Azithromycin
M. tuberculosis treatmetns	INH-SPIRE (Streptomycin, pyrazinamide, isoniazid, rifampin, ethambutol)
M. avium intracellulare	Azithromycin, rifampin, ethambutol, streptomycin
M. leprae treatments	Dapsone, rifampin, clofazimine
2nd line therapy of TB	cycloserine (2nd-line therapy)
Side effects of TB durgs	hepatotoxicity
Side effects: optic neuropathy (red-green color blindness)	ethambutol
Endocarditis with surgical or dental procedures prophylaxis	Penicillins
PCP pneumonia prophylaxis	TMP-SMX, aerosolized pentamidine
History of recurrent UTIs prophylaxis	TMP-SMX
Syphills prophylaxis	Benzathine penicillin G
Gonorrhea prophylaxis	ceftriaxone
Meningococcal infection prophylaxis	Rifampin (drug of choice), minocycline
Penicillins/cephalosporin drug resistance	B-lactamase cleavage of b-lactam ring, altered PBP in cases of MRSA or penicillin-resistant S. pneumonia
Aminoglycosides drug resistance	Modification via acetylation, adenylation, phosphorylation
Vancomycin drug resistance	Terminal D-ala of cell wall component replaced with D-lac; decreased affinity
Chloramphenicol drug resistance	modification via acetylation
Macrolides drug resistance	methylation of rRNA near erythomycin's ribosome binding site
Tetracylcin drug resistance	Decreased uptake, increased transport out of cell
Sulfonamides	Altered enzymes (bacterial dihydropterate synthetase), decreased uptake, or increased PABA synthesis,
Quinolones	Altered gyrase or reduced uptake
Antifungals that bind to ergosterol include: Mechansim:	Antifungals: nystatin, amphotericin B. They bind to ergosterol and form pores that allow leakage of electrolytes
Amphotericin: Clinical use	Wide spectrum systemic mycoses: Crypto, Histo, Blasto, Coccidio, Candida, Mucor, Aspergillis. Use intrathecally for meningitis
For meningitis with systemic fungi what drug do you administer?	Amphotericin, intrathecally
Amphotericin: toxicity	Fever/chills (Shake and bake), hypotension, nephrotoxicity, arrythmia, anemia, IV phlebitis (amphoterrible).
What can reduce toxicity of amphotericin?	Hydration reduces nephrotoxicity, liposomal reduces toxicity
Nystatin: clinical use	"swish and swallow" for oral candida; topical for diaper rash; (too toxic for systemic use)
Antifungals that bind ergosterol:, Antifungals that block synthesis of ergosterol	Antifungals that bind: amphotericin B, nystatin, Antifungals that block synthesis: azoles, terbinafine
antifungals used for systemic mycoses	amphotericin B, azoles, flucytosine (use with ampho)
Fluconazole use:	cryptococcal (Crosses BBB unlike amphotericin), candidal infections
Ketoconazole use:	Local infections of Blastomycoses, Coccidio, Histoplasmosis, Candida albicans
Clotrimazole use:	Topical fungal infections
Micanzole use:	Topical fungal infections
Azoles: toxicity	Hormone synthesis inhibition (gynecomastia), liver dysfunction (inhibits cytochrome P-450), fever, chills
Flucytosine: Mechanism	Inhibits DNA synthesis by converstion to 5-flurouracil.
Flucytosine: Clnical use	Systemic fungal infections (candida, crypto) in combination with amphotericin
Flucytosine: toxicity	Nausea, vomitin, diarrhea, bone marrow suppression
Caspofungin: mechanism	Inhibits cell wall synthesis by inhibiting B-glucan
Caspofungin: use	Invasive aspergillosis
Caspofungin: toxicity	GI upset, flushing
Terbinafine: mechanism	Inhibit fungal enzyme squalene epoxidase (decrease ergosterol synthesis)
Terbinafine: use	dermatophytoses, onychomycosis
Griseofulvin: mechanism	Interferes with microtubule function: disrupts mitosis;
Griseofulvin: Clinical use	oral treatment of superficial infections; inhibits growth of dermatophytes (tinea ringworm)
Griseofulvin: toxicity	Teratogenic, carcinogenic, confusion, headaches, increases P-450 and warfin metabolism, deposits in kertain-containing tissues
Treatment of sporothrix schenckii	potassium iodide, itraconazole
Treatment of tinea versicolor	Selenium sulfide (selsun), miconazole
Treatment of tinea peidis	azoles
Amantidine: mechanism	blocks M2 protein, acidifying virus and preventing uncoating and penetration of virus. Causes release of daopmine from intact nerve terminals.
Amantidine: clinical use	Prophylaxis and treatment for influenza A; Parkinson's disease. "Amantidine blocks influenza A, and rubellA, and causes problems with the cerebellA"
Amantidine: Toxicity	Ataxia, dizziness, slurred speech
Mechanism of resistance	Mutated M2 protein. 90% of all influenza A strains are resistant to amantidine, so not used
Rimantidine is different than amantidine because	it has fewer side CNS side effects and does not cross the BBB.
Oseltamivir and ____: Mechanism	Inhibit influenza neuraminidase (decreases the release of progeny virus)
Oseltamivir: clinical use	Influenza A and B
Ribavirin: mechanism	Inhibits synthesis of guanine nulceotides by competively inhibiting IMP dehydrogenase
Ribavirin: clinical use	RSV, chronic hepatitis C
Ribavirin: toxicity	Hemolytic anemia, severe teratogen
Acyclovir: mechanism	Guanisine analog; inhibits DNA polymerase by chain termination. Monophosphorylated by HSV/VZV thymidine kinase
Acyclovir: clinical use	HSV, VZV, EBV. USed for HSV-induced mucocutaneous and genital lesions, encephalitis. Prophylaxis in immunocompromised patients.
For herpes zoster (shingles) use ____.	Famciclovir
Acyclovir: mechanism of resistance	thymidine kinase
Gancyclovir: mechanism	5' monophosphate formed by a CMV viral kinase, or HSV/VSV thymidine kinase. Preferentially inhibits viral DNA polymerase
Gancyclovir: clinical use	CMV, especially for immunocompromised patients
Gancyclovir: Toxicity	Leukopenia, neutropenia, thrombocytopenia, renal toxicity. More toxic to host enzymes than acyclovir
Gancyclovir: Mechanism of resistance:	Mutated CMV DNA polymerase or lack of viral kinase
Foscarnet: Mechanism	blocks viral DNA polymerase by binding to pyrophosphate binding site. Does not need to be activated by viral kinase.
Foscarnet: Clinical use	CMV retinitis in immunocompromised patients when ganciclovir fails; acyclovir-resistant HSV
Foscarnet: Toxicity	Nephrotoxicity
Foscarnet: mechanism of resistance	Mutated DNA polymerase
Protease inhibitors end in ___-	"navir" Navir (never) TEASE a proTEASE
Protease inhibitors: mechanism of action	Inhibit maturation of new virus by blocking protease in progeny virions
Protease inhibitors: Toxicity	GI intolerance (nausea, diarrhea) hyperglycemia, lipodystrophy
Protease inhibitor that causes thrombocytopenia	Indinaivr
Name the Nucleoside reverse transcriptase inhibitors	Zidovudine (AZT), didanosine (ddI), zalcitabine (ddC), stavudine (d4T), lamivudine (3TC), abacavir.
Non-nucleoside reverse transcriptase inhibitors:	Never Ever, Deliver nucleosides (Nevirapine, Efavirenz, Delaviridine)
Non-nucleoside mechanism of action	Preferentially inhibit reverse transcriptase of HIV; prevent incorporation of DNA copy of viral genome into host DNA
Toxicity of reverse transcriptase inhibitors	bone marrow suppression (neutropenia, anemia), peripheral neuropathy, lactic acidosis (nucleosides), rash (non-nucleosides), megablastic anemia
Reverse transcriptase inhibitors:	Highly active antiretroviral therapy (HAART)
HAART includes:	2 nucleoside reverse transcriptase inhibitors, with a non-nucleoside reverse transcriptase inhibitor (efavirenz) or a protase inhibitor (lopinavir-ritonavir)
When is HAART initiated?	when CD4 count is < 500/high viral load
ZDV: clinical use	First line therapy for HIV, preventation of maternal-fetal HIV transmission
Ritonavir:lopinavir: mechanism of action	Protease inhibitor; inhibits HIV protease and conversion of gag-pol polyprotein to functional proteins
Enfuvirtide: mechanism of action	bind viral gp 41; inhibit conformation change requried for fusion with CD4 cells (block entry)
Enfuvirtide: clinical use	Drug resistant HIV infection
Enfuvirtide: Toxicity:	Hypersensitivity reaction, SQ reactions, increased risk of bacterial pneumonia
Interferons: mechanism of action	glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis. Induce ribonuclease that degrades viral mRNA
Interferons alpha	Chronic hepatitis B/C, Kaposi's,
IFN-Beta: use	MS
IFN-gamma: use	NADPH oxidase deficiency (chronic granulomatous disease)
Antibiotics to avoid during pregnancy	SAFE Moms Take Really Good Care (Sulfonamides, Aminoglycosides, fluoroquinolones, erythromycin, metronidazole, tetracylines, ribavirin, griseofulvin, chloramphenicol)
Sulfonamides in pregnancy	kernicterus
Aminoglycosides in pregnancy	ototoxicity
Fluoroquinolones in pregnancy	cartilage damage
Erythromycin in pregnancy	acute cholestatic hepatitis in mom (clarithromycin -embryotoxic)
Metronidazole in pregnancy	mutagenesis
Tetracyclines in pregnancy	discolored teeth, inhibition of bone growth
antiviral that's teratogenic	Ribavirin
antifungal that's teratogenic	Griseofulvin
chloramphenicol in pregnancy	"gray baby"
Antifungal that inhibits P450 ___, Antifungal that induces P450 ____.	Inhibits: Azoles, Induces = Griseofulvin
didanosine (aka ___). Example of a ____	Didanosine = ddI (nucleoside reverse transcriptase inhibitor)
zalcitabine (aka ___) Example of a ____	zalcitabine = ddC (nucleoside reverse transcriptase inhibitor)
stavudine (aka ____). Example of a ____	Stavudine = d4T (nucleoside reverse transcriptase inhibitor)
lamivudine (aka ____). example of a ___	lamivudine = 3TC (nucleoside reverse transcriptase inhibitor)
abacavir (aka ___). example of a ____.	nothing else ! (nucleoside reverse transcriptase inhibitor)
Prophylaxis for Mycobacterium avium	Azithromycin
Treatment for Mycobacterium avium	Azithromycin, rifampin, ethambutol, streptomycin
treatment for TB	INH-SPIRE (streptomycin,Isoniazid, rifmapin, ethambutol)
treatmet for M. leprae	Dapsone, rifampin, clofazimine
Prophylaxis for M. tuberculosis	Isoniazid
___ causes neuromuscular blockade if given after surgery	Aminoglycosides
Pneumonic for aminoglycosides	Mean GNATS canNOT kill anaerobes (Gentamycin, neomycin, tobramycin, streptomycin), NOT (neurotoxicity, ototoxcity, teratogen)
___ that can cause ATN	aminoglycosides