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