antimicrobials
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| 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, aztreonam
🗑
|
||||
| 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
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
ddecampo
Popular USMLE sets