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BugDrug for USMLE
MicroPharm
Term | Definition |
---|---|
Block cell wall synthesis by inhibition of peptidoglycan crosslinking | penicillin, methcillin, ampicillin, piperacillin, cephalosporin, azetroenam, imipenem |
block peptidoglycan synthesis | bacitracin vancomycin |
block nucleotide synth by inhib folic acid synthesis - involved in methylation | sulfonamides trimethoprim |
block dan topoisomerases | fluroquinolones (-floxacin) |
block mRNA synthesis | Rifampin |
Damage DNA | Metronidozole |
Block proein synthesis at 50S ribosomal subunit | CCELS at 50 Choramphenicol, Clindamycin Erythromycin (macrolides) Streptogramins - quinupristin, dalfopristin, linozolid |
Block protein syneth at 30S ribosomal subunit | buys AT 30 Aminoclygosides tetracyclines |
beta lactamase inhibitors | Clavulanic Acid Sulbactam Tazobactam (CAST) |
Ampicillin/Amoxicillin - Clinical Use | Extended spectrum penicillin - HELPSS kill Enterococci - H. flu - E. coli - Listeria monocytogenes - Proteus mirablilis - Salmonella - Shigella ENTEROCOCCI |
Organisms not covered by cephalosporins | L Listeria A Atypicals (Chlamydia, Mycoplamsa) M MRSA - except ceftaroline E Enterococci |
1st Gen Cephs | cefAZOLin, cephALEXin PEcK - Proteus, Ecoli, Kelbs |
Use prior to surgery to prenvent S.aureus infx | cefazolin |
2nd Gen Cephs | ceFOXitin, ceFAClor, ceFOPROzil, ceFURoxime HENPEcKS H.flu, Enterobacter, Neisseria, Proteus, Ecoli, Klebs, Serratia |
synergistic with aminoglycosides | aztreonam - gram negative rods ONLY |
cilatatin | inhibitor of renal dehydropeptidase I - for imipenem |
D-ala D-ala --> D-ala D lac | Vancomycin |
Red man syndrome - cause and prevention | Vancomycin -- antihistamine |
Vancomycin tox | NOT + Red man syndrome Nephrotox Ototox Thrombophebitis |
inhibit formation of initiation complex | aminoglycoside |
blocking translocation | macrolides - macroSLIDES binds to the 23S rRNA |
block peptide transfer | clindamycin |
prevent attachment to amino acyl tRNA | Tetracycline |
prevents attachment of 50S to other parts of the ribosomal unit | Linezolid |
requires O2 for uptake | Aminoglycosides: GNATS Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin |
Bowel surgery | Neomycin |
resistance by transferase enzymes: acetylation, phosphorylation or adenylation | aminoglycosides |
diuretic used in SIADH | Demeclocycline - a tetracycline |
divalent cations inhibit uptake | Tetracyclines |
methylation at 23S rRNA | resistance to macrolides |
Macrolide toxicity | Motility issues Arrhythmia - prolonged QT Cholestatic hepatitis Rash eOsinophilia |
lack of UDP glucuronyl transferase | gray baby syndrome if given chorlamphenicol |
pseudomembranous colitis | C. diff overgrowth due to clindamycin |
PABA antimetabolites inhibit dihydropteroate syntase | Sulfonamides |
hemolysis if G6PD def + kernicterus in infants | SMX - sulfonamides |
prolonged QT damage cartilage tendon rupture | Fluroquinolones |
free radical toxic metabolites in that damage bac DNA | Metronidazole |
Disulfuram-like reaction | Metronidazole |
M. tuberculosis - prophalaxis; tx | P: Isoniazide Tx: RIPE - Rifampin, Isoniazid, Pyrazinamide, Ethambutol |
M. avium-intracellulare - proph | P: Azithrotmyicn Tx: RASE - Rifampin, Azithromycin, Ethambutol, Streptomycin |
M. leprae - proph, tx | P: n/a Tx: Tuberculoid: Dapsone + Rifampin Lepromatous: Dapsone+Rifampin + Clofazimine |
requires bacterial catalase peroxidase | Isoniazid |
dec synth of mycolic acid | isoniazid |
prevents neurotoxicity of isoniazid | Pyridoxine (Vit B6) |
inhibits DNA-dependent RNA polymerase | Rifampin |
red/orange body fluids | rifampin |
acidify intracellular environment | pyrazinamide - converts to pyrazinoic acid |
decrease carbohydrate polymerization of mycovaterium cell wall by blocking arabinosyltranserase | ethambutol |
Red green color blindness (optic neuropathy) | ethambutol |
meningococcal infection | ciprofoxacin (drug of choice) rifampin for children |
conorrhea | ceftriaxone |
syphilis | benazthine penicillin G |
history of recurrent UTI | TMP SMX |
PCP (pneumo jirovici) | TMP SMX; dapsone |
endocarditis with surgical or dental procedures | penicillins |
prego with group b strep | ampicillin |
prophylaxis of strep pharyngitis in child with prior rheumatic fever | oral penicillin |
prevention of post surgical infection due to S. aureus | Cefazolin |
H. flu | rifampin |
Prevention of conococal or chlamydial conjunctivitis in newborn | erythromycin ointment |
MRSA | vancomycin, linezolid |
VRE | linezolid, streptogramin |
binds ergosterol and forms membrane pores | Amphotericin B |
Clinical Use for Amphotericin B | Crypococcus Blastomyces Coccidioides Histoplasma Candida Mucor |
Topical; binds ergosterol and forms membrane pores | Nystatin; swish and swallow; thrush, diaper rash; vaginal |
Inhibits ergosterol synthesis | -azoles |
cryptococcal meningitis in AIDS | fluconazole |
candida | fluconazole |
blastomyces | itraconazole |
coccidiodes | itraconazle |
histoplasma | itraconazole |
gynecomastia | -azoles; esp ketoconazole |
inhibits DNA and RNA biosynthesis via cytosine deaminase | Flucytosine --> 5-FU |
used in combo with amphotericin b | flucytosine --> 5-FU |
bone marrow suppression | Flucytosine --> 5-FU |
Inhibits cell wall synthesis by inhibiting synthesis of B-glucan | capsofungin; micafungin |
Invasive aspergillosis Candida | capsofungin micafungin |
inhibits the fungal enzyme squalene epoxidase | Terbinafine |
tx for dermatophytoeses | terbinafine |
interferes with microtubule function; disrupts mitosis | griseofulivin |
deposits in keratin containing tissues (eg. nails) | griseofulvin |
inhibits growth of dermatophytes (tine, ringworm) | griseofulvin |
toxoplasmosis | pyrimethamine |
trypanosma brucei | suramin melarsoprol |
T. cruzi | nifurtimox |
leishmaniasis | sodium stibogluconate |
blocks detoxification of heme in to hemozin. | Chloroquine: Heme accumulates and is toxic to plasmoida |
Resistance to Cholroquine | pumpt that dec intracellular concentration of drug. Use: artemether/lumifantrine or atovaquone/proguanil |
life threatening malaria | quinidine |
chloroquine toxicity | Retinopathy |
Enterobius Ascaris Ancylostoma Necator | Bendazole or pyrantal |
Strongylodies | Ivermectin or albendazole |
Onchocerca | Ivermectin |
Loa loa Wuchereria bancrofti | Diethylcarbamazine |
Toxocara | Albendazole or mebendazole |
Tapeworms: Taneia solium; Diphyllobotrium latum | Praziqantel |
Taenia solium neurocysticercosis | Bendazoles |
Echinococcus | bendazoles |
Trematodes (flukes): Schistosoma Clonorchis Pragonimus westermani | Praziquantel |
inhibits infulenza neuraminidase | zanamivir, oseltamivir |
inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase | Ribavirin |
Guanosine analog. Inhibits viral DNA polymerase by chain termination | Acyclovir/ Valcyclovir |
Acyclovir - Clinical Uses | HSV-1; HSV-2; VZV; weakly EBV NO CMV!!!!! |
5' monophosphate formed by a CMV viral kinase. Guanosine alanog Inhibits viral DNA polymerase. | Gancyclovir |
CMV - tx | Gancyclovir |
viral DNA polymorease inhibitor that binds to pyrophospate binidng site of the enzyme. Does not require activation by viral kinase | Foscarnet |
CMV retinitis in immunocompromised patients | Foscarnet Cidofovir |
preferentially inhibits viral DNA polymerase NO phosphorylation by viral kinase | Cidofovir |
how to reduce tox of Cidofovir | coadmin w/ probenecid and IV saline --> dec nephrotoxicity |
HIV rx | - 2 NRTIs - nucleoside reverse transcriptase inhibitors + (1 NNRTI - nonnucleoside rev transcriptase inhib OR 1 protease inhib OR 1 integrase inhib) |
prevents maturation of new viruses | protease inhib - navir |
nucleoTide analog that does not have to be activated | tenofovir |
Bone marrow supression can be reversed by: | G-CSF and erythropoietin |
sometimes suffix for NRTIs | -vudine/-nosine |
Bind to reverse transcriptase does not require phosphorylation | NNRTI |
Bind to reverse transcriptase requires phosphorylation | NRTI |
Name the NNRTIs | Nevirapine Dlavirenze Delavirdine |
Inhibits HIV genome integration into host cell chromosome by reversible inhibition of HIV integrase | Raltegravir - integrase inhibitor |
Glycoprotiens synthesized by virus infected cells Block replication of both RNA and DNA viruses | Interferons |
IFNa | HBV HCV Kaposi Sarcoma (HSV-8) |
IFNb | MS |
IFNg | NADPH oxidase deficiency |
pt has HIV, hepatitis, neutropenia and myopathy. whats he taking? | IFNa |
Treatments for Pseudomonas | FAACE Fluroquinolones Aztreonam Aminoglycosides Cefepine Extended Spectrum Penicillins |
Abx used in Pregnancy | ACE Amoxicillin Clindamycin Erythromycin |
NEVER USE IN PREGNANCY (1) | Countless SAFe Moms Take Really Good Care Clarithromycin - ebryotoxic Sulfonamides - kernitures Aminoglycosides- ototoxicity Fluroquinalones - cartilage damage Metronidazole - mutagenesis |
NEVER USE IN PREGNANCY (2) | Countless SAFe Moms Take Really Good Care Tetracycline - discolored teeth, bone growth inhibition Ribavirin - teratogenic Griseofulvin - teratogenic Chloramphenicol - grey baby |