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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 |
Created by:
Suny510