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USMLE

Pharm 3

QuestionAnswer
Gentamicin, neomycin, amikacin, tobramycin, streptomycin - what class of antibiotics? Aminoglycosides
Bactericidal, inhibit formation of initiation complex and cause misreading of mRNA. Require O2 for uptake, therefore ineffective against anaerobes AMINOGLYCOSIDES
Which aminoglycoside is used for bowel surgery Neomycin
Aminoglycosides are _ with beta lactams Synergistic
Aminoglycosides are clinically used for treatment of _ Severe gram negative rod infections
Toxicity of aminoglycosides Nephrotoxicity (especially with cephalosporins), Ototoxicity (especially with loop diuretics)
Doxycycline, demeclocycline, minocycline - name class of antibiotics Tetracyclines
Bacteriostatic, bind to 30S and prevent attachment of aminoacyl-tRNA, limited CNS penetration Tetracyclines
Which tetracycline is fecally eliminated and can be used in patients with renal failure Doxycycline
Must NOT take tetracyclines with _ Why? Milk, Antacids, Iron containing preparations, Divalent cations inhibit its absorption in gut
Clinical use of tetracyclines Vibrio cholerae, Acne, Chlamydia, Ureaplasma, Urealyticum, Mycoplasma pneumonia, Borelia burgdorferi, Riccketsia, Tularemia, ("VACUUM your BedRoom Tonight")
Toxicity of tetracyclines GI distress, discoloration of teeth and inhibition of bone growh in children, photosensitivity
Erythromycin, azithromycin, clarithromycin- name class of antibiotics Macrolides
Inhibit protein synthesis by blocking translocation - bind to 23S rRNA of 50S ribosomall subunit, bacteriostatic Macrolides
Clinical use macrolides URI, Pneumonia, STD, gram positive cocci (streptococcal infections in patients allergic to penicillin), Mycoplasma, Legionella, Chlamydia, Neisseria
Toxicity macrolids GI discomfort, acute cholestatic hepatitis, eosinophilia, skin rashes
Patient on antibiotic therapy develops acute cholestatic hepatitis - which clas of drug? Macrolides
Most common cause of non compliance with macrolides GI discomfort
Inhibits 50S peptidyltransferase, bacteriostatic Chloramphenicol
This drug is used for treatment of meningitis (H flu, N meningitidis, Strep pneumoniae) but conservatively used due to toxicities Chloramphenicol
Toxicities with chloramphenicol Anemia (dose dependent), Aplastic anemia (dose independent), Gray baby syndrome
Which drug causes gray baby syndrome and why Chloramphenicol, - premature infants because they lack liver UDP-glucuronyl transferase)
Blocks peptide bond formation at 50S ribosomal subunit, bacteriostatic Clindamycin
Which antibiotic is used to treat anaerobic infections (Bacteroides fragilis, Clostridium perfringens) CLindamycin
Toxicity associated with clindamycin Pseudomembranous colitis (C. difficile overgrowth), fever, diarrhea
PABA antimetabolites inhibit dehydropteorate synthase, bacteriostatic Sulfonamides
Which sulfonamides are used for treatment of simple UTI Triple sulfas or SMX
Clinical use of sulfonamides Gram positive, Gram negative, Nocardia, Chlamydia
Toxicity with sulfonamides Hypersensitivity reactions, Hemolysis if G6PD deficient, Nephrotoxicity (tubulointerstitial nephritis), Kernicterus in infants, Displace other drugs from albumin (warfarin)
Antibiotic inhibits dihydropteorate synthase Sulfonamides
Antibiotic inhibits dihydrofolate reductase Trimethoprim, pyrimethamine
Inhibits bacterial dihydrofolate reductse, bacteriostatic Trimethoprim
This drug is used in combination with sulfonamides causing sequential block of folate synthesis Trimethoprim
This drug is used for recurrent UTI's, Shigella, Salmonella, Pneumocystis carinii pneumonia TMP-SMX
Toxicity of trimethoprim Megaloblastic anemia, Leukopenia, Granulocytopenia ("TMP - Treats Marrow Poorly")
Toxicity connected with trimethoprim can be alleviated by _ Supplemental folinic acid
Ciprofloxacin, norfloxacin, ofloxacin, sparfloxacin, moxifloxacin, gatifloxacin, enoxacin - name class Fluoroquinolones
Antibiotics inhibit DNA gyrase (topoisomerase II), bactericidal Fluoroquinolones
Used clinically for treatment of gram negative rods of urinary and GI tracts (including Pseudomonas), Neisseria, some gram positive organisms Fluoroquinolones
Are fluoroquinolones safe in pregnant women Contraindicated in pregnant women and in children because animal studies show damage to cartilage.
Fluoroquinolones toxicity Tendonitis and tendon rupture in adults, GI upset, Superinfections, Skin rashes, Headache, Dizziness ("FluoroquinoLONES hurt attachments to your BONES")
Forms toxic metabolites in bacterial cells, bactericidal Metronidazole
Antiprotozoal, Giardia, Entamoeba, Trichomonas, Gardenrella vaginalis, anearobes (bacteroides, clostridium) - name drug Metronidazole
This drug is used with bismuth and amoxicillin (or tetracycline) for "triple therapy" against H pylori Metronidazole
Created by: Asclepius
 

 



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