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USMLE
Pharm 3
| Question | Answer |
|---|---|
| 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 |
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Asclepius
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