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USMLE

Comprehensive Pharm 11

QuestionAnswer
examples of macrolides the MACRO WREATH's CLARity is EZ to see Erythromycin Clarithromycin Azithromycin
MOA macrolides cidal/static? blocks protein transloation by binding to the 50S ribosomal subunit
clinical uses for macrolides URIs pneumonia STDs gm + cocci (for pts allergic to penicillin) Mycoplasma Chlamydia Legionella Neisseria
toxicity of macrolides GI discomfort acute cholestatic hepatitis eosinophilia skin rash increases serum [] theophylline and oral anti-coagulants
MOA chloramphenicol cidal/static? binds 50S, inhibiting peptidyl transferase static
clinical uses for chloramphenicol meningitis
toxicities associated with chloramphenicol anemia aplastic anemia gray baby sndrome
what causes gray baby syndrome premature infants lack UDP gluuronyl transferase
MOA clindamycin cidal/static? blocks peptide bond formation at 50S ribosomal subunit static
clinical uses for clindamycin treats anaerobic infections (above the diaphragm)
toxicity of clindamycin c. diff overgrowth fever diarrhea
MOA sulfonamides cidal/static? PABA antimetabolites inhibit dihydropterate synthase static
clinical uses for sulfonamides gram +/- nocardia chlamydia
which sulfonamide can be used to treat simple uti's triple sulfa
toxicity associated with sulfonamides hypersensitivity hemolysis with G6PD deficiency tubulointerstitial nephritis kernicterus in infants displaces other drugs from albumin
MOA trimethoprim static/cidal? inhibtits bacterial dihydrofolate reductase static
clinical use of trimethoprim used in combo with sulfamethoxaole treats recurrent uti's, shigella, salmonella, PCP
toxicity of trimethoprim megaloblastic anemia leukopenia granulocytopenia (TMP = treats marrow poorly)
examples of fluorquinolones ___-floxacin (also nalidixic acid which is a quinolone)
MOA fluoroquinolones cidal/static? inhibits topoisomerase II (DNA gyrase) cidal
toxicity associated with fluoroquinolones gi upset superinfections skin rashes h/a dizziness cartilage damage bone pain tendonitis, tendon rupture (adults) myalgia and leg cramps in kids "fluoroquinolones hurt attachments to your bones"
contraindications of fluoroquinolones pregnant women children
MOA metronidazole static/cidal? forms toxic metabolites in bacterial cell cidal
clinical uses for metronidazole anti-protazoal GET GAP on the METRO Giardia Entamoeba Trichomonas Gardnerella vaginalis Anaerobes H. PYLORI treats anaerobic infx below the diaphragm (as opposed to clindamycin, which treats them above the diaphragm)
toxocitiy of metronidazole disulfiram like rxns with etoh h/a metallic taste
MOA polymyxins bind to cell membranes of bacteria and disrupt osmotic properties act like detergents
clinical uses for polymyxins resistant gram - infxs
toxicity associated with polymxyins neurotoxicity acute renal tubular necrosis
1st line anti-TB drugs INH-SPIRE streptomycin pyrazinamide isoniazid rifampin ethambutol
2nd line anti-tb drug cycloserine
drugs for tb proph INH alone
MOA INH decreased synth of mycolic acid
toxicity of INH hemolysis in G6PD deficiency neurotoxicity (prevent with B6) hepatotoxicity SLE-like syndrome INH = Injures Neurons and Hepatocytes
MOA rifampin inhibits DN Adependent RNA polymerase (the rif-raf RAN around the block)
uses for rifampin m. tb delays resistance to dapsone when treating leprosy meningococcal proph proph in contacts of children with HiB
4Rs of rifampin RNA polymerase inhibitor Revs up microsomal p450 Red/orange body fluids rapid resistance if used alone
meningococcal proph rifampin (drug of choice) minocycline
gonorrhea proph ceftriaxone
proph in a pt with h/o repeated uti's tmp-smx
proph against PCP tmx-smp (drug of choice) aerosolized pentamide
proph against endocarditis with surgical/dental procedures penicillins
Created by: Asclepius