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Antimicrobials

First Aid: Antimicrobials

QuestionAnswer
Block cell wall synthesis by inhibition of peptidoglycan cross-linking Penicillin and it's derivatives (anything ending in cillin), cephalosporins, aztreonam, and imipenem
These are the penicillin derivatives are resistant to penicillinase and used to treat S. aureus. Methicillin, nafcillin, dicloxacillin; not used to treat MRSA (methicillin resistant s. aureus)
These drugs can cause pseudomembranous colitis. Clindamycin, ampicillin
Ampicillin is effective against these organisms. "HELPS!"; H. influenzae, E. coli, Listeria, Proteus, Salmonella
Extended spectrum penicillins, used to treat pseudomonas infection. Ticarcillin, carbenicillin, piperacillin; use with clavulinic acid
This drug, often used in conjunction with penicillin, inhibits Beta lactamase Clavulinic acid (also sulbactam and tazobactam)
The second generation of this drug was expanded to include H. influenzae, Enterobacter, and Serratia. What did the first generation already treat? Cephalosporins; Proteus, E. coli, Kliebsella
This is the drug of choice for enterobacter, and is administered with cilastatin. Imipenem; cilastatin inhibts renal dihydropeptidase I which inactivats imipenem in the renal tubules
This drug is first choice for enterbacter, but can causes seizures (CNS toxic). Imipenem
This drug inhibits mucopeptide formation by binding D-ala D-ala portion of cell wall precursors preventing crosslinking. Vancomycin
What is vancomycin used against and what are it's side effects? Multidrug-resistant organisms such as S. aureus and Clostridium difficile; nephrotoxic, ototoxic, thrombophlebitis, diffuse flushing "red man syndrome"
What are the protein synthesis inhibitors and what ribosomal subunit do they act on? "Buy AT 30, CELL at 50!"; aminoglycosides (gentamicin, streptomycin) work on 30s; Chloramphenicol, Erythromycin (a macrolide), Lincomycin, and cLindamycin work on 50s
What are the major side effects of aminoglycosides? Nephrotoxic, ototoxic, teratogenic
This aminoglycoside is given orally as prophylaxis for bowel surgery. Neomycin
This drug can cause discoloration of the teeth and inhibition of bone growth in children. Tetracycline
This drug is used to treat meningitis (H. influenzae, N. meningitidis, and s. pneumoniae) Chloramphenicol
What are the major toxicities of chloramphenicol? myelosuppression and occasionally an irreversible aplastic anemia; also causes "gray baby syndrome" (cyanosis and cardiovascular collapse)
This drug is used to treat anaerobic infections (e.g. Bacteroides fragilis, C. perfringens) Clindamycin
These two drugs used in combination cause sequential block of folate synthesis. Sulfonamides (inhibit dihydropterate synthase); Trimethroprim (inhibits dihydrofolate reductase)
What two antimicrobials are triggers for G6PD hemolysis? Sulfonamides and isoniazid (INH)
This drug inhibits DNA gyrase (topoisomerase II). Fluoroquinolones (-floxacin)
What are the major side effects of fluoroquinolones? Tendonitis and tendon rupture in adults; myalgias and leg cramps in kids
This antiprotozoal is also used in combination therapy for H. pylori. Metronidazole; Bismuth and amoxicillin (or tetracycline) are the other two in H. pylori treatment
What drug has a disulfiram like reaction with alcohol. Interestingly disulfiram may be effective in treating organisms resistant to this drug. Metronidazole (Cephalosporins also have a disulfiram like reaction)
This topical agent disrupts bacterial cell membranes. Polymyxins
What are the 5 major anti-TB drugs, and what is their common toxicity? "SPIRE" Streptomycin, Pyrazinamide, Isoniazide, Rifampin, Ethambutol; all are hepatotoxic
This drug is the only solo prophylactic TB agent. Isoniazid
What are the major toxicities of isoniazid? neurotoxic (preventable w/ B6), hepatotoxic (like all anti-TB's), SLE-like syndrome, G6PD hemolysis
This drug inhibits DNA-dependent RNA polymerase, and may be used as prophylactic agent for HIB contacts. Rifampin (treats tuberculosis)
This drug can cause Red/orange body fluids. Rifampin
This antifungal, too toxic for systemic use, is used for "swish and swallow" treatment of oral candidiasis or topically for diaper rash. Nystatin; binds ergosterol disrupting fungal membranes
This drug is used to treat cryptococcal meningitis in AIDS patients. Fluconazole
What is the treatment for systemic mycoses? Locally, treat with ketaconazole and fluconazole; systemically treat with amphotericin B
These drugs cause gynecomastia by inhibiting hormone synthesis. Azoles
This drug, which works in a similar fashion to the azoles, is used to treat dermatophytoses. Terbinafine
This drug interferes with microtubule function disrupting mitosis. Used to treat tinea (ringworm). Griseofulvin
This drug which blocks viral penetration/uncoating is used as prophylaxis for influenza A and has use in parkinson's treatment. Amantadine
What are the side effects of amantadine? ataxia, slurred speech, dizziness; rimantidine is a derivative with fewer CNS effects
These drugs inhibit influenza neuraminidase and are effective against both A and B. Zanamivir, oseltamivir
This drug inhibits guanine synthesis and is used to treat RSV and chronic hepatitis C Ribavirin
This drug preferentially inhibits CMV DNA polymerase. Ganciclovir
This drug is used to treat HSV, VZV, EBV. Acyclovir
This is the drug used for CMV retinitis or acyclovir resistant HSV. Foscarnet
What are the HIV protease inhibitors? saquinavir, ritonavir, indinavir
Nucleoside reverse transcriptase inhibitors. Zidovudine (AZT), lamivudine, didanosine (ddI), stavudine, abacavir
Non-Nucleoside reverse transcriptase inhibitors. Nevirapine, efavirenz, delavirdine
Are antimicrobials fun to learn? Yes!!!
Treatment for gaint roundworm (Ascaris), hookworm(Ancylostoma), pinworm (Enterobius). Mebendazole and pyrantel pamoate
Treatment for schistosomes. Praziquantel
Treatment for clonorchis sinensis praziquantel
Treatment for pneumocystis carinii. TMP-SMX
Treatment for Chaga's disease? Nifurtimox
Treatment for trypanosomiasis? Suramin (except chaga's, use nifurtimox)
Firstline treatment for malaria? Chloroquine
Created by: rahjohnson