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antimicrobials
| Question | Answer |
|---|---|
| Toxicity of penicillin | Coombs + (hemolytic anemia) |
| Clinical use of penicillin G | Streptococcal, pneumococcal, meningococcal infections, syphillis |
| Probenicid interacts will all beta lactams except ___. It causes them to ____ levels of Beta lactams | aztreonam (monbactam). Causes increase in the serum level of the antibiotic |
| Naficillin is used to treat | MSSA (bone, joint, UTI, respiratory, endocarditis) |
| Other drugs in the same class as nafcillin are ___, ____. Oral forms that are similar include | Oxacillin, methicillin. Oral forms included cloxacillin, dicloxacillin |
| Methecillin is used rarely because of | interstitial nephritis |
| Ampicillin and amoxicillin are ___. Which one is given orally? What beta lactamase inhibitor is used for each? | aminopenicillins. Amoxillicin = oral, Ampicillin-sulbactam, piperacillin-tazobactam, |
| What beta lactam can decrease hormonal contraceptive effectiveness? | Amoxicillin |
| Clinical use of amoxicillin/ampicillin | "Amped penicillin" penicillin spectrum + gram negative: Respiratory tract infections (otitis, sinusitis, pneumonia), skin infections (bite wounds); HELPS kille enterococci (Hemophilus, e. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella |
| Ticarcillin (class) and Piperacillin (class). They need to use a beta lactamase inhibitor. What are they? | Ticaracillin = carboxypenicillin, Piperacillin = ureidopenicillin. Tircacillin = clavulanate, Piperacillin uses tazobactam. |
| Ticarcillin, carbenicillin, piperacillin are used for | antipseudomonal agents and gram negative rods, especially enterobacteria. (TCP = takes care of pseudomonas) |
| 1st generation = , 2nd generation = , 3rd generation cephalosporins, 4th = cefepime | 1st generation = (cefazolin, cephalexin), 2nd generation = cefotoxin, cefaclor, cefuroxime, 3rd generation = ceftriaxone, cefotaxime, ceftazidime, 4= cefepime |
| Side effects of cephalosporins: | penicillin allergy 10-15%, Bleeding or disulfiram reaction in those cephalosporins with methylthiotetrazole group (cefotetan, cefoperazone, cefamandole) |
| 1st generation cephalosporin (name 2). Good for: | cefazolin, cephalexin. surgical prophylaxis, cellulitis. Good for staph/strep. 1st generations are first on the PEcKing order: Proteus, E. coli, Klebsiella |
| 2nd generation cephalosporin (name 3). Good for: | Cefoxitin, cefaclor, cefuroxime. HENs are 2nd in the PEcKing order: Haemophilus, Enterobacter, Neisseria, proteus, E. coli, Klebsiella, Serratia |
| 3rd generation cephalosporin (name 3). Good for | ceftriaxone, cefotaxime, ceftazidime. Serious gram-negative infections resistant to other B-lactams. (cross BBB). |
| For pseudomonas: use | Ceftazidime, cefepime |
| Hemolytic toxicity | Penicillin (Coombs + ) |
| Clinical use of penicillin G | Streptococcal, pneumococcal, meningococcal infections, syphillis |
| Probenicid interacts will all beta lactams except ___. It causes them to ____ levels of Beta lactams | aztreonam (monbactam). Causes increase in the serum level of the antibiotic |
| Naficillin is used to treat | MSSA (bone, joint, UTI, respiratory, endocarditis) |
| Other drugs in the same class as nafcillin are ___, ____. Oral forms that are similar include | Oxacillin, methicillin. Oral forms included cloxacillin, dicloxacillin |
| Methecillin is used rarely because of | interstitial nephritis |
| Ampicillin and amoxicillin are ___. Which one is given orally? What beta lactamase inhibitor is used for each? | aminopenicillins. Amoxillicin = oral, Ampicillin-sulbactam, piperacillin-tazobactam, |
| What beta lactam can decrease hormonal contraceptive effectiveness? | Amoxicillin |
| Clinical use of amoxicillin/ampicillin | "Amped penicillin" penicillin spectrum + gram negative: Respiratory tract infections (otitis, sinusitis, pneumonia), skin infections (bite wounds); HELPS kille enterococci (Hemophilus, e. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella |
| Ticarcillin (class) and Piperacillin (class). They need to use a beta lactamase inhibitor. What are they? | Ticaracillin = carboxypenicillin, Piperacillin = ureidopenicillin. Tircacillin = clavulanate, Piperacillin uses tazobactam. |
| Ticarcillin, carbenicillin, piperacillin are used for | antipseudomonal agents and gram negative rods, especially enterobacteria. (TCP = takes care of pseudomonas) |
| 1st generation = , 2nd generation = , 3rd generation cephalosporins, 4th = cefepime | 1st generation = (cefazolin, cephalexin), 2nd generation = cefotoxin, cefaclor, cefuroxime, 3rd generation = ceftriaxone, cefotaxime, ceftazidime, 4= cefepime |
| Side effects of cephalosporins: | penicillin allergy 10-15%, Bleeding or disulfiram reaction in those cephalosporins with methylthiotetrazole group (cefotetan, cefoperazone, cefamandole) |
| 1st generation cephalosporin (name 2). Good for: | cefazolin, cephalexin. surgical prophylaxis, cellulitis. Good for staph/strep. 1st generations are first on the PEcKing order: Proteus, E. coli, Klebsiella |
| 2nd generation cephalosporin (name 3). Good for: | Cefoxitin, cefaclor, cefuroxime. HENs are 2nd in the PEcKing order: Haemophilus, Enterobacter, Neisseria, proteus, E. coli, Klebsiella, Serratia |
| 3rd generation cephalosporin (name 3). Good for | ceftriaxone, cefotaxime, ceftazidime. Serious gram-negative infections resistant to other B-lactams. (cross BBB). |
| For pseudomonas: use | Ceftazidime, cefepime |
| Hemolytic toxicity | Penicillin (Coombs + ) |
| Clinical use of penicillin G | Streptococcal, pneumococcal, meningococcal infections, syphillis |
| Probenicid interacts will all beta lactams except ___. It causes them to ____ levels of Beta lactams | aztreonam (monbactam). Causes increase in the serum level of the antibiotic |
| Naficillin is used to treat | MSSA (bone, joint, UTI, respiratory, endocarditis) |
| Other drugs in the same class as nafcillin are ___, ____. Oral forms that are similar include | Oxacillin, methicillin. Oral forms included cloxacillin, dicloxacillin |
| Methecillin is used rarely because of | interstitial nephritis |
| Ampicillin and amoxicillin are ___. Which one is given orally? What beta lactamase inhibitor is used for each? | aminopenicillins. Amoxillicin = oral, Ampicillin-sulbactam, piperacillin-tazobactam, |
| What beta lactam can decrease hormonal contraceptive effectiveness? | Amoxicillin |
| Clinical use of amoxicillin/ampicillin | "Amped penicillin" penicillin spectrum + gram negative: Respiratory tract infections (otitis, sinusitis, pneumonia), skin infections (bite wounds); HELPS kille enterococci (Hemophilus, e. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella |
| Ticarcillin (class) and Piperacillin (class). They need to use a beta lactamase inhibitor. What are they? | Ticaracillin = carboxypenicillin, Piperacillin = ureidopenicillin. Tircacillin = clavulanate, Piperacillin uses tazobactam. |
| Ticarcillin, carbenicillin, piperacillin are used for | antipseudomonal agents and gram negative rods, especially enterobacteria. (TCP = takes care of pseudomonas) |
| 1st generation = , 2nd generation = , 3rd generation cephalosporins, 4th = cefepime | 1st generation = (cefazolin, cephalexin), 2nd generation = cefotoxin, cefaclor, cefuroxime, 3rd generation = ceftriaxone, cefotaxime, ceftazidime, 4= cefepime |
| Side effects of cephalosporins: | penicillin allergy 10-15%, Bleeding or disulfiram reaction in those cephalosporins with methylthiotetrazole group (cefotetan, cefoperazone, cefamandole) |
| 1st generation cephalosporin (name 2). Good for: | cefazolin, cephalexin. surgical prophylaxis, cellulitis. Good for staph/strep. 1st generations are first on the PEcKing order: Proteus, E. coli, Klebsiella |
| 2nd generation cephalosporin (name 3). Good for: | Cefoxitin, cefaclor, cefuroxime. HENs are 2nd in the PEcKing order: Haemophilus, Enterobacter, Neisseria, proteus, E. coli, Klebsiella, Serratia |
| 3rd generation cephalosporin (name 3). Good for | ceftriaxone, cefotaxime, ceftazidime. Serious gram-negative infections resistant to other B-lactams. (cross BBB). |
| For pseudomonas: use | Ceftazidime, cefepime, aztreonam |
| Beta lactams that display no cross-reactivity include | Monobactams (aztreonam) and some cephalosporins (10-15%) |
| For patients wtih renal insufficiency that can't tolerate aminoglycosides, use ___. | aztreonam |
| Aztreonam is used for: | Gram negative rods (enterobacter, pseudomonas); NO Gram positive/anaerobic activity |
| Impinem (class) is used with ___ because it is a dehydropeptidase inhibitor. Dehydropeptidase increases/decreases imipenim? | Carapenem. Use wtih cilastatin. Cilastatin inactivates renal tubules and prevents degradation of imipenem. |
| Clinical use of impenem: | gram-positive coci, gram negative rods, anaerobes. Drug of choice for enterobacter. use for life saveing (because of negative side effects) |
| Meropenem is unlike imipenem because | it is stable to dihydropeptidase and has less severe side effects |
| Toxicity of imipenem | GI distress, skin rash, CNS toxicity (seizures) |
| Which cephalosporin has the greatest gram negative coverage? | Generations 3,4 |
| Which cephalosporin has the greatest gram + coverage? | Generations 1, 4 |
| Which cephalosporin covers anaerobes | Generation 2 |
| Protein synthesis inhibitors (30s) | TAG = Tetracyclines, Aminoglycosides |
| Protein syntheis inhibitors (50s) | CCLLEan =Clindomycin, Chloramphenicol, Erythromycin, Lincomycin, Linezolid |
| Inhibit formation of initiaion complex and cause misreading of mRNA. | aminoglycosides |
| Requires O2 for uptake, therefore ineffective against ____. | Aminoglycosides |
| Synergistic with B-lactam antibiotics | Aminoglycosides |
| Clinical use: aminoglycosides | Severe gram negative rods (pseudomonas, enterobacter, staph |
| Synergistic with beta lactams | aminoglycosides (Amp-gent) |
| Bowel surgery | Neomycin (aminoglycoside) |
| Toxicity: aminoglycosides | Nephrotoxicity (cephalosporins, Ototoxicity (loop diuretics), Teratogen |
| Aminoglycoside types | "GNATS" Gentomycin, Neomycin, amikacin, tobramycin, streptomycin |
| Aminoglycoside used for TB | Streptomycin |
| Mechanism: Vancomycin | Inhibits cell wall mucopeptide formation by binding D-ala D-ala portion of cell wall. Bactericidal. Resistance occurs with amino acid change to D-ala |
| Vancomycin = BC/BS, Aminoglycosides BC/BS? | both BC |
| Tetracycline types | Tetracycline, doxycycline, demeclocycline, minocycline |
| Mechanism: tetracycline | Bacteriostatic; Bind to 30s and prevent attachment of aminoacyl-tRNA. limited CNS penetration |
| Limited CNS penetration | Tetracycline |
| Which tetracycline can be used in patients with renal failure? | doxycycline |
| What can't you take with tetracyclines? | Milke, antacids, iron-containng preparations (divalent cations inhibit absorption into gut |
| Clincal uses for tetracycline | VACUUM The BedRoom that looks like a cyclone- Vibrio, Acne, Chlamydia, Ureaplasma, Urealyticum, Mycoplasma pneumoniae, Tularemia, H. pylori, Borrelia burgdorferi, Rickettsia |
| Toxicity: Tetracylcines | GI distress, discoloration of teeth, inhibition of bone growth in children, photosensitivity, contraindicated in pregnancy |
| Macrolide types | erythromycin, azithromycin, clarithromycin |
| Mechanism: macrolides | Inhibit protein synthesis by blocking translocation (moving the peptide strand to the p site); it binds to 23S rRNA of teh 50s ribosomal unit; bacteriostatic |
| Clinical uses: macrolides | Atypical pneumonia (mycoplasma, legionella, chlamydia, Neisseria), typical (s. pneumoniae), gram positive cocci |
| Toxicity: macrolides | GI distress (motilin receptors), acute cholestatic hepatitis, eosinophila, skin rashes. |
| Increases serum concentration of theophyllines, anticoagulants, diazepam | Erythromycin |
| Mechanism:Chloramphenicol | Inhibits 50s peptidyltransferase activity; bacteriostatic (peptidyltransferase = adds peptide to amino acid in A site" |
| Clinical use: chloramphenicol | meningitis (H. influenzae, Neisseria, S. pneumoniae) |
| Toxicity: Chloramphenicol | Anemia (dose dependent), aplastic anemia, gray baby syndrome (lack UDP-glucoronyl transferase) |
| Mechanism: Clindamycin | Blocks peptide bond formation at 50S ribosomal subunit |
| Clinical use:clindamycin | treat anaerobic infections (bacteroides fragilis, clostridium perfringens) ==> aspiration, abcess |
| Toxicity: clindamycin | C. dificile, fever, diarrhea |
| Sulfonamide allergy: what not to give | furosemide, thiazides, acetazolamide |
| blocks dihydropteroate synthetase | sulfonamides (can't produce nucleotides) |
| blocks dihydrofolate reductase | trimethoprim |
| Sulfonamides: clinical use | Gram positive, gram negative, Nocardia, chlamydia |
| Sulfonamides: toxicity | Hypersensitivity reactions, hemolysis of G6PD, nephrotoxicity (tubulointerstitial nephritis, photosensitivity, kernicterus in infants, displace other drugs from albumin (warfin) |
| TMP-SMX: clinical use | recurrent UTIs, shigella, salmonella, PCP |
| TMP-SMX: toxicity | Megaloblastic anemia, leukopenia, granulocytopenia |
| INH: mechanism | Decreases synthesis of mycolic acid |
| INH: clinical use | TB prophylaxis, treatment |
| INH: toxicity | Neurotoxicity, hepatotoxicity (INH = injures neurons, hepatocytes), pyridoxine (B6) can prevent neurotoxicity |
| Rifampin: mechanism | Inhibits DNA dependent RNA polymerause |
| Rifampin: clinical use | TB, delays resistance to dapsone in leprosay, used for meningococcal prophylaxis in patients with Hib contact |
| Rifampin: toxicity | Hepatotoxicty, (increase p-450, orange body fluids) |
| 4 R's of rifampin | RNA polymerase inhibitor, Revs up microsomeal P-450, Red/orange body fluids, Resistance if used alone |
| Treatment of MRSA, VRE | MRSA= vanco, VRE = linezoild, streptogramins (quiinupristin/dalfopristin) |
| Nalidixic acid is a___ | quinolone |
| Fluoroquinolones: Mechanism | inhibit DNA gyrase (topoisomerase II). |
| Fluoroquinolones: Clinical use | Gram negative rods of urinary/GI tracts (pseudomonas, neisseria, gram positive) |
| Fluoroquinolones: toxicity | GI upset, superinfections, skin rash, headache dizziness. Contraindicated in pregnant women. Must not be taken with antacids, tendonitis, tendon rupture in adults, leg cramps, myalgias in kids. |
| Metronidazole: mechanism | forms toxic metabolites in the bacterial cell that damage DNA. |
| Metronidazole: clinical use | GET GAP on the Metro (Giardia, Entamoeba, trichomonas, Gardenerella, Anaerobes, H.Pylori |
| Metronidazole: toxicity | Disulfiram-like reaction, metallic taste |
| Polymyxins: mechanism | bind to cell membranes of bacteria and disrupt their osmotic properties. (positive; act like detergent) |
| Polymyxins: clinical use | resistant gram-negative infections |
| Polymyxins: toxicity | neurotoxicity, acute renal tubular necrosis |
| Prophylaxis: M. tuberculae, M. avium intracellulare | Isoniazid, Azithromycin |
| M. tuberculosis treatmetns | INH-SPIRE (Streptomycin, pyrazinamide, isoniazid, rifampin, ethambutol) |
| M. avium intracellulare | Azithromycin, rifampin, ethambutol, streptomycin |
| M. leprae treatments | Dapsone, rifampin, clofazimine |
| 2nd line therapy of TB | cycloserine (2nd-line therapy) |
| Side effects of TB durgs | hepatotoxicity |
| Side effects: optic neuropathy (red-green color blindness) | ethambutol |
| Endocarditis with surgical or dental procedures prophylaxis | Penicillins |
| PCP pneumonia prophylaxis | TMP-SMX, aerosolized pentamidine |
| History of recurrent UTIs prophylaxis | TMP-SMX |
| Syphills prophylaxis | Benzathine penicillin G |
| Gonorrhea prophylaxis | ceftriaxone |
| Meningococcal infection prophylaxis | Rifampin (drug of choice), minocycline |
| Penicillins/cephalosporin drug resistance | B-lactamase cleavage of b-lactam ring, altered PBP in cases of MRSA or penicillin-resistant S. pneumonia |
| Aminoglycosides drug resistance | Modification via acetylation, adenylation, phosphorylation |
| Vancomycin drug resistance | Terminal D-ala of cell wall component replaced with D-lac; decreased affinity |
| Chloramphenicol drug resistance | modification via acetylation |
| Macrolides drug resistance | methylation of rRNA near erythomycin's ribosome binding site |
| Tetracylcin drug resistance | Decreased uptake, increased transport out of cell |
| Sulfonamides | Altered enzymes (bacterial dihydropterate synthetase), decreased uptake, or increased PABA synthesis, |
| Quinolones | Altered gyrase or reduced uptake |
| Antifungals that bind to ergosterol include: Mechansim: | Antifungals: nystatin, amphotericin B. They bind to ergosterol and form pores that allow leakage of electrolytes |
| Amphotericin: Clinical use | Wide spectrum systemic mycoses: Crypto, Histo, Blasto, Coccidio, Candida, Mucor, Aspergillis. Use intrathecally for meningitis |
| For meningitis with systemic fungi what drug do you administer? | Amphotericin, intrathecally |
| Amphotericin: toxicity | Fever/chills (Shake and bake), hypotension, nephrotoxicity, arrythmia, anemia, IV phlebitis (amphoterrible). |
| What can reduce toxicity of amphotericin? | Hydration reduces nephrotoxicity, liposomal reduces toxicity |
| Nystatin: clinical use | "swish and swallow" for oral candida; topical for diaper rash; (too toxic for systemic use) |
| Antifungals that bind ergosterol:, Antifungals that block synthesis of ergosterol | Antifungals that bind: amphotericin B, nystatin, Antifungals that block synthesis: azoles, terbinafine |
| antifungals used for systemic mycoses | amphotericin B, azoles, flucytosine (use with ampho) |
| Fluconazole use: | cryptococcal (Crosses BBB unlike amphotericin), candidal infections |
| Ketoconazole use: | Local infections of Blastomycoses, Coccidio, Histoplasmosis, Candida albicans |
| Clotrimazole use: | Topical fungal infections |
| Micanzole use: | Topical fungal infections |
| Azoles: toxicity | Hormone synthesis inhibition (gynecomastia), liver dysfunction (inhibits cytochrome P-450), fever, chills |
| Flucytosine: Mechanism | Inhibits DNA synthesis by converstion to 5-flurouracil. |
| Flucytosine: Clnical use | Systemic fungal infections (candida, crypto) in combination with amphotericin |
| Flucytosine: toxicity | Nausea, vomitin, diarrhea, bone marrow suppression |
| Caspofungin: mechanism | Inhibits cell wall synthesis by inhibiting B-glucan |
| Caspofungin: use | Invasive aspergillosis |
| Caspofungin: toxicity | GI upset, flushing |
| Terbinafine: mechanism | Inhibit fungal enzyme squalene epoxidase (decrease ergosterol synthesis) |
| Terbinafine: use | dermatophytoses, onychomycosis |
| Griseofulvin: mechanism | Interferes with microtubule function: disrupts mitosis; |
| Griseofulvin: Clinical use | oral treatment of superficial infections; inhibits growth of dermatophytes (tinea ringworm) |
| Griseofulvin: toxicity | Teratogenic, carcinogenic, confusion, headaches, increases P-450 and warfin metabolism, deposits in kertain-containing tissues |
| Treatment of sporothrix schenckii | potassium iodide, itraconazole |
| Treatment of tinea versicolor | Selenium sulfide (selsun), miconazole |
| Treatment of tinea peidis | azoles |
| Amantidine: mechanism | blocks M2 protein, acidifying virus and preventing uncoating and penetration of virus. Causes release of daopmine from intact nerve terminals. |
| Amantidine: clinical use | Prophylaxis and treatment for influenza A; Parkinson's disease. "Amantidine blocks influenza A, and rubellA, and causes problems with the cerebellA" |
| Amantidine: Toxicity | Ataxia, dizziness, slurred speech |
| Mechanism of resistance | Mutated M2 protein. 90% of all influenza A strains are resistant to amantidine, so not used |
| Rimantidine is different than amantidine because | it has fewer side CNS side effects and does not cross the BBB. |
| Oseltamivir and ____: Mechanism | Inhibit influenza neuraminidase (decreases the release of progeny virus) |
| Oseltamivir: clinical use | Influenza A and B |
| Ribavirin: mechanism | Inhibits synthesis of guanine nulceotides by competively inhibiting IMP dehydrogenase |
| Ribavirin: clinical use | RSV, chronic hepatitis C |
| Ribavirin: toxicity | Hemolytic anemia, severe teratogen |
| Acyclovir: mechanism | Guanisine analog; inhibits DNA polymerase by chain termination. Monophosphorylated by HSV/VZV thymidine kinase |
| Acyclovir: clinical use | HSV, VZV, EBV. USed for HSV-induced mucocutaneous and genital lesions, encephalitis. Prophylaxis in immunocompromised patients. |
| For herpes zoster (shingles) use ____. | Famciclovir |
| Acyclovir: mechanism of resistance | thymidine kinase |
| Gancyclovir: mechanism | 5' monophosphate formed by a CMV viral kinase, or HSV/VSV thymidine kinase. Preferentially inhibits viral DNA polymerase |
| Gancyclovir: clinical use | CMV, especially for immunocompromised patients |
| Gancyclovir: Toxicity | Leukopenia, neutropenia, thrombocytopenia, renal toxicity. More toxic to host enzymes than acyclovir |
| Gancyclovir: Mechanism of resistance: | Mutated CMV DNA polymerase or lack of viral kinase |
| Foscarnet: Mechanism | blocks viral DNA polymerase by binding to pyrophosphate binding site. Does not need to be activated by viral kinase. |
| Foscarnet: Clinical use | CMV retinitis in immunocompromised patients when ganciclovir fails; acyclovir-resistant HSV |
| Foscarnet: Toxicity | Nephrotoxicity |
| Foscarnet: mechanism of resistance | Mutated DNA polymerase |
| Protease inhibitors end in ___- | "navir" Navir (never) TEASE a proTEASE |
| Protease inhibitors: mechanism of action | Inhibit maturation of new virus by blocking protease in progeny virions |
| Protease inhibitors: Toxicity | GI intolerance (nausea, diarrhea) hyperglycemia, lipodystrophy |
| Protease inhibitor that causes thrombocytopenia | Indinaivr |
| Name the Nucleoside reverse transcriptase inhibitors | Zidovudine (AZT), didanosine (ddI), zalcitabine (ddC), stavudine (d4T), lamivudine (3TC), abacavir. |
| Non-nucleoside reverse transcriptase inhibitors: | Never Ever, Deliver nucleosides (Nevirapine, Efavirenz, Delaviridine) |
| Non-nucleoside mechanism of action | Preferentially inhibit reverse transcriptase of HIV; prevent incorporation of DNA copy of viral genome into host DNA |
| Toxicity of reverse transcriptase inhibitors | bone marrow suppression (neutropenia, anemia), peripheral neuropathy, lactic acidosis (nucleosides), rash (non-nucleosides), megablastic anemia |
| Reverse transcriptase inhibitors: | Highly active antiretroviral therapy (HAART) |
| HAART includes: | 2 nucleoside reverse transcriptase inhibitors, with a non-nucleoside reverse transcriptase inhibitor (efavirenz) or a protase inhibitor (lopinavir-ritonavir) |
| When is HAART initiated? | when CD4 count is < 500/high viral load |
| ZDV: clinical use | First line therapy for HIV, preventation of maternal-fetal HIV transmission |
| Ritonavir:lopinavir: mechanism of action | Protease inhibitor; inhibits HIV protease and conversion of gag-pol polyprotein to functional proteins |
| Enfuvirtide: mechanism of action | bind viral gp 41; inhibit conformation change requried for fusion with CD4 cells (block entry) |
| Enfuvirtide: clinical use | Drug resistant HIV infection |
| Enfuvirtide: Toxicity: | Hypersensitivity reaction, SQ reactions, increased risk of bacterial pneumonia |
| Interferons: mechanism of action | glycoproteins from human leukocytes that block various stages of viral RNA and DNA synthesis. Induce ribonuclease that degrades viral mRNA |
| Interferons alpha | Chronic hepatitis B/C, Kaposi's, |
| IFN-Beta: use | MS |
| IFN-gamma: use | NADPH oxidase deficiency (chronic granulomatous disease) |
| Antibiotics to avoid during pregnancy | SAFE Moms Take Really Good Care (Sulfonamides, Aminoglycosides, fluoroquinolones, erythromycin, metronidazole, tetracylines, ribavirin, griseofulvin, chloramphenicol) |
| Sulfonamides in pregnancy | kernicterus |
| Aminoglycosides in pregnancy | ototoxicity |
| Fluoroquinolones in pregnancy | cartilage damage |
| Erythromycin in pregnancy | acute cholestatic hepatitis in mom (clarithromycin -embryotoxic) |
| Metronidazole in pregnancy | mutagenesis |
| Tetracyclines in pregnancy | discolored teeth, inhibition of bone growth |
| antiviral that's teratogenic | Ribavirin |
| antifungal that's teratogenic | Griseofulvin |
| chloramphenicol in pregnancy | "gray baby" |
| Antifungal that inhibits P450 ___, Antifungal that induces P450 ____. | Inhibits: Azoles, Induces = Griseofulvin |
| didanosine (aka ___). Example of a ____ | Didanosine = ddI (nucleoside reverse transcriptase inhibitor) |
| zalcitabine (aka ___) Example of a ____ | zalcitabine = ddC (nucleoside reverse transcriptase inhibitor) |
| stavudine (aka ____). Example of a ____ | Stavudine = d4T (nucleoside reverse transcriptase inhibitor) |
| lamivudine (aka ____). example of a ___ | lamivudine = 3TC (nucleoside reverse transcriptase inhibitor) |
| abacavir (aka ___). example of a ____. | nothing else ! (nucleoside reverse transcriptase inhibitor) |
| Prophylaxis for Mycobacterium avium | Azithromycin |
| Treatment for Mycobacterium avium | Azithromycin, rifampin, ethambutol, streptomycin |
| treatment for TB | INH-SPIRE (streptomycin,Isoniazid, rifmapin, ethambutol) |
| treatmet for M. leprae | Dapsone, rifampin, clofazimine |
| Prophylaxis for M. tuberculosis | Isoniazid |
| ___ causes neuromuscular blockade if given after surgery | Aminoglycosides |
| Pneumonic for aminoglycosides | Mean GNATS canNOT kill anaerobes (Gentamycin, neomycin, tobramycin, streptomycin), NOT (neurotoxicity, ototoxcity, teratogen) |
| ___ that can cause ATN | aminoglycosides |
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ddecampo
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