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Pharm_Final
Pharma_Penicillins to Anti-Fungals
| Question | Answer |
|---|---|
| What's a life threatening superinfection caused by C. Difficile? Tx? | Pseudomembranous Colitis. Discontinue Abx & if severe give electrolyes, fluids, corticosteroids |
| What treats Brucella and Legionella | Doxycycline (a Tetracycline) |
| Antipseudomonal Penicillins have great G- coverage. What can they treat? | Citrobacter, Enterobacter, Pseudomonas A, Serratia |
| Types of Tapeworm | Beef, Dwarf, Fish, Pork |
| Pneuomocystis Carinii is a common AIDS infection. Prophylactic tx? | Co-trimoxazole (TMP-SMZ) |
| DOC for Aerobic G+ Bacillus rods? | Vancomycin |
| Which Anaerobic bacteria DOC is NOT metronidazole? | Those that are G+: Use Penicillin or Clindamycin first. Actinomyces, Clostridia, Peptococcus, Peptostreptococcus |
| Anaerobic bacteria that are not G+ are treated by what? | Metronidazole |
| Fusobacterium, Prevotella & Porphyromonas are anaerobic bacteria which can be treated by which 3 drugs? | 1)Metronidazole 2)Penicillin 3)Clindamycin |
| Gram Negative Anaerobic Bacteria | C Difficile, Bacteriodes Fragilis, Fusobacterium, Prevotella, Porphyromonas |
| Treatment for Mycobacterium TB? | INH+Rifampin+Ethambutol+Pyramizinamide |
| DOC's for Mycoplasma Pneumonia? | 1)Tetracycline OR 2)Erythromycin |
| DOC for ALL Chlamydia? | Tetracyclines |
| Treatment for Chlamydia Trachomotis? | Tetracycline or Azithromycin |
| Treatment for Chlamydia Pneumoniae? | Tetracycline or Erythromycin |
| DOC for Borrelia Recurrentis? | Doxycycline(a Tetracycline) |
| DOC's for Early Burgdorferi? | Amoxicillin OR Doxycyline(a Tetracycline) |
| In pneumococcal meningitis penicillin + chloramphenicol leads to what? | Antagonism |
| DOC for Sphirocytes: Leptospira & Treponema | Penicillin |
| Drug classes that cause hemopoetic toxicity? | Chloramphenicol, Sulfonamides, Anti-Virals |
| DOC for Shigella (a G- Aerobic Rod)? | Quinolone |
| DOC for Salmonella? | 3rd Generation Cephalosporin "Ceft" or "Cefo" and/or Cefixime (only oral) |
| Gram Negative Rods | Brucella,E. Coli, Enterobacter, H Pylori, Klebsiella,Legionella,Pseudomonas, Proteus,Shigella, Salmonella. |
| What's the only fungus whose DOC is not Amphotericin B. Tx? | Aspergillus. DOC=Voriconazole |
| DOC for late Borrelia Burgdorferi(G- Spirochete)? | Ceftriaxone (3rd Gen Cephalosporin) |
| Mycobacterium Leprae (which becomes leprosy) is treated by? | Dapsone + Rifampin +/- Clofazimine |
| To prevent Group B Strep & Strep Pneumo, use what? | Penicillin prophylaxis |
| Respiratory infections caused by Haemophilus Influenza & Legionella Pneumophilia can be treated by what? | Co-Tromoxazole (TMP-SMZ, Bactrim-oral) |
| How do you treat Trematodes (Flukes)? | Biltricide & Bitin |
| What's the DOC's for Aerobic G- Moraxella Catarrhalis? | 1) 2nd/3rd Gen Cephalosporins OR 2) Bactrim (TMP-SMZ, Co-Trimoxazole) |
| To prevent Meningococceal Infection & Haemophilus B treat prophylactically with? | Rifampin |
| Bacteriostatic; in the urinary tract reaches "cidal" concentrations. Inhibits G+ and G- | Bactrim(Co-Trimoxazole, TMP-SMZ) & Fansidar(good for malaria) |
| Sulfasalazine is a prodrug used in which treatment? | Ulcerative Colitis & Rheumatoid Arthritis |
| How do you treat Listeriosis? | Ampicillin or Co-Trimoxazole(TMP-SMZ, Bactrim-oral) |
| What can treat nocardiosis? | Sulfadiazine |
| What treats toxoplasmosis? | Sulfadiazine+Pyrimethine |
| GI Infections caused by G- (Shigellosis, Nontyphoid Salmonella & Salmonella Typhi) can all be treated by? | Co-Trimoxazole (TMP-SMZ, Bactrim-oral) |
| What's more toxic, azithromycin or erythromycin? | Erythromycin |
| What has increased drug interactions, azithromycin or erythromycin? | Erythromycin |
| This drug interacts with the hepatic metabolism of drugs like carbamezapine, clotapine, cyclosporine, methadone, quinidine, protease inhibitors. | Erythromycin |
| DOC for Campylobacter Jejuni (G- Aerobic Rod)? | Macrolides (Azithromycin or Erythromycin) |
| Activates cell wall autolysis inhibiting terminal cross-linking of peptidoglycan --> Cell lysis. | Cephalosporin (beta lactam structure therefore can be inhibited by beta lactamases). Each generation increases potency, spectrum and resistance to beta-lactamase. |
| This beta-lactam drug cannot treat enterococci, listeria, or MRSA. | Cephalosporins |
| At the R1 Position there is a change in what for cephalosporins? | Kinetics |
| At the R2 Position there is a change in what for cephalosporins? | Activity level of drug |
| What drug class inhibits DNA Gyrase, thus inhibiting replication? | Fluoroquinones (synthetic nalidixic acid) |
| DOC for Brucella (G- Aerobic Rods)? | Doxycycline+Rifampin(OR Aminoglycoside) |
| Enterococcus, Strep A/B, Strep Pneumo, Viridans Strep and beta-lactamase positives & negatives are all good examples of what type of bacteria. | Gram Positive Cocci |
| What's the general DOC for gram + cocci? | Penicillins |
| Beta-lactamase inhibitors are used to expand the spectrum of penicillins. They cannot be used on MRSA. What are they? | Clavulinic Acid, Sulbactam, Tazobactam |
| Clavulinic Acid is typically paired with this to extend it's spectrum. | Amoxicillin or Ticarcillin |
| Sulbactam is typically paired with this to extend it's spectrum. | Ampicillin |
| Tazobactam is typically paired with this to extend it's spectrum. | Piperacillin |
| Amphotericin B, Aminoglycosides, Cephalosporins, Sulfonamides, and Vancomycin all produce this side effect | Renally toxic |
| Fluoroquinones, Sulfonamides and Tetracyclines all produce this side effect | Photosensitivity |
| Enterococci, Listeria and MRSA cannot be treated by what? | Cephalosporins |
| DOC's for Helicobacter Pylori(a G- Aerobic Rod)? | Bismuth+Metronidazole+ Amoxicillin or Tetracycline |
| Penicillin can work for some anerobics. What are they? | Gram +: Actinomyces, Peptococcus, Peptostreptococcus Fusobacterium Porphyromonas Prevotella |
| This oral Sulfa drug crosses the BBB and can acheive urine concentrations 10-20x of plasma. Use in EXTREME situations; can use IV. Drug? | Co-Trimoxazole(TMP-SMZ, Bactrim-Oral) |
| DOC for 1st attack UTI? | Co-Trimoxazole(TMP-SMZ, Bactrim-Oral) |
| DOC for Nocardiosis? | Co-Trimoxazole(TMP-SMZ, Bactrim-Oral) |
| DOC for Trachoma? | Co-Trimoxazole(TMP-SMZ, Bactrim-Oral) |
| DOC for Toxoplasmosis? | Co-Trimoxazole(TMP-SMZ, Bactrim-Oral) |
| DOC for Pneumocystis Carinii? | Co-Trimoxazole(TMP-SMZ, Bactrim-Oral) |
| DOC for AIDS? | Co-Trimoxazole(TMP-SMZ, Bactrim-Oral) |
| This drug treats uncomplicated UTIs, turning your urine brown. It's NOT resistant to E. Coli. Can be "static"/"cidal". Oral. | Nitrofurantoin |
| This drug damages bacterial DNA, ribosomes & metabolism. Acid will increase its effect therefore good for UTIs(will turn urine brown), activity will decrease with bad glomerula filtration. | Nitrofurantoin |
| What's the one gram+ aerobic rod that can be treated w/an extended spectrum penicillin(Amoxicillin)? | Listeria |
| What's the DOC for Listeria? | Amoxicillin |
| Horizontal and vertical transfers can lead to what? | Microbial resistance |
| Actinomyces, Bacteroides, C. Difficile & Peptococcus are all examples of what? | Anaerobes |
| DOC for Nocardia (G+ Aerobic Rod)? | Sulfadiazine or TMP-SMZ(Bactrim, Co-Trimoxazole)--Both are Sulfas. |
| DOC for Listeria (G+ Aerobic Rod)? | Ampicillin +/- Aminoglycoside |
| Patient presents with TB. What do you use for prophylaxis? | Isoniazid (INH) |
| Patient presents with UTI and Pneumocystis Carinii. What do you use for prophylaxis? | TMP-SMZ(Bactrim, Co-Trimoxazole) |
| What binds to the 23S Subunit? | Ketek, Linezolid |
| Improved treatment for Brucellosis? | Doxycycline+ a Rifampin or Aminoglycoside --> Summation Effects |
| Improved treatment for Enterococcal Endocarditis OR Pseudomonas? | Penicillin + Aminoglycoside -->Summation Effects |
| Improved treatment for Listeria? | Ampicillin + Aminoglycoside -->Summation Effects |
| Improved treatment for Helicobacter Pylori? | Bismuth + Metronidazole + Tetracycline -->Summation Effects |
| Aminoglycosides, Vancomycin & Minocycline all cause this toxic effect. | Ototoxicity |
| This drug of last resort is a cell wall inhibitor that prevents transpeptidation by binding terminal PBP. | Vancomycin-parenteral or oral |
| To treat MRSA and G+ infections with people allergic to penicillin should use what parenterally? | Vancomycin-parenteral |
| Vancomycin is used orally to treat what? | Staph & C Difficile Infections |
| Ototoxicity, Nephrotoxicity & Red Man Syndrome are all side effects from this drug. | Vancomycin |
| DOC for late Borrelia Burgdorferi (G- Spirochete)? | Ceftriaxone (3rd Gen Cephalosporin) |
| Patient has active pulmonary/extra-pulmonary TB and a UTI. Would like to use a 2nd line broad spectrum. Abx? | Cycloserine (cell wall inhibitor) |
| This class of drug inhibits D-ala joining peptidoglycan pentapeptide and can be "cidal" or "static." | Cycloserine |
| A big concern using Cycloserine is this side effect | Enters CNS |
| Patient has a minor cut and would like to prevent superficial skin & eye infection. What do you use? | Bacitracin (Neosporin+Polymyxin) |
| You would never want to inject this drug which is normally used topically because of nephrotoxicity | Bacitracin (Neosporin+Polymyxin) |
| This drug interferes with the cell wall by inhibiting the final lipid carrier step. | Bacitracin (Neosporin+Polymyxin) |
| All Cell Wall Inhibitors are "Static" or "Cidal"? | Bacteristatic |
| What's the danger of using 2nd Line TB Agents? | Lower potency & greater toxicity effects. Can lead to MDR. |
| This second line TB Agent inhibits folic acid synthesis and can lead to thyroid injury. | PAS |
| This second line TB Agent inhibits peptide synthesis and can lead to CNS toxicity & GI Neuropathy | Ethionamide |
| This second line TB Agent competes with D and L-Ala in cell wall building and can lead to CNS toxicity & GI Neuropathy. | Cycloserine |
| This second line TB Agent inhibits DNA polymerization and RNA polymerization and can lead to rash. | Rifabutin |
| This second line TB Agent inhibits protein synthesis and can lead to kidney and ototoxic effects. | Capreomycin |
| Pseudomonas can be treated by this to inhibit resistance. | Aminoglycosides in addition to anti-pseudomonals. |
| Enterococca, G- Bacilli, Pseudomembranous Colitis and Candida Superinfections are all possible from this class of drugs. | Cephalosporins |
| This class of drug is dose-dependent due to renal tubular necrosis. | Cephalosporins |
| Aminoglycosides + Cephalosporin: Antagonist or Synnergistic Effect? | Synnergistic Effect |
| Ceftizoxime, Cefoperazone and Ceftazdime all treat this. | Pseudomonas |
| The DOC for Neisseria Gonorrhea is this. | Ceftriaxone |
| Cefotaxime Sodium, Cefoperazone and Ceftriaxone all perform this function. | CNS Penetration |
| What is the only 3rd generation cephalosporin which is metabolized by the liver, penetrates the CNS and is against Pseudomonas. | Cefoperazone |
| Most 3rd generation cephalosporins are not metabolized where? | The liver (Only Cefoperazone is) |
| This oral drug is effective against nematodes, insects & acarine parasites. Can also be used for threadworm, roundworm and skin infection. | Ivermectin |
| This drug works by paralyzing parasites via the increase of GABA to the peripheral nerves. | Ivermectin |
| Itching, tender nodes & fever are side effects of this drug used to treat threadworm. | Ivermectin |
| The DOC for ringworms inhibits microtubule polymerization by binding b-tubulin leading to a blocked uptake of glucose and other nutrients eventually leading to death. | Vermox |
| This DOC for roundworm, whip/hook/pinworm is good for mixed infections and can be used for skin larva migrans. | Vermox |
| Vermox, the DOC for roundworms, leads to these toxic effects. | Embryotoxic & Teratogenic (therefore contraindicated if pregnant). |
| What's the DOC for b-lactamase producing enterobacter infections? | Carbapenem: Either Imipenem or Meropenem |
| This drug is more likely to induce seizure and is contraindicated in people with renal failure, brain lesions, head trauma and seizures. | Imipenem |
| This carbapenem is less likely to induce seizures than Imipenem. | Meropenem |
| DOC for E. Coli? | Cefprozil (2nd gen cephalosporin |
| This class of drugs activates autolytic cell wall enzymes. | Cephalosporins |
| Aminoglycosides like Tobramycin are used in combination with which drugs for pseudomonas treatment? | Piperacillin/Ticarcillin(4th gen penicillin) |
| Citrobacter,Enterobacter, Pseudomonas & Serratia contain what inducible enzyme which can lead to antagonism? | Beta-Lactamase |
| What's a life-threatening superinfection that involves the colon & small intestine being inflamed? | Staphylococcal Enterocolitis |
| Staphylococcal Enterocolitis can be treated how? | Discontinue abx & treat Staph w/Vancomycin. |
| DOC for Penicillin Resistant Strep Pneumo? | Ceftriaxone (3rd gen cephalosporin) |
| Aminoglycosides, Carbapenems, Quinolones, Rifampin, Tetracycline & Tigecycline (Glycylcycline) can all treat what? | Gram - Bacilli |
| DOC for Neisseria Gonorrhea? | Ceftriaxone or Cefixime(orally) 3rd Gen Cephalosporins |
| DOC for E. Coli, Klebsiella, Proteus? | 1st or 2nd Generation Cephalosporins |
| DOC for Vibrio species (G- Aerobic Species) | Tetracycline |
| This cephalosporin has increased resistance to b-lactamases and better G+ coverage than its previous generation. Given parenterally and covers Pseudomonas, Enterobacteria & MSSA. | Cefepime (4th generation) |
| DOC for Legionella (G- Aerobic Rods) | 1)Azithromycin + Rifampin OR 2)Quinolone + Rifampin |
| DOC for Salmonella (G- Aerobic Rod) | 1)3rd Generation Cephalosporin (Ceft/Cefo) 2)Quinolone 3)TMP-SMZ (Co-Trimoxazole, Bactrim) |
| DOC for Citrobacter, Enterobacter & Serratia (Aerobic G- Rods) | 1)Carbapenem 2)Quinolone 3)TMP-SMZ (Co-Trimoxazole, Bactrim) |
| Macrolides all end in these letters: | "thromycin"=Azithromycin, Erythromycin, Clarythromycin |
| Is Erythromycin more or less toxic than Azithromycin? | Erythromycin>Azithromycin>Clarithromycin (Toxicities) |
| This class of drugs inhibits protein synthesis in Gram + organisms; but can lead to diarrhea & GI upset with hepatic changes like jaundice. | Macrolides: Azithromycin, Clarithromycin, Erythromycin |
| This macrolide is the most toxic. | Erythromycin |
| An alternative for H Pylori tx is the addition of this macrolide with omeprazole. | Clarithromycin |
| This macrolide can lead to QT prolongation & arrythmia when coupled with Cisapride, Pimozide, Sparfloxacin or Grepafloxacin. | Erythromycin |
| This drug can lead to interstitial pulmonary fibrosis and severe polyneuropathies and degeneration of neurons. | Nitrofurantoin |
| This drug is contraindicated in pregnant women, people with impaired liver function, allergies and those <1 month old. | Nitrofurantoin |
| Monobactam (Azactam) is pretty resistant to what? | beta-lactamase |
| This drug can be used for G- rods, including pseudomonas and serratia WITHOUT cross sensitivity (unlike other drugs with similar structure). | Azactam (a monolactam) |
| Phlebitis, Rash and abnormal liver can all be caused by this monobactam. | Azactam |
| This carbapenem is inactivated by renal tubules therefore it is administered with Celastatin to inhibit the dihydropeptidase inhibition. | Imipenem |
| This carbapenem may cause seizures, is given IV and covers G+ and G- ANaerobes. | Imipenem |
| This carbapenem is NOT inactivated by dihydropeptidases, is given IV and covers G+ and - ANaerobes | Meropenem |
| This carbopenem is the most stable against beta-lactamase | Ertrapenem |
| When using carbapenems to treate pseudomonas what should you add to improve tx? | Glycosides |
| This 2nd generation Cephalosporin can cause serum sickness. | Cefaclor |
| This 2nd generation Cephalosporin is the only one which can cross the BBB. | Cefuroxime |
| This 2nd generation Cephalosporin is the DOC for E. Coli | Cefprozil |
| Pregnant patient has urogenital chlamydia infection. What would you treat with? | Erythromycin |
| Patient has respiratory infection but is resistant to penicillin & erythromycin. What should you NOT use? | A Ketolide (Ketek) |
| This class of drugs is taken orally and may cause serious hepatotoxicity and diarrhea; is metabolized by Cyp3A4. FDA says it can no longer be used. | A Ketolide (Ketek) |
| DOC for Moraxella Catarrhalis | 2nd or 3rd Generation Cephalosporin |
| In a patient with infectious mono caused by Epstein Barr Virus this penicillin will cause a rash. | Methicillin |
| Penicillin can cause the following side effects. | GI, Electrolytes, Allergy(Methicillin rash is NOT an allergy), Superinfections |
| What's the DOC for most all surgery prophylaxis? | Cefazolin |
| Salmon, Shigella and H. Pylori can all be treated by which penicillin? | Ampicillin |
| Prostate & UTIs with G- rods can be treated with what? | Bactrim or Bactrim+Sulfonamide(for chronic UTIs) |
| Patient is resistant to TMP-SMZ and Fluoroquinolones but has an E. Coli infection=Uncomplicated UTIs. Tx? | Nitrofurantoin |
| This drug damages bacterial DNA by producing a highly reactive intermediate which attacks ribosomal proteins, DNA, metabolism and other macromolecules. "Static" and "Cidal." | Nitrofurantoin |
| This TB treatment inhibits DNA dependent RNA polymerase (rpoB subunit). Leads to enzyme induction which leads to increased metabolism of thyroid/adrenal hormones/VitD/CypP450. | Rifampin |
| This TB treatment, when metabolized, turns orange. Can use as a single drug in latent TB cases but does decrease birth control efficacy. | Rifampin |
| This drug is known to cause pseudomembranous colitis. | Clindamycin |
| There are 2 short lasting (8-9hr) Tetracyclines which are? | Oxytetracycline & Tetracycline |
| What's the only tetracycline excreted in the feces. | Doxycycline |
| There are 2 long lasting (16-18hr) Tetracyclines which are? | Doxycycline & Minocycline |
| What's the only intermediate length lasting tetracycline? | Demeclocycline |
| These drugs inhibit protein synthesis by binding 30s so that amino acids cannot be added. Are bacteriostatic and can reach everywhere but the CNS and joints. | Tetracyclines |
| Oxacillin, Cloxacillin, Methicillin & Naftacillin are all examples of what type of drugs? | Penicillinase Resistant |
| MSSA can be treated by this class of penicillins that cannot be inhibited by penicillinase. | Penicillinase Resistant |
| These drugs kill based on concentration & have a significant Post-Antibiotic Effect. Drug? Dosing? | Aminoglycosides. Single large dose better than smaller multiple doses. |
| This drug irreversibly inhibits protein synthesis and is concen-dependent killing. Does not penetrate the CNS & cannot be given orally but great in combo w/others. | Aminoglycosides |
| Suspicion of Sepsis & Endocarditis. Would also like to treat for G- Enteric Bacteria. Use which "cidal" drug IV/IM. | Aminoglycosides |
| Ototoxicity, Nephrotoxicity, Overgrowth of non-susceptible organisms & neuromuscular weakness are all side-effects of this drug. | Aminoglycosides |
| DOC for Aerobic G- N. Meningitidis? | Penicillin G |
| This process incorporates free DNA leading to antimicrobial resistance. | Transformation |
| DOC for N. Gonorrhea? | Ceftriaxone (can penetrate CNS). |
| This 3rd generation cephalosporin used for gonorrhea tx is highly protein bound which lengthens the half-life. It also displaces bilirubin from Albumin. Contraindicated in infants. | Ceftriaxone |
| The increase of PABA, drug antagonist, and efflux will help resistance of this type of drugs. Also builds resistance by decreased permeability & alternative Folic Acid Metabolic pathway. | Sulfa Drugs (Bactrim, TMP-SMZ, Cotromoxazole) |
| This drug of last resort binds the 23s subunit to inhibit protein synthesis so can no longer make 70s. Taken orally/IV; is reversible/non-selective MAOI | Linezolid (an Oxazolidinone) |
| This normally "static" MAOI when paired with strep becomes what? | "Cidal" Drug: Linezolid (an Oxazolidinone) |
| This MAOI does not involve liver oxidative system to metabolize. Just oxidation. Drug of last resort against G+. | Linezolid (an Oxazolidinone) |
| These inhibit protein synthesis by binding ribosomes during early and late phase. What class of drugs? | Streptogramins: Dalfopristin: Early Phase binds 50s Quinupristin: Late Phase binds 50s |
| This IV infused drug is used to treat VRE Faecium, Skin infections caused by MSSA/MRSA, Penicillin Resistant S.Pneumo, & MDR Strep by inhibiting early/later protein synthesis. | Dalfopristin(early)/Quinupristin(late) in streptogramins. |
| This IV infused drug which inhibits early/late protein synthesis also inhibits P450 metabolism and will therefore lead to increased conc of those drugs. Not for use in kids, pregnant, liver dz, streptogramin hypersensitives. | Dalfopristin(early)/Quinupristin(late) |
| This drug inhibits translation of proteins and is good for G+ cocci and all Anaerobes. Is "static"/"cidal" dependent on concen but cannot treat enterococci or meningitis. | Clindamycin |
| Inhibits translation & used for streptococci, MRSA, toxic shock(+vancomycin), osteomylitis & Toxoplasma Encephalitis. But CANNOT treat enterococci or meningitis. Side Effect: Pseudomembranous Colitis. | Clindamycin |
| This drug which can potentially cause pseudomembranous colitis can cross the placenta and can enter breast milk therefore contraindicated if pregnant. | Clindamycin |
| This oral broad-spectrum is like a macrolide but has inc affinity to 23s to inhibit protein synth. Good for respiratory infections but black-boxed for Upper Resp Infections. Also good for intracellular/atypical bacteria. Metabolized by CYP3A4 in liver. | Ketek (Ketolide) |
| This drug used for Impetigo is used topically on this skin of nose. | Mupirocin |
| This drug used for Impetigo reversibly binds to bacterial isoleucyl tRNA synthetase leading to inhibition of protein/RNA synth. | Mupirocin |
| What inhibits peptidoglycan chain elongation? | Vancomycin |
| Treatment for Legionnaire's Disease (G-)? | Azithroomycin |
| This potentially dangerous drug is best for CNS penetration. | Chloramphenicol -metabolized in liver, excreted in kidney |
| This TB drug has an unknown mechanism but needs Mtb to be active. Is active at acidic pH therefore best for Mtb in macs. Best for dormant TB cases | Pyramidizine -Use in combo w/INH & Rifampin to increase percent resistance. |
| This IV drug is "Cidal" against MRSA, MSSA, Aerobic & Anaerobic G+s. Cannot penetrate the PM and leads to rapid membrane depolarization upon binding leading to cell death. NO known resistance! | Daptomycin |
| This class of drugs substitute at an amino group to inhibit folate metabolism and are difft based on absorption rate, excretion & urine sol. Must have a free Para amino grp to have antibacterial action. | Sulfonamides (all begin w/"Sulfa" or Bactrim/Septra=TMP-SMZ=CoTrimoxazole) |
| Orally used for UTIs decomposes into formaldehyde & NH3 in acidic urinary tract. Good for G- especially E. Coli. NO Resistance to drug, only to increased pH of urine. | Methenamin |
| Pt presents w/proteus UTI infection. Would like to treat w/Methenamin. Can you? | Methanmin cannot be used since Proteus will cause the pH to rise and will no longer be able to work; best at lower pHs. |
| DOC for MSSA | Penicillinase Resistant Penicillin: Oxacillin, Cloxacillin, Naftacillin, Methicillin |
| This metabolic antagonist of fungal DNA/RNA activates 5FU to inhibit fungal DNA/RNA synthesis. Can enter the CNS, good for meningeal infections, & is renally excreted, therefore don't use if renal impairment. | Flucytosine |
| This Anti-Fungal is the DOC for Cryptococcus when paired with Amphotericin B. | Flucytosine |
| Side effects of this anti-fungal which is the DOC for cryptococcus is decreased bone marrow(anemia, leukopenia, thrombocytopenia), and increase ALT/AST. | Flucytosine (when treated Cryptococcus add Amphotericin B) |
| Patient has been taking Amphotericin B to treat a fungal infection and has INC BUN & Serum Creatinine (Azotemia=Nephrotoxic). What do you expect to see? | Acute liver failure & renal damage & hypokalemia along w/other side effects which lasts 6wks-4mos. |
| If chills, fever, m spasms, vomiting and headache occur after every injection of Amphotericin B there is what toxicity? Tx? | Infusion Related-Immediate -Slow the infusion rate and decrease daily dose |
| This polyene antifungal interacts w/sterol of fungal membrane (depolarizing) which leads to pore formation and loss of internals eventually leading to cell death. Is broad & DOC for most fungal infections. | Amphotericin B |
| The DOC for most fungal infections is taken IV and has higher plasma concentrations than CSF. Is kidney & extra-renally eliminated but can bind human sterols, therefore is toxic. Drug? | Amphotericin B |
| Pt on hemodialysis & has kidney/liver impairment. Should you adjust dose to give Amphotericin B? | NO! Has no effect on AmpB's concentration! |
| All antifungals except Griseofulvin & Flucytosine target what? | The cell membrane or cell wall. |
| This broad antifungal is a substitute for the normal DOC. Has large distrib w/low CNS penetration. Usually metab by liver prior to elim. Can cause gynecomastici by inhibiting adrenal/testicles and can inc serum enzymes. Inhibits P450! Drug? | Ketoconazole |
| This class of anti-fungal drugs inhibits synthesis of Ergosterol leading to depletion in the cell membrane which leads to an increase in toxic intermediates & increased membrane permeability. | "Conazole" Ketoconazole, Fluconazole, Voriconazole, Itraconazole |
| Moraxella Catarrhalis, Meningitidis, and N. Gonorrhea are all examples of what type of bacteria. | Gram - Cocci |
| These classes all work by inhibiting transpeptidase to inhibit transpeptidation & cell wall formation. | Beta-Lactams: -Penicillin, Monobactam, Cephalosporins, Carbapenems |
| Almost all abx that inhibit bacterial cell wall synthesis are "cidal" and tx cells that must be in growth phase. Why? | Need in growth phase so that when bacteria's own autolysins work they are unable to grow since they are still lysing but unable to produce new cell wall. Leads to cell wall being penetrable. |
| Sulfonamide, Tetracycline, AmpB, Clindamycin, INH, and Erythromycin all cause this side-effect | Hepatotoxicity |
| Why do you give probenicid + penicillin? | Probenicid inhibits renal elimination prolonging the effects of the drug it is paired with. |
| This elective surgery is the only one NOT treated by cefazolin. Tx? | Colorectal: use Erythromycin + Neomycin |
| Adverse Effects of Chemotherapy include what? | Overextension of the pharm effect, organ directed toxicity, hypersensitivity rxns. |
| Pneumococci resistant to penicillin is an example of a what? | Super threatening resistance |
| To treat the most common superinfection you continue with abx & treat the fungal superinfection w/AmpB or Nystatin. Infection? | Intestinal Candidiasis |
| Amphotericin B is DOC for all fungi except which? | Aspergillus |
| Patient has penicillin & pneumococcal resistant pneuomocci. Can you use Ketek? | Yes, but cautiously because of serious risks of severe liver toxicity. Do not use if upper respiratory infection. |
| How is a bacteria resistant to penicillins? | Inducing beta-lactamase, if G- has dec perm, changes in PBP(MRSA), inactive autolytic enzymes, lack of cell wall, efflux |
| Can you use penicillin to treat listeria or staph. Why? | No. Have inactive autolytic enzymes |
| Can you use penicillin to treat mycoplasma L form or chlamydia. Why? | No. Do not have cell walls. |
| Patient presents with pertussis prophylactic tx? | Erythromycin |
| This oral natural penicillin has good G+ and some anerobic covg. No anti-pseudomonal. Can treat N Gonorrhea, S. pneumo, treponema. | Penicillin V |
| This most common natural penicillin has highest G+ coverage, no anti-pseudomonal activity(pseudo is G-/Aerobic).Can treat N Gonorrhea, S. pneumo, treponema. | Penicillin G |
| This process involves transfer of genes through sex pilus. | Conjugation |
| After limited exposure to abx, pt has a persistent suppression of bacterial growth. Condition called. | Post-antibiotic Effect (will occur longer in life than in lab because of post-antibiotic leukocyte enhancement) |
| This resistance is acquired through mitosis with progeny receiving resistance passed down on the chromosomes. | Mutational Resistance |
| This resistance is passed from plasmid transfer (the resistance is not on the chromosome of the cell). | Plasmid Resistance |
| An appendectomy & ER colorectal surgeries both need which type of prophylaxis. | 3rd generation cephalosporin since an emergency |
| DOC for Pseudomonas Aeruginosa? | Antipseudomonal Penicillin + Aminoglycoside --Antipseudomonal Penicillin=Piperacillin or Ticarcillin |
| Acyclovir is used in prophylaxix of what dx? | Genital Herpes Simplex |
| If bacteria resistant to vancomycin. What can you do? | Is usually resistant to all other abx. Maybe try Linezolid. |
| Nitrofurantoin, Methenamine & Naladixic Acid are used exclusively for what? | UTIs |
| What are superinfections, when are they typically seen? | Superinfection: devo of an infection during the tx of another. Usually seen in broad spectrum abx. |
| Pt has mycoplasma pneumo. Tx? | Erythromycin OR Tetracycline |
| How do you prevent emergence of resistant microorganisms? | Decrease toxicity, broad spectrum coverage: -mTB: INH + Rifampin -Pseudomonas: Gentamicin + Carbenicillin |
| How is chemo unique? | Selective toxicity to parasite, passively selects for resistance, hypersenstivity & organ directed toxicity, lowers microorganism load so host can eliminate. |
| Common misuses of antibiotics | Use of abx on a virus Tx of untreatable infections Tx of fever of undetermined origin Improper Dose Improper Duration |
| Extended Spectrum Penicillins have great G- covg(low G+). If you apply with a penicillinase inhibitor can include anaerobic covg. Does not tx pseudomonas, but can tx E Coli, Salmonella, Shigella, H Influenzae, Proteus. Drugs? | Ampicillin & Amoxicillin |
| A side effect of this broad spectrum is this type of rash. | Ampicillin Rash |
| What should you never treat MRSA with? | Penicillins |
| MRSA is resistant to this therefore cannot treat with it or other related drugs because the resistance is not related to b-lactamase activity of PBP. Tx? | Resistant to Methicillin. Treat with Vancomycin. |
| Anaphylactic shock, skin rash, immune caused blood dyscrasia & hemolytic anemia are all sings of what? | Allergies |
| This process involves bacteriophages. | Transduction |
| What's the only G+ Aerobic Cocci which does NOT use Penicillin as it's DOC? | MRSA. Use Vancomycin |
| Why is it impt if a drug is acid resistant? | Can be absorbed orally. |
| Why is it impt to reach/keep adequate blood levels? | Resistance Prevention |
| When is the only time you should use antibacterial prophylaxis? | When benefits outweigh the risks. |
| Process of Rx drug writing prior to known antimicrobial is called? | Empirical Antimicrobial Therapy: Treat with both G+/G- till know organism then discontinue un-needed coverage. |
| What inhibits transpeptidase which inhibits cross-linking of cell wall? | beta-lactams |
| Penicillins are often used in summation of tx. Why? | Inhibits cell wall to increase permeability for other drug. |
| These segmented flat worms w/4 suckers cause mild illness and UTB deficiency. | Tapeworms |
| This type of drug is concen dependent on it's killing action. | "Cidal" -Aminoglycosides & Quinolones |
| This type of drug is time dependent on it's killing action. | "Cidal" -beta lactams, vancomycin |
| These types of drugs slow growth and reproduction and have a decreased inhibitory concentration. | Bacteristatics |
| MAC and mTB commonly present in which pop of pts? | HIV pts |
| Ototoxicity, Nephrotoxicity & Red Man syndrome are side effects of this drug. | Vancomycin |
| DOC for sheep liver flukes? | Bitin |
| Rare lymphoid disease found in rabbit hunters is Tularemia. Tx? | Aminoglycosides (usually Gentamicin) |
| Aminoglycosides | Amikocin, Streptomycin, Gentamicin,Tobramycin |
| Treat with MULTIPLE anti-leprosy drugs since one can lead to resistance (unethical <2) for this disease? | Mycobacterium Leprae |
| Rifampin+Dapsone is the DOC for what? | Leprosy. If MB leprosy, also add Clofazimine. |
| To treat which leprosy would you add Clofazime to your regimen of Rifampin+Dapsone? | MB Leprosy |
| This drug used to treat leprosy (in combo w/Rifampin) is the MOST widely used and least expensive oral drug. | Dapsone |
| Side effects of this leprosy drug which is slowly excreted are peripheral neuritis(dose related),methemoglovinemia,leukopenia & agranulocytes. | Dapsone |
| Chloramphenicol reversibly binds to the 50s subunit of 70s. What does this effect? | "Static" inhibition of protein synth. Humans contain 70s therefore potentially fatal. Is distributed widely including eye & CNS. |
| Drugs that effect which subunit are potentially fatal because of their presence in humans? | 70s |
| Chloramphenicol is mostly static but in which organisms is it cidal? | H Infuenzae, N. Meningitidis, Strep Pneumo |
| What's responsible for the pharmacokinetics of aminoglycosides. | Polarity |
| To be effective aminoglycosides need what? | Aerobic conditions for active transport in order to inhibit protein synthesis by binding 30s. |
| Aminoglycosides are for Aerobes or Anaerobes? | Aerobes!! |
| R-Factor Transmission, Ribosomonal Receptor Deficiency, Lack of Drug Perm into bacteria & metabolism BY bacteria can all lead to drug resistance for this. | Aminoglycosides |
| Pt taking this med is NOT female or under 18, but has had a seizure, jaundice and recently a tendon rupture after using this drug. | Fluoroquinolones "floxacin" |
| Drugs that end in "floxacin" are what? | Fluoroquinolones |
| Pt has a UTI but creatinine clearance is <50ml/min & has renal failure. Can you use Nitrofurantoin. | No |
| This drug localizes in bones & teeth but not joints or CNS causing side effects like inhibition of bone growth and dental discoloration. | Tetracyclines |
| Pregnant woman wants to tx her and her 8 y/o child w/tetracyclines. Can you? | No pregnancy or under 8 |
| Chloramphenicol is a "broad spectrum" abx and is 1st successful synthetic abx. Why should you worry? Is it DOC? | Chloramphenicol is associated with fatal aplastic anemia & other fatal side effects. Do NOT use as DOC/1st choice. |
| It is during life-threatening infections like typhoid fever, meningitis, and other severe infections that you should use this potentially fatal drug. | Chloramphenicol: Fatal Aplastic Anemia |
| DOC for listeria infections? | Extended Spectrum Penicillins (Ampicillin/Amoxicillin) Couple w/a penicillinase inhibitor |
| G+ cells have more or less cell wall than G-. | Less cell wall |
| Tx of N. Meningitidis? | Penicillin G |
| Which carbapenem should you NOT use for pseudomonas? | Etrapenem |
| This carbapenem(NOT used in pseudomonas tx) is good w/enterobacter which are b-lactamase(+). Give IV/IM. Half Life=5hrs | Etrapenem |
| If TB resistant to INH and Rifampin called MDR or XDR? | MDR |
| If TB resistant to INH,Rifampin & any fluoroquinone & one injectible (capreomycin, kanacasmycin, amikacin) called MDR or XDR? | XDR |
| DOC for Tapeworms | Biltricide |
| Except for Trova/Moxi/Gatifloxacin fluoroquinolones are NOT effective against? | Anaerobes |
| DOC for C Difficile? | Metronidazol |
| What's better at treating Staph & Strep between Eryhtromycin & Clarithromycin? | Erythromycin |
| What's better at treating Mycoplasma, Chlamydia, Moraxella, Haemophilus Influenze between Eryhtromycin & Clarithromycin & Azithromycin? | Azithromycin |
| Between Clarithromycin and Erythromycin what is always better treatment (besides staph/strep)? | Clarithromycin |
| DOC for Diphtheria? | Penicillin or Erythromycin (if Penn allergy) |
| Pt has MRSA & Impetigo. Tx? | Intranasal Mupirocin. |
| Pt has toxic shock & MRSA. Also, osteomylitis & toxoplasma encephalitis. Tx? | Clindamycin (add Vancomycin for TSS) |
| To treat toxic shock treatment what do you add to Clindamycin? | Vancomycin |
| Pt should not use this drug if hypersensitive or has pheochromocytoma. This drug will interact with beta blockers, Anesthetics, Sympathomimetics, MAOIs, Hetero/Tri-Cyclic antidepressants & SSRIs. | Linezolid |
| To treat infections due to enterococci & strep agalactiae would couple what with an aminoglycoside? | Gentamicin (Aminoglycoside) + Pen G |
| DOC for Cholera? | Tetracyclines |
| DOC for Chalmydia? | Tetracyclines |
| DOC for Ricketts? | Tetracyclines |
| DOC for Lyme disease? | Tetracuclines |
| Resistance to this is usually conferred by Efflux pumps, but it can still be effected by other drugs like minocycline,doxycycline & tigecycline which don't use the pumps. | Tetracycline |
| Pt has systemic infection, a UTI and possible anthrax. Tx? | Ciprofloxacin (Fluoroquinolone) |
| What's the best Fluoroquinolone against G- bacteria. Especially Pseudomonas? | Ciprofloxacin |
| This pulmonary dz resistant to anti-Tb & anti-macrolides can be tx w/2-3 antimicrobials for 12mos. Commonly co-infected w/HIV | Mycobacterium Avium Complex (MAC) |
| In cases of MAC where resistant to clarithromycin, what should you include? | Amikacin (aminoglycoside) given IV |
| Aminoglycosides, Ethambutol & Rifabutin/Clofazimine/Rifampin/Ciprofloxacin given all 3 together can be good for tx of what? | MAC (Mycobacterium Avium Comples) |
| To treat extracellular Tb it's better to use this aminoglycoside. Should adjust if renal impairment since renally excreted. There's renewed interest in this drug bc of MDR/XDR | Streptomycin |
| Pt presents w/moderate Erythema Nodosum Leprosum. DOC? | Thalidomide. |
| Why is thalidomide contraindicated in pregnancy. | Teratogenic effects |
| To treat antihelmnitic must interfere with what? | Energy Metabolism Neuromuscular Coordination Microtubular Fcn Cell Permeability |
| Treatment of nematodes(roundworm)? | "Verm"/"Mint" Vermox, Ivermectin, Antiminth, Mintezole |
| Peripheral neuritis is seen when INH is given to whom? | Slow acetylators AIDs Pts DM Pts Alcoholics |
| To prevent peripheral neuritis during tx administer what? | INH + Pyridoxine |
| What aminoglycoside is used as a 2nd line Tb agent? | Streptomycin |
| What are first line tx of Tb? | INH, Rifampin, Ethambutol |
| You suspect sepsis & endocarditis. Also a possible G- Enteric Bacteria. Tx? | Aminoglycoside |
| Mansoni, Haematobium & Japoriicum are all shistosomes which eventually end up where to infect? | Enter through skin, travel to mesenteric/vesicular v and eggs will travel to lung/liver |
| These drugs can cross react w/diuretics/celecoxib/oral abx. Possible side effects include blood dyscrasia, kidney/liver, peripheral n damage, Steven's Johnson & Photosensitivity. Kern's icterus is also a possible side effect. | Sulfa drug toxicity |
| The possible side effect of Kern's icterus contraindicates this type of drug in children less than 2 mos? | Sulfa drug |
| This aminoglycoside is used to treat gonorrhea? | Spectinomycin |
| These 3 aminoglycosides can be used in combination to treat Gram -s. | Amikacin, Gentamicin, Tobramicin |
| Pt presents w/syphilis & is allergic to your DOC (Penicillin). Tx? | Erythromycin |
| For G+ infections: bacterial pneumo, skin infection, VRE & MRSA can use this but sparingly. | Linezolid (IV or oral-100%bioavail orally) |
| Pt presents w/uncomplicated lower UTI. Good cell wall inhibitor? | Fosfomycin -Addition of b lactam, aminoglycoside or fluoroquinone can be synnergistic. |
| This oral broad spectrum is used against intestinal & systemic nematodes; MOSTLY threadworm. It's an alternative to threadworm (stronglylidasis) & skin larva migrans. | Mintezole |
| This drug which is mostly used for threadworm tx interferes w/microtubule aggregation in worms. It's not the DOC typically. | Mintezole |
| Inhibits mycolic acid synthesis (activated by Mtb protein) and is "static"/"cidal" dependent on latent/active Tb. Can reach therapeutic conc in granulomas. | INH |
| In patients w/G6PD deficiency this drug will lead to hemolysis. | INH |
| Pt has uncomplicated urethral, endocervical, rectal & (epididymal for hubby) chlamydia infection. Tx? | Azithromycin |
| This causes a bile duct block increasing liver size & producing URQ pain. Through food/skin penetration. | Liver Fluke(Trematode) |
| This organism causes cough, hemoptysis & chest pain. Through skin/food. | Lung Fluke (Trematode) |
| Clofazimine + Rifampin is orally used to treat what by inhibiting reproduction/growth by binding DNA guanines. Condition? | MB leprosy |
| Para-Aminosalicylic Acid, Cycloserine & Ethionamide are all oral static drugs which used as? Can Cause CNS toxicity. | 2nd Line TB Agent |
| Capreomycin & Kanamycin are IM, cidal drugs which used as? Can cause XDR. | 2nd Line TB Agent |
| Rifabutin & Fluoroquinolones are oral, cidal drugs used as? Can cause XDR. | 2nd Line TB Agent |
| Fast acetylators in INH can lead to which side effects? | Abnormal tests, Hepatotoxicity, Jaundice |
| INH & Rifampin are first line to treat what? | TB |
| This drug uncouples oxidative phosphorylation & is active against lung/liver flukes and is DOC for sheep liver flukes. Can produce rxns to antigens released from dying worms. | Bitin |
| Lung/Liver Flukes can be treated by? | Bitin |
| All G+ Aerobic Cocci can be treated by? | Penicillin unless MRSA. |
| This drug's side effects include Gray Baby syndrome, Bone Marrow Depression & Fatal Aplastic Anemia do to the binding of 70s. Drug? | Chloramphenicol |
| This condition is caused by bad gluconyryl transferase activity. Condition, Drug? | Chloramphenicol leads to Gray Baby Syndrome |
| Inhibition of Arabinogalactin (cell wall) synthesis is good treatment of active, growing Mtb. Can be used w/INH, Rif, PZA to treat TB. | Ethambutol. |
| Decreased vision (R/G color blindness), optic & peripheral neuritis along w/confusion all side effects of this TB drug. | Ethambutol |
| Tapeworms, Flukes & ALL Shistomes can be treated with this drug. Contraindicated during pregnancy because can lead to spontaneous abortions. | Biltricide |
| This drug is used to increase worm's permeability to Ca leading to contraction, paralysis and death. | Biltricide |
| DOC for Filaria Infestation | Ivermectin |
| This drug w/broad spectrum against nematodes is an alternative to mebendazole. Blocks the NMJ leading to ACh release & cholinesterase inhibition. Leads to paralysis & worm expulsion. Drug? | Antiminth (avail OTC) -Few systemic side effects |
| Moraxella Catarrhalis, E. Coli, Klesbiella, Proteus & Salmonella can all be treated by? | TMP-SMZ(Bactrim, CoTrimoxazole)-cannot use in Sulfa contraindications or Cephalosporins |
| DOC for Aerobic N. Gonorrhea? | 2nd/3rd gen cephalosporin= Ceftriaxone or Cefpodoxime |
| DOC for Anthrax Prophylaxis? | Ciprofloxacin |
| DOC for Aerobic G- Rods E. Coli, Klebsiella and Proteus | 1st or 2nd Gen Cephalosporin OR TMP-SMZ |
| These drugs inhibit DNA Gyrase & Topoisomerase 4 for a cidal effect. Tolerated well orally and is distributed widely, poor in CNS and excreted by kidney. | Fluoroquinolones ("floxacin") |
| Which fluoroquinolone is least active against G+ and -? | Norfloxacin |
| Cipro/Enox/Lomeflox/Levloflox/Oflox fluoroquinolones are all good for what type of coverage? | Gram - |
| Gati/Gemi/Maxi are all good for what type of coverage involving fluoroquinolones? | MRSA & Resp Tract Infections |
| Mutations in gyrase enzyme, decrease permeability to bacteria & abx modification can all cause resistance in what drugs? | Fluoroquinolones ("floxacin") |
| Besides rickets, lyme dz, chlamydia & cholera. Tetracyclines can be used for? | H Pylori, Rocky Mtn Spotted Fever, Amebiasis, Acne, Gonorrhea, Brucellosis, Plague(if given w/aminoglycoside) |
| Ciprofloxacin can be used to treat what? | Anthrax, Gonorrhea, GI tract infections, UTI, respiratory infections resistant to b-lactams & strep pneumo. |
| DOC for Anthrax? | Ciprofloxacin |
| DOC for Shigella? | Fluoroquinolones ("floxacin") |
| DOC for Citrobacter? | Fluoroquinolones ("floxacin") |
| DOC for Serratia? | Fluoroquinolones ("floxacin") |
| DOC for Salmonella? | Fluoroquinolones ("floxacin") |
| DOC for Enterobacter? | Fluoroquinolones ("floxacin") |
| Tetracyclines are DOC for numerous infections including: | Cholera, Rickets, Mycoplasma Pneumo, Chlamydia, Lyme Dz |
| Yersinia Pestis a Gram - infection is best/safely treated by? | Doxycycline(a Tetracycline) |
| A derivative of minocycline, this is used IV only for tetracycline resistant organisms & skin & intra-abdom infections. Also, MRSA, VRE, MRSE, PRSP(Penn Resist Strep Pneumo) | Tigecycline (a glycylcycline): static |
| DOC for Burkholderia Cepacia or stenotrophomonas maltophilia? (G- Aerobic rods) | Bactrim (TMP-SMZ0 |
| Nitrofurantoin & Sulfonamide can cause this? | Hemolytic Anemia |
| Ethambutol & INH can cause? | Visual Toxicity |
| Aminoglycosides, Tetracyclines & Glycylcyclines all bind this subunit. | 30s |
| Polymyxin B & E both cannot be used orally but are good for G- coverage. How is it typically used? | In combo w/Neomycinn & Bacitracin for wounds/burns/pseudomonas in eye. |
| These drugs bind to G- PM (Lipid A of endotoxin) leading to increase wall perm & loss of essential metabolites. Has NO G+ coverage at all. | Polypeptides: Polymyxin B & Polymyxin E |
| Piperacillin & Ticarcillin are examples of these types of penicillins. They're acid sensitive & therefore not oral. | Anti-Pseudomonal Penicillins |
| Acinetobacter can also be treated by this class of drugs. | Anti-Pseudomonal Penicillins -Piperacillin, Ticarcillin |
| This drug is not toxic because it doesn't really decompose till the urine. Not for people with renal or hepatic insufficiency. | Methenamicin |
| Nalidixic Acid + Nitrofurantoin leads to a synnergistic or antagonist effect? | Antagonist |
| Drugs with "Kef" are this generation of cephalosporin & thus have good G+ covg, ok G-. Cannot treat pseudomonas. | 1st Generation Cephalosporins ("Kef") |
| DOC for MSSA | 1st Generation Cephalosporins ("Kef") |
| This drug inhibits Gram- and was the first quinolone(not fluorinated). It's not used for systemic use and has no pseudomonal activity. | Naladixic Acid |
| This sulfa drug competes w/PABA in the synthesis of folic acid and prevents redox of dihydrofolate to tetrahydrofolate which is essential for I-C transfer. | Bactrim (TMP-SMZ) |
| Borrelia Recurrentis, Early Borrelia Burgdorferi, Leptospira & Treponema can all be treated by what? | Penicillin |
| Thalidomide, a teratogenic tx for erythema nodosum leprosum (ENL) is an orphan drug for which diseases? | Primary Brain Malignancy Kaposi's HIV Wasting Reactional Lepromatous Leprosy Recurrent Aphtous Ulcers & stomatitis Tx of Mycobacterium Infections Tx/Prevention of Graft v Host Dz Multiple Myeloma |
| "Azoles" are used for what? | Anti-Fungal |
| This anti-fungal is less toxic than Amphotericin B & better tolerated than ketoocnzole. Good orally & penetrates CSF well (good for Fungal Meningitis). Less Drug interactions than other azoles. Renal elim. | Fluconazole (Diflucan) |
| Have a mold infection, which azole can you use; fluconazole or voriconazole? | Voriconazole |
| DOC for Aspergillus(a mold fungi) | Voriconazole |
| This DOC for Aspergillus has numerous drug interactions (use P450 system) and can cause Visual Impairment. | Voriconazole |
| This drug is used as a salvage tx for Scedosporium Apiosporium or Fusarium in pts resistant to other anti-fungals | Voriconazole |
| Tx of Esophageal Candidiasis | Voriconazole |
| This drug is closely related to ketoconazole but has LESS side-effects. Has greater activity against Aspergillus but NOT the DOC. Take oral, liver metab. Highly bound to plasma protein | Itraconazole |
| This class of drugs inhibits b(1,3)-D-glucan which is NOT present in mammal cells but is present in fungal cell walls. | Echinocandins ("fungin") |
| This class of drugs end up in "fungin" | Echinocandins |
| This drug is used to tx invasive Aspergillosis in refractory periods. Administered by SLOW IV infusion. Liver elim. | Caspofungin |
| This drug can INC liver enzymes (AST, ALT) & histamine release | Caspofungin |
| This drug binds to microtubules of certain fungi & destroys the mitotic spindle structure. Fungistatic | Griseofluvin |
| DOC for onychomycosis | Griseofluvin |
| Used to treat ringworm (dermatophytosis infections of skin, hair, nails). Taken orally. Binds to keratin & prevents infetsion in new skin structures. Excreted unchanged in feces. | Griseofluvin |
| Treatment period for Griseofulvin in order to replace infected dermatophyte keratin. | 6mos-1yr |
| Pts w/acute intermittent porphyria & hepatocellular failure should not use | Griseofluvin |
| Blood issues, rash, photosensitivity, angioedema, albumineria, hepatoxicity, leukopenia & CNS effects can all be caused by | Griseofluvin |
| This fungicide is orally effective for onychomycosis since conc in nails. Interferes w/sterol biosynth; inhibits squalene monooxygenase, build up of squales is toxic to fungi. Less active against candida than dermatophytes. | Terbinafine |
| Used primarily for Candidal infections. Oral or topical. Not absorbed from skin or muscous membrane. | Nystatin |
| Used topically for athlete's foot/jock itch | Tinactin |
| Topical azoles for skin & vaginal candidiasis | Lotrimin Monistat Vagistat |
| Azoles, 2nd Gen Penicillins, Caspofungin, Cefoperazone, Chloramphenicol, Clyndamycin, Macrolides, Rifampin, Sulfa Drugs,Tetracyclines(NOT Doxycycline) all metabolized where? | Liver |
| A 26-year-old male patient is diagnosed and treated for a Neisseria gonorrhoeae infection. If he tests positive for Chlamydia infection as well, the treatment regimen should include: | Azithromycin |
| Cefepime is effective against? | Gram + and G- bacteria |
| What is eliminated primarily by the liver? | Chloramphenicol |
| 28-year-old female patient was treated w/tetracycline for 2 wks bc of a Mycoplasma pneumo infection. At end of the treatment period she developed oral candidiasis (thrush). Which of the following drugs would be suitable for treatment of this infection? | Nystatin |
| 48-year-old male postal worker was potentially exposed to spores of Bacillus anthracis. Which of the following adverse effects is a concern, when he receives a prophylactic treatment with the proper drug? | Tendon Rupture (associated w/Ciprofloxacin) |
| 60-year-old male patient is taking warfarin (Coumadin). Which of the following drugs would have the least interaction with this drug btwn Azith, Clarith, Eryth | Azithromycin |
| 64-year-old woman with an infection due to vancomycin-resistant Enterococcus faecium (VRE) was given a parenteral bactericidal antibiotic which inhibits protein synthesis by binding to the 50S ribosomal subunit. She was most likely treated with: | Quinupristin; Dalfopristin |
| 78-year-old female patient in a nursing home has been treated with nitrofurantoin (Furadantin) for months because of repeated urinary tract infections. Which of the following adverse reactions may occur? | Pulmonary Fibrosis |
| Actively secreted into proximal tubular fluid by the anion transport system | Penicillin G |
| This drug functions by altering function of plasma membrane | Amphotericin B |
| Co-trimoxazole (Bactrim) is the DOC for treatment of what? | Urinary Tract Infections |
| Combination w/a penicillinase inhibitor will extend the spectrum of? | Amoxicillin |
| DOC for Legionella Infections | Macrolides (Azithromycin, Clarithromycin or Erythromycin) |
| DOC for N. Gonorrhea belongs to this class | 3rd Generation Cephalosporins |
| DOC for many systemic fungal infections | Amphothericin B |
| Drug-Induced Liver Toxicity Associated with? | Sulfamethoxazole (TMP-SMZ, Bactrim, CoTrimoxazole) |
| INH to slow acetylators | Peripheral Neuropathy |
| This class of drugs binds to bacterial membranes & causes rapid depolarization | Lipopeptides -Daptomycin |
| Macrolide should not be combined w/penicillin in tx of bacterial infection bc they antagonize how? | Macrolide will stop protein synthesis and cell will not grow, which is needed for penicillin to work(need synthesis/growth for autolysins) |
| This inhibits mycolic acid synthesis | INH _For tx of TB |
| Most active drug for tx of leprosy is? | Dapsone |
| Most impt and most often seen side effect in aminoglycosides | Nephrotoxicity |
| This class alters cell membrane permeability by binding to phospholipids | Polymyxins |
| Potentially dangerous adverse effect of fluoroquinolones? | Hepatotoxicity |
| Renal Excretion is a major route for this drug | Streptomycin |
| Stevens-Johnson is associated with? | Sulfamethoxazole(TMP-SMZ, Bactrim, CoTrimoxazole) |
| Nervous system dysfunctions caused by INH can be reversed by? | Pyridoxine |
| This drug may be effective against G- methicillin sensitive penicillinase producing bacteria. | Azactam |
| Administered topically for vaginal candidiasis tx? | Tioconazole(Vagistat) |
| Used topically for superficial infections of the skin. | Tolnaftate (Tinactin) |
| Azithromycin binds to which subunit? | 50S |
| Binds DNA gyrase & inhibits DNA replication | Moxifloxacin (Fluoroquinolone) |
| Binds to 30S subunit | Doxycycline (a Tetracycline) |
| Inhibits Folate Synthesis | Sulfamethoxazole(TMP-SMZ, Bactrim, Co-Trimoxazole) |
| Primarily bacteriostatic | Sulfamethoxazole(TMP-SMZ, Bactrim, Co-Trimoxazole) |
| Used to treat systemic fungal infections | Ketoconazole |
| Gentamicin + Piperacillin: antagonist or synnergist | Synnergists! |
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