MicroPharm
Help!
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| Block cell wall synthesis by inhibition of peptidoglycan crosslinking | penicillin, methcillin, ampicillin, piperacillin, cephalosporin, azetroenam, imipenem
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| block peptidoglycan synthesis | bacitracin vancomycin
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| block nucleotide synth by inhib folic acid synthesis - involved in methylation | sulfonamides
trimethoprim
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| block dan topoisomerases | fluroquinolones (-floxacin)
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| block mRNA synthesis | Rifampin
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| Damage DNA | Metronidozole
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| Block proein synthesis at 50S ribosomal subunit | CCELS at 50
Choramphenicol,
Clindamycin
Erythromycin (macrolides)
Streptogramins - quinupristin, dalfopristin, linozolid
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| Block protein syneth at 30S ribosomal subunit | buys AT 30
Aminoclygosides
tetracyclines
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| beta lactamase inhibitors | Clavulanic Acid
Sulbactam
Tazobactam
(CAST)
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| Ampicillin/Amoxicillin - Clinical Use | Extended spectrum penicillin - HELPSS kill Enterococci
- H. flu
- E. coli
- Listeria monocytogenes
- Proteus mirablilis
- Salmonella
- Shigella
ENTEROCOCCI
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| Organisms not covered by cephalosporins | L Listeria
A Atypicals (Chlamydia, Mycoplamsa)
M MRSA - except ceftaroline
E Enterococci
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| 1st Gen Cephs | cefAZOLin, cephALEXin
PEcK - Proteus, Ecoli, Kelbs
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| Use prior to surgery to prenvent S.aureus infx | cefazolin
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| 2nd Gen Cephs | ceFOXitin, ceFAClor, ceFOPROzil, ceFURoxime
HENPEcKS
H.flu, Enterobacter, Neisseria, Proteus, Ecoli, Klebs, Serratia
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| synergistic with aminoglycosides | aztreonam - gram negative rods ONLY
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| cilatatin | inhibitor of renal dehydropeptidase I - for imipenem
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| D-ala D-ala --> D-ala D lac | Vancomycin
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| Red man syndrome - cause and prevention | Vancomycin -- antihistamine
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| Vancomycin tox | NOT + Red man syndrome
Nephrotox
Ototox
Thrombophebitis
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| inhibit formation of initiation complex | aminoglycoside
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| blocking translocation | macrolides - macroSLIDES binds to the 23S rRNA
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| block peptide transfer | clindamycin
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| prevent attachment to amino acyl tRNA | Tetracycline
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| prevents attachment of 50S to other parts of the ribosomal unit | Linezolid
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| requires O2 for uptake | Aminoglycosides: GNATS
Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin
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| Bowel surgery | Neomycin
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| resistance by transferase enzymes: acetylation, phosphorylation or adenylation | aminoglycosides
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| diuretic used in SIADH | Demeclocycline - a tetracycline
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| divalent cations inhibit uptake | Tetracyclines
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| methylation at 23S rRNA | resistance to macrolides
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| Macrolide toxicity | Motility issues
Arrhythmia - prolonged QT
Cholestatic hepatitis
Rash
eOsinophilia
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| lack of UDP glucuronyl transferase | gray baby syndrome if given chorlamphenicol
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| pseudomembranous colitis | C. diff overgrowth due to clindamycin
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| PABA antimetabolites inhibit dihydropteroate syntase | Sulfonamides
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| hemolysis if G6PD def + kernicterus in infants | SMX - sulfonamides
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| prolonged QT damage cartilage tendon rupture | Fluroquinolones
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| free radical toxic metabolites in that damage bac DNA | Metronidazole
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| Disulfuram-like reaction | Metronidazole
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| M. tuberculosis - prophalaxis; tx | P: Isoniazide
Tx: RIPE - Rifampin, Isoniazid, Pyrazinamide, Ethambutol
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| M. avium-intracellulare - proph | P: Azithrotmyicn
Tx: RASE - Rifampin, Azithromycin, Ethambutol, Streptomycin
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| M. leprae - proph, tx | P: n/a
Tx: Tuberculoid: Dapsone + Rifampin
Lepromatous: Dapsone+Rifampin + Clofazimine
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| requires bacterial catalase peroxidase | Isoniazid
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| dec synth of mycolic acid | isoniazid
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| prevents neurotoxicity of isoniazid | Pyridoxine (Vit B6)
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| inhibits DNA-dependent RNA polymerase | Rifampin
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| red/orange body fluids | rifampin
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| acidify intracellular environment | pyrazinamide - converts to pyrazinoic acid
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| decrease carbohydrate polymerization of mycovaterium cell wall by blocking arabinosyltranserase | ethambutol
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| Red green color blindness (optic neuropathy) | ethambutol
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| meningococcal infection | ciprofoxacin (drug of choice)
rifampin for children
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| conorrhea | ceftriaxone
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| syphilis | benazthine penicillin G
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| history of recurrent UTI | TMP SMX
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| PCP (pneumo jirovici) | TMP SMX; dapsone
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| endocarditis with surgical or dental procedures | penicillins
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| prego with group b strep | ampicillin
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| prophylaxis of strep pharyngitis in child with prior rheumatic fever | oral penicillin
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| prevention of post surgical infection due to S. aureus | Cefazolin
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| H. flu | rifampin
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| Prevention of conococal or chlamydial conjunctivitis in newborn | erythromycin ointment
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| MRSA | vancomycin, linezolid
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| VRE | linezolid, streptogramin
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| binds ergosterol and forms membrane pores | Amphotericin B
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| Clinical Use for Amphotericin B | Crypococcus
Blastomyces
Coccidioides
Histoplasma
Candida
Mucor
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| Topical; binds ergosterol and forms membrane pores | Nystatin; swish and swallow; thrush, diaper rash; vaginal
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| Inhibits ergosterol synthesis | -azoles
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| cryptococcal meningitis in AIDS | fluconazole
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| candida | fluconazole
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| blastomyces | itraconazole
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| coccidiodes | itraconazle
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| histoplasma | itraconazole
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| gynecomastia | -azoles; esp ketoconazole
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| inhibits DNA and RNA biosynthesis via cytosine deaminase | Flucytosine --> 5-FU
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| used in combo with amphotericin b | flucytosine --> 5-FU
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| bone marrow suppression | Flucytosine --> 5-FU
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| Inhibits cell wall synthesis by inhibiting synthesis of B-glucan | capsofungin; micafungin
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| Invasive aspergillosis Candida | capsofungin
micafungin
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| inhibits the fungal enzyme squalene epoxidase | Terbinafine
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| tx for dermatophytoeses | terbinafine
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| interferes with microtubule function; disrupts mitosis | griseofulivin
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| deposits in keratin containing tissues (eg. nails) | griseofulvin
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| inhibits growth of dermatophytes (tine, ringworm) | griseofulvin
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| toxoplasmosis | pyrimethamine
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| trypanosma brucei | suramin
melarsoprol
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| T. cruzi | nifurtimox
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| leishmaniasis | sodium stibogluconate
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| blocks detoxification of heme in to hemozin. | Chloroquine: Heme accumulates and is toxic to plasmoida
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| Resistance to Cholroquine | pumpt that dec intracellular concentration of drug.
Use: artemether/lumifantrine or atovaquone/proguanil
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| life threatening malaria | quinidine
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| chloroquine toxicity | Retinopathy
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| Enterobius Ascaris Ancylostoma Necator | Bendazole or pyrantal
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| Strongylodies | Ivermectin or albendazole
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| Onchocerca | Ivermectin
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| Loa loa Wuchereria bancrofti | Diethylcarbamazine
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| Toxocara | Albendazole or mebendazole
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| Tapeworms: Taneia solium; Diphyllobotrium latum | Praziqantel
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| Taenia solium neurocysticercosis | Bendazoles
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| Echinococcus | bendazoles
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| Trematodes (flukes): Schistosoma Clonorchis Pragonimus westermani | Praziquantel
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| inhibits infulenza neuraminidase | zanamivir, oseltamivir
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| inhibits synthesis of guanine nucleotides by competitively inhibiting IMP dehydrogenase | Ribavirin
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| Guanosine analog. Inhibits viral DNA polymerase by chain termination | Acyclovir/ Valcyclovir
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| Acyclovir - Clinical Uses | HSV-1; HSV-2; VZV; weakly EBV
NO CMV!!!!!
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| 5' monophosphate formed by a CMV viral kinase. Guanosine alanog Inhibits viral DNA polymerase. | Gancyclovir
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| CMV - tx | Gancyclovir
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| viral DNA polymorease inhibitor that binds to pyrophospate binidng site of the enzyme. Does not require activation by viral kinase | Foscarnet
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| CMV retinitis in immunocompromised patients | Foscarnet
Cidofovir
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| preferentially inhibits viral DNA polymerase NO phosphorylation by viral kinase | Cidofovir
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| how to reduce tox of Cidofovir | coadmin w/ probenecid and IV saline --> dec nephrotoxicity
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| HIV rx | - 2 NRTIs - nucleoside reverse transcriptase inhibitors +
(1 NNRTI - nonnucleoside rev transcriptase inhib OR
1 protease inhib OR
1 integrase inhib)
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| prevents maturation of new viruses | protease inhib - navir
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| nucleoTide analog that does not have to be activated | tenofovir
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| Bone marrow supression can be reversed by: | G-CSF and erythropoietin
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| sometimes suffix for NRTIs | -vudine/-nosine
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| Bind to reverse transcriptase does not require phosphorylation | NNRTI
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| Bind to reverse transcriptase requires phosphorylation | NRTI
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| Name the NNRTIs | Nevirapine
Dlavirenze
Delavirdine
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| Inhibits HIV genome integration into host cell chromosome by reversible inhibition of HIV integrase | Raltegravir - integrase inhibitor
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| Glycoprotiens synthesized by virus infected cells Block replication of both RNA and DNA viruses | Interferons
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| IFNa | HBV
HCV
Kaposi Sarcoma (HSV-8)
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| IFNb | MS
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| IFNg | NADPH oxidase deficiency
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| pt has HIV, hepatitis, neutropenia and myopathy. whats he taking? | IFNa
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| Treatments for Pseudomonas | FAACE
Fluroquinolones
Aztreonam
Aminoglycosides
Cefepine
Extended Spectrum Penicillins
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| Abx used in Pregnancy | ACE
Amoxicillin
Clindamycin
Erythromycin
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| NEVER USE IN PREGNANCY (1) | Countless SAFe Moms Take Really Good Care
Clarithromycin - ebryotoxic
Sulfonamides - kernitures
Aminoglycosides- ototoxicity
Fluroquinalones - cartilage damage
Metronidazole - mutagenesis
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| NEVER USE IN PREGNANCY (2) | Countless SAFe Moms Take Really Good Care
Tetracycline - discolored teeth, bone growth inhibition
Ribavirin - teratogenic
Griseofulvin - teratogenic
Chloramphenicol - grey baby
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