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