Glossary of Chapter 19: Miscellaneous Antibxs
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- List 3 important qualities of the fluoroquinolones?
- 1. Safe
2. Oral absorption
3. Penetrate extremely well into tissues
- What is the fluoroquinolone mechanism of action?
- Think "flock of sinners" -- "gyrating": inhibition of DNA gyrase
- What are the adverse effects of ciprofloxacin?
- Can cause seizures in patients with renal insufficiency or when combined with NSAIDs
- Describe fluroquinolone drug levels in the stool and kidneys?
- Enterohepatic circulation and then excretion via kidney leads to high levels in both stool and kidneys
- What are the clinical uses of fluoroquinolones?
- Gram (-)s!
1. multi-resistant pseudomonas aeruginosa
3. Complicated UTIs
4. Gram (-) facultative intracellular organisms - Legionella, Salmonella, Mycobacterium, etc
5. Chronic osteomyelitis caused by Staph aureus
- Vancomycin covers which bugs? Makes it the opposite coverage of which drug? Which nasty bugs in particular?
- Covers all gram (+)s! Opposite of aztreonam.
2. Multi-resistant Staph epidermidis
3. Enterococcus (strep faecalis)
- A rapid infusion of vancomycin can cause which adverse effect?
- Nonimmunologic release of histamine: Red Man syndrome
- Why is vancomycin effective in C dif treatment?
- Not absorbed orally, so when taken orally, cruises down the GI tract to kill C dif.
- Sulfa drugs - mechanism of action?
- Competitively inhibits production of TH4 by bacteria.
- Sulfamethoxazole is often given with which drug?
- Describe the absorption and excretion of sulfa drugs?
- Oral absorption.
Excretion in urine - good for UTIs.
- Which people often have adverse effects on TMP/SMX?
- AIDS patients.
- What are the clinical uses of TMP/SMX?
- Think of the mnemonic: TMP S
T - respiratory TREE: strep pneumo, H flu
M- MOUTH (GI tract): gram (-)s like Shigella, Salmonella, and E coli
P - PEE (GU tract): infections by the E coli and other enterics
S - SYNDROME (AIDS): Pneumocystis carinii and other protozoan prevention (prophylaxis)
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