FA Antimicrobials 171-173
Terms
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- Name 4 sulfonamides.
-
Sulfamethoxazole (SMX)
Sulfisoxazole
Triple sulfas
Sulfadiazine - PABA antimetabolites that inhibit dihydropteroate synthase.
- Sulfonamides
- Indications for Sulfonamides in general
-
G(+)
G(-)
Nocardia
Chlamydia - Toxs of Sulfonamides
-
Hypersensitivity reactions
Hemolysis if G6pd def
Tubulointerstitial nephritis
Kernicterus in infants
Displaces other drugs from albumin like warfarin - Inhibits dihydrofolate reductase.
- Trimethoprim
- Used in combo with sulfonamides to block folate syn
- Trimethoprim
- Indications for TMX-SMX
- Recurrent UTI, Shigella, Salmonella, PCP
- Toxs of Trimethoprim
-
Treats Marrow Poorly:
Megaloblastic anemia
Leukopenia
Granulocytopenia - What can you add to alleviate someof the toxicities of trimethoprim?
- Folinic acid
- Name 2 fluoroquinolones that don't end in "-floxacin"
-
Enoxacin
Nalidixic acid - Inhibits DNA gyrase. Bactericidal.
- fluoroquinolones
- Indicaitons for fluoroquinolones
-
G(-) rods of urinary and GI tract (pseudomonas)
Neisseria
Some G(+) - 2 most serious Toxs of Fluoroquinolones
-
contraindicted in pregnant women and children for damage to cartilage;
tendonitis and tendon rupture in adults - Forms toxic metabolies in the bacterial cell
- Metronidazole
- Indictions for Metronidazole
-
GET: giardia, entamoeba, trichomonas
Bacteroides, Clostridium, H.Pylori (as part of triple therapy) - Tox of metronidazole
- disulfiram-like rxn with OH; H/A, metallic taste
- Bind to cell membranes of bacteria and disrupts osmotic properites.
- Polymyxins
- Indications for polymyxins
- Resistant G(-)
- Toxs of polymyxins
- neurotox, acute renal tubular necrosis
- name the 5 anti-TB drugs
- IRPES: isoniazid (INH), rifampin, pyrazinamide, ethambutol, streptomycin
- dec syn of mycolic acids
- INH
- only agent used solo for TB
- iNH
- blocks mrna syn
- rifampin
- 4R's of rifampin
-
RNA pol inhibitor
Revs up microsomal P-450
Red/orangle body fluids
Rapid Resistance if used alone - resistance mech of penicillins/cephalosporins
- beta-lactamase cleavage of beta-lactam ring
- resistance mech of vancomycin
- d-ala ala to d-ala lac
- resistance mech of tetracyline
- dec uptake or inc transport out of cell
- resistance mech of sulfonamides
- altered enzyme (dihydropteroate synthetase); dec uptake, inc PABA syn
- prophylaxis used for meningococcus
-
*rifampin
minocycline - prophylaxis used for gonorrhea
- ceftriaxone
- prophylaxis used for syphilis
- (benzathine) penicllin G
- prophylaxis used for history of recurrent UTI
- TMX-SMX
- prophylaxis used for PCP
- *TMX-SMX, pentamidine
- prophylaxis used for endocarditis due to surgical or dental procedures
- penicillins