Miscellaneous Antibiotics
Terms
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- Pronounce Fluoroquinolone
- floÍorÅˈkwinlËŒÅn
- What does Fluoroquinolone family of antibiotics have in common?
- They all end in "FLOXACIN"
- Why is Fluoroquinolone on the verge of becoming very important?
- Because it's safe, achieves high blood levels w/oral absorption and penetrates well into tissues
- What is the mechanism of action of Fluoroquinolone family drugs?
- Prevents DNA gyrase causing the breakage of the bacterial DNA structure
- Why is there a resistance to Fluoroquinolones?
- Overuse world wide
- Does Fluoroquinolones cover gram negative or gram positive?
- Gram Negative more than positive
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Which gram negative bacteria does Fluoroquinolone cover?
- Pseudomonas aeruginosa, cystic fibrosis,Enterobacteriaceae(prostatitis & epididymitis), Escherichia coli, Salmonella, Shingella,& Campylobacter.
- What intracellular organisms does Fluoroquinolone cover?
- Legionella, Brucella, Samonella & Mycobacterium
- What gram positives does Fluoroquinolone cover?
- Legionella, Mycoplasma, & Chlamydia
- What don't Fluoroquinolones cover?
- Most gram negatives and anaerobes
- Is Fluoroquinolones used in animals?
- True
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What are the effects of Fluoroquinolones?
- Nausea, vomiting, belly pain, diarrhea, cartilage damage(in animals), rare achilles tendonitits, tenton rupture, headache and insomnia; NOT FOR KIDS!
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Why does Fluoroquinolones penetrate well?
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Excreted in the bile, reabsorbed in the intestine and excreted via kidney. It also penetrates well into bones and prostate.
- Quinolones(floxacin) are good because
- They achieve high renal levels and can be used for UTI's
- Name the four quinolones that have improved coverage on gram positive bacteria
- Levofloxacin, Ofloxacin, Sparfloxacin & Grepafloxacin
- What atypical bacteria do the new gram positive drugs cover?
- Legionella, Mycoplasma, & Chlamydia
- What else do the gram positives on the works cover?
- Community acquired pneumonia
- What does Travofloxacin cover?
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G+(Staphylococcus arureus) and G-(Pseudomonas aerugionosa); also anerobes(Bacteroides fragilis)
- What are the the effects of Sparfloxacin?
- 8% of patients develop photosensitivity and cause Q-T intervals can cause arrhythmia torsades de pointes.
- If allergic to penicillin what drug is used?
- Vancomycin
- What does Vancomycin cover? Examples
- All gram positives such as MR Staphylococcus aureus, Enterococcus- Streptococcus faecalis and MR Staphylococcus epidermidids.
- Opposite of Vancomycin, which means?
- Aztreonam covers all Gram Negatives
- What happens when Vancomycin is given too quick?
- There is an noimmunologic release of histamine which causes a red rash
- What does Vancomycin prevent?
- Peptoglycan production
- Which drug is used for vancomycin resistant organisms?
- Synercid which are quinopristin and dalfopristin
- What is TH4?
- Tetrahydrofolate
- How do people make TH4?
- They don't, we get it from ouir diets
- Why do we need TH4?
- Nucleotide & DNA formation
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What is PABA & who uses it?
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Since bacteria can make their own TH4, they need Para Amino Benzoic Acid to help make it.
- What two drugs are used as antimetabolites antibiotics?
- Trimethoprim & Sulfamethoxazole
- How does Sulfamethoxazole kill bacteria?
- Thinking that the Sulfa drug is PABA, then it stops TH4 production.
- Why doesn't the sulfa drug affect humans?
- Humans don't make their own TH4
- TH4 after giving up a carbon
- TH2 - dihydrofolate
- Who changes TH2 back to TH4?
- Dihydofolate reductase
- How does Trimethoprim kill bacteria?
- It acts as dihydrofolate reductase of bacteria and stops TH2 to TH4 reduction which stops DNA formation in bacteria.
- Pharmocokenetics of antimetabolites antibiotics?
- Oral absorption excreted in urine; good for UTI's
- What are the effects of tmp/sulfa?
- Nausea, vomitting, diarrhea and skin rashes
- Who are the people who develop adverse effects from TMP/SULFA and what are they?
- People with AIDS get nausea, skin rashes, diarrhea, & bone marrow suppression
- What does TMP/SULFA cover?
- Gram positives and negatives; protozoans too
- What doesn't TMP/SULFA cover?
- Anearobic organisms
- Trimethoprim covers?
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Respiratory- Spretococcus pneumoniae & Haemoplilus influenzae
Mouth- gastrointestinal tract - diarrhea
Pee- Genitourinary tract - Escherihia coli - Sulfamethoxazole covers?
- Prevents PCP( Pneumocytis carinii pnemonia) when CD4+ T-cells drops below 250 in AIDS