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What is the MOA of Penicillins and how does resistance occur?
- 1.Bind PBP (Penicillin Binding Protein)
- 2. Block transpeptidase cross-linking of cell wall
- 3. Activate autolytic enzymes
- 1. Alteration of PBP protein.
- 2. Beta lactamases 3.
- 3.Porin structure change
- Penicillin (V) - Oral
- Penicillin (G) - IV
Drugs of choice for Penicillin resistant S. Aureus
Drug of choice for MRSA
Clavulinic acid, sulbactam and tazobactum are what kind of drugs?
Beta lactamase inhibitors
What are the aminopenicillins and what is their coverage?
Amoxicillin and Ampicillin
almonella and enterococci.
- HELPS with enterococci.amOxicillin -- Oral
Ticarcillin, carbenicillin, pipercillin treat which infection?
TCP - Take Care of Pseudomonas
What are the 1st generation cephalosporins and what are they indicated for?
Cefazolin and Cephalexin
roteus, E. c
- Gram (+) cocci
What are the 2nd generation cephalosporins are indicated for which infections?
- H. influenzae, Enterobacter, Neisseria, Proteus, E. coli, Klebsiella, Serratia
- Gram(+) cocci
What is Ceftriaxone (3rd gen) used for?
What is Ceftazidime (3rd gen) used for?
What are the side effects of vancomycin?
- Redman Syndrome (diffuse flushing)
was filmed in VANC
What are the side effects of aminoglycosides?
Which drugs should be avoided with aminoglycosides for fear of side effect exacerbation and what side effects are exacerbated respectively?
Aminoglycosides + cephalosporins = Nephrotoxcicity
Aminoglycosides + loop diuretics = Ototoxcicity
What are the aminoclycosides and what are they indicated for?
Gentamycin, Neomycin, Amikacin, Tobramycin
- MOA: Enter cell through oxygen transporter and inhibit initiation complex and cause misreading of mRNA. 30s subunit inhibitor
- Indications: Severe gram(-) rod infections
- Suffix: -mycin
What is a drug with penicillin-like activity that is safe for Penicillin allergic patients and renal compromised patients who cannot tolerate aminoglycosides? What's the drug's spectrum?
- Aztreonam (binds to PBP3)
- Only works for gram (-) infections
Drugs used for severe life threatening bacterial infections or as a last resort when all has failed
- Impipenem + Cilastatin
What is the MOA of vancomycin and how does resistance to it occur?
- MOA: Inhibits cell wall transglycosylation by binding to D-ala D-ala of cell wall
- Resistance: Change of D-ala D-ala to D-ala D-lac
1st line treatment for syphilis
What is Linezolid indicated for and what is its MOA and side effects?
Indications: VRSE and VRE
MOA: Inhibit formation of initiation complex by binding to 50s subunit.
Side Effects: has weak MAOI activity which can lead to serotonin syndrome as a drug reaction.
Which drugs bind to the ribosomal 30s subunit and which bind to the 50s subunit?
30s : Aminoglycosides, Tetracyclines
50s : Chloramphenicol, Clindamycin, Erythromycin(macrolides), Lincomycin, Linezolid.
Buy AT 30, CCELL at 50
What are the side effects of Chloremphenicol?
- Anemia (dose dependent)
- Aplastic anemia (dose dependent)
- Gray baby syndrome (premature infants lack UDP-glucoronyl transferase)
Drugs causing interstitial nephritis?
Which drugs predispose the patient to pseudomembranous colitis (C. Diff)?
What is the most worrying side effect of the Imipenem + Cilastatin combo?
CNS toxicity (seizures)
How can vancomycin "red man syndrome" be prevented?
Pretreatment of with antihistamines or slow infusion rate
When is the only time that vancomycin is indicated for oral use?
Psuedomembranous colitis (C. diff)
What are the sulfonamide drugs and what is their MOA?
- Sulfamethaxazole (SMX), Sulfisoxazole, Sulfadiazine
- MOA: Act as PABA antimetabolites causing inhibition of dihydropteroate synthetase
What are the side effects of sulfonamides?
- G6PD hemolysis
- Nephrotoxicity (tubulointerstitial nephritis)
- Photosensitivity (SAT for a photo)
- Kernicterus (infants)
What is drug A and what it drug B?
What is the MOA of Trimethoprim and what is it used for?
- MOA: Inhibits bacterial Dihydrofolate Reductase (DHFR)
- Uses: Recurrent UTIs, Shigella, Salmonella, Pneumocystis jirovecci pneumonia
What are the side effects of Trimethoprim?
- Megaloblastic Anemia
Leucovorin rescue (folinic acid supplementation)
What are the tetracyclines and what are their MOA and indications?
Tetracyline, Doxycycline, Demeclocycline, Minocycline
MOA: Bind 30s subunit and prevent attachment of aminoacyl-tRNA
Indications: V.cholera, Acne, Chlamydia, Ureaplasma urealyticum, Mycoplasma, Tularemia, H.pylori, Borrelia burgdoferi, Rickettsia
VACUuM THe Bed Room
What are the main side effects of tetracyclines?
- Discoloration of teeth
- Inhibition of bone growth
- Fanconi's syndrome (expired tetracyclines)
- Contraindicated in pregnancy and children
- Fanconi's syndrome - renal proximal tubule damage leading to decreased reabsorption of solutes.
Which drug class(es) should not be taken with milk or antacids?
What are the macrolides and what is their MOA and indications?
Erythromycin, Azithromycin, Clarithromycin
Inhibit protein synthesis by blocking translocation, bind to 23s tRNA of 50s subunit
neumonias (atypical- Mycoplasma, Chlamydia, Legionella), U
What is the MOA of Cholramphenicol and what is it indicated for?
MOA: Inhibits 50s peptidyltransferase activity
Indications: Meningitis (H.influenzae, N.meningiditis, S.pneumoniae)
What are the main side effects of Chloramphenicol?
- Gray baby syndrome (premature infants lack UDP-glucuronyl transferase)
- Anemia (dose dependent)
- Aplastic anemia (dose dependent)
What is the MOA of clindamycin and what is it indicated for?
MOA: Blocks peptide bond formation at 50s subunit
Indications: Anaerobic infections in the lungs
What are the Flouroquinolones and what is their MOA?
Ciprofloxacin, Norfloxacin, Ofloxacin, Moxifloxacin, Gatifloxacin, Enoxacin
MOA: Inhibit DNA Gyrase (bacterial topoisomerase II).
What are the side effects of Flouroquinolones?
Contraindicated in pregnancy and children
- Tendonitis and tendon rupture (adults)
- Cartilage damage (children)
- Leg cramps and myalgias (children)
Which organisms can Metronidazole be used for? And what's it's MOA?
MOA: Creates free radicals that cause bacterial DNA damage
Indications: Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (below the lungs), H.Pylori
GET GAP on the Metro!
What are the side effects of Metronidazole?
- Disulfram reaction
- Metallic taste
What are the polymyxins and what are their MOA and side effects?
Polymyxin B, Colistimethate (Polymyxin E)
MOA: Bind bacterial cell membrane and disrupt osmotic properties
Side effects: Neurotoxicity, Acute renal tubular necrosis
What is the Tuberculosis drug regiment?
Streptomycin can be added too.
What is the MOA of Rifampin and what are the side effects?
Inhibits DNA-dependent RNA polymerase
- Side effects:
- Induces CYP450
- Causes secretions to turn red/orange
- Mild hepatoxicity
- R's of Rifampin:
- Revs up CYP450
- RNA polymerase
- Red/orange secretions
What are the MOA and side effects of Isoniazid(INH)?
MOA: Decreases mycolic acid synthesis
Side Effects: N
- INH causes NHLor
- INH causes lNH (lower case L)
Which drugs are known to cause drug induced lupus?
Sulfa drugs, Hydralazine, Isonizid, Phenytoin, Procainamide
Solo drug used for prophylaxis of TB?
What are the Isoniazid drug toxicities?
- INH can cause lNH (lower case L)
- or just remember NHL
Drug(s) causing gingival hyperplasia
Drug's that can cause gout?
Drugs that can cause photosensitivity?
for a photo
Drugs that can cause Steven-Johnson syndrome?
- Sulfa drugs
Drugs causing cinchonism?
- All quinine drugs (derived from cinchona tree)
- Cinchonism - rash, blurred vision, tinnitus, headache, nausea, vomiting, confusion
Drug's causing drug induced nephrogenic diabetes insipidus?
Drugs potentiating seizures?
Drugs causing Parkinsonian symptoms?
They all decrease dopamine levels.
Drugs causing Nephrotoxicity AND Neurotoxicity?
- Loop diuretics
Drugs causing thyroid dysfunction?
- Amiodarone - contains high levels of iodine
Drugs causing hot flashes?
Drugs causing gynecomastia?
Drugs causing focal and massive hepatic necrosis?
- Deathcap Mushroom (Amanita phalloides)
Drugs causing pulmonary fibrosis?
Drugs causing agranulocytosis?
Drugs causing aplastic anemia?
Drugs causing hemolytic anemia in G6PDH deficient patients?
Hemolytic anemis IS PAIN
Drugs causing megaloblastic anemia?
Drugs causing Torsades de Pointes?
- Potassium channel blockers (class III)
- Quinidine (class IA)
Drugs causing cutaneous flushing?
- Ca2+ channel blockers
Cytochrome P-450 Inducers
- St. John's wort
Cytochrome P-450 Inhibitors
- Protease Inhibitors (HIV)