Pharm 1

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Neda317
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295962
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Pharm 1
Updated:
2015-07-26 01:00:19
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pharm
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antibiotics page 182-195
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  1. MECHANISM OF RESISTANCE
    Cephalosporins
    Structural change in penicillin-binding proteins(transpeptidases).
  2. always giveCarbapenems with ____
    • Cilastatin 
    • (inhibitor of renal dehydropeptidase I) to  inactivation of drug in renal tubules.
  3. Which carbapenem is better and why
    Meropenemhas a dec. risk of seizures and is stable to dehydropeptidase I.
  4. penicillin allergy and G(-) rod bac give
    Monobactam ( Aztronam)
  5. Inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors.Bactericidal. Not susceptible to β-lactamases.
    Vancomycin
  6. This antibiotic Require O2 for uptake; therefore ineffective against anaerobes.
    • Aminoglycosides
    • (Gentamicin, Neomycin, Amikacin,Tobramycin, Streptomycin)
  7. Aminoglycosides  MO-resistance
    Bacterial transferase enzymes inactivate the drug by acetylation, phosphorylation, or adenylation.
  8. Aminoglycosides toxicity
    • Nephrotoxicity, Neuromuscular blockade,Ototoxicity
    • (especially when used with loop diuretics). Teratogen.
  9. Treats anaerobic infections above the diaphragm
    Clindamycin
  10. tx of anaerobic infections below diaphragm
    metronidazole
  11. which antibiotic gives Serotonin syndrome?
    Oxazolidinones ( Linezolid)
  12. gram-positive cocci (streptococcal infections in patients allergic to penicillin) give ___
    Macrolides
  13. MO-Resistance of Sulfonamides
    Altered enzyme (bacterial dihydropteroate synthase), dec. uptake, or inc. PABA synthesis
  14. Hypersensitivity reactions, hemolysis if G6PD deficient,
    Sulfonamides
  15. May cause tendonitis or tendon rupture in people > 60 years old and in patients taking prednisone.
    • Fluoroquinolones
    • (Ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, moxifloxacin, gemifloxacin, enoxacin.)
  16. antibiotic TOXICITY Myopathy, rhabdomyolysis.
    Daptomycin
  17. Rifamycins Rifampin, rifabutin MOA
    Inhibit DNA-dependent RNA polymerase
  18. Rifamycins Rifampin, rifabutin 
    4 R’s
    • Rifampin’s 4 R’s:RNA polymerase inhibitor Ramps up microsomal cytochrome P-450 Red/orange body fluids
    • Rapid resistance if used alone
    • Rifampin ramps up cytochrome P-450, butrifabutin does not.
  19. Isoniazid MOA
    dec. synthesis of mycolic acids. Bacterial catalase peroxidase(encoded by KatG) needed to convert INH to active metabolite.
  20. Isoniazid  neurotoxicity can prevented w
    Pyridoxine (vitamin B6)
  21. Ethambutol MOA
    dec. carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase
  22. High risk for endocarditis and under going surgical or dental procedures
    Amoxicillin
  23. Exposure to gonorrhea
    Ceftriaxone
  24. History of recurrent UTIs
    TMP-SMX
  25. Exposure to meningococcal infection
    Ceftriaxone, ciprofloxacin, or rifampin
  26. Pregnant woman carrying group B strep
    Penicillin G
  27. Prevention of gonococcal conjunctivitis in newborn
    Erythromycin ointment
  28. Prevention of postsurgical infection due to       S. aureus
    Cefazolin
  29. Prophylaxis of strep pharyngitis in child with prior rheumatic fever
    Benzathine penicillin G or oral penicillin V
  30. Exposure to syphilis
    Benzathine penicillin G
  31. Treatment of highly resistant bacteria MRSA
    vancomycin, daptomycin, linezolid, tigecycline, ceftaroline
  32. Treatment of highly resistant bacteria VRE
    linezolid and streptogramins (quinupristin, dalfopristin).
  33. Multidrug-resistant P. aeruginosa, multidrug-resistant Acinetobacter baumannii:
    polymyxins B and E (colistin).
  34. Amphotericin B MECHANISM MOA
    Binds ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes.
  35. AZOLEs MOA
    Inhibit fungal sterol (ergosterol) synthesis by inhibiting the cytochrome P-450 enzyme that converts lanosterol to ergosterol
  36. zoles toxicity
    Testosterone synthesis inhibition (gynecomastia, especially with ketoconazole), liver dysfunction(inhibits cytochrome P-450).
  37. Flucytosine MOA
    Inhibits DNA and RNA biosynthesis by conversion to 5-fluorouracil by cytosine deaminase
  38. Terbinafine MOA
    Inhibits the fungal enzyme squalene epoxidase
  39. Echinocandins MOA
    Inhibit cell wall synthesis by inhibiting synthesis of β-glucan
  40. Anidulafungin, caspofungin, micafungin.
    family of
    Echinocandins
  41. Griseofulvin MOA
    Interferes with microtubule function; disrupts mitosis. Deposits in keratin-containing tissues (e.g.,nails).
  42. Treatment of plasmodial species other than P. falciparum
    Chloroquine
  43. Treat P. falciparum with
    artemether/lumefantrine or atovaquone/proguanil
  44. For life-threatening malaria,use _____ in U.S. (___ elsewhere) or ___
    • quinidine
    • quinine or artesunate.
  45. coadminister with ____ and ____  decrease Nephrotoxicity of Cidofovir
    • probenecid 
    • IV saline
  46. CLINICAL USE
    IFN-α:
    chronic hepatitis B and C, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum,renal cell carcinoma, malignant melanoma
  47. IFN-β use?
    multiple sclerosis.
  48. IFN-γ use?
    chronic granulomatous disease.
  49. Interferons toxicity
    Neutropenia, myopathy.
  50. Hepatitis C therapy
    • Ribavirin
    • Simeprevir
    • Sofosbuvir
  51. Ribavirin use in
    Chronic HCV, also used in RSV (palivizumab preferred in children)
  52. Simeprevir use
    Chronic HCV in combination with ribavirin and peginterferon alfa.Do not use as monotherapy.
  53. Sofosbuvir use
    Chronic HCV in combination with ribavirin, +/–peginterferon alfa.Do not use as monotherapy.
  54. Ribavirin toxicity
    hemolytic anemia; severe teratogen
  55. Simeprevir toxicity
    photosensitivity reactions, rash.
  56. Sofosbuvir toxicity
    fatigue, headache, nausea.

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