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- Nukes- AZT, 3tC, DDI, D4T
- Non Nukes- EFV, NVP (Nevirapine)
- Protease Inhibitors-Lopinavair, Ritonavir
How do nukes work?
grab DNA reverse transcriptase is trying to build
How do non nukes work?
hook reverse transcriptase itself to keep it from working
How do PIs work?
prevent final assembly of virus
Who needs ARVs?
- Depends on CD4 count (WHO stage II w CD4 count below 350mm3
- clinical sx (opportunistic infections)
- do they want to
- WHO stage 3 of HIV disease regardless of CD4 count
ARV tx success?
by 24 weeks less than 400 copies/mL
drug adverse effects
anorexia, sore dry mouth, swallowing difficulties, constipation/diarrhea, n/v/altered taste, depression tiredness lethargy
Lactic acidosis, hepatox, pancreatitis, peripheral neuropathy, fat accumulation, hyperlipidemia, premature CAD, hyperglycymie, insulin resistance/DM, bone disorders, osteoperosis, bone marrow suppression, hypersensitivity reactions, skin rashes
What ABs can cause renal toxicity?
aminoglycosides and sulfanamides, flouroquinalones
What abs can cause thrombocytopenia
penicillins and cephalosporins
ABs and weird side effects in kids
weight bearing joint effects?
ototoxicity and nephrotoxicity?
liver and kidney monitoring in babies?
which ABs alter membrane perm?
PCNs, cephalo, vanco
which ABs inhib protein sybnth
EES, tetracyclines, clindamycin, aminoglycosids
Which ABs inhibit nucleic acid syth?
flouroquinalones, HIV anti retrovirals
Which AB inhibits cell metab and growth?
Which ABs effect bacterial cell walls?
Which ABs have beta lactam?
penicillins, cephalosporins, carbapenems
broad spectrum ABs
ABs w AEs other than nvd and allergies
don't give if
- pt is allergic to penicillins
- Oral—Keflex (cephalexin); Ceclor (cefaclor), Lorabid (lorcarbef); Omnicef (cefdinir)
- Parenteral—Ancef (kefzol); Mefoxin (cefoxitin); Claforan (cefotaxime), Fortaz (ceftazidime), Rocephin (ceftriaxone); Maxipime (cefepime)
Carbapenems (meropenem, primaxin)
Monobactam (azactam, aztreonam)
- has beta lactams, but stable in presc of beta lactamase
- active against g- bacteria, lots of resistant strains
- preserves normal g pos and anaerobic flora
ABs affecting protein synthesis
- aminoglycosides- gentamycin
- macrolide antibiotics-erythromycin
Narrow spectrum ABs
Aminoglycosides/gentamycin (G- orgs), flouroquinalones (cipro)
what do they do? How? spectrum?
How do you check therapeutic levels?
cidal G-, G+, narrow spect
- protein synth inhibitors
- pneumonia, MRSA, some URIs, endocarditis, bacteremia, sepsia, skin infections, UTIs
- accumulate in kidneys and ears
- ototox, nephrotox
- Peak and trough
What AB do they give for chlamydia, mycoplasma, protozoa?
What AB causes renal and phototoxicity and kid's teeth blue?
What do macrolides (erythromycin, Zithromax (azithromycin), Biaxin (clarithromycin), and Dynabac (dirithromycin) work against?
what kind of tox is risk?
- G+ cocci like Neisseria, terponema, mycoplasma, bacteroides, clostridia, corynebacterium
- coumadin, theophylline, prednisone, norpace, lanoxin, tegretol, alfenta, parlodel (dopamine agonist)
What ABs are contraindicated in liver disease?
Fucking terrible sunburn
flouroquinalones, macrolides, sulfanamides
- G + only, hypotension, flushing, rash
- G+ cocci
- good for acne and BV
- can cause colitis
- good against clostridium and protozoa like giardis, amebiasis, trich
- topically for rosacea, BV
- avoid ETOH
amphocerin, vancomycin, cephalosporins, loop ds, neuro blocking agents can inc effects
What are sulfas used for
UTIs, pneumocystis carinii
Which ABs can cause bone marrow depression, folic acid def, and cholestatic jaundice?
may cause crystalluria, tx ulcerative colitis and RA
silver sulfadiazine is useful in_____
- fluconazole (Diflucan)
- Nystatin (P), (Mycostatin)
- may be used orally, topically or vaginally
- generally well tolerated
Acyclovir is a_________
- HSV, Herpes zoster
- lightheadedness, anorexia, n/v, HA
- confusion, tremors, sz
- IV may be nephrotoxic