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61 Cards in this Set
- Front
- Back
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what are 4 flouroquinolones?
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gemifloxacin
moxifloxacin levofloxacin ciprofloxacin |
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what is gemifloxacin?
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a fluoroquinolone
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what is moxifloxacin?
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a flouroquinolone
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what is levofloxacin?
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a flouroquinolone
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what is ciprofloxacin?
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a flouroquinolone
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what is the class II 2nd generation flouroquinolone?
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ciprofloxacin
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what is cipro mainly used for? (2)
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gram - and atypicals
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what is the flouro of choice for pseudomonas?
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cipro
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what is the main benefit of cipro?
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flouro of choice for pseudomonas
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what does cipro not reliably cover?
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gram +s
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what 3 flouros have similar coverage?
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levofloxacin
moxifloxacin gemifloxacin |
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what will levofloxacin, moxifloxacin, gemifloxacin cover? (6)
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staph (no MRSA)
strep enterococcus gram -s some anaerobes atypicals |
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what is the only 3rd generation flouro that is reliable for pseudomonas?
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levofloxacin
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what is covered well by 3rd generation flouros but not by cipro?
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strep pneumonia
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what are the 3rd generation flouoros known as? (3)
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anti-pneumococcals
respiratory quinolones above the waist quinolones |
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what is the first line quinolone for STDs?
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third generation (levofloxacin, moxifloxacin, gemifloxacin)
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what is the MOA of flouros?
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inhibits topoisomerase II and IV
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what are 2 mechanisms of resistance for flouros?
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altered target site
efflux pump |
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what are 5 therapeutic uses for flouros?
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RTIs
UTIs skin/soft tissue infections STDs anthrax |
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what 2 flouros should not be used for UTIs?
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moxifloxacin
gemifloxacin |
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how are flouros excreted?
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renally
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why can't moxifloxacin be used to treat UTI?
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because it is fully metabolized before it reaches the kidneys
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which flouro is PO only?
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gemifloxacin
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what will cipro interact with? (2)
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theophylline
caffeine |
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what is the main drug interaction of flouro?
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complexation with metallic ions, especially in the stomach
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what metallic agents with flouros combine with?(2)
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di or trivalent agents
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what must you do with flours due to their metallic interaction?
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must separate taking it from consumption of ions in food, vitamins, antacids
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what may cause cartilage damage in pregnancy?
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flouros
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what 2 drugs are collectively known as antifolates?
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sulfonamides and trimethoprim
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what 2 drugs are collectively known as bacterial nucleic acid synthesis inhibitors?
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sulfonamides and trimethoprim
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what is the MOA of SMX-TMP/bactam?
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target tetrahydrofolic acid, a cofactor needed to make nucleotide bases
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becuase of synergistic effects, what are rarely used in infectious disease as a single agent?
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sulfonamides
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what are 2 sulfonamide combination drugs?
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SMX-TMP
bactam |
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what is the main use of SMX-TMP/bactram and why?
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UTIs because of its effect on lesser gram negatives
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what staph is SMX-TMP/bactram primarily used against?
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CA-MRSA
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what is uses as a PCP prophylaxis in HIV?
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SMX-TMP/bactram
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what are 2 mechanisms of resistance to SMX-TMP/bactram?
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altered target site
overproduction of PABA |
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what drug can displace unconjugated bilirubin from albumin and cause kernicterus?
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SMX-TMP/bactram
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what can SMX-TMP/bactram cause due to its need to be protein bound?
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kernicterus due to it displacing hemoglobin
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what is the main adverse effect of SMX-TMP/bactram?
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allergies to sulfa component
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what can the rash from SMX-TMP/bactram range from?
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mild to SJS
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what drug has the highest risk for SJS?
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bactam
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what are 3 other examples of sulfonamides?
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sulfalazine
dapsone silver sulfasiazine |
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what are 3 regimens for latent TB?
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Isoniazid x9 months
isoniazid x 6 months rifampin x 4 months |
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what is the 4 drug combo used to treat active TB?
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INH
rifampin pyrazinadine ethambutol |
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how is INH administered?
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IV and PO
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what are the 2 MOAs with INH?
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competitive antagonism
inhibits mycolic acid synthesis |
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what are 2 adverse effects of INH?
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mild to severe liver side effects
peripheral neuropathy |
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when should you stop INH treatment? (2)
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if LFT increase with symptoms of liver failure
or if AST>5x the upper limit of normal without symptoms |
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how does INH cause peripheral neuropathy?
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interferes with pyridoxine metabolism
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what should patients do to avoid neuropathy with INH?
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supplement with vitamin B6
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what is a 2nd line agent for TB?
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rifampin
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what is the only monotherapy use for rifampin? (2)
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bacterial meningitis prophylaxis and LBTI
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what is the MOA of rifampin?
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inhibits DNA-dependent RNA-polymerase
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why is it okay to use rifampin as a monotherapy for TB?
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because TB grows so slowly it takes longer to develop resistance
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what are 5 side effects of rifampin?
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strong P450 inducer
hepatotoxicity thrombocytopenia flu-like syndrome orange discoloration of body fluids |
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what is pyrazinamide used for?
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only used in combination therapy for active TB
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what are 3 side effects of pyrazinamide?
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hepatotoxicity
arthralgias red/green color discrimination |
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what is cycloserine?
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a second line TB agen used when TB has become resistant to first line drugs
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what is ethonamide?
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a second line TB agen used when TB has become resistant to first line drugs
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what is P-aminosalicylic acid?
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a second line TB agen used when TB has become resistant to first line drugs
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