antibacterial chemotherapy III
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- Name an aminoglycoside or two
- gentamicin, tobramycin, streptomycin
- What is the MOA if the aminoglycosides?
- irreversible inhibition of protein synthesis
- Are aminoglycosides bactericidal or static?
- cidal
- Do aminoglycosides penetrate the csf?
- no
- what are some toxicities associated with aminoglycosides
- Nephrotoxic and ototoxic. he kept reinforcing this during lecture
- what is the spectrum of activity of aminoglycosides?
- good for grm - rods and certain gm + with vancomycin synergistic with penicilin for psuedomonas and steptomycin is good for TB
- Name a fluoroquinolone or two
- Ciprofloxacin, levofloxacin
- What is ciprofloxacin used for?
- psuedomonas
- what is levofloxacin used for
- respiratory infections
- what is a general use/spectrum of activity for flouroquinolones
- uti, gi, gonorrhea
- what is a major adverse effect of flouroquinolones
- cartilage rupture, especially in young people
- what is the moa of flouroquinolones
- block dna gyrase and topoisomerase enzymes so it is bactericidal
- what is the moa of sulfonamides?
- inhibit paba-->folic acid in dna synthesis
- Sulfonamides are bactericidal or static?
- static
- what are some adverse effects of sulfonamides
- acidic urined and kidneys get crystal collection
- do sulfonamides penetrate the csf?
- yes
- what drug is good for brain and spinal fluid infections?
- sulfonamides
- what is an adverse effect of flouroquinolones
- qt elongation
- name some sulfonamides
- Sulfadiazine, Sulfisoxazole, Sulfamethoxazole
- describe the spectrum of activity of sulfonamides
- good for atypical pathogens likc chlamydia, nocardia, non-bacteria: protazoans: toxoplasma, plasmodium falciparum (malaria)
- sulfonamide adverse effects?
- stevens johnson syndrome, cns toxic in infants, drug interactions with coumadine and methotrexate
- what is the moa of trimethoprims?
- block folic acid --> folinic acid in dna synthesis
- what is the trimethoprim spectrum of activity
- against gpc and gnr good for respiratory pathogens and peds patients
- does trimethoprim treat psuedomonas?
- no
- describe the ratio of bacrim and septra
- 1:5 trimethoprim:sulfamethoxazole
- what is this the drug of choice for pneumocystis carinii and pneumocystis jiroveci
- trimethoprim
- tetracyclines spectrum of activity
- treat weird infections like rcketssia, ,ehrlichia, coxiella, chlamydia, borrelia, brucelosis, rabbit fever, tularemia, cholera, oysters:vulnificus
- name a group III tetracycline
- doxycycline (ca-mrsa)
- name an adverse rxn for doxycycline
- stained teeth
- toxicities of tetracyclines
- phototoxic skin rxn, hepatotoxic, bone problems in infants, vertigo ataxia
- name some macrolides
- Erythromycin Clarithromycin (Biaxin®) Azithromycin (Zithromax®) Telithromycin (Ketek®)
- moa of macrolides
- inhibiting bacterial protein synthesis bacteriostatic
- macrolides penetrate csf?
- not really
- what is another name for azithromycin? whats so cool about it?
- z pack... 55-76 hour half life
- Erythromycin indications or spectrum of activity
- grm + cocci and legionella and mycoplasma NO gm - rods
- what is clarithro and azithro used for?
- haemophilious and moraxella. less gi effects than erythro but much more $$$ treats MAC in HIV pts
- Clindamycin Spectrum of activity
- Anaerobes - very active against most Bacteroides fragilis isolates Aerobic gram-positive cocci - good activity against streptococci (but not enterococci).
- when you think of clindamycin what should you think about regarding its therapeutic aspects
- anti-anaerobic therapy bacteriodes fragilis alt drug for aerob gm + staph and strep protazoa, pneumocystis toxoplasma baesia, plasmodium
- when should you adjust the dose of clindamycin
- for hepatic failure pts
- does clindamycin penetrate csf?
- no
- is clindamycin bactericidal or static?
- static
- adverse effect of clindamycin?
- can cause clostridium dificil colitis