Term
|
Definition
irreversible inhibition of protein synthesis,
binds 30s subunit of bacterial ribosome, blocking the initiation of peptide syntheis |
|
|
Term
| Entry of Aminoglycosides into gram (-) cell |
|
Definition
| requires active transport via an oxygen dependent process with a proton gradient, low pH or low O2 decreases cell membrane transport |
|
|
Term
| synergism and aminoglycosides |
|
Definition
| PCN's, cepsh and vanc make it easier for AG's to penetrate |
|
|
Term
| T/F, aminoglycosides are cidal? |
|
Definition
| TRUE, despite being protein systh inh,they are cidal |
|
|
Term
| Spectrum of Aminoglycosides |
|
Definition
| mostly gram (-) but will cover gram + if used with an inh of cell wall synth |
|
|
Term
| Can you use an AG alone in a G+ inf |
|
Definition
|
|
Term
| Treatment of staph, strep or entero endocarditis |
|
Definition
| low does AG plus B=lactam or Vanc |
|
|
Term
|
Definition
streptomycin,
neomycin
kanamycin
paromomycin
gentamicin
tobramycin
amikacin
netilmicin
spectinomycin
simoci
dibekacin
isepamicin |
|
|
Term
| Elimination of gentamicin |
|
Definition
| Renal only so reduce dose in renal failure, or give something else |
|
|
Term
|
Definition
High dose G(-) 1.5mg/kg q12
Low does G(+) 2-2.5 mg/kg q12
MUST adjust for body weight as AG's do NOT distribute to fat |
|
|
Term
| Do AG's exert conc dep killing |
|
Definition
| YES, and exert post antibiotic effect |
|
|
Term
|
Definition
both time and conc dependent
Nephrotoxicity usually reversible
Ototoxicity - irreversible |
|
|
Term
| contraindicated drugs with AG's |
|
Definition
| amphotercin B, cyclosporines, Vanc, and NSAIds increase the likelihood of nephrotoxicity |
|
|
Term
|
Definition
| Gent primarily vestib damage |
|
|
Term
| Big contraindicative for AG's |
|
Definition
| furosemide, often given to maintain urinary output, is also toxic to the VIII cranial nerve |
|
|
Term
|
Definition
most common = drug alteration, addition of ph, adenyl, acteyl
decreased transport into cell - pseudo has 40 efflux pumps
changes in 30s binding site |
|
|
Term
| ace in the hole for bacteria resistant to gentamicin or tobramycin |
|
Definition
|
|
Term
|
Definition
| poor GI abs, must be given iv for systemic infections |
|
|
Term
| Common topical AG in ear drops eye drops and ointments |
|
Definition
|
|
Term
| Drug given PO to decontaminate the gut prior to surgery |
|
Definition
|
|
Term
|
Definition
Excellent G + covers MRSA, VRA, PCN res strep pneumo
Minimal Gram (-) activity |
|
|
Term
|
Definition
binds unique site
23S ribosomal RNA OF
50S subunit blocking assembly of 70s |
|
|
Term
| Is linezolid static or cidal? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
STATIC esp with MRSA and VRE
poor for endocarditis or osteomyelitis
Expensive comp to vanc
contraindicated with SSRI's since it is a MAOI
periph neuropathy and irrev optic neuritis |
|
|
Term
| Reversible bone marrow depression side effect |
|
Definition
| Linezolid 25% platelet decrese in 10 days |
|
|
Term
|
Definition
| unknown bu appears to depolarize the cell resulting in loss of potassium and cell death |
|
|
Term
|
Definition
| Cidal with conc dependent cidal activity |
|
|
Term
| Therapeutic uses of Daptomycin |
|
Definition
MRSA in patients who can't handle vanc
VRE including E. faecalis |
|
|
Term
| Can you use Dapto for SSTIs or MRSA pneumo |
|
Definition
| NO, inactivated by surfactant |
|
|
Term
| Detailed MOA of Trimeth Sulfa, which acts where? |
|
Definition
Sulfamethoxazol acts first to inhibit dihydropteroate synthase so NO DHR dihydro
trimeth acts second to inhibit DHfolate reductase so NO THF
PABA is the precursor to DHF and DHF to THF |
|
|
Term
| What is THF used for and what drug(s) block it's synth |
|
Definition
| used to make purines and amino acids, trimeth blocks THF synth, and sulf block DHF |
|
|
Term
| Competitive agonist of PABA |
|
Definition
| Sulfamethoxazole, thus inhibits dihydropteroate synt to prevent synth of DHF |
|
|
Term
| DOC for treatment of Pneumocystis jiroveci |
|
Definition
|
|
Term
| Spectrum of Trimeth sulfa |
|
Definition
Staph including MRSA
Entero in ICU
E.coli and Klebsiellas |
|
|
Term
| Bugs Resist to Trimeth sulfa |
|
Definition
| Pseudomonas, enterococci, or bacteroides |
|
|
Term
| Weaknesses on trim-sulfa coverag |
|
Definition
| Does NOT cover group A streptococcus. For SSTIs, use either po cephalexin or po amoxicillin with po trimsulfa |
|
|
Term
| Trim-sulfa side effects: lots |
|
Definition
severe allergic reacion in skin, photosens, fever, uticaria,
Stevens Johnson syndrome - severe erythema multiforme with mucous mem involvement
Toxic epidermal necrolysis - full thickness epidermal necrosis with widespread skin loss |
|
|
Term
| Problem in older men being treated with trim-sulfa |
|
Definition
|
|
Term
| Treatment for uncomplicated UTIs |
|
Definition
|
|
Term
| How to treat outpatient MRSA infections? |
|
Definition
Clinda is preferred over trim-sulfa b/c clinda covers staph a and b.trimsulfa does not cover GAS and doxy does not cover GBS
Trim sulfa works well in the treatment of MRSA abcesses after drainage |
|
|
Term
| Treatment of inpatient MRSA |
|
Definition
For SSTIs clinda, trim-sulfa, or doxy, latest UH reg is doxy +i.v. cefazolin
Vanc for severe MRSA inf or crit ill patients
Linezolid for patients who can't handle Vanc, or uncomplicated MRSA inf |
|
|
Term
| Second line drug for MRSA bacteremia behind Vanc |
|
Definition
|
|
Term
| Doc for infections caused by Nocardia spp in immunocompromised patients |
|
Definition
|
|
Term
| DOC in ICU infections by Stenotroph malt resistant bact |
|
Definition
|
|
Term
|
Definition
| Bacterial enzymes rapidly reduce nitrofur to a ractive intermed which damages DNA to cause cell death |
|
|
Term
| Nitrofurantoin Cidal or Static |
|
Definition
static at low concentrations
cidal at high concentrations |
|
|
Term
| Drugs that are safe to use in Pregnant women |
|
Definition
| Nitrofurantoin, amoxacillin and cephalexin |
|
|
Term
| Weakness of Nitrofurantoin |
|
Definition
CANNOT be used to treat pyelonephritis or prostatitis limited to the urine
turns urine brown
S/E's hepatitis, neuropathies, and pulmonary fibrosis after long term treatment for UTI's |
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