Flashcards with Answers on Microbiology
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| HAART |
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| initiated when present with AIDS defining illness, low CD4 <350 or high viral load; 2 NRTI and 1 NNRTI |
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| protease inhibitor names |
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| navir |
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| NRTI names |
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| tenofovir, emtricitabine, abacavir, lamivudine, zidovudine, didanosine, stavudine |
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| NNRTI names |
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| "vir" - nevirapine, efavirenz, delavirdine, entervirene |
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| integrase inhibitor name |
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| raletgravir |
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| fusion inhibitors |
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| enfuvirtide (inhibits gp41), maraviroc (inhibits gp120) |
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| protease inhibitor MOA |
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| prevent maturation of new viruses |
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| NRTI MOA |
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| competitively inhibit nucleotide binding to RT and terminate the DNA chain |
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| NNRTI MOA |
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| bind RT at a site different from NRTI |
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| integrase inhibier MOA |
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| inhibits HIV genome integration into host cell chromosome by reversibly inhibiting HIV integrate |
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| GI intolerance HIV drug |
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| protease inhibitors |
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| HIV SE: inhibit cytochrome P450 |
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| protease inhibitors |
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| HIV drug SE: lipodystrohy and hyperglycemia |
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| protease inhibitors |
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| HIV drug SE: pancreatitis |
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| ritonavir, didanosine, stavudine, calcitabine |
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| HIV drug SE: nephrolithiasis |
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| indinavir, atazanavir |
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| HIV drug SE: peripheral neuropathy |
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| didanosine, stavudine, salcitabine |
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| HIV drug SE: hepatic steatosis |
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| didanosine, stavudine |
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| HIV drug SE: HSR |
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| abacavir |
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| HIV drug SE: rash |
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| NNRTI |
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| HIV drug SE: false+ drug test to cannabinoids |
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| efavirenz |
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| HIV drug SE: weir dreams |
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| efavirenz |
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| HIV for general prophylaxis in pregnancy |
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| zidovudine |
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| HIV drug for occupational exposure |
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| AZT and lamivudine |
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| HIV drug SE: hypercholesterolemia |
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| raltegravir |
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| PABA antimetabolites |
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| sulfonamides |
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| use of sulfonamides |
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| gram positive, gram negative, nocardia, chlamydia, UTI |
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| hemolysis if G6PD |
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| sulfonamides |
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| kernicterus in infants |
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| sulfonamides |
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| photosensitivity |
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| sulfonamide, tetracyclines |
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| nephrotoxicity |
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| sulfonamides |
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| bacterial dihydrofolate reductase |
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| trimethoprim |
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| megaloblastic anemia |
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| trimethoprim |
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| inhibit topoisomerase II |
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| fluoroquinolones |
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| inhibit topoisomerase II |
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| fluoroquinolones |
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| use of FQ |
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| gram-negative rods, neisseria and some gram positive |
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| Ci in pregnancy and children |
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| FQ |
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| tendonitis and tendon rupture |
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| FQ |
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| forms free radical toxic metabolites that damage DNA |
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| metronidazole |
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| use of metronidazole |
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| giardia, e histolytica, trichomonas, gardnerella, anaerobes, h Pylori |
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| disulfuram-like reaction |
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| metronidazole |
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| IV penicillin |
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| penicillin G |
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| oral penicillin |
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| penicilin V |
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| penicillin MOA |
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| binds PBP; blocks transpeptidase cross linking; activates autolytic enzymes |
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| use of penicillin |
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| gram positive and syphilis |
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| penicillin toxicity |
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| hpersensitivity, hemolytic anemis |
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| penicillin resistance |
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| beta-lactamases cleave beta-lactam ring |
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| clinical use methicillin, nafcillin, dicloxacin |
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| S aureus except MRSA |
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| toxicity of methcillin, nafcillin, dicloxacillin |
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| hypersensitivity; interstitial nephritis = methicillin |
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| ampicillin vs amoxicillin oral bioavailablitity |
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| amoxicillin has greater oral bioavailability |
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| clinical use of ampicillin/amoxicillin |
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| H flu, E coli, Listeria, Proteus, Salmonella, Shigella |
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| toxicity in ampicillin, amoxicillin |
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| ampicillin rash; psuedomembranous colitis |
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| ticarcillin, carbenicillin, piperacillin cinical use |
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| pseudomonas and gram neg rods |
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| beta-lactamase inhibitors |
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| clavulanic acid, sulbactam, tazobactam |
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| 1st gen cephalo coverage |
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| Proteus, E coli, Klebsiella |
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| 2nd gen cephalo coverage |
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| H flu, Enterobacter, Neisseria, Proetus, E coli, Klebsiella, Serratia |
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| 3rd gen cephalo coverage |
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| serious gram neg |
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| ceftriaxone uses |
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| meningitis, CAP and gonorrhea |
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| ceftazidime use |
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| psudomonas |
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| 1st gen cephalos |
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| cefazolin, cephalexin |
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| 2nd gen cephalos |
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| cefoxitin, cefaclor, cefuroxime |
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| 3rd gen cephalos |
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| cetriaxone, cefotaxime, ceftazidime |
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| 4th gen cephalo coverate |
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| psudomonas, gram+ |
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| 4th gen cephalo |
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| cefepime |
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| cephalosporin toxicities |
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| HSR, vit K deficiency, inc nephrotoxic with AG, disulfiram-liek rxn |
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| aztreonam MOA |
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| monobactam, binds PBP3 |
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| aztreonam clinical use |
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| gram- only; penicillin llergic pts and those with renal insuff |
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| aztreonam toxicity |
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| usually nontoxic, occasional GI upset |
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| imipenem/cilastatin, meropenem MOA |
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| braod spectrum Beta-lactamase R carbapenem |
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| cilastatin fxn |
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| inhibits renal dehydropeptidase I to dec inactivation of drug in renal tubules |
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| imipenem/cilastatin and meropenem use |
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| gram+ cocci, gram- rods, anaerobes; life-threatening infections |
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| imipenem/cilastatin and meropenem toxicity |
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| GI distress, skin rash, CNS toxicity |
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| vancomycin MOA |
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| inhibits cell wall mucopeptide formation by binding D-ala D-ala |
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| vancomycin use |
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| gram+ only; MRSA, enterococci, C diff (oral) |
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| vancomycin toxicity |
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| nephrotocix, ototoxic, thrombophlebitis |
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| prevention of redman |
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| pretreat with antihistamines |
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| vancomycin resistance |
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| change of D-ala D-ala -> D-ala D-lac |
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| TB prophylaxis |
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| INH |
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| TB tx |
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| rifampin, INH, pryazinamide, ethambutol |
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| MAC prophylaxis |
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| azithromycin |
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| MAC tx |
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| azithromycin, rifampin, ethambutol, streptomycin |
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| M leprae tx |
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| dapsone, rifampin, clofazimine |
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| TB drug: menincococcal prophylaxis |
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| rifampin |
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| INH use |
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| TP; solo prophylaxis |
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| TB drug: neurotoxic |
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| INH |
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| TB drug: dec synth of mycolic acids |
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| INH |
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| TB drug: inhibits DNA-dep RNA pol |
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| rifampin |
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| TB drug: delayse R to dapsone when for leprosy |
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| rifampin |
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| TB drug: hepatotoxic |
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| INH, pyrazinamide |
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| TB drug: orange body fluids |
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| rifampin |
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| TB drug: inc P450 |
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| rifampin |
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| TB drug: blocks mycobacterial FA synthase I |
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| pyrazinamide |
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| TB drug: effective in acidic pH of phagolysosomes |
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| pyrazinamide |
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| TB drug: hyperuricemia |
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| pyrazinamide |
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| TB drug: block arabinosyltransferase |
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| ethambutol |
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| TB drug: optic neuropathy |
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| ethambutol |
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| aminoglycoside names |
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| gentamicin, neomycin, amikacin, tobramycin, streptomycin |
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| AG - MOA - use |
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| bactericidal inhibits 30S; misreading of mRNA; requires O2 for uptake - gram neg rod infections; neomycin for bowel surgery |
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| AG - toxicity - resistance |
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| - nephrotoxic, ototoxic and teratogen - inactive drug by acetylation, phsophorylation or adenylation |
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| tetracycline names |
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| tetracycline, doxycyline, demclocycline, minocycline |
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| tetracyclines - MOA - use |
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| - bacteriostatic, bind 30s and prevent attachment of aminoacyl-tRNA - vibrio, acne, chlamydia, ureaplasma, mycoplasma, tularemia, H pylori, B burgdorferi, R ricketsii |
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| tetracyclines - interaction - toxicity - resistance |
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| - NOT with milk, antacids, or iron containing preparations - GI distress, discoloration of teeth and inhibition of bone growth in children, photosensitivity - dec uptake into cells or inc efflux out of cells |
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| macrolide names |
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| erythromycin, azithromycin and clarithromycin |
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| macrolides - MOA - use |
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| - block translocation; binds 23sRNA or 50S; bacteriostatic - atypical pneuonias, URIs and STDs; gram positive cocci, neisseria |
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| macrolides - toxicity 0 resistance |
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| - prolonged QT, GI disconfort, acute cholestatic hepatitis, eosinphilia, skin rashes - methylation of 23sRNA binding site |
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| inhibit 30s |
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| AG and tetracyclines |
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| inhibit 50s |
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| chloramphenicol, clindamycin, erytromycin, linezolid |
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| chloramphenicol - MOA - use |
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| - blocks peptide bond formation at 50S ribosomal subunit - meningitis (H flu, N meningitidis, S pneumo) |
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| chloramphenicol - toxicity - resistance |
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| - anemia, aplastic anemia, gray baby syndrome - plasmid encoded acetyltransferase that inactivates the drug |
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| clindamycin - MOA - use - toxicity |
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| - blocks peptide bond formation at 50S, bacteriostatic - anaerobic infections - pseudomembranous colitis, fever, diarrhea |
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| prophylaxis: - meningococcal - gonorrhea - syphilis - UTIs - endocarditis |
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| - ciprofloxacin, rifampin, minocycline - ceftriaxone - benzathine penicillin G - TM-SMX - penicillins |
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| HIV prophylxis - CD4 < 200 - CD4 < 100 - CD4 < 50 |
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| - TMP-SMX for PCP - TMP-SMX + azithro for PCP and todo - Azithromycin for MAC |
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| MRSA and VRE tx |
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| MRSA = vancomycin VRE = linezolid or synercid |
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| CAP - outpatient - inpatient - ICU setting |
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| - macrolides - FQ - beta-lactam + FQ OR azithromycin |
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| antifungals: - membrane function - cell wall synthesis - nucleic acid synthesis - lanosterol synthesis - ertosterol snthesis |
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| - amphotericin B - caspofungin - 5-FC - naftifine, terbinafine - fluconazole , itraconazole, voriconazole |
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| amphotericin B mechanism |
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| binds ergosterol forms membrane pores allow leakage of electrolytes |
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| Amphotericin B clinical use - supplement? |
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| - serious system mycoses (crypto, blast, coccidio, aspergillus, his to, candida, nucor) - K and Mg because of altered renal tubule permeability |
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| nystatin - mechanism - use |
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| - same as amphoB, topical - swish and swallow for oral candidiasis; topical for diaper rash or vaginal candidiasis |
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| azoles MOA |
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| inhibit ergosterol synthesis by inhibiting P450 enzyme that converse lanosterol to ergosterol |
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| azoles clinical use |
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| - fluconzaole = cryptococcal meningitis in AIDS and candidial infections - ketoconazole = blasto, coccidio, histo, candida; hypercortisolism - clotrimazole and miconazole fro topical fungal infections |
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| azole toxicity |
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| hormone synthesis inhibition, liver dysfunction, fever, chills |
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| flucytosine - MOA - use - toxicity |
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| - inhibits DNA synth by conversion to 5FU - systemic fungal infections (crypto) in combo with ampho B - N/V diarrhea, BM suppression |
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| caspofungin - MOA - use - toxicity |
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| - inhibits cell WALL synth by inhibiting synth of beta-glucan - invasive aspergillosis, candida - GI upset, flushing |
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| terbinafine - MOA - use - toxicity |
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| - inhibits fungal enzyme squalene epoxidase - dermatophytoses, onychomycosis - abnormal LFTs, visual disturbances |
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| griseofulvin - MOA - use - toxiity |
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| - interferes with MT function, disrupts mitosis; deposits in keratin containing tissues - oral tx of superficial infections; inhibit dermatophytes - teratogenic, carcinogenic, confusion, HA, inc P450 and warfarin |
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| antiprotozoan therapy - toxoplasma or palsmodium falciparum - T brucei - T cruzi - leishmania |
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| - pryimethamine - suramin and melarsoprol - nifurtimox - sodium stibogluconate |
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| chloroquine - MOA - use - toxicity |
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| - blocks plasmdium heme polymerase - plasmodium species - retinopathy, G6PD hemolysis |
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| antihelminthic therapy |
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| mebendazole, pyrantel pamoate, ivermectin, diethylcarbamazine, praziquantel |
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| amantadine - MOA - use |
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| - blocks viral penetration/uncoating (M2 protein), release of dopamine - influenza A; parkinsons |
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| amantadine - toxicity - resistance |
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| - ataxia, dizziness, slurred speech - mutated M2 protein |
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| zanamivir, osteltamivir - MOA - use |
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| - inhibit influenza neuraminidase, decreasing release - influenza A and B |
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| ribavirin - MOA - use - toxicity |
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| - inhibits synthesis of guanine nucleotides by inhibiting IMP dehydrogenase - RSV, HCV - hemolytic anemia, teratogenic |
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| acyclovir - MOA - use |
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| - guanosine analog; triphsophate formed by cellular enzymes; inhibit viral DNA polymerase - HSV< VZV, EBV |
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| valacyclovir |
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| prodrug of acylovir with better oral bioavailability |
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| acyclovir - toxicity - resistance |
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| - few - lack of viral thymidine kinase |
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| famciclovir |
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| for herpes zoster |
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| ganciclovir - MOA - clinical use |
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| - 5'-monophsophate formed by CMV viral kinase; guanosine analog; inhibits viral DNA polymerase - CMV (esp in IS pt) |
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| valganciclovir |
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| prodrug of ganciclovir for better oral bioavailability |
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| ganciclovir - toxicity - resistance |
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| - leukopenia, enutropenia, thrombocytopenia, renal toxicity - mutated CMV DNA polymerase or lack of viral kinase |
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| foscarnet - MOA - use |
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| - DNA polymerase inhibits that binds to pyrophosphate binding size of the enzyme - DMV retinitis when ganciclovir fails |
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| foscarnet - toxicity - resistance |
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| - nephrotoxic - mutated DNA polymerase |
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| cidofovir - MOA - use - toxicity |
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| - inhibits viral DNA polymerase; NOT phosphorylation by viral kinase - acyclovir resistant HSV, CMV retinitis - nephrotoxic (administer with probenecid) |
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| interferons - MOA - use - toxicity |
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| - glycoproteins synthesized by virus infected cells block replication of both RNA and DNA viruses - IFN-alpha= HBV< HCV, kaposi; IFN-beta = MS; IFN-gamma= CGD - neutropenia |
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| abx to avoid in pregnancy |
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| clarithro, sulfonamides, AG, FQ, metronidazole, tetracyclines, ribavirin, griseofulvin, chloramphenicol |
