nusiel2's version from 2015-06-26 03:03


Question Answer
fluorquinolonescartilage damage
tetracyclinediscolored teeth, inhibits bone growth
chloramphenicolegray baby :(


Question Answer
ethambutol mech SEinhibits carb polymerization in mycobacterium cell wall by inhibiting arabinosyltransferase; red-green color blindness
isoniazid mechdecreases mycolic acid; metabolized to active via bacterial catalase peroxidase (Katg);
isoniazid SEhepatotox, lupus, neurotox; neuro and lupus prevented by b6
rifampin mech SE4 r's - inhibis DNA-depend RNA polymerase; red/orange fluids, revs up p450, rapid tolerance used alone
rifampin ppx formeningococcal, TB, H. flu
pyrazinamide mechinhibits mycolic acid synthesis - inhibts mycolic fatty acid synthase I; active in acid phagolysosome
pyrazinamide SEhepatotox, hyperuricemia
AIDS Ppx200 - TMP-SMX; 100 - TMP-SMX; 50 - azithromycin
empiric flu treatment - outpatient, in patient, ICUout-macrolide; in-fluoroquinolone; ICU: either + b-lactam
amphotericin B mech and SEbinds ergosterol, makes membrane pores - electrolyte leakage; fungi; intrathecal for meningitis (doesn't cross BBB), hypokalemia nd hypomagnesia - supplement
ampho B SEIV phlebitis, anemia, hypotension, arrhythmia, nephrotox, fevers/chills; hydration dec nephrotox; causes hypo- Mg and hypo-K so need to supplement!
nystatin mech, usesame mech as ampho B; oral candida, vaginosis, diaper rash- TOPICAL
azoles mech and SEinhibits p450 that metabolizes lanasterol to ergosterol; inhibits liver p450, steroid synthesis - gynecomastia; fever and chills
ketoconazole usesystemic fungi
miconazole; cloprimazole usetopical fungi
fluconazole useAIDS cryptococus; and all candida
flucytosine use and mechmetab via cytosine deaminase to 5-FU; SE BM suppression; used with amphoB for systemic fungi
caspofungininhibit synthesis of b-glucan and stops cell wall synthesis; flushing(histamine release), GI upset; invasive aspergillosis, candida
terbinafine mech and SEinhibit squalene epoxidase; dermatophytes-esp.onchomycoses(toe or nail); inc LFTs, visual disturbances
griseofulvin use; mechinterferes with microtubules, disrupts mitosis; deposits in keratin containing tissues; oral for superficial infection - ringworm, tinea
griseofulvin SEteratogenic, carcinogenic, confusion, HA, increases both p450 and warfarin metab.
pyramethamine usetoxoplasmosis
sodium stibogluconate useleishmaniasis
suramin & melarsprol uset. brucei
nifurtimox uset. cruzi
chloroquine mechblocks detoxification of heme to hemozoin so it accumulate and is toxic to plasmodia;not for p. falciparum(membrane pump decreases drug concentraton) use artemether/lumifantrine or atovaquone/proguanil.
quiniine or artisunate-life threatening malaria
chloroquine SEretinopathy
helminth tximmobilize helminth - ivermectin, diethylcarbamazine, praziquantel(flukes/trematodes), mebendazole, pyrantel palmoate


Question Answer
amantadineblocks viral uncoating/viral penetration (M2 PROTEIN); influenza a; also increases dopa release; influenza a PPX, parkinson's
amantadine SEataxia, slurred speed, DZ; rimantadine - fewer CNS SE
amantadine resistancemutated M2 protein; 90% influenza A resistant, so not used
oseltamivr, zanamavirinfluenza A and B, blocks neuraminidase - release of progeny
ribavirin use; mechanismRSV, HEP C; blocks Guanine synthesis by blocking IMP dehydrogenase
ribavirin SEvery teratogenic and hemolytic anemia
acyclovirguanosine analog; monophos- by viral thymidine kinase; rest by cell enzymes; inhibits DNA polymerase HSV/VSV/EBV, HSV - mucocutaneous and oral lesions, encephalitis; few SE; ppx in immunocomp; no effect against latent viruses
acyclovir resistno viral thymidine kinase
valacyclovirprodrug; better oral availability
ganciclovirCMV kinase monosphosphorylates, cell enzymes triphosphorylate, inhibits DNA polymerase ; use as ppx esp in immunocomp; SE leukopenia, neutropenia, thrombocytopenia, renal tox; more toxic to host enzymes than acyclovir;
valganciclovirprodrug; better oral availability,
ganciclovir resistanceCMV DNA polymerase or no viral kinase
foscarnetpyrophoshate analog blocks viral DNA polymerase ; nephrotox; use for CMV retinitis or HSV resistant to other meds
cidofovirinhibits viral DNA polym; use for CMV retinitis in immunocomp or HSV-resistant; long half life; nephrotox(coadminister w/ probenecid and IV saline to reduce toxicity)
-navir'sprotease inhibitors; lipodystrophy; hyperglycemia; GI intolerance; nephropathy, hematuria (indinavir). inhibit p450(ritonavir)
neVIRapine efaVIRenz, delaVIRdineNNRTIs; bind reverse transcriptase at different site, no phos for activation; same SE as NRTIs
tenofovirNRTI, nucleotide analog. does not have to be activated, rest are nucleosides need phosphorylation to be active
NRTIsmust be phosphorylated by thymidine kinase; no 3'-OH group, so bind to reverse transcriptase and terminate DNA prolong.; SE periph neuropathy; BM suppression (reverse with epo or GM-CSF)
zidovudineuse as ppx and pregnancy; megaloblastic anemia
NNRTisrash, periph neuropathy, BM suppression - reverse with erythropoietin or GM-CSF
raltegravirintegrase inhibitor; reversible inibitor!; hypercholesterolemia
interferonsGlycoproteins ysnthesized by virus infected cells, block DNA&RNA viruses; neutropenia, myopathy
IFN alphachronic hep B, kaposi sarcoma
IFN betaMS
IFN gammaNADPH oxidase deficiency


Question Answer
penicillinG and V, binds PBP, blocks transpeptidase, enables autolytic enzymes; bacteriocidal to g+rods, g+cocci, g-coccis, spirochetes; SE - hypersens., hemolytic anemia
penicillin resistanceB-lactamase cleaves lactam ring
penicilinase-resistantdiclox-, naf-, oxa-, meth- ; due to bulky R group SE hypersens., interstitial nephritis; just staph!
methicillininterstitial nephritis
ampicillin, amoxacillinwider spectrum, same mech, amox- better oral availability, SE- pseudomembranous colitis, hypersensetivity
ampicillin SErash
ampi/amox- useHELPSS enterococci; h. flu, e.coli, listeria, proteus, salmonella, shigella, enterococci
antipseudomonalsticaricillin, pipericillin, carbenicillin; pseudomans and g-rods, use with clavulanic acid; SE-hypersens.
b-lactamase inhibitorssulbactam, tazobactam, clavulanic acid


Question Answer
mechanisminhibts cell wall synth.; more resistant to b-lactam
1st gencephalexin, cephalozolin(use prior to surgery staph aureus) gram + cocci , PEcK
2nd genfac fox fur ;gram + cocci HEN PeCKS
HEN PeCKSh. influenzae, enterobacter, neisseria, proteus, ecoli, klebsiella, serratia marcescen,
3rd genserious g-; neisseria (ceftriaxone) and pseudomonas (ceftasidime)
4th gencefipimine; g+ and pseudomonas
SEhypersens, vit K def, increase aminoglycoside nephrotox, disulfiram like with ethanol, cross-reactivity with PCN in 5-10%


Question Answer
aztreonamb-lactamase R; monobactam inhibits cell wall synth. binds PBP3; no cross reactivity with PCN; g- RODS ONLY, for renal insufficiency (no aminoglyc) or PCN allergic; SE - sometimes GI upset
imepenam/cilastatin, meropenembroad spectrum, b-lactamase R; g+ rods, g- cocci, anaerobes; only life-threatening infections; SE - SZ, severe GI distress, rash
cilastaininhibits dihydropeptidase I in renal tubules, breaks down imepenem
meropenemresistant to dihydropeptidase I, less SZ
vancomycin mech/usebinds d-al-dala preventing mucopeptide cell wall precursor formation; g+ only, serious infections
vancomycin SESE - nephrotox, ototox, thrombophlebitis, red-man syndrome
vancomycin resistanced-ala d-ala --> d-ala d-lac

protein synthesis inhibitors

Question Answer
Aminoglycosides"GNATS" gentomycin, neomycin, amikacin, tobramycin, streptomycin; binds 30s and stop mRNA synthesis; need O2 for uptake; g+ rods (aerobes); SE: nephro (with cephalo), ototox (with loop diuretics), teratogenic
aminoglycoside resistanceadenylation, phosphorylation, acetylation
neomycincolon surgery
tetracylinesdoxycycline, tetracycline, demeclocycline, minocycline ; binds 30s inhibiting aminoacyl-tRNA attachment; don't take with iron supplement, lactose prod, antacids; use- borrelia, chlamydia, rickettsia, m. pnumonia because it stores intracell; SE- teeth discoloration, stops bone growth iin children, GI, photosens
tetracycline resistancedecrease influx or increased efflux via plasmid
macrolidesclarithromycin, azithromycin, erythromycin; bacteriostatic; binds 50s ihibiting translocation; SE- GI distress, prolonged QT, eosinophilia, acute cholestatic hep, skin rash, increased blood conc. of oral anticoag and theophyllines
marcolide useatypical pneumonia! ; STD, URI, G+ cocci, neisseria
macro resistance23rRNA methylation
chloramphenicolbacteriostatic; prevents peptide form. at 50s; meningitis - h.flu, neisseria, strep pneumo; anemia (dose dep), aplastic anemia (dose indep.), gray baby syndrome
chlormphenicol resistance plasmid - acetylation
gray baby syndromechloramphenicol due to low liver UDP glucoronyl transferase
clindamycinbacteriostatic; blocks peptide fromation in 50s subunit; anaerobic for lung aspiration or lung abscess; c.diff, diarrhea, fever
anaerobic above vs below diaphragmabove = clindamycin, below = metronidazole
sulfonamidesPABA antimetabolite inhibits dihydropteorate synthetase; bacetriostatic; g+, g-, nocardia, chlamydia; SE - G6PD, hypersens, nephrotox (tubulointerstitial nephritis), kernicterus in baby, photosens,, displaces drugs from albumin-warfarin
sulfa resistanceincreased PABA, enzyme mut, dec uptake
trimethroprimblocks dihydrofolate reductase; used with sulfas; UTIs, shigella, salmonella, PCP; megaloblastic anemia, granulcytopenia-, leukopenia;
stop TMP SEsupplement folate/folinic acid
nalidixic acidfluoroquinolone, a quinolone
fluoroquinolonebactericidal; floxacins, enoxacin, nalidixic acid; blocks DNA Gyrase/toposiomerase II; g- rods urinary and GI, neisseria, some g +; SE - HA, DZ, rash, superinfection!, GI, bone problems (more)
fluoroquinolone and bonescontra in pregnancy, children due to cartilage damage; tendonitis/rupture in adults; leg cramps/myalgia in children
fluoroquinolone restanceDNA gyrase mut
metronidazolebactericidal; forms free radicals in bacteria-kills DNA; GI, metallic taste, disulfiram-like; GET GAP- giardia, entamoeba, trichimonas, gardenerella, anaerobes, h.pylori,