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  1. ´╗┐What is the Moa kind of sulfonamides/pyrimidines?
  2. What kind of effect does sulfonamides/pyrimidines have?
  3. Which enzyme does sulfonamides compete against PABA for?
    Dihydroperoate synthase
  4. Which enzyme does pyrimidines (Trimethoprim) work on?
    Dihydrofolate reductase
  5. What does sulfonamides compete with for dihydropteroate synthase?
  6. What are the 3 major groups of sulfonamides?
    • Oral absorbable (Bactrim DS)
    • Oral nonabsorbable (sulfasalazine)
    • Topical (Silvadene cream)
  7. What are the clinical uses of sulfonamides?
    • use early on
    • use in combination with topical agents
  8. What are the adverse effects of sulfonamides?
    • fever, rash, photosensitivity, urticaria, GI upset
    • Steven-Johnson Syndrome
    • UTI problems (drink lots of fluids with)
    • Hematopoietic Problems (glucose-6-phosphate dehydrogenase deficiency)
    • which helps with production of RBC's
    • Kernicterus in newborns if given during pregnancy (elevated bilirubin that causes neuro effects)
  9. What is Stevens-Johnson Syndrome?
    systemic reaction to a med in which the mucous membranes slough off
  10. What is Trimethoprim & Trimethoprim-Sulfamethoxazole (TMP-SMZ) Moa?
    synergistic combo of folate antagonists that blocks purine production & nucleic acid synthesis
  11. What is the pk of TMP-SMZ?
    • given as 1:5 ratio
    • reduce in renal failure
    • Pregnancy Category C if given late in pregnancy
    • Concentrates in prostatic/vaginal fluids
    • excreted in breast milk
    • Contraindicated in infants <2 months
  12. What are uses of oral TMP-SMZ?
    • MRSA
    • resistant pneumococci & E. coli
  13. What are the uses for IV TMP-SMZ?
    • pneumocystitis PNA (agent of choice)
    • bacterial sepsis
  14. What other things does TMP-SMZ treat?
    • UTI's
    • toxoplasmosis
  15. What are the adverse effects of TMP-SMZ?
    • rash, urticaria, photosensitivity, GI upset,
    • bone marrow suppression
    • hyperkalemia
    • partial cross allergy w/ diuretics, diazoxide, sulfonylurea hypoglycemic agents
    • AIDS Pt's have worse reactions
  16. What is the adverse effects of Trimethoprim alone?
    • Megaloblastic anemia
    • leukopenia
    • granylocytopenia
  17. What is the Moa of Flouroquinolones?
    Inhibition of DNA gyrase (Toposomerase II/IV) so bacteria can't reproduce
  18. What is chemistry of flouroquinolones?
    synthetic fluorinated analogs of nalidixic acid
  19. What is the pk of flouroquinolones?
    • blocks bacterial DNA synthesis
    • dosage adjustment if CC<50 ml/min (except Moxifoaxacin)
    • Crosses the placenta
    • Pregnancy Category C
    • Divalent & trivalent cation products can impair oral absorption
  20. What is flouroquinolones used for?
    • UTI
    • bacterial diarrhea (salmonella, E. coli)
    • bones, joints, soft-tissues, intra-abdominal
    • atypical PNA
  21. Which antibiotic is not longer recommended to treat gonococcal infections?
  22. Which flouroquinolone is the DOC for tx/prophylaxis of anthrax?
  23. What is Levofloxacin known as?
    respiratory fluroquinolone (pneumococcus)
  24. What are adverse effects of flouroquinolones?
    • GI
    • QT interval prolongation
    • Not for Pt <18 yrs
    • tendon rupture
    • risk for Sz
  25. Which antibiotic has a Black Box warning for myasthena gravis, tendonitis, & tendon rupture?
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