The Pharm of Old McDonald 1

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  1. penicillin G and pencillin V
    • pencillinase-sensitive penicillin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal (mostly on g+)
    • Strep pneumo, strep pyog, actinomyces
    • Neis meningitidis (g-), Trep pallidum
    • G is IV and IM; V is oral
    • beta lactam ring
    • cleaved by beta lactamase
    • Hypersensitivity, direct Coombs hemolytic anemia
  2. ampicllin
    • penicillinase-sensitive extended spectrum penicillin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal (extended to more g-)
    • Strep pneumo, strep pyog, actinomyces, List monocytogenes
    • Neis meningitidis, H pylori, E coli, Proteus mirabilis, Salmonella, Shigella (g-), Trep pallidum
    • beta lactam ring
    • cleaved by beta lactamase unless claculanic acid
    • Hypersensitivity, pseudomembranous colitis
    • amp HHELPSS kill enterococci
  3. amoxicillin
    • penicillinase-sensitive extended spectrum penicillin
    • greater oral bioavalability than ampicillin, otherwise same
    • inhibit peptidoglycan xlinking cell wall. Bactericidal (extended to more g-)
    • Strep pneumo, strep pyog, actinomyces, List monocytogenes
    • Neis meningitidis, H pylori, E coli, Proteus mirabilis, Salmonella, Shigella (g-), Trep pallidum
    • beta lactam ring
    • cleaved by beta lactamase unless claculanic acid
    • Hypersensitivity, pseudomembranous colitis
    • amo HHELPSS kill enterococci
  4. dicloxacillin
    • penicillinase-resistant penicillin narrow spectrum
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • Methycillin sensitive staph aureus (not MRSA!)
    • beta lactam ring with bulky R group
    • NOT cleaved by beta lactamase
    • Hypersensitivity, interstitial nephritis
    • NO Degradation (d for dicloxacillin)
  5. nafcillin
    • penicillinase-resistant penicillin narrow spectrum
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • Methycillin sensitive staph aureus (not MRSA!)
    • beta lactam ring with bulky R group
    • NOT cleaved by beta lactamase
    • Hypersensitivity, interstitial nephritis
    • NO Degradation (n for naf)
  6. oxacillin
    • penicillinase-resistant penicillin narrow spectrum
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • Methycillin sensitive staph aureus (not MRSA!)
    • beta lactam ring with bulky R group
    • NOT cleaved by beta lactamase
    • Hypersensitivity, interstitial nephritis
    • NO Degradation (o for oxacillin)
  7. piperacillin
    • antipseudomonal penicillinase-sensitive extended spectrum penicillin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal (extended to pseudomonas and g-)
    • Strep pneumo, strep pyog, actinomyces, List monocytogenes
    • Neis meningitidis, H pylori, E coli, Proteus mirabilis, Salmonella, Shigella, Pseudomonas (g-), Trep pallidum
    • beta lactam ring
    • use with claculanic acid to prevent beta lactamase
    • Hypersensitivity
  8. ticarcillin
    • antipseudomonal penicillinase-sensitive extended spectrum penicillin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal (extended to pseudomonas and g-)
    • Strep pneumo, strep pyog, actinomyces, List monocytogenes
    • Neis meningitidis, H pylori, E coli, Proteus mirabilis, Salmonella, Shigella, Pseudomonas (g-), Trep pallidum
    • beta lactam ring
    • use with claculanic acid or sulbactam or tazobactam to prevent beta lactamase
    • Hypersensitivity
  9. calvulanic acid
    • beta lactamase inhibitor
    • add to penicillins
    • CAST for penicillins (Calvulanic Acid, Sulbactam, Tazobactam)
  10. sulbactam
    • beta lactamase inhibitor
    • add to penicillins
    • CAST for penicillins (Calvulanic Acid, Sulbactam, Tazobactam)
  11. tazobactam
    • beta lactamase inhibitor
    • add to penicillins
    • CAST for penicillins (Calvulanic Acid, Sulbactam, Tazobactam)
  12. cefazolin
    • 1st gen cephalosporin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • staph, strep, Proteus mirabilis, E coli, Klebsiella pneumoniae
    • prior to surgery to prevent staph
    • beta lactam but less susceptible to beta lactamase
    • resistance by penicillin binding protein change aka transpeptidase change
    • hypersensitivity (penicillin allergy is a no go), direct Coombs hemolytic anemia, disulfram-esque (alcohol), Vit K deficiency, increase nephrotox of aminoglycosides
    • Don't phal for/be fazed by the 1st gen. They ain't worth a PEcK (proteus, e coli, klebsi)
    • Faze 1 of surgery
    • Organisms not covered by gens 1-4 are LAME (listeria, atypicals (mycoplas and chlam), MRSA, Enterococci (group D "strep" E faecium, E faecalis)
  13. cephalexin
    • 1st gen cephalosporin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • staph, strep, Proteus mirabilis, E coli, Klebsiella pneumoniae
    • beta lactam but less susceptible to beta lactamase
    • resistance by penicillin binding protein change aka transpeptidase change
    • hypersensitivity (penicillin allergy is a no go), direct Coombs hemolytic anemia, disulfram-esque (alcohol), Vit K deficiency, increase nephrotox of aminoglycosides
    • Don't phal for/be fazed by the 1st gen. They ain't worth a PEcK (proteus, e coli, klebsi)
    • Organisms not covered by gens 1-4 are LAME (listeria, atypicals (mycoplas and chlam), MRSA, Enterococci (group D "strep" E faecium, E faecalis)
  14. cefaclor
    • 2nd gen cephalosporin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • staph, strep, Proteus mirabilis, E coli, Klebsiella pneumoniae, H flu, Enterobacter aerogenes, Neisseria, Serratia marcescens
    • beta lactam but less susceptible to beta lactamase
    • resistance by penicillin binding protein change aka transpeptidase change
    • hypersensitivity (penicillin allergy is a no go), direct Coombs hemolytic anemia, disulfram-esque (alcohol), Vit K deficiency, increase nephrotox of aminoglycosides
    • HENS PEcK at fake fox fur (HENS = H flu, Enterobacter aerogenes, Neisseria, Serratia marcescens) (fake = cefaclor) (hen = 2nd gen)
    • Organisms not covered by gens 1-4 are LAME (listeria, atypicals (mycoplas and chlam), MRSA, Enterococci (group D "strep" E faecium, E faecalis)
  15. cefoxitin
    • 2nd gen cephalosporin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • staph, strep, Proteus mirabilis, E coli, Klebsiella pneumoniae, H flu, Enterobacter aerogenes, Neisseria, Serratia marcescens
    • beta lactam but less susceptible to beta lactamase
    • resistance by penicillin binding protein change aka transpeptidase change
    • hypersensitivity (penicillin allergy is a no go), direct Coombs hemolytic anemia, disulfram-esque (alcohol), Vit K deficiency, increase nephrotox of aminoglycosides
    • HENS PEcK at fake fox fur (HENS = H flu, Enterobacter aerogenes, Neisseria, Serratia marcescens) (fox = cefoxitin) (hen = 2nd gen)
    • Organisms not covered by gens 1-4 are LAME (listeria, atypicals (mycoplas and chlam), MRSA, Enterococci (group D "strep" E faecium, E faecalis)
  16. cefuroximine
    • 2nd gen cephalosporin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • staph, strep, Proteus mirabilis, E coli, Klebsiella pneumoniae, H flu, Enterobacter aerogenes, Neisseria, Serratia marcescens
    • beta lactam but less susceptible to beta lactamase
    • resistance by penicillin binding protein change aka transpeptidase change
    • hypersensitivity (penicillin allergy is a no go), direct Coombs hemolytic anemia, disulfram-esque (alcohol), Vit K deficiency, increase nephrotox of aminoglycosides
    • HENS PEcK at fake fox fur (HENS = H flu, Enterobacter aerogenes, Neisseria, Serratia marcescens) (fur = cefuroxime) (hen = 2nd gen)
    • Organisms not covered by gens 1-4 are LAME (listeria, atypicals (mycoplas and chlam), MRSA, Enterococci (group D "strep" E faecium, E faecalis)
  17. ceftriaxone
    • 3rd gen cephalosporin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • serious Neisseria (meningitis, gonorrhea) disseminiated Lyme
    • beta lactam but less susceptible to beta lactamase
    • resistance by penicillin binding protein change aka transpeptidase change
    • hypersensitivity (penicillin allergy is a no go), direct Coombs hemolytic anemia, disulfram-esque (alcohol), Vit K deficiency, increase nephrotox of aminoglycosides
    • T.X., T.Z. are 3 (3rd gen) (ceftriaxone)
    • Organisms not covered by gens 1-4 are LAME (listeria, atypicals (mycoplas and chlam), MRSA, Enterococci (group D "strep" E faecium, E faecalis)
  18. cefotaxime
    • 3rd gen cephalosporin (same as ceftriaxone)
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • serious Neisseria (meningitis, gonorrhea) disseminiated Lyme
    • beta lactam but less susceptible to beta lactamase
    • resistance by penicillin binding protein change aka transpeptidase change
    • hypersensitivity (penicillin allergy is a no go), direct Coombs hemolytic anemia, disulfram-esque (alcohol), Vit K deficiency, increase nephrotox of aminoglycosides
    • T.X., T.Z. are 3 (3rd gen) (cefotaxime)
    • Organisms not covered by gens 1-4 are LAME (listeria, atypicals (mycoplas and chlam), MRSA, Enterococci (group D "strep" E faecium, E faecalis)
  19. ceftazidime
    • 3rd gen cephalosporin (same as ceftriaxone)
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • pseudomonas but not as good as cefepime
    • beta lactam but less susceptible to beta lactamase
    • resistance by penicillin binding protein change aka transpeptidase change
    • hypersensitivity (penicillin allergy is a no go), direct Coombs hemolytic anemia, disulfram-esque (alcohol), Vit K deficiency, increase nephrotox of aminoglycosides
    • T.X., T.Z. are 3 (3rd gen) (ceftazidime)
    • Organisms not covered by gens 1-4 are LAME (listeria, atypicals (mycoplas and chlam), MRSA, Enterococci (group D "strep" E faecium, E faecalis)
  20. cefepime
    • 4th gen cephalosporin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • staph, strep, Proteus mirabilis, E coli, Klebsiella pneumoniae, best for pseudomonas
    • beta lactam but less susceptible to beta lactamase
    • resistance by penicillin binding protein change aka transpeptidase change
    • hypersensitivity (penicillin allergy is a no go), direct Coombs hemolytic anemia, disulfram-esque (alcohol), Vit K deficiency, increase nephrotox of aminoglycosides
    • Fep fell pseudomonas
    • Organisms not covered by gens 1-4 are LAME (listeria, atypicals (mycoplas and chlam), MRSA, Enterococci (group D "strep" E faecium, E faecalis)
  21. ceftaroline
    • 5th gen cephalosporin
    • inhibit peptidoglycan xlinking cell wall. Bactericidal
    • staph, strep, Proteus mirabilis, E coli, Klebsiella pneumoniae, H flu, Enterobacter aerogenes, Neisseria, Serratia marcescens MRSA but not pseudomonas
    • beta lactam but less susceptible to beta lactamase
    • resistance by penicillin binding protein change aka transpeptidase change
    • hypersensitivity (penicillin allergy is a no go), direct Coombs hemolytic anemia, disulfram-esque (alcohol), Vit K deficiency, increase nephrotox of aminoglycosides
    • Organisms not covered by gens 1-4 are LAME (listeria, atypicals (mycoplas and chlam), MRSA, Enterococci (group D "strep" E faecium, E faecalis)
  22. imipenem
    • carbapenem
    • inhibit peptidoglycan xlinking cell wall. Bactericidal broad sepctrum g+, g-, anaerobes
    • beta lactam resistant
    • bad adverse effects GI, skin rash, CNS tox (seizures), so only used when others fail or life threatening infection
    • dehydropeptidase I in renal tubule inactivates drug
    • cilastatin inhibits dehydropeptidase I to make the drug lastin
  23. meropenem
    • carbapenem
    • inhibit peptidoglycan xlinking cell wall. Bactericidal broad sepctrum g+, g-, anaerobes
    • beta lactam resistant
    • bad adverse effects GI, skin rash, but decreased risk of CNS tox (seizures), only used when others fail or life threatening infection
    • not degraded by dehydropeptidase I in renal tubule
    • cilastatin not needed
  24. ertapenem
    • carbapenem
    • inhibit peptidoglycan xlinking cell wall. Bactericidal broad sepctrum g+, g-, anaerobes
    • beta lactam resistant
    • bad adverse effects GI, skin rash, CNS tox (seizures), so only used when others fail or life threatening infection
    • dehydropeptidase I in renal tubule inactivates drug
    • cilastatin inhibits dehydropeptidase I to make the drug lastin
  25. doripenem
    • carbapenem
    • inhibit peptidoglycan xlinking cell wall. Bactericidal broad sepctrum g+, g-, anaerobes
    • beta lactam resistant
    • bad adverse effects GI, skin rash, CNS tox (seizures), so only used when others fail or life threatening infection
    • dehydropeptidase I in renal tubule inactivates drug
    • cilastatin inhibits dehydropeptidase I to make the drug lastin
  26. aztreonam
    • monobactam
    • inhibit peptidoglycan xlinking cell wall by binding penicillin binding protein 3. Bactericidal gram negative rods that are aerobes only (H flu, enterobacter, pseudomonas)
    • synergistic with aminoglycosides
    • Usually non toxic (no penicillin cross reactivity)
  27. vancomycin
    • binds D-ala D-ala to inhibit cell wall peptidoglycan formation. Bactericidal most tough g+ and bacteriostatic C diff (oral)
    • Resistance if D-ala D-lac
    • nephrotox, ototox, thrombophlebitis, red man syndrome (prevented with pretreat antihistamine and slow infusion)
    • the fine print for the vanc account was NOT read (nephro/ototox, thrombophelbitis, red man) and now I lack a dolla lac and "D-ala"
  28. bacitracin
    • inhibits cell wall peptidoglycan formation
    • topical
    • for beta hemolysis strep agalactiae is resistant; strep pyogenes is sensitive
    • B-BRAS (bacitracin group B Resistant [agalctiae], group A Sensitive [pyogenes])
  29. optochin
    • for alpha hemolysis viridans strep (S mutans, mitis) is resistant; strep pneumoniae is sensitive
    • OVeRPaSs (Optochin Viridans Resistant; Pneumonia Sensitive
  30. novobiocin
    • for coagulase negative staph staph saprophyticus is resistant; staph epidermidis is sensitive
    • NO StRESs on the staph retreat (NOvobiocin Saprophyticus Resistant; Epidermidis Sensitive
  31. aminoglycoside
    • binds 30S subunit preventing initiation complex formation, misread mRNA, block xlocation. Bactericidal g- aerobes (O2 dependent uptake)
    • synergy with beta lactam antibioitics
    • bacteria acetylate, phosphorylate, adenylate drug (transferases) to inactivate
    • buy AT 30 CeL 'eM for 50 (Aminoglycosides, Tetracyclines inhibit 30S subunit; Clindamycin/Chloramphenicol, Linezolid, Macrolides inhibit 50S subunit.
    • A mean gent strept ami and neomi to bras. That's deafinitely bad for babies' and kids' idea of strong men (ototox, teratogen, nephrotox, neuromuscular block)
  32. gentamicin (class/special?)
    • aminoglycoside
    • A mean gent strept ami and neomi to bras (a mean oglycoside, gentamicin, streptomycin, amikacin, neomycin, tobramycin)
  33. streptomycin (class/special?)
    • aminoglycoside
    • 2nd line mycobacterium tuberculosis
    • tinnitus, vertigo, ataxia, nephrotoxicity
    • A mean gent strept ami and neomi to bras (a mean oglycoside, gentamicin, streptomycin, amikacin, neomycin, tobramycin)
  34. amikacin (class/special?)
    • aminoglycoside
    • A mean gent strept ami and neomi to bras (a mean oglycoside, gentamicin, streptomycin, amikacin, neomycin, tobramycin)
  35. neomycin (class/special?)
    • aminoglycoside
    • A mean gent strept ami and neomi to bras (a mean oglycoside, gentamicin, streptomycin, amikacin, neomycin, tobramycin)
  36. tobramycin (class/special?)
    • aminoglycoside
    • A mean gent strept ami and neomi to bras (a mean oglycoside, gentamicin, streptomycin, amikacin, neomycin, tobramycin)
  37. tetracyclines
    • tetracycline, doxycycline, minocycline
    • bind A site on 30S prevent new tRNA attach. Bacteriostatic borrelia burgdorferi, mycoplasma pneumoniae, rickettsia, chlamydia (good intracellular concentration), acne
    • low CNS penetration. divalent cations prevent gut absorption (milk [Ca], antacids [Ca, Mg], iron)
    • plasmid-encoded pump it out of bacteria
    • GI, yellow teeth/inhibit bone growth in kids (teratogen), photosensitivity (think Peru)
    • Had an upset stomach b/c yellow teeth and looked short in the photo (GI, yellow teeth, inhibit bone growth, photosensitivity
    • buy AT 30 CeL 'eM for 50 (Aminoglycosides, Tetracyclines inhibit 30S subunit; Clindamycin/Chloramphenicol, Linezolid, Macrolides inhibit 50S subunit.
  38. minocycline (class/special?)
    tetracycline
  39. doxycycline (class/special?)
    • fecal-elimination tetracycline, safe in renal failure
    • doodoo cycle
  40. chloramphenicol
    • blocks peptidyl transferase at 50S subunit. Bacteriostatic meningitis (H flu, N mening, S pneumo), rickettsia rickettsii (rocky mtn spotted fever)
    • anemia, anaplastic anemia, gray baby (premies lack UDP-glucuronyl transferase). rarely used in US (tox)
    • takes the cholor out of you (anemia, gray baby)
    • buy AT 30 CeL 'eM for 50 (Aminoglycosides, Tetracyclines inhibit 30S subunit; Clindamycin/Chloramphenicol, Linezolid, Macrolides inhibit 50S subunit.
  41. clindamycin
    • block translocation at 50S. Bacteriostatic anerobic above diaphragm (metro below)(aspiration pneumonia [bacteroides, clostridium perfinges], lung abscess, oral infection, invasive strep pyog, gardnerella vag (so it can be used below too)
    • buy AT 30 CeL 'eM for 50 (Aminoglycosides, Tetracyclines inhibit 30S subunit; Clindamycin/Chloramphenicol, Linezolid, Macrolides inhibit 50S subunit.
    • pseudomembranous colitis, fever, diarrhea
    • Good above diaphragm bad below (C diff)
  42. linezolid
    • oxazolidinone
    • bind to 50S preventing binding to 30S. Bacteriostatic/cidal g+ (including MRSA and VRE)
    • 50S ribosomal RNA point mutation resistance
    • bone marrow suppression, peripheral neuropathy, serotonin syndrome
    • Not lyin' when I say marrowage makes my toes tingle and my heart pound (marrow suppression, peripheral neuropathy, serotonin syndrome)
  43. macrolides
    • bind to 23S rRNA of 50S blocking translocation. Bacteriostatic atpyical pneumonia (mycoplasma, chlamydia, legionella), bordatella pertusis, strep (when penicillin allergy), STIs (chlamydia)
    • methylation of 23S rRNA resistance
    • GI motility, long QT, cholestatic hepatitis, rash, eosinophilia
    • MACRO side effects (Motility, Arrhythmia, Cholestatic hepatitis, Rash, eOsinophilia)
    • macaroni is clear az air without cheese (clarithromycin, azithromycin, erythromycin)
  44. clarithromycin (class/special?)
    • macrolide
    • macaroni is clear az air without cheese (clarithromycin, azithromycin, erythromycin)
    • inhibit P-450
    • embryotoxic
  45. azithromycin (class/special?)
    • macrolide
    • macaroni is clear az air without cheese (clarithromycin, azithromycin, erythromycin)
    • does NOT inhibit P-450 (erythromycin, clarithromycin are)
  46. erythromycin (class/special?)
    • macrolide
    • macaroni is clear az air without cheese (clarithromycin, azithromycin, erythromycin)
    • inhibit P-450
  47. sulfonamides
    • sulfamethoxazole (SMX), sulfisoxazole (NOT -azoles!), sulfadiazine
    • inhibit dihydropeteroate (PABA+pteridine->dihydropteroic acid), part of folate synthesis, reducing THF (purines, thymidine for DNA, and methionine for protein). Bacteriostatic g+, g-, nocardia, chlamydia. Bacteriocidal with trimethoprim
    • resistance by altered dihydropteroate synthase, reduced uptake, increased PABA synthesis
    • hypersensitivity, G6PD def hemolysis, nephrotox (tubulointerstitial nephritis), photosens, kernicterus in infants, displace warfarin/others from albumin
    • SulTry is folly (sulfa inhibit 1st step in folate pathway)
    • I sulled (sold) kids photos of baby corn to buy favabean war rashions (sulfonamides, nephrotox, infant kernicterus, G6PD hemolysis, albumin, hypersensitivity)
  48. sulfamethoxazole (class/special?)
    • sulfonamide
    • aka SMX
    • UTI
  49. sulfisoxazole (class/special?)
    sulfonamide
  50. sulfidiazine (class/special?)
    sulfonamide
  51. dapsone
    • same as sulfonamide antibiotics, different structure
    • inhibit dihydropeteroate (PABA+pteridine->dihydropteroic acid), part of folate synthesis, reducing THF (purines, thymidine for DNA, and methionine for protein). Leprosy (lepromatous and tuberculoid), pneumocystis jirovecii prophylaxis
    • hemolysis if G6PD deficient
  52. trimethroprim
    • aka TMP
    • inhibits bacterial dihydrofolate reductase (dihyrofolic acid->THF), reducing purines, thymidine for DNA, and methionine for protein. Further down than sulfonamides/dapsone in folate pathway. Bacteriostatic combo with sulfonamides for UTI, shigella, salmonella, pneumocystis jirovecii (tx and prophylaxis), toxoplasmosis prophylaxis
    • megaloblastic anemia, leukopenia, granulocytopenia (give with folinic acid)
    • sultry is folly (trimethoprime ihibit last step in folate metabolism)
  53. fluoroquinolones
    • ciprofloxacin, norfloxacin, levofloxacin, ofloxacin, moxifloxacin, gemifloxacin, enoxacin
    • inhibit prokaryotic topoisomerase II (DNA gyrase) and IV. Bactericidal g- of UTI and GI (including pseudomonas), neisseria, some g+
    • chromosome mutation in DNA gyrase, plasmid-encoded pump out
    • GI upset, superinfections, skin rash, headache, dizziness, long QT (some), leg cramp/myalgia, damage growing cartilage (contraindicated pregnant, nursing, under 18), tendonitis/rupture in over 60 pop. or with prednisone
    • flox of 2 and 4 tangled flouers (topoisomerase II and IV)
    • fluoroQTbones (long QT, cartilage for kids, tendon for old/steroids)
  54. enoxacin (class)
    fluoroquinolone
  55. daptomycin
    • disrupts cell membrane of g+ staph aureus (esp MRSA), bacteremia, endocarditis, VRE (vanc resistant enterococci)
    • surfactant in lungs inactivates it, can't tx pneumonia
    • myopathy, rhabdomyolysis
    • lungs and muscle adapt when running (no pneumonia coverage, myopathy/rhabdomyolysis, daptomycin)
  56. metronidazole
    • forms ROS damage DNA. Bactericidal anerobic below diaphragm (clinda above) bacteroides, Clostridium difficile, H pylori (triple therapy w/ PPI and clarithromycin), gardnerella vag. Antiprotazoal giardia, entamoeba, trichomonas
    • disulfram-like, headache, metalic taste
    • GET pro radicals off the metro (Giardia, Entamoeba, Trichomonas [protozoa], free radicals, metronidazole)
    • The alcohol I bought on the metro had a metalic taste and gave me a headache (disulfram-like, metronidazole, metalic taste, headache)
  57. rifamycins
    • inhibit RNA polymerase, reducing mRNA synthesis. Mycobacterium tuberculosis, delay dapsone leprosy resistance, meningococcal prophylaxis for contact of child w/ H flu B
    • rifampin is P-450 inducer; rifabutin is not, orange body fluid(both)
    • RifAMPin ramps up P-450 but rifaBUTin does not
    • RNA polymerase mutation, rapid resistance if monotherapy
    • orange tipped rifle only hated by the NRA (orange fluid, rifamycin, don't use alone, RNA inhib)
    • TB is RIPE for treatment (Rifamycins, Isoniazid, Pyrazinamide, Ethambutol)
  58. rifampin (class/special?)
    • rifamycin
    • P-450 inducer
    • RifAMPin ramps up P-450 but rifaBUTin does not
    • TB is RIPE for treatment (Rifamycins, Isoniazid, Pyrazinamide, Ethambutol)
  59. rifabutin (class/special?)
    • rifamycin
    • NOT a P-450 inducer (rifampin is), favored over rifampin for HIV patient
    • RifAMPin ramps up P-450 but rifaBUTin does not
    • TB is RIPE for treatment (Rifamycins, Isoniazid, Pyrazinamide, Ethambutol)
  60. isoniazid
    • aka INH
    • decrease synthesis of mycolic acids (2nd layer of cell wall), converted to activce form by KatG encoded catalase peroxidase. Mycobacterium tuberculosis (tx and monotx prophylaxis/latent TB)
    • resistance by mutation reduces KatG
    • inhibits P-450, drug-induced lupus, hepatoxcitiy, halflife altered by slow/fast acetylators, induces vit B6 deficiency (sideroblastic anemia, peripheral neuropathy [mito iron bulidup])
    • INHA6 isoniazid (Inhibit P-450, Nduced lupus, Hepatotox, Acetylators, b6 def)
    • TB is RIPE for treatment (Rifamycins, Isoniazid, Pyrazinamide, Ethambutol)
  61. pyrazinamide
    • mech uncertain (intracellular prodrug) works best in acid (host phagolysosome). Mycobacterium tuberculosis
    • hyperurecemia, hepatotoxicity
    • TB is RIPE for treatment (Rifamycins, Isoniazid, Pyrazinamide, Ethambutol)
  62. ethambutol
    • inhibit arabinogalactan synthesis (3rd layer of cell wall) by blocking arabinosyltransferase to reduce carbohydrate polymerization. Mycobacterium tuberculosis
    • red-green color blind
    • ethan hunt snipes arabs (ethambutol, optic neuropathy, arabinogalactans)
    • TB is RIPE for treatment (Rifamycins, Isoniazid, Pyrazinamide, Ethambutol)
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The Pharm of Old McDonald 1
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Become a pharmacist!
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