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Antibiotics Flashcards

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1
Q

amoxicillin

A
  • Cell wall synthesis inhibitor, beta-lactam compound, penicillin, broad spectrum
  • MOA: bind and inhibit PBP enzymes–>prevent maintenance of peptidoglycan cell wall
  • Adverse effects: hypersensitivity, hemolytic anemia, secondary vaginal candidiasis infection, can cause drug induced liver damage
  • Beta-lactamase sensitive
  • Organisms: gram (+) cocci, E.coli, H.influenzae, L.monocytogenes, B.burgdorferi, H.pylori
  • use: URT, pharyngitis, fever w/ neutropenia
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2
Q

amoxicillin

A
  • Cell wall synthesis inhibitor, beta-lactam compound, penicillin, broad spectrum
  • MOA: bind and inhibit PBP enzymes–>prevent maintenance of peptidoglycan cell wall
  • Adverse effects: hypersensitivity, hemolytic anemia, secondary vaginal candidiasis infection
  • Beta-lactamase sensitive
  • Organisms: gram (+) cocci, E.coli, H.influenzae, L.monocytogenes, B.burgdorferi, H.pylori
  • Use: uncomplicated skin & soft tissue, neonatal meningitis
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3
Q

azlocillin

A
  • Cell wall synthesis inhibitor, beta-lactam compound, penicillin, extended spectrum
  • MOA: bind and inhibit PBP enzymes–>prevent maintenance of peptidoglycan cell wall
  • Adverse effects: hypersensitivity, hemolytic anemia, secondary vaginal candidiasis infection
  • Beta-lactamase sensitive
  • Organisms: gram (-) rods, antipseudomonal
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4
Q

ticarcillin

A
  • Cell wall synthesis inhibitor, beta-lactam compound, penicillin, extended spectrum
  • MOA: bind and inhibit PBP enzymes–>prevent maintenance of peptidoglycan cell wall
  • Adverse effects: hypersensitivity, hemolytic anemia, secondary vaginal candidiasis infection
  • Beta-lactamase sensitive
  • Organisms: gram (-) rods, antipseudomonal
  • use: complicated skin & soft tissue, bone/joint, intra-abdominal
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5
Q

piperacillin

A
  • Cell wall synthesis inhibitor, beta-lactam compound, penicillin, extended spectrum
  • MOA: bind and inhibit PBP enzymes–>prevent maintenance of peptidoglycan cell wall
  • Adverse effects: hypersensitivity, hemolytic anemia, secondary vaginal candidiasis infection
  • Beta-lactamase sensitive
  • Organisms: gram (-) rods, antipseudomonal
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6
Q

methicillin

A
  • Cell wall synthesis inhibitor, beta-lactam compound, penicillin, very-narrow spectrum
  • MOA: bind and inhibit PBP enzymes–>prevent maintenance of peptidoglycan cell wall
  • Adverse effects: hypersensitivity, hemolytic anemia, secondary vaginal candidiasis infection
  • Beta-lactamase resistant
  • Organisms: staphylococci (not MRSA)
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7
Q

nafcillin

A
  • Cell wall synthesis inhibitor, beta-lactam compound, penicillin, very-narrow spectrum
  • MOA: bind and inhibit PBP enzymes–>prevent maintenance of peptidoglycan cell wall
  • Adverse effects: hypersensitivity, hemolytic anemia, secondary vaginal candidiasis infection
  • Beta-lactamase resistant
  • Organisms: staphylococci (not MRSA)
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8
Q

oxacillin

A
  • Cell wall synthesis inhibitor, beta-lactam compound, penicillin, very-narrow spectrum
  • MOA: bind and inhibit PBP enzymes–>prevent maintenance of peptidoglycan cell wall
  • Adverse effects: hypersensitivity, hemolytic anemia, secondary vaginal candidiasis infection
  • Beta-lactamase resistant
  • Organisms: staphylococci (not MRSA)
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9
Q

penicillin G

A
  • Cell wall synthesis inhibitor, beta-lactam compound, penicillin, narrow spectrum
  • MOA: bind and inhibit PBP enzymes–>prevent maintenance of peptidoglycan cell wall
  • Adverse effects: hypersensitivity, hemolytic anemia, secondary vaginal candidiasis infection
  • Beta-lactamase sensitive
  • Organisms: streptococci, pneumococci, meningococci, Treponema pallidum
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10
Q

penicillin V

A
  • Cell wall synthesis inhibitor, beta-lactam compound, penicillin, narrow spectrum
  • MOA: bind and inhibit PBP enzymes–>prevent maintenance of peptidoglycan cell wall
  • Adverse effects: hypersensitivity, hemolytic anemia, secondary vaginal candidiasis infection
  • Beta-lactamase sensitive
  • Organisms: streptococci, pneumococci, meningococci, Treponema pallidum
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11
Q

clavulanic acid
sulbactam
tazobactam

A
  • Beta-lactamase inhibitors
  • use: avoid inactivation of cell wall inhibitors by bacterial degradation
  • often prescribed with amoxicillin, ampicillin, and piperacillin
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12
Q

cefazolin

A
  • cell wall synthesis inhibitor, beta-lactam compound
  • 1st generation cephalosporin
  • MOA: bind and inhibit PBPs
  • Adverse effects: hypersensitivity, disulfiram-effect (avoid alcohol), bleeding disorder
  • beta-lactamase sensitive
  • use: surgical prophylaxis, uncomplicated skin/soft tissue
  • does NOT enter CNS
  • organisms: gram (+) cocci
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13
Q

cephalexin

A
  • cell wall synthesis inhibitor, beta-lactam compound
  • 1st generation cephalosporin
  • MOA: bind and inhibit PBPs
  • Adverse effects: hypersensitivity, disulfiram-effect (avoid alcohol), bleeding disorder
  • beta-lactamase sensitive
  • use: surgical prophylaxis
  • does NOT enter CNS
  • organisms: gram (+) cocci
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14
Q

cefotetan

A
  • cell wall synthesis inhibitor, beta-lactam compound
  • 2nd generation cephalosporin
  • MOA: bind and inhibit PBPs
  • Adverse effects: hypersensitivity, disulfiram-effect (avoid alcohol), bleeding disorder
  • beta-lactamase sensitive
  • does NOT enter CNS
  • organisms: gram (+) cocci, some gram (-)
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15
Q

cefaclor

A
  • cell wall synthesis inhibitor, beta-lactam compound
  • 2nd generation cephalosporin
  • MOA: bind and inhibit PBPs
  • Adverse effects: hypersensitivity, disulfiram-effect (avoid alcohol), bleeding disorder
  • beta-lactamase sensitive
  • does NOT enter CNS
  • organisms: gram (+) cocci, some gram (-)
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16
Q

cefuroxime

A
  • cell wall synthesis inhibitor, beta-lactam compound
  • 2nd generation cephalosporin
  • MOA: bind and inhibit PBPs
  • Adverse effects: hypersensitivity, disulfiram-effect (avoid alcohol), bleeding disorder
  • beta-lactamase sensitive
  • enters CNS
  • organisms: gram (+) cocci, some gram (-)
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17
Q

ceftriaxone

A
  • cell wall synthesis inhibitor, beta-lactam compound
  • 3rd generation cephalosporin
  • MOA: bind and inhibit PBPs
  • Adverse effects: hypersensitivity, disulfiram-effect (avoid alcohol), bleeding disorder
  • beta-lactamase sensitive
  • use: empirical tx of meningitis and sepsis, osteomyelitis, septic arthritis, hospital acquired/ventilated related pneumonia, endocarditis
  • enter CNS
  • organisms: gram (+) and gram (-) cocci, gram (-) rods
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18
Q

cefotaxime

A
  • cell wall synthesis inhibitor, beta-lactam compound
  • 3rd generation cephalosporin
  • MOA: bind and inhibit PBPs
  • Adverse effects: hypersensitivity, disulfiram-effect (avoid alcohol), bleeding disorder
  • beta-lactamase sensitive
  • use: empirical tx of meningitis and sepsis
  • enter CNS
  • organisms: gram (+) and gram (-) cocci, gram (-) rods
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19
Q

cefdinir

A
  • cell wall synthesis inhibitor, beta-lactam compound
  • 3rd generation cephalosporin
  • MOA: bind and inhibit PBPs
  • Adverse effects: hypersensitivity, disulfiram-effect (avoid alcohol), bleeding disorder
  • beta-lactamase sensitive
  • use: empirical tx of meningitis and sepsis
  • enter CNS
  • organisms: gram (+) and gram (-) cocci, gram (-) rods
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20
Q

cefixime

A
  • cell wall synthesis inhibitor, beta-lactam compound
  • 3rd generation cephalosporin
  • MOA: bind and inhibit PBPs
  • Adverse effects: hypersensitivity, disulfiram-effect (avoid alcohol), bleeding disorder
  • beta-lactamase sensitive
  • use: empirical tx of meningitis and sepsis
  • enter CNS
  • organisms: gram (+) and gram (-) cocci, gram (-) rods
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21
Q

cefepime

A
  • cell wall synthesis inhibitor, beta-lactam compound
  • 4th generation cephalosporin
  • MOA: bind and inhibit PBPs
  • Adverse effects: hypersensitivity, disulfiram-effect (avoid alcohol), bleeding disorder
  • beta-lactamase resistant
  • use: broadest spectrum, osteomyelitis sepsis
  • enter CNS
  • organisms: gram (+) and gram (-)
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22
Q

aztreonam

A
  • cell wall synthesis inhibitors, beta-lactam compound
  • monobactam compound
  • MOA: bind and inhibits PBPs
  • beta-lactamase resistant
  • enter CNS
  • organisms: gram (-) rods
  • use: serious pneumonia, meningitis, and sepsis
  • adverse effects: hypersensitivity
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23
Q

doripenem
imipenem
ertapenem
meropenem

A
  • cell wall synthesis inhibitors, beta-lactam compound
  • carbapenems compound
  • MOA: bind and inhibits PBPs
  • beta-lactamase resistant but susceptible to carbamenemase
  • imipenem inactivated by kidney–>administered with cilastatin
  • enter CNS
  • organisms: gram (-) and gram (+)
  • use: empirical tx of life-threatening infections
  • adverse effects: vomiting, diarrhea, hypersensitivity, hypotension, confusion, tremors, seizures
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24
Q

vancomycin

A
  • cell wall synthesis inhibitor
  • glycopeptide antibiotic
  • MOA: bind D-ala-D-ala pentapeptide–>prevent elongation of peptidoglycan–>inhibit cell wall synthesis
  • good tissue penetration but NOT CNS
  • organisms: gram (+) and gram (-)
  • Use: uncomplicated skin, MRSA, C.diff, meningitis, sepsis
  • adverse effects: flushing “red man syndrome”, ototoxicity, nephrotoxicity
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25
bacitracin
- cell wall synthesis inhibitor - polypeptide - MOA: block incorporation of aa and nucleic acids into cell wall - topical and ophthalmic ointment - use: broad spectrum for gram (+) and gram (-) - adverse effects: hypersensitivity is rare
26
fosfomycin
- cell wall synthesis inhibitor - phosphoenolpyruvate - MOA: prevents synthesis of UDP-N-acetylmuramic acid--> blocks early step in cell wall synthesis - use: broad spectrum for gram (-) and (+), uncomplicated UTI in females
27
daptomycin
- target cell membrane - lipopetide - MOA: binds membrane (Ca2+ dependent) --> depolarization of membrane--> bactericidal - use: gram (+), complicated tissue and skin, bacteremia, endocarditis, MRSA, enterococcus - adverse effects: myopathy
28
polymyxin B
- target cell membrane - detergent - MOA: bind phospholipids in cell membrane--> disrupt structure - use: topically for skin in combo w/ bacitracin, gram (-) - adverse effects: rare
29
streptomycin
- protein synthesis inhibitor - aminoglycoside - MOA: bind 30S (maybe 50S) and blocks formation of initiation complex (step 1) - use: bactericidal, combo w/ beta-lactams for serious gram (-) - adverse effects: nephrotoxicity, ototoxicity, hypersensitivity
30
genamicin
- protein synthesis inhibitor - aminoglycoside - MOA: bind 30S (maybe 50S) and blocks formation of initiation complex (step 1) - use: bactericidal, combo w/ beta-lactams for serious gram (-), neonatal jaundice - adverse effects: nephrotoxicity, ototoxicity, hypersensitivity
31
kanamycin
- protein synthesis inhibitor - aminoglycoside - MOA: bind 30S (maybe 50S) and blocks formation of initiation complex (step 1) - use: bactericidal, combo w/ beta-lactams for serious gram (-) - adverse effects: nephrotoxicity, ototoxicity, hypersensitivity
32
amikacin
- protein synthesis inhibitor - aminoglycoside - MOA: bind 30S (maybe 50S) and blocks formation of initiation complex (step 1) - use: bactericidal, combo w/ beta-lactams for serious gram (-) - adverse effects: nephrotoxicity, ototoxicity, hypersensitivity
33
tobramycin
- protein synthesis inhibitor - aminoglycoside - MOA: bind 30S (maybe 50S) and blocks formation of initiation complex (step 1) - use: bactericidal, combo w/ beta-lactams for serious gram (-) - adverse effects: nephrotoxicity, ototoxicity, hypersensitivity
34
neomycin
- protein synthesis inhibitor - aminoglycoside - MOA: bind 30S (maybe 50S) and blocks formation of initiation complex (step 1) - use: bactericidal, combo w/ beta-lactams for serious gram (-) - adverse effects: nephrotoxicity, ototoxicity, hypersensitivity
35
erythromycin
- protein synthesis inhibitor - macrolide - MOA: binds 50S and impairs translocation to P site (step 4) - bacteriostatic at low conc. and bactericidal at high - use: gram (+) and some gram (-), pneumonia, Legionella pneumophila, C. jejuni, H. pylori - adverse effects: stomach cramps, nausea, vomiting, diarrhea (motilin receptor agonist), CYP450 inhibition
36
clarithromycin
- protein synthesis inhibitor - macrolide - MOA: binds 50S and impairs translocation to P site (step 4) - bacteriostatic at low conc. and bactericidal at high - use: gram (+) and some gram (-), pneumonia, Legionella pneumophila, C. jejuni, H. pylori - adverse effects: stomach cramps, nausea, vomiting, diarrhea (motilin receptor agonist), CYP450 inhibition
37
azithromycin
- protein synthesis inhibitor - macrolide - MOA: binds 50S and impairs translocation to P site (step 4) - bacteriostatic at low conc. and bactericidal at high - use: gram (+) and some gram (-), pneumonia, Legionella pneumophila, C. jejuni, H. pylori - adverse effects: stomach cramps, nausea, vomiting, diarrhea (motilin receptor agonist), CYP450 inhibition
38
tetracycline
- protein synthesis inhibitors - tetracyclines - MOA: binds 30S subunit of ribosome--> prevent binding of new aminoacyl-tRNA to A site (step 1) - use:broad spectrum, bacteriostatic, H. pylori, Rickettsia, Borrelia burgdorferi, Brucella, Vibrio - adverse effects: nutrient interaction (bind calcium-->growth of calcified tissue, discoloration of teeth, affect growth), disrupt normal flora, photosensitivity, chelator (prevent absorption of cations)
39
minocycline
- protein synthesis inhibitors - tetracyclines - MOA: binds 30S subunit of ribosome--> prevent binding of new aminoacyl-tRNA to A site (step 1) - use:broad spectrum, bacteriostatic, H. pylori, Rickettsia, Borrelia burgdorferi, Brucella, Vibrio - adverse effects: nutrient interaction (bind calcium-->growth of calcified tissue, discoloration of teeth, affect growth), disrupt normal flora, photosensitivity, chelator (prevent absorption of cations)
40
doxycycline
- protein synthesis inhibitors - tetracyclines - MOA: binds 30S subunit of ribosome--> prevent binding of new aminoacyl-tRNA to A site (step 1) - use:broad spectrum, bacteriostatic, H. pylori, Rickettsia, Borrelia burgdorferi, Brucella, Vibrio - adverse effects: nutrient interaction (bind calcium-->growth of calcified tissue, discoloration of teeth, affect growth), disrupt normal flora, photosensitivity, chelator (prevent absorption of cations)
41
tigecycline
- protein synthesis inhibitors - tetracyclines - MOA: binds 30S subunit of ribosome--> prevent binding of new aminoacyl-tRNA to A site (step 1) - use:broad spectrum, bacteriostatic, H. pylori, Rickettsia, Borrelia burgdorferi, Brucella, Vibrio, multi drug resitant enterococci and gram (-) - adverse effects: nutrient interaction (bind calcium-->growth of calcified tissue, discoloration of teeth, affect growth), disrupt normal flora, photosensitivity, chelator (prevent absorption of cations)
42
clindamycin
- protein synthesis inhibitor - MOA: binds 50S subunit of ribosome-->prevent formation of initiation complexes and translocation to P site - use: narrow spectrum, gram (+) cocci, MRSA, uncomplicated skin/soft tissue - adverse effects: nausea, vomiting, diarrhea, C.diff infection
43
chloramphenicol
- protein synthesis inhibitor - MOA: binds 50S subunit of ribosome--> prevents transpeptidation or peptidyl bond formation (step 2) - use: broad spectrum, bacteriostatic, 2nd line agent, typhus, Rocky Mountain spotted fever, eye infections - adverse effects: RBC suppression, Gray Baby Syndrome (infants lack glucuronic acid conjugation--> shock, vomiting, vascular collapse)
44
linezolid
- protein synthesis inhibitor - oxazolidinone - MOA: bind P site of 50S ribosome--> inhibit formation of ribosomal-fMET-tRNA complex (Step 1) - use: MRSA, multi-drug resistant enterococci - adverse effects: myelosuppression
45
sulfadiazine
- DNA synthesis inhibitor, antifolate drug - sulfonamide - MOA: compete with PABA for enzyme dihydropteroate synthase-->block dihydrofolic acid synthesis--> block DNA synthesis - broad spectrum - in combo w/ other drugs for gram (+/-) - adverse effects: hypersensitivity, photosensitivity, Steven-Johnson syndrome (serious/fatal skin and mucous membrane eruption)
46
sulfamethoxazole
- DNA synthesis inhibitor, antifolate drug - sulfonamide - MOA: compete with PABA for enzyme dihydropteroate synthase-->block dihydrofolic acid synthesis--> block DNA synthesis - broad spectrum - in combo w/ other drugs for gram (+/-), UTIs, prostatitis - adverse effects: hypersensitivity, photosensitivity, Steven-Johnson syndrome (serious/fatal skin and mucous membrane eruption)
47
sulfamethizole
- DNA synthesis inhibitor, antifolate drug - sulfonamide - MOA: compete with PABA for enzyme dihydropteroate synthase-->block dihydrofolic acid synthesis--> block DNA synthesis - broad spectrum - in combo w/ other drugs for gram (+/-) - adverse effects: hypersensitivity, photosensitivity, Steven-Johnson syndrome (serious/fatal skin and mucous membrane eruption)
48
trimethoprim
- DNA synthesis inhibitors, antifolate drug - trimethoprim - MOA: inhibits bacterial dihydrofolate reductase--> impaired DNA synthesis - use: gram (-), UTIs, prostatitis - adverse effects: bone marrow suppression, megaloblastic anemia, leukopenia, granulocytopenia
49
pyrimethamine
- DNA synthesis inhibitors, antifolate drug - trimethoprim - MOA: inhibits bacterial dihydrofolate reductase--> impaired DNA synthesis - use: gram (-) - adverse effects: bone marrow suppression, megaloblastic anemia, leukopenia, granulocytopenia
50
trimethoprim-sulfamethoxazole (TMP-SMX)
- DNA synthesis inhibitors, antifolate - MOA: synergistic activity - use: UTI and prostatitis
51
norfloxacin
- DNA synthesis inhibitor - group 1 - fluoroquinolones - MOA: disrupt winding of DNA/ separation of strands during transcription and translation (topoisomerase II and IV) - least effective but broad spectrum against gram (+/-) - use: urinary, GI, respiratory, STI, anthrax - adverse effects: nausea, vomiting, diarrhea, bind divalent cations, prevent absorption, QT prolongation
52
ciprofloxacin
- DNA synthesis inhibitor - group 2 - fluoroquinolones - MOA: disrupt winding of DNA/ separation of strands during transcription and translation (topoisomerase II and IV) - broad spectrum best against gram (-) but some gram (+) - use: urinary, GI, respiratory, STI, anthrax, fever w/ neutropenia - adverse effects: nausea, vomiting, diarrhea, bind divalent cations, prevent absorption, QT prolongation
53
levofloxacin
- DNA synthesis inhibitor - group 2 - fluoroquinolones - MOA: disrupt winding of DNA/ separation of strands during transcription and translation (topoisomerase II and IV) - broad spectrum best against gram (-) but some gram (+) - use: urinary, GI, respiratory, STI, anthrax - adverse effects: nausea, vomiting, diarrhea, bind divalent cations, prevent absorption, QT prolongation
54
oxfloxacin
- DNA synthesis inhibitor - group 2 - fluoroquinolones - MOA: disrupt winding of DNA/ separation of strands during transcription and translation (topoisomerase II and IV) - broad spectrum best against gram (-) but some gram (+) - use: urinary, GI, respiratory, STI, anthrax - adverse effects: nausea, vomiting, diarrhea, bind divalent cations, prevent absorption, QT prolongation
55
gatifloxacin
- DNA synthesis inhibitor - group 3 - fluoroquinolones - MOA: disrupt winding of DNA/ separation of strands during transcription and translation (topoisomerase II and IV) - broad spectrum best against gram (+) but some gram (-) - use: urinary, GI, respiratory, STI, anthrax - adverse effects: nausea, vomiting, diarrhea, bind divalent cations, prevent absorption, QT prolongation
56
gemifloxacin
- DNA synthesis inhibitor - group 3 - fluoroquinolones - MOA: disrupt winding of DNA/ separation of strands during transcription and translation (topoisomerase II and IV) - broad spectrum best against gram (+) but some gram (-) - use: urinary, GI, respiratory, STI, anthrax - adverse effects: nausea, vomiting, diarrhea, bind divalent cations, prevent absorption, QT prolongation
57
moxifloxacin
- DNA synthesis inhibitor - group 3 - fluoroquinolones - MOA: disrupt winding of DNA/ separation of strands during transcription and translation (topoisomerase II and IV) - broad spectrum best against gram (+) but some gram (-) - use: urinary, GI, respiratory, STI, anthrax - adverse effects: nausea, vomiting, diarrhea, bind divalent cations, prevent absorption, QT prolongation
58
metronidazole
- DNA damage - MOA: prodrug-->organism activates--> reaction metabolites bind DNA--> disrupt function/ cause damage - use: anaerobic bacteria, abdomina, vaginitis, C. diff, brain abscess - adverse effects: nausea, vomiting, diarrhea, disulfiram-effect (avoid alcohol)
59
isoniazid
- first line anti-tuberculosis drug - bactericidal for actively growing bacilli - penetrates macrophages - structurally similar to pyridoxine (vit. B6) - MOA: activated by mycobacterial catalase-peroxidase enzyme (Kat G)--> impedes proteins synthesizing mycolic acid - use: prophylactic, active, and latent regimens - resistance: mutation in Kat G, over expression of Inh A protein (mycolic acid synthesis) - 2 drugs MUST be used for active TB - adverse effects: hepatitis (age and alcoholics increased risk), peripheral neuropathy (slowly metabolized)
60
rifampin
-first line anti-tuberculosis drugs -gram (+/-) and chlamydia sensitive -MOA: bind DNA-dependent RNA polymerase--> inhibit transcription -bactericidal, penetrate tissue and phagocytic cells -use: 1st line active TB, alternative to INH in latent TB -resistance: point mutation in RNA polymerase gene adverse effects: nausea vomiting, headache, dizziness, hepititis, red-orange urine feces sweat tears and saliva (harmless) -inducer of cytochrome P450-->eliminate many drugs--> contraindicated in HIV patients taking antiretrovirals
61
pyrazinamide
- first-line anti-tuberculosis drugs - analogue of nicotinamide use in combo therapy - MOA: bacterial pyrazinamidase enzyme activates--> inhibit mycolic acid synthesis? - dependent on acidic environment - use: part of active TB regimen - resistance: mutation in pyrazinamidase enzyme - enter macrophages - adverse effects: hepatotoxicity, hyperuricemia--> acute gouty arthritis
62
ethambutol
- first-line anti-tuberculosis drug - MOA: inhibits arabinosyl transferase-->inhibit cell wall synthesis - use: active TB, M. avium complex (MAC) - resistance: point mutation in arabinosyl transferase - use in combo - adverse effects: retrobulbar neuritis (impaired vision, red-green color blindness), hyperuricemia
63
streptomycin
- first-line anti-tuberculosis drug - aminoglycoside antibiotic - MOA: interfere with bacterial protein synthesis - use: M. tuberculosis, M. avium complex, TB of strains resistant to other drugs - injected, penetrates cells poorly - resistance: point mutations in ribosomal proteins - adverse effects: ototoxic, nephrotic
64
rifabutin
- second line anti-tuberculosis drug - MOA: inhibits RNA polymerase - use: active M. tuberculosis and M. avium complex (greater against MAC) - less potent induce of cytochrome P450--> use for HIV pts instead of rifampin
65
M. avium complex (MAC) tx
- pulmonary infection: macrolide (clarithromycin or azithromycin), rifampin, ethambutol, streptomycin - disseminated: macrolide, rifampin, ethambutol - prophylaxis in HIV pts: clarithromycin or azithromycin
66
Active TB regimen
- initial: INH, RIF, PZA, and EMB daily (8 wks) | - continuation phase: INH, RIF daily (18 wks)
67
Leprosy regimen
- dapsone, clofazimine, rifampin - tuberculoid: 1-2 yrs - lepromatous: 5 yrs
68
dapsone
- leprosy treatment - MOA: competitive inhibitor of folic acid synthesis - high conc in skin, muscle, kidney - adverse effects: non-hemolytic anemias, hemolytic anemia in pts with G6PD
69
clofazimine
- leprosy treatment - MOA: bactericidal dye, DNA binding? - highly lipophilic - skin discoloration--> red-brown to black
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