Review

• Nalidixic acid may cause _______in children

  cartilage erosion
• what is the primary MOA of pencillins?

  inhibits cell wall synthesis and inactivating penicillin binding proteins
• what is MOA of vancomycin?

  increases bacterial cell wall permeability and inhibits RNA synthesis
• what is the MOA of tetracyclines?

  inhibiting protein synthesis
• what is the MOA of aminoglycosides?

  cause misreading of the code for mRNA template to inhibit protein synthesis
• what is the antibacterial action of gentamicin?

  continues to exert antimicrobial effects even after plasma levels decrease below detectable levels
• what should a pt stop taking if being treated with erythromycin?


  simvastatin
• what treats traveler's diarrhea and gram - bacillus?

  ciprofloxacin
• ____ has different therapeutic applications for depending on generation

  Fluoroquinolones
• which adverse effect most likely to occur with sulfonamides?

  skin rxn
• what is a major side effect of ciprofloxacin?

  tendonitis and tendon rupture
• what is the primary reason of drug combination of TB?

  delay or prevent drug resistance
• what route does fluconazole eliminate?

  Renal
• which TB drug induces P450 system that increases metabolism of other drugs?

  Rifampin
• which antiviral decrease shedding with herpes?

  Valacyclovir
• which gen of Cephalosporins work against gram + cocci?

  first gen
• what route is cefepime eliminated?

  tubular secretion and/or glomerular filtration
• what three cephalosporins cause bleeding tendencies

  Cefotenten, cefazolin, and cetriaxone
• what two cephalosporins cause alcohol intolerance?

  cefazolin and cefotenten
• which macrolide least likely to cause QT prolong?

  Azithromycin
• what cephalosporins work against gram - anaerobic B. fragilis?

  cefoxitin (mefoxin)
• which UTI med works against Enterococcus faecalis?

  Amoxicillin
• what is the first line abx for immunocompromised pt with PNA be treated as outpt?

  levofloxacin
• what abx is appropriate to treat a 4 week old dx with chlamydial pna?

  erythromycin
• what is the primary method of B-lactam resistance with strep pna?

  modification of target site
• when taking cefdinir, what lab should you order first before prescribing to an elderly person?

  creatinine clearance
• when taking clindamycin long term, what side effect should be warned?

  C-diff
• what are the second line drugs for TB?

  cycloserine

  ethionamide

  capreomycin

  para-aminosalicyclic acid (PAS)

  quinolones (levoflaxacin and moxifloxacin)
• induction phase


  eliminate active tubercle bacili

  8 weeks

  drugs: Rifampin, Isoniazid, Pyrazinamide, Ethambutol (RIPE)
• continuation phase of TB

  eliminate persisters

  18 weeks

  drugs used: Isoniazid and Rifampin
• Multidrug TB 


  resistant to both isoniazid and rifampin

  acquired by contact with someone with the bacteria, ineffectual course of therapy - too short, dosage to low, erratic pt adherence with too few drugs
• Extensively drug resistant TB

  resistant to Isoniazid and rifampin

  all fluoroquinolones

  at least one injectable second line drugs: amikacin, capreomycin, streptomycin
• avoid Rifampin and HIV pts


  acts as an inducer and accelerates metabolism of PIs and NNRTIs which decreases HIV meds
• what TB med accelerates metabolism and of antiretroviral drugs but still be used for HIV?

  Rifabutin
• what meds are treated with latent TB?

  Isoniazid and Rifampin
• what reversal agent is given to Isoniazid if it causes peripheral neuropathy?

  Pyridoxine, Vit B6
• Isoniazid inhibits what enzymes?

  CPY2C9, 19, E1

  which increases levels of phenytoin, carbamazepine, diazepam, and triazolam (pdct)
• what drug interactions are with Rifampin?

  induces P450, which hastens metabolism

  decrease effectiveness with oral contraceptives, warfarin, and drugs for HIV
• Para-aminosalicylic acid (PAS)


  second line drug for TB

  inhibits synthesis of folic acid

  better tolerated by children than adults

  sodium-loading in large doses
• What do you need to monitor in Ethionmaide?

  AST/ALT before and after treatment

  BSG for hypoglycemia