Pharm One-Liners: Antimicrobials

Mechanism of action of penicillin

Block cell wall synthesis by inhibiting transpeptidase and block peptidoglycan cross-linkage

Penicillins active against penicillinase secreting bacteria (4)

Methicillin, nafcillin, oxacillin, dicloxacillin

Cheap wide spectrum antibiotic drug of choice for otitis media

Amoxicillin

Class of antibiotics that have 10% cross sensitivity with penicillins

Cephalosporins

Penicillins active against pseudomonas (2)

Piperacillin

Ticarcillin

Drug of choice for N. gonorrhea

Ceftriaxone

Beta lactam that can be used in penicillin-allergic patients

Aztreonam

Adverse effect of imipenem

seizures

Drug of choice for treatment of serious pseudomembranous colitis

Oral vancomycin

Drug used for MRSA

Vancomycin

Mechanism of action of vancomycin

Binds D-Ala-D-Ala on murein monomers and prevent polymerization of the murein monomers

Antibiotic causing red-man syndrome, and prevention of red-man syndrome

Vancomycin; can be prevented by infusion at a slow rate and antihistamines

Drug class that causes tooth discoloration

Tetracycline

Mechanism of action of tetracycline

Decreases protein synthesis by binding to 30S ribosome and prevent binding of tRNA

Toxicities of aminoglycosides (2)

nephrotoxicity and ototoxicity

Aminoglycoside less used due to its irreversible vestibular toxicity and teratogenicity

Streptomycin

Mechanism of action of macrolides (erythromycin, clarithromycin)

Inhibit protein synthesis by binding to 23S rRNA of 50S ribosome subunit

Drug of choice for Legionnaires' disease (2)

Azithromycin or levofloxacin

Drug notorious for causing pseudomembranous colitis

Clindamycin

Drug that causes gray baby syndrome and aplastic anemia

Chloramphenicol

Inhibits isoleucyl tRNA and used topically for impetigo

Mupirocin

Drug of choice for giardia, entamoeba, pseudomembranous colitis (C. diff.), and trichomonas

Metronidazole

Drug of choice for treatment of mild to moderate pseudomembrane colitis

Metronidazole

Adverse effect of metronidazole when given with alcohol

Disulfiram-like reaction

Mechanism of action of fluoroquinolones

Inhibit DNA gyrase (topoisomerase II) and topoisomerase IV

Reason fluoroquinolones are contraindicated in children and pregnancy

Cartilage damage

Anemia caused by trimethoprim

megaloblastic anemia

Antibacterials that cause hemolysis in G6PD-deficient patients

Sulfonamides

Mechanism of action of sulfonamides

Inhibit dihydropteroate synthase

Quadruple therapy for the treatment of tuberculosis

Rifampin, Isoniazid, Pyrazinamide, and Ethambutol

Meningitis prophylaxis in exposed patients

Rifampin

Common adverse effect of rifampin

Orange urine discoloration

Neurotoxicity with isoniazid prevented by

Administration of Vitamin B6 (pyridoxine)

Adverse effects of isoniazid (3)

Systemic lupus-like erythematosus, peripheral neuritis, hepatitis

Treatment of choice for leprosy (2)

Dapsone and rifampicin

Toxicity of Amphotericin B

nephrotoxicity

Adverse effect of ketoconazole only in men

gynecomastia

Mechanism of action of nystatin

Binds to ergosterol and creates a pore in fungal membrane

Technique used to diagnose perianal itching, and the drug used to treat it

Scotch tape technique and mebendazole (albendazole)

Drug used in exoerythrocytic cycle of malaria

Primaquine

Drug of choice for influenza A and B (2)

Oseltamivir or Zanamivir

Drug of choice for respiratory syncytial virus (RSV)

Ribavirin

Drug of choice for herpes and its mechanism of action

Acyclovir, activated by viral thymidine kinase, inhibits viral DNA replication

Mechanism of action of acyclovir

Activated by viral thymidine kinase, inhibits viral DNA replication

Drug of choice for cytomegalovirus (CMV) treatment

Ganciclovir

Adverse effect of ganciclovir

Myelosuppression (neutropenia)

First line for the treatment of chronic hepatitis B virus (HBV) infections

IFN + nucleoside reverse transcriptase inhibitor (NRTI)

First line for the treatment of chronic hepatitis C virus (HCV) infections in genotype 1 patients

IFN + ribavirin + protease inhibitor (-previr)

HIV medications used to reduce mother-to-child transmissions during birth (2)

Zidovudine, nevirapine

Antivirals associated with neutropenia (3)

Ganciclovir, zidovudine, interferon

Nucleoside reverse inhibitors approved for both HIV and HBV infections (2)

Tenofovir, lamivudine

Antiviral/antiretroviral that are teratogens (2)

Efavirenz, ribavirin

Anti-retroviral with a dose limiting toxicity of pancreatitis and peripheral neuropathy

Didanosine

Anti-retroviral agents associated with fatal Stevens-Johnson syndrome (3)

Nevirapine, efavirenz, etravirine

Anti-retroviral class that causes drug interactions by causing induction of CYP enzymes

Non-nucleos(t)ide reverse transcriptase inhibitors

Anti-retroviral class that causes drug interactions by causing inhibition of CYP enzymes

Protease inhibitors