Antibacterial drugs II | Quizlet

What are fluoroquinolones and list examples

broad-spectrum synthetic bactericidal agent

Ciprofloxacin

Ofloxacin

Norfloxacin Levofloxacin

What is the spectrum for fluoroquinolones?

active against G-negative bacteria and some G-positive bacteria

Indications of fluoroquinolones

urinary tract infections sexually transmitted infections (e.g. gonorrhea)

skin, bone and joint

infections prostatitis gastrointestinal infections lower respiratory tract infections

What is the group of drugs that have interactions with medications containing metallic cations?

fluoroquinolones

Fluoroquinolones SE

• nausea, vomiting, diarrhea, abdominal pain

• confusion, convulsions, hallucinations

• allergic reactions

• phototoxicity

• cardiotoxicity (prolongation of the QT-interval)

• hepatic and renal damage

• tendinitis, tendon rupture

Nitroimidazole derivatives drugs examples

Metronidazole Tinidazole

Nitroimidazole derivatives MOA

• entry into the cell → inhibition of the protein synthesis by interacting with DNA & causing loss of its helical structure & strand breakage → bactericidal effect

Nitroimidazole derivatives indiactions

anaerobic abdominal and CNS infections, dental infections, bacterial vaginosis, Helicobacter pylori infections, Clostridium difficile- associated diarrhea, colitis, protozoal infections

Minor Nitroimidazole derivatives SE

nausea, vomiting, diarrhea

• metallic taste

• vaginitis

• headache, dizziness

• urine abnormality

• candidiasis

• flu-like symptoms

Major Nitroimidazole derivatives SE

• pancreatitis

• peripheral neuropathy • CNS toxicity (seizures, encephalopathy, paresthesias, mental confusion, depression

What is a black box warning for nitroimidazole derivatives

Carcinogenity

What are the group of drugs that have disulfiram reaction when combined with ethanol?

Nitromidazole derivatives

List Inhibitors of Protein Synthesis drugs

Tetracyclines

Aminoglycosides

Chloramphenicol

Macrolides

Lincosamides

Tetracyclines examples

Tetracycline Doxycycline

What are tetracyclines

bacteriostatic activity against a broad spectrum of pathogens

Tetracyclines indications

atypical pneumonias, bronchitis,

chlamydial genital infections,

rickettsial infection (Rocky Mountain spotted fever, typhus, Q fever),

Lyme disease,

traveler's diarrhea, acne,

Helicobacter pylori eradication

What causes the decrease of gastric absorption of tetracyclines

chelation to divalent cations or bile acid resins

Tetracyclines SE

• diarrhea, nausea, vomiting, abdominal pain

• photosensitivity (red rush, skin blistering)

• hepatotoxicity

• renal failure

• discoloration of teeth & inhibition of bone growth in children

Tetracyclines contraindications

pregnancy breastfeeding pediatric patients under the age of 8 patients with renal or liver impairment

Aminoglycosided examples

Gentamicin

Tobramycin

Neomycin

Aminoglycosides MOA

bactericidal activity against a broad spectrum of pathogens (aerobic Gram-negative bacteria, mycobacteria)

Aminoglycosides indications

severe Gram-negative infections caused by Enterobacter, Pseudomonas, Klebsiella, E. coli, and Serratia that affect the respiratory system, the gastrointestinal tract, urinary tract, bone, skin, blood, and soft tissues, tuberculosis

What group of drugs have poor gastrointestinal absorption?

Aminoglycosides

Aminoglycosides SE

ototoxicity (due to accumulation in inner ear)

• nephrotoxicity (due to accumulation in renal cortex)

• neuromuscular blockade and acute muscle paralysis (especially in patients with preexisting myasthenia gravis)

Aminoglycosides contraindications

pre-existing hearing loss

renal impairment myasthenia gravis pregnancy

Chloramphenicol MOA

bacteriostatic activity against a broad spectrum of pathogens

Chloramphenicol indications

invasive ampicillin-resistant Haemophilus influenzae infections, for patients allergic to penicillin with pneumococcal, meningococcal or Haemophilus influenzae meningitis, brain abscess, rickettsioses, bacterial conjunctivitis, prophylaxis for surgical wound infections

Why is chloramphenicols usage limited

• limited usage due to serious side effects

Chloramphenicol SE

grey syndrome,

aplastic anemia, neutropenia, thrombocytopenia, nausea,

vomiting,

diarrhea,

headache,

rush

Macrolides examples

Azithromycin Clarithromycin Erythromycin

Macrolides MOA

bacteriostatic antibiotics

What are the effects of macrolides?

• anti-inflammatory & immunomodulatory effects (particularly azithromycin)

Macrolides indications

pneumonia, sinusitis, pharyngitis, tonsillitis, uncomplicated skin infections, otitis media in pediatric patients, Helicobacter pylori infection (clarithromycin), gonococcal & chlamydial infection

Macrolides SE

• gastrointestinal disturbances (nausea, vomiting, abdominal pain, diarrhea)

• cardiotoxicity- QT-interval prolongation → torsades de pointes, ventricular tachycardia, ventricular fibrillation

• rash, itching, allergic reactions

• hepatotoxicity • hearing loss

Lincosamides examples

Clindamycin

Clindamycin MOA

binds reversibly to the 50S subunit of the bacterial ribosome and inhibits protein synthesis → bacteriostatic activity

Clindamycin indications

dental abscesses, intra-abdominal infections, lower respiratory infections, gynecological infections, bone and joint infections, skin infections, streptococcal pharyngitis, acne vulgaris, bacterial vaginosis

Clindamycin SE

pruritis, xeroderma, erythema, burning (after topical use), vaginal candidiasis and pruritis (after intravaginal administration), pseudomembranous colitis, nausea, vomiting and diarrhea (after systemic administration

Tuberculosis - cause

caused by Mycobacterium tuberculosis

Tuberculosis - what does it affects the most

lungs

Tuberculosis - infection

spread from person to person through the air

Tuberculosis - group of higher risk

people with HIV, malnutrition or diabetes or smokers have a higher risk of falling ill

Tuberculosis - symptoms

prolonged cough, chest pain, fatigue, weight loss, fever, night sweats

List anti-tubercular drugs

• isoniazid

• rifampicin

• ethambutol

• streptomycin

• pyrazinamide

What is isonazid

• bactericidal activity against growing Mycobacterium tuberculosis • prodrug

Isoniazid MOA

inhibits the synthesis of mycolic acids, which are essential components of mycobacterial cell wall

Isoniazid SE

restlessness, insomnia, muscle twiching, hepatitis, peripheral neuropathy

Rifampicin MOA

• bactericidal activity

• inhibits bacterial DNA-dependent RNA polymerase

Rifampicin indications

treatment of tuberculosis and leprosy

Rifampicin SE

hepatic damage, hypersensitivity, flu-like symptoms, red/orange discoloration of body fluids, diarrhea, nausea

Pyrazinamide MOA

• bactericidal activity

• prodrug

• the active form accumulates inside the bacterial cell, disrupts the bacterial membrane potential, and inhibits fatty acid synthesis

Pyrazinamide SE

nausea, hyperuricemia, flushing, rash, photosensitivity, hepatitis

Ethambutol MOA

• bacteriostatic activity

• acts as an arabinose analogue and inhibits arabinosyl transferase, resulting in impaired synthesis of the mycobacterial cell wall

Ethambutol SE

visual disturbances, optic neuritis, hyperuricemia, gastrointestinal upset, allergic reactions