Allman - Sulf, Trim, Nitro, Meth Flashcards Preview

POD Exam 2 > Allman - Sulf, Trim, Nitro, Meth > Flashcards

Flashcards in Allman - Sulf, Trim, Nitro, Meth Deck (19):
1

Sulfonamide Mechanism of action

Compete with PABA for the enzyme dihydropteroate synthetase thus depriving the cell of tetrahydrofolic acid (a cofactor in the synthesis of DNA)

- Bacteriostatic alone but can be combined to form bactericidal action.

2

Sulfonamide Excretion

RENAL (extent varies with agent)

3

Sulfonamide Adverse Effects

Anaphylaxis
Cutaneous Reactions (rash, SJS...)
Nephrotoxicity (crystalluria from IV)
*Kernicterus - when given in last months of pregnancy (increased fetal blood levels of unconjugated bilirubin)

4

Sulfonamides Spectrum of Activity

Gram + = staph, strep
Gram - = Piddly, PEK, CE
Atypicals = chlamydia

5

Sulfonamides commonly used for:

Acute UTI
Malaria
Rheumatic Fever Prophylaxis

6

Trimethoprim mechanism of action

Nonsulfonamide pyrimidine analogue that inhibits dihydrofolate reductase thus preventing the formation of tetra hydrophilic acid
- static or cidal depending on conditions

7

Trimethoprim excretion

Unchanges; Renal + tubular filtration

8

Trimethoprim Adverse Effects

Cutaneous
GI

9

What type of patients can be negatively affected by Trimethoprim?

Patients with folate deficiency
Alcoholics
Debilitated Patients
Pregnant women
Malabsorptive syndromes

10

Trimethoprim Spectrum of Activity

Gram + = strep, staph
Gram - = down to SCE

11

What is trimethoprim used for? (3)

Acute UTI
Recurrent/Prophylaxis UTI
Traveler's Diarrhea

12

Trimethoprim + Sulfamethoxazole = ?

Bactrim (bactericidal) - SYNERGY

13

What is Bactrim used for?

UTI ( all types)
Respiratory Tract Infections (pneumonia, otitis media, sinusitis)
GI
STDs
Malaria
Osteomyelitis
Bacteremia
Menigitis
Strenotrophamonas Maltophilia (VENTS)

14

Bactrim drug interactions: 2

1. Warfarin - potentiates anticoagulant effects
2. Methotrexate - increase in free methotrexate concentrations

15

Nitrofurantoin Facts:

- cheap
- UTIs (acute and prophylaxis)
- Renal excretion
- Can cause pulmonary reactions (flu like symptoms with SOB)
- ALL gram + (MRSA VRE)
- Gram - + down to CE
- NOT polynephritis

16

Methenamine mechanism of action:

No anitbacterial effect alone
Hydrolyzed to formaldehyde at urine ph

17

Adverse effects of Methenamine

Avoid with hepatic insufficiency - causes ammonia byproduct

Avoid with renal failure - acid forms could potentially lead to systemic acidosis

18

Methenamine spectrum of activity

Virtually ALL bacteria and fungi are susceptible to formaldehyde

19

Methenamine used for:

UTI Prophylaxis

NOT FOR ACUTE UTI