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Flashcards in Antibiotics for STDs Deck (18)
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1
Q

Cephalosporins drugs

Macrolide drug

Nitroimidazoles

Regular penicillins

Tetracyclines

A

ceftriaxone, cefixime

azithromycin

metonidazole

Penicillin G, crystalline/benzathine

doxycycline

2
Q

Tetracycline drug, forms

bind to __of bacterial ribosome and stop addition of ___ in growing polypeptide

Prevent binding of ___ to the binding site

__ and __
__ dec use

A

doxycycline (I/O)

30s subunit, next AA

aminoacyl tNA

bacteriostatic, broad spectrum
resistance

3
Q

common mechanism of resistance is expression of __
expels __
__ not as well expelled

another mech is ___ proteins
these displace tetracyclines from __ on ribosome

steps

1: Tetracycline __ ribosome
2: __ ribosome protection protein forces ___ off binding site
3: __ unbinds, ribosome is __

A

efflux pumps
tetracycline
tigecycline

ribosomal protection
bidning site

binds
GTP-dependent, tetracycline
protection protein, drug-free

4
Q

Doxycycline can be used for __ and __ and __ and __
some __

__ and __ are preferred in tx of ___

D has best __ of tetracyclines, interacts w least amount of __

__ elimination via __/__
enters most tissues ___

A

gram +/-, intracellular, spirochete
anaerobes

doxycycline, azithromycin, chlamydia

oral bioavailability, food

mixed, hepatic/renal
well

5
Q

Tetracyclines bind __ and __ ions, doxyclcine somewhat __

__ and __ and some __ dec oral absorption, especially more __ tetracyclines

pts should __ these products __ before/after dosing

SE
GI distress such as __
P__, use ___

bind to __ and __ in fetuses/young kids, leading to ___

A

divalent/trivalent, less

dairy, iron supps, antacids, hydrophilic

avoid, 2hrs

esophageal irritation
photosensitivity, protection

teeth/bone
permanent discoloration

6
Q

Nitroimidazole drug, preps

drug sensitive organisms like __ and __ can convert metronidazole to ___ metabolite, binding to __ and causing __

__ spectrum, __ AB
can kill __, targets ___

pharmacokinetics allow for __
excellent __
elimated via __/__

A

Metronidazole, I/O/T/vaginal gel

anaerobes, parasites
cytotoxic reactive, DNA, fragmentation

narrow, bacteriocidal
protozoa, anaerboes

use w variety of infections
oral bioavailability
hepatic/renal

7
Q

Metro is mostly ___
SE
Inhibits ___, leading to N/V/C w even small amt of __

Darkens __
Peripheral ___, can produce ___
__ neuropathy most likely

Often used for mild to moderate __ infections
likely __ infections, such as __ or __
__ and __

A

well tolerated
acetaldehyde dehydro, NV, cramps, EtOH

urine
neuropathy
lastign damage
sensory

C diff
anaerobic, orofacial/abdominal
Bacterial vaginosis/trichomonas

8
Q

Nonresistant trichomoniasis tx w ___ usually __

trichomoniasis only treated w ___

tinidazole may be slightly __ against resistant pathogens

resistance to __ can be overcome by ___ dose
resistance usually due to dec expression of ___ needed for ___

redox proteins can only __ so much, as they are needed for __

A

metronidazole, oral, single dose

nitroimidazoles

nitroimidazoles, inc
redox proteins, drug activation

dec, energy metabolism

9
Q

Pt w problems to nitroimidazoles

__ abuse, preexisting __ as this leads to __
metronidazole __
alternative tx have __ cure rate
__ protocol may be considered

A
ethanol, neuropathies
SE
hypersensitivity
lower
desensitization
10
Q

Primary/secondary/early latent <1 yr syphillis tx w __

latent > 1 yr, or unknown tx w ___

neurosyphillis tx w ___

Penicillin G form
MOA: \_\_, bactericidal inhibitor of \_\_\_
\_\_ spectrum including \_\_
\_\_ elim
can enter \_\_, \_\_ levels req

__ common, severe
well suited for use w

A

benzathine PenG

benzathine PenG

crystalline PenG

injection

beta lactam, cell wall synth
broad, spirochetes
renal
CNS, high

hypersensitivity rxn
preg

11
Q

Crystalline PenG
__ soluble, administered __
t1/2 is __, must be admin __
achieves highest __ of all PenG forms

Benzathine
__ form of PenG, admin __
therapeutic blood levels maintained for __
preferred except when __ expected

Adv of benzathine
__ admin is convenient and has __
prolonged therapeutic blood level ensures __ of slow grow TP

A

water, IV
few hrs, freq
CNS levels

slow released, IM
2-3 wks
neurosyph

single, pt compliance
eradication

12
Q

Main issue complicating PenG is __
__ protocols allow short term exposure
___ is alternative AB

development of __ is not an issue w TP

__ Rxn is a post tx __ febrile rxn

seen w/in __ after tx
caused by ___ and __
may be more common in __ than __

A

hypersensitivity
desensitization
doxycycline

resistance

Jarish Herxheimer, cytokine mediated

24hrs
spirochete lysis/endotoxin release
early than late stages

13
Q

Ab to chlamydia
Adults/adolescents __ or __
Pregnancy __

most important classes are __ and __

tetracyclines use
Macrolide drug, preps, use

MOA macrolides: \_\_ protein synth inhibitors
\_\_ spectrum ,includes \_\_ and \_\_ bacteria
\_\_ elim
azithromycin has _ t1/2
\_\_ tolerated
A

azithro/doxy
azithro

macrolides, tetracyclines

chlam, syph
azithromycin, OIT, chalm, gon

bacteriostatic
broad, gram -/IC
hepatic
long
well
14
Q

Avoid __ during preg/nurs/children < 8

azithromycin’s __ and single __ enhances compliance

Doxycycline more active against serovars causing __

A

doxy
long t1/2, dose
lymphogranuloma venerum

15
Q

Adults/adolescents w uncomplicated gonoccal infection tx w

if ceftriaxone not available, treat w __ and __

__ cephalosporins, ie __, is drug of choice for Gono

__ also given to combact __ and treat coexisting __

3rd gen cephs include __ and _ to treat __, prep

A

Ceftriaxone + azithromycin

cefexim + azithro

3rd gen, ceftriaxone

macrolide, resistance, chlam

Ceftriaxone/cefexime, I/O, gonorrhea

16
Q

Cephalosporin MOA: __, bactericidal inhibitors of ___
__ spectrum, excellent __ coverage
distributed __ in body, including __

__ has longest t1/2

can have __ w penicillin

A

beta lactam, cell wall synth
broad, gram -
widely, CNS

ceftriaxone

cross hypersensitivity

17
Q

Many drugs have been __ from tx Gonorrhea due to __

resistance to __ remains common

if __ of NG strains resistant to AB, CDC __ use for empirc tx

__ most effect AB left to tx

__ strains w mutated __ are being reported

__ was dropped as first line due to __

another goal is to slow further development of ___ strains, in order to preserve efficacy of __

A

retired, resistance

penicillin

5%, discourages

3rd gen cephalosporins

cephalosprin resistant, penicillin binding proteins

cefexime, resistance

cephalosporin resistant, ceftriaxone

18
Q

__ used when ceftriaxone not available
not useful against __ infection

___ added to ceftriaxone to inc ___ and treat __ coinfect

may help to slow development of ___ resistance

Azithro can be combined w __ or ___ for use in pt w __ allergy

A

cefexime, pharyngeal

azith, efficacy, ceftriaxone

ceftriaxone

fluoroquinolones, aminoglycosides, cephalosporin