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Pharmacology TC4
Metronidazole
Mechanism of Action
Bactericidal
Forms Free Radical Toxic Metabolites
Damages DNA
Indications
Giardia lamblia
Entamoeba Histolytica
Trichomonas
Gardnerella
Anaerobes
Side Effects
Metallic taste
Disulfiram like Reaction with Alcohol
2 mins
Aminoglycosides
Drug Names
Gentamicin
Neomycin for Bowel Surgery Prep
Amikacin
Tobramycin
Streptomycin
Mechanism of Action
Bactericidal
Inhibit Formation of Initiation Complex
Cause Misreading of mRNA
Require O2 for Uptake
Resistance
Resistance by Transferase Enzymes
Acetylation
Phosphorylation
Adenylation
Indications
Gram-Negative Rod Infections
Synergistic with B-Lactam Antibiotics
Side Effects
Nephrotoxicity Especially When Used with Cephalosporins
Ototoxicity Especially When Used with Loop Diuretics
Teratogen
5 mins
Tetracycline Drug Names and Indications
Drug Names
Demeclocycline
Minocycline
Doxycycline
Fecally Eliminated
Can be Used in Renal Failure
Indications
Antidiuretic Hormone Antagonist
Chlamydia
Rickettsia
Borrelia burgdorferi
Helicobacter Pylori
Mycoplasma Pneumonia
3 mins
Tetracycline Mechanism
Binds to 30 S to Prevent Attachment of Aminoacyl tRNA
Limited CNS Penetration
Divalent Cations Inhibit Absorption
Must Not Take with Milk, Antacids, Iron
1 min
Tetracycline Toxicities
Inhibition of Bone Growth in Children
Teratogen
Discoloration of Teeth
Photosensitivity
GI Distress
2 mins
Protein Synthesis Inhibitors
Drug Names
30S inhibitors
Aminoglycosides
Tetracyclines
50S inhibitors
Chloramphenicol
Clindamycin
Erythromycin
Lincomycin
Linezolid
3 mins
Macrolides
Mechanism of Action
Bacteriostatic
Bind to 23S rRNA of 50S Subunit
Inhibit Protein Synthesis by Blocking Translocation
Macrolides
Erythromycin
Azithromycin
Clarithromycin
Indications
Gram-Positive Cocci
Atypical Pneumonia
Chlamydia
Considerations
Resistance by Methylation of 23S rRNA Binding
2 mins
Macrolides Side Effects
Side Effects
Diarrhea
Prolonged QT Interval
P450 Inhibitor
Cholestatic Hepatitis
Skin Rash
Eosinophilia
3 mins
Chloramphenicol
Mechanism
Bacteriostatic
Inhibits 50S Peptidyltransferase Activity
Indications
Meningitis
Rocky Mountain Spotted Fever in Pregnant Women
Side Effects
Anemia
Aplastic Anemia
Gray Baby Syndrome due to Decreased UDP-Glucuronyl Transferase
Resistance Caused by Plasmid Encoded Acetyltransferase
2 mins
Clindamycin
Mechanism of Action
Bacteriostatic
Binds 50S Ribosomal Subunit
Blocks Translocation
Indications
Anaerobic Infections above the Diaphragm
Aspiration Pneumonia
Lung Abscess
Side Effects
Can Cause Pseudomembranous Colitis
1 min
Amphotericin B
Indications
Systemic Mycosis
Fungal Meningitis
Last Resort for Protozoan infections
Mechanism
Polyene
Binds Ergosterol
Forms Membrane Pores
1 min
Amphotericin B Side Effects & Toxicity
Side Effects
Fever/Chills "Shake and Bake"
Nephrotoxicity
Milder with Liposomes
Hypotension
Anemia
IV Phlebitis
Arrhythmias
1 min
Flucytosine
Indications
Cryptococcus
Candida
Used in Combination with Amphotericin B or Azoles
Mechanism
Inhibits DNA and RNA Synthesis
Converted to 5-FU by Cytosine Deaminase
Side Effects
Bone Marrow Suppression
1 min
Echinocandins
"-Fungin" Suffix
Indications
Invasive Aspergillosis
Candida
Mechanism
Inhibits Cell Wall Synthesis
Inhibits Synthesis of Beta-glucan
Side Effects
GI Distress
Flushing
1 min
Griseofulvin
Mechanism
Disrupts Microtubules in Mitosis
Indications
Antifungal for Superficial Infections
Tinea and Ringworm
Side Effects
Teratogen
P450 Inducer
Confusion
Headache
2 mins
Nystatin
Indications
Candidiasis
Vaginal
Oral
Cutaneous
Mechanism
Polyene
Binds Ergosterol
Forms Membrane Pores
Topical form of Amphotericin B
Side Effects
Rash
1 min
Azoles (Ketoconazole)
"-azole" suffix
Indications
Local and Less Serious Systemic Mycosis
Mechanism
Inhibits Ergosterol Synthesis
Inhibits P450
Side Effects
Liver Dysfunction
Inhibition of Testosterone Synthesis
1 min
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