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Vancomycin: mechanism and side effects (four)
similar to pens--inhibits peptidoglycan construction-->bactericidal
side effects: nephrotoxic, ototoxic, thrombophlebitis, "red man syndrome"
similar to pens; interferes with regeneration of lipid carriers in peptidoglycan synthesis by blocking dephosphorylation
Quinolones: mechanism, route of admin
inhibits DNA gyrase (topoisomerase II)-->bactericidal
Quinolones: side effects (two) and contraindications (what type of pts)
side effects: n/v/d, can have suprainfections with streptococci and candida
Contraindicated in pts < 18 yrs and > 60 yrs for cartilage damage (tendinitis and tendon rupture); also in preg and nursing mothers
Quinolones: 2 mechanisms for drug resistance
1. gyrase mutation
2. decreased permeability of drug through porins
Quinolones: 8 indications
1. UTI by multi-drug resistant bacteria
2. gastroenteritis (by shigella, salmonella, E.coli, helicobacter)
3. osteomyelitis and soft tissue infections (not routine)
4. intraabdominal and respiratory tract infections (not routine)
5. gonococcal infections
7. prophylaxis for traveler's diarrhea
Which quinolone is particularly anti-pneumoncoccal?
ofloxacin--has closely related levofloxacin and moxifloxacin which are also "respiratory" quinolones
Erythromycin: indications (ten)
1. DOC in community-acquired pneumonia (includes S. pneumoniae, Legionella, M. pneumoniae)
2. Treponema if pens allergy
4. Chlamydia (esp during preg)
8. Bordetella pertussis
10. Gram pos: Pneumococci, Streptococci, Staphylococci, C. diphtheriae (eliminate carrier state)
Similar spectrum as pen G
Metronidazole: mechanism and route of admin
inhibits DNA synthesis-->bactericidal
oral; IV available
Metronidazole: side effects (two)
1. minor GI and CNS disturbances
2. Interferes with EtOH metabolism--disulfram-like effect-->decreases activity of aldehyde dehydrogenase, so aldehyde toxicity
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