Drug Class Names Mechanism Bugs Resistance Toxicity Notes

INHIBITORS OF -lactams – Bind PBPs (transpeptidases), Hypersensitivity with a range of Most are eliminated
PEPTIDOGLYCAN penicillins, block cross-linking of manifestations– urticarial skin rash is through the kidney –
CROSS LINKING cephalosporins, peptidoglycan  activation of common, but anaphylaxis is possible except nafcillin and
carbapenems autolytic enzymes. Bactericidal 1. IgE mediated – rapid onset, oxacillin are eliminated in
anaphylaxis, angioedema, bile (N and O say NO to
laryngospasm the kidney!)
monobactam - 2. IgM and IgG antibodies fixed to
aztreonam cells – vasculitis, neutropenia,
positive Coomb’s test
3. Immune complex formation –
vasculitis, serum sickness (fever,
urticaria, proteinuria, arthralgia,
lymphadenopathy 5-10 days after
starting the drug), interstitial
nephritis
4. T cell mediated – urticarial and
maculopapular rashes, Sevens
Johnson syndrome

-LACTAM: Penicillin V (oral) & Same Penicillin G Penicillinase – a type of Hemolytic anemia Use penicillins for
PENICILLINS Penicillin G ● Streptococci  lactamase prophylaxis of
Bacteriocidal (IV/injection) ● S pneumo -  resistance endocarditis with surgical
● Meningococci Jarisch Herxheimer reaction in or dental procedures
● Treponema pallidum syphilis – looks like sepsis
● Actinomyces
Penicillin G for syphilis
prophylaxis
Penicillin V
● Streptococci and oral
pathogens Oral penicillin for
prophylaxis of strep
pharyngitis in a kid with a
history of rheumatic fever
● Amino-penicillins = Ampicillin Same Gram positives Penicillinase Psuedomembranous colitis (broad
-lactamase-sensitive Amoxicillin – better ● Gram postive cocci – not spectrum)
penicillins oral bioavailability staph
HELPSS kill enterococci! ● Listeria (ampicillin)
● Enterococci Maculopapillar rash is common with
ampicillin

More gram negatives

● H Influenza
● E coli
● Proteus
● Salmonella & shigella

Amoxicillin –can be used for

lyme disease and as part of
combined therapy for H pylori
● -lactamase-resistant Oxacillin Same Staph aureus that has MRSA has altered Methicillin – interstitial nephritis Nafcillin commonly used
penicillins Nafcillin penicillinase. Don’t use for penicillin binding protein for skin and soft tissue
Dicloxicillin MRSA – bug now has altered target site infections, unless MRSA is
Methicillin PBP sites. suspected
● Anti-psuedomonals Ticarcillin Same Works for most enteric gram Penicillinase. Use with  Synergy with
Piperacillin negative rods – including lactamase inhibitors. aminoglycosides against
psuedomonas and anaerobes pseudomonas and
(e.g., bacterioides). enterococci.

1
●  lactamase inhibitors Clavulanic acid “Suicide inhibitors” of  lactamase
Sulbactam – they irreversibly inhibit the
Tazobactam enzyme to protect penicillins

 LACTAM - Less susceptible to penicillinases Mainly due to - Broad range of hypersensitivity Renal clearance, with
CEPHALOSPORINS than penicillins lactamases, but Vitamin K deficiency active secretion blocked
Bacteriocidal changed PBPs and Assume penicillin allergy applies to by probenecid. Except
changed porin structures cephalosporins cefoperazone and
are possible ● For gram +, consider macrolides ceftriaxone, largely
● For gram -, consider aztreonam eliminated in bile.
 nephrotoxicity of aminoglycosides
Bugs not covered by
cephalosporins are
LAME
● Listeria,
● Atypicals
(chlamydia,
mycoplasma),
● MRSA (except
ceftaroline),
● Enterococci
1st generation Cefazolin Do not enter CNS Gram positive cocci and some Often used before
Cephalexin gram negatives (1st gen drugs surgery to prevent S.
PEcK at gram negatives) aureus infections
● Proteus
● E coli
● Klebsiella.

2nd generation Cefoxitin Most don’t enter CNS Gram positive cocci and more
Cefaclor gram negatives – (2nd gen is a
Cefuroxime HEN - PecKS at gram
negatives)
● H. Influenza
● Enterobacter aerogenes
● Neisseria
● Proteus
● E coli
● Klebsiella
● Serratia marcescens
3rd generation Ceftriaxone Most enter CNS! Wider spectrum: Ceftriaxone – meningitis,
Cefotaxime ● Gram positive cocci gonorrhea, and
Ceftazidime ● Gram-negative cocci, many community acquired
Important for empiric management rods. pneumonia. Largely
of meningitis and sepsis elimated in bile.
Use for serious gram negative
infections resistant to other  Ceftazidime –
lactams pseudomonas
th
4 generation Cefepime Resistant to most beta lactamases Even broader spectrum! 
activity against pseudomonas
and gram positive bugs
5th generation Ceftaroline Broad coverage of gram Doesn’t cover

2
 positives and gram negatives – psuedomonas
MRSA but not pseudomonas

CARBAPENEMS Imipenem Bind to PBPs just like penicllins, Wide spectrum ●  Elimination in renal disease Important in hospitals for
Bactericidal Meropenem but are not -lactams and are ● Gram positive cocci ● GI distress empiric use in severe, life-
Ertapenem resistant to beta lactamases. ● Gram negative rods - ● Drug fever (cross-allergenicity threatening infections
Doripenem including pseudomonas with penicillins),
IV ONLY (ertapenem has  ● CNS effects – seizures with
Risk of seizures limits use to life- pseudomonas coverage) imipenem in overdose or renal Renal elimination. Give
threatening infections ● Anaerobes dysfunction. Meropenem is less imipenem with cilistatatin
risky. to inhibit rapid renal
metabolism
MONOBACTAMS Aztreonam Same as penicillin. Resistant to Gram negative rods No cross-allergenicity with IV only
Bactericidal beta lactamases. penicillins or cephalosporins!
IV ONLY

INHIBITORS OF
PEPTIDOGLYCAN
SYNTHESIS
VANCOMYCIN Vancomycin Inhibits cell wall peptidoglycan Only gram positives. Serious, Resistance is rare, but is Nephrotoxicity Renal elimination
Bactericidal formation by binding D-ala D-ala multi-drug resistant bugs: emerging in staph Ototoxicity
portion of cell wall precursors – ● MRSA (VRSA) and enteroccal Hypotension
can’t elongate the peptidoglycan ● Enterococci (VRE) strains Thrombophlebitis
chain. ● Clostridium difficil (oral Red man syndrome – diffuse
dose for pseudomembranous flushing. Prevent with antihistamines
colitis) Amino acid and slow infusion rate
Doesn’t enter CNS ● S pneumo if resistant modification – D-ala D-
penicillins ala  D-ala D-lactate
PROTEIN SYNTHESIS
INHIBITORS – 30S
SUBUNIT
AMINOGLYCOSIDES Gentamicin 1. Binds to the 30s subunit to Severe gram-negative rod Drug inactivation by ● Nephrotoxicity – especially Synergistic with 
Bactericidal Neomycin block formation of the infections – but not effective acetylation, when mixed with lactams for enterococci
Amikacin initiation complex (A initiates against anaerobes. (Mean phosphorylation, or cephalosporins (penicillin G or ampicillin)
Tobramycin the alphabet)  bacteriostatic. GNATS cannot kill anaerobes) adenylation ● Neuromuscular blockade and pseudomonas
Streptomycin (like linezolid at 50s) ● Ototoxicity (extended spectrum)
2. Also causes misreading of ● Teratogen
mRNA and blocks translocation Streptomycin is used for TB and
 bacteriocidal. is 1st line for bubonic plague Neomycin for bowel
and tularemia. surgery

Requires oxygen for uptake!

TETRACYCLINES Tetracycline Binds to the 30s subunit and
Bacteriostatic Doxycycline prevents attachment of
Minocycline aminoacyl-tRNA to the A site.
(like streptogramins at 50s)
Limited CNS penetration
Doxycycline > tetracycline
● Borrelia burdorferi
● Mycoplasma pneumonia
● Rickettsia and chlamydia
(reaches high intracellular
concentrations)
● Acne
● Doxycycline – prostatitis,
reaches high concentrations
● Minocycline –
meningococcus carrier
states
 uptake or  efflux out ● GI distress
of bacterial cells by ● Discoloration of teeth & inhibition
plasmid-encoded of bone growth in kids
transport pumps ● Photosensitivity
● Contraindicated in pregnancy
● Superinfections  candidiasis,
colitis
Doxycycline has  fecal elimination
Divalent cations limit
absorption - don’t mix
with milk (ca2+) or
antacids (ca2+ or mg2+) or
iron containing
preparations
Use demeclocycline to
block ADH receptor in
SIADH

PROTEIN SYNTHESIS
INHIBITORS – 50S
SUBUNIT
CHLORAMPENICOL Chloramphenicol Blocks peptidyltransferase, ● Meningitis – H influenza, N Drug inactivation by ● Anemia (dose dependent) Limited usefulness b/c of
Bacteriostatic which transfers amino acid from A meningitidis, S pneumo acetyltransferase – ● Aplastic anemia – dose toxicities but still used in
site to P site and catalyzes peptide ● Rocky mountain spotted encoded by plasmids independent developing countries

3
 Not 1st line for bond. Acts at the 50s subunit
anything in
developed countries!
CLINDAMYCIN Clindamycin Inhibits translocation of the
Bacteriostatic peptidyl-tRNA from the A site to
the P site  ribosome can’t move
in 5’ to 3’ direction on mRNA. Acts
at the 50s subunit
MACROLIDES Azithromycin Same as clindamycin
Bacteriostatic Clarithromycin (“macroslides”). Bind to the 23S
Erythromycin rRNA of the 50s subunit
LINEZOLID Linezolid Binds to the 50s subunit to block
Bacteriostatic (usually) assembly of the initiation
complex (like 50s version of
aminoglycosides)
STREPTOGRAMINS Quinupristin Several mechanisms. Bind to 50s
Bacteriostatic alone, Dalfopristin and prevent interaction of
Bacteriocidal together amino-acyl tRNA with the
acceptor site (like tetracyclines at
the 30s). Also block release of
completed polypeptide
FOLIC ACID SYNTHESIS
SULFONAMIDES Sulfamethoxazole Block first step of folate
Bacteriostatic Sulfisoxazole synthesis, which is PABA +
Sulfadiazine pteridine  dihydropteroic acid.
Sulfasalazine Acts as antimetabolite of
dihydropterate synthase.
Normally dihdropteroic acid
continues on to dihydrofolic acid 
tetrahydrofolic acid  purines,
thymidine, and methionine. Then
DNA and proteins, respectively.
TRIMETHOPRIM Trimethoprim Blocks bacterial dihydrofolate
Bacteriostatic reductase, acts as a folate analog.
Use in combo with sulfonamides,
causing sequential block of folate
synthesis
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fever (Rickettsia rickettsi)
Anaerobes above the
diaphragm - aspiration
pneumonia, lung abscesses,
and oral infections
(bacteroides, clostridium
perfringens, peptostreptococcus,
fusobacterium, prevotella)
Gram positive cocci (S
pyogenes). Sometimes used for
osteomyelitis – high
concentration in bone
● Atypical pneumonias –
mycoplasma (including
avium), chlamydia, legionella
● STDs – chlamydia
● Gram positive cocci –
streptococcal infections in
patients allergic to penicillin
Highly resistant bugs – MRSA
and VRE, drug resistant
S pneumo
VRSA and VRE, other drug
resistant gram-positive cocci
● Gram positives
● Gram negatives
● Nocardia
● Chlamydia
● Triple sulfas or Bactrim for
UTI
Usually combined w/
trimethoprim to avoid resistance
Bactrim:
● UTIs
● Shigella and salmonella
● Pneumocystis jirovecii –
disc shaped yeast, causes
interstitial pneumonia in
● Gray baby syndrome in because of cost
preemies because they lack liver
UDP-glucuronyl transferase
Cross resistance for ● Psuedomembranous colitis from Best for lung abscesses
staph with C difficile from aspiration! Although
erythromycin – if ● Fever klebsiella can cause such
erythromycin resistant, ● Diarrhea infections, mixed
will quickly gain anaerobic bugs are most
resistance to common.
clindamycin!
Metronidazole for
anaerobes below the
diaphragm
Methylation of target MACRO: Clarithromycin – combine
site on 23S rRNA ● Motility issues with metronidazole and
prevents drug binding ● Arrhythmia by  QT PPI in triple therapy for H
● Acute cholestatic hepatitis pylori
● Rash
● eOsinophilia
Azithromycin –
prophylaxis in AIDS for
 serum concentration of Mycobacterium avium
theophyllines, oral anticoagulants (CD4 < 50)
Very rare Can cause serotonin syndrome
Inactivating enzymes, 
efflux
Altered enzyme,  ● Hypersensitivity Sulfasalazine – ulcerative
uptake, or  PABA ● Hemolysis if G6PD deficient colitis
synthesis ● Nephrotoxicity –
tubulointerstitial nephritis
● Photosensitivity
● Displace bilirubin and other
drugs from albumin – e.g.,
warfarin; kernicterus in infants
and pregnancy
● Stevens Johnson syndrome
Altered dihydrofolate Give folic acid to avoid: Can give Bactrim for
reducatase ● Megaloblastic anemia prophylaxis w/ recurrent
● Leukopenia UTIs
● Granulocytopenia
Prophylaxis in AIDS for
 AIDS pneumocystis pneumonia
● Pneumonia treatment and (CD4 < 200)
prophylaxis
● Toxoplasmosis
prophylaxis
DNA TOPOISOMERASES
FLOUROQUINOLONES Ciprofloxacin Inhibit DNA gyrase ● Gram negative rods of Mutation in DNA More common Ciprofloxacin is the drug
Bactericidal Norfloxacin (topoisomerase II) and urinary & GI tracts – gyrase (topoisomerase ● GI upset of choice for prophylaxis
Levofloxacin topoisomerase IV. TII relaxes includes pseudomonas! II) encoded by ● Superinfections of N. mengitidis
Oflofloxacin supercoiled DNA and TIV ● Neisseria chromosome. ● Skin rashes infections. Use rifampin for
Sparfloxacin separates replicated DNA during ● Some gram positives ● Headache, dizziness children.
Moxifloxacin cell division
Gemifloxacin Also plasmid encoded
Enoxacin resistance, efflux Rare
pumps. ● Tendonitis, tendon rupture (esp
> 60 yrs, taking prednisone), leg
cramps, myalgias
●  QT

Contraindicated in pregnant women,

nursing moms, and kids under 18 yrs
due to possible damage to cartilage

QUINOLONE Nalidixic acid

DAMAGES DNA
METRONIDAZOLE Metronidazole Forms free radical toxic ● Protozoa – giardia, ● Disulfiram like reaction with Clindamycin for anaerobes
Bacteriocidal metabolites  damage DNA entamoeba, trichomonas, alcohol (severe flushing, above the diaphragm
Antiprotozoal ● Gardnerella (gram variable tachycardia, hypotension)
rod) ● Headache
● Use with PPI and ● Metallic taste
clarithromycin for triple
therapy against H Pylori
● Anaerobes below the
diaphragm
ANTIMYCOBACTERIAL
DRUGS
ISONIAZID Isoniazid  synthesis of mycolic acids. Used only for TB – the only Mutations in KatG gene ● INH Injures Neurons & Different half lives in fast
Requires bacterial catalase- agent that is ever used solo for for catalase-peroxidase Hepatocytes vs. slow acetylators
peroxidase (encoded by KatG) to TB  no activation of ● Drug-induced lupus
convert INH to active metabolite isoniazid.
Similar in structure to Vitamin B6 –
competes with B6 in synthesis of
nucleotides (including GABA) 
defective end products. Also  renal
excretion of B6. Prevent
neurotoxicity and lupus w/ B6.

RIFAMYCINS Rifampin Inhibits DNA-dependent RNA ● TB
Rifabutin polymerase ● Leprosy – delays
resistance to dapsone
● Can use for prophylaxis
with Neisseria meningitidis
or exposure to kids with H
influenza. But ciprofloxacin
is the drug of choice for
menginococcal prophylaxis)
5
Enzyme alteration ● Minor hepatotoxicity and drug 4 R’s of Rifampin
interactions ( P450) 1. RNA polymerase
● Orange body fluids (not inhibitor
dangerous) 2. Ramps up microsomal
● In HIV, rifabutin is better because P450
< P450 stimulation – rifAMPin 3. Red/orange body fluids
amps up P450s but rifaBUTin 4. Rapid resistance if
does not used alone
PYRAZINAMIDE Pyrazinamide Acidifies intracellular TB Rapid resistance if used Hyperuricemia
environment by conversion to solo Hepatotoxicity
pyrazinoic acid – effective in
acidic pH of phagolysosome,
where TB engulfed by
macrophages is found
ETHAMBUTOL Ethambutol  carbohydrate polymerization TB Rapid resistance if used Optic neuropathy – red/green color
of mycobacterium cell wall by solo blindness,  visual acuity, central
blocking arabinosyltransferase scotoma

6
Antifungal Drugs
Drug Class Names Mechanism Use Resistance Toxicity Notes
POLYENES Amphotericin Binds ergosterol and forms membrane Serious, systemic mycoses Low ergosterol Caused by cholesterol binding: Give intrathecally for fungal
B pores  leakage of electrolytes. ● Cryptococcus neoformans, content in cell ● Fever & chills meningitis
Unfortunately also binds cholesterol to a candida – +/- flucytosine for membranes ● Hypotension
lesser degree  toxicity meningitis ● Nephrotoxicity because  GFR -  w/
● Mucor hydration Give w/ K+ and Mg2+
● Aspergillis ● Hypomagnesemia, hypokalemia in
Poor penetration into CNS – combine w/ ● Blastomyces, coccidiodes most pts – altered permeability of renal
flucytosine for cryptococal meningitis histoplasma tubules
● Arrhythmias
● Anemia -  renal EPO
Liposomal form has  toxicity
● IV phlebitis
Nystatin Topical form of amphotericin B Candidiasis – oral, diaper, vaginal Also used in Thayer-martin
media (VPN) to grow
Neisseria – inhibits
competition from fungus
TRIAZOLES Fluconazole Inhibit fungal ergosterol synthesis by Local and less serious systemic ● Inhibit testosterone synthesis  Can use ketoconazole to
Ketoconazole inhibiting the cytochrome P450 enzyme that mycosis gynecomastia (especially ketoconazole) treat PCOS (also
Clotrimazole converts lanosterol to ergosterol ● Fluconazole – in AIDS, use for ● Liver dysfunction – inhibits P450s spironolactone). But
Miconazole chronic suppression of gynecomastia and
Itraconazole Cryptococcus neoformans amenorrhea
Voriconazole meninigitis and candida of all
kinds
● Itraconazole – blasto, coccidio,
histo, sporo
● Clotrimazole and miconazole
for topical fungal infections
PYRIMIDINES Flucytosine Inhibits DNA and RNA synthesis by Systemic fungal infections - Resistance is Bone marrow suppression – not reversible
conversion to 5-flourouracil by cytosine especially cryptococcal meningitis fast if used solo with leukovorin. 5’ fluorouracil is an
deaminase. 5’-flourouracil directly messes in combo w/ amphotericin. Can also antimetabolite used in cancer treatment. If
up RNA and also messes up the conversion combine therapy for candida. overdose, can rescue with uridine
of dUMP to dTMP for DNA.
ECHINOCANDINS Caspofungin Inhibit cell wall synthesis by inhibiting Invasive aspergillosis, candida GI upset
Micafungin synthesis of glucan, a component of the Flushing – from histamine release
Anidulafungin fungal cell wall
TERBINAFINE Terbinafine Inhibits fungal squalene epoxidase in Dermatophytoses – especially GI upset
Dermatophytes dermatophytes only (think squamous onychomycosis = fungal infection of Headaches
cells)  ultimately results in  ergosterol finger/toe nails Hepatotoxicity
Taste disturbance
GRISEOFULVIN Griseofulvin Interferes with microtubule formation Oral treatment of superficial Teratogenic
Dermatophytes (grease the MTs), disrupts mitosis. Deposits infections, inhibits growth of Carcinogenic
in keratin-containing tissues (e.g., nails) dermatophytes (tinea, ringworm) Confusion
 warfarin and P450 metabolism

7
Drug Class Name Mechanism Use Resistance Toxicity Notes
Inhibit Zanamivir Inhibit influenza neuraminidase to  release of progeny Influenza A and B Amantidine and rimantidine
release of Oseltamivir virus (orthomyxyviruses) used to inhibit influenza
viral progeny uncoating – no longer used
b/c of  resistance
Inhibit nucleic Ribavarin Inhibits synthesis of guanine nucleotides by RSV Hemolytic anemia
acid competitively inhibiting inosine monophosphate Chronic Hep C Severe teratogen – makes sense
synthesis dehydrogenase, which converts IMP  GMP  GTP. b/c human cells use IMP
Virus can’t make RNA. dehydrogenase to make GMP
Acyclovir Guanosine analog that selectively inhibit viral DNA 1. HSV – oral/genital ulcers Virus mutates thymidine Must be adequately hydrated! No effect on latent virus
Famcyclovir polymerase. Get monophosphorylated by HSV/VSV and encephalitis. If kinase  no Risk of obstructive crystalline (only targets replicating
Valacyclovir thymidine kinase  selective for infected cells. Then resistant, try foscarnet monophosphorylation of nephropathy and acute renal virus)
Drug-MP  Drug-TP via cellular enzymes, and inhibits or cidofovir drug. failure!
viral DNA polymerase via chain termination. 2. VZV – use famciclovir
for zoster (in older Valacyclover
FAMily members)
3. Weak activity against
EBV
Gancicyclovir Like acyclovir, etc. CMV – especially in immune Lack of viral kinase or Renal toxicity Valgancyclovir is a prodrug
compromised mutated viral DNA with better
polymerase.
 Try foscarnet More toxic to host enzymes than
acyclovir:
● Leukopenia
● Neutropenia
● Thrombocytopenia
Foscarnet Viral DNA polymerase inhibitor – binds to 1. CMV retinitis – in DNA polymerase can Nephrotoxicity
pyrophosphate binding site of the enzyme. Doesn’t need immune compromised mutate
activation by viral kinase! patients
2. HSV – resistant to
acyclovir
Cidofovir Like foscarnet – but maybe a different binding site Same as foscarnet Nephrotoxicity – coadminister with
probenicid and IV saline to 
Inhibit viral Interferon  Binds to receptors on cell surface to  protein synthesis. 1. Chronic Hep B and Hep Neutropenia
protein Normally made by virus-infected cells. Exhibits wide C Myopathy
synthesis range of antiviral and anti-tumor properties 2. Condyloma
acuminatum
3. Kaposi sarcoma
4. Renal cell carcinoma,
hairy cell leukemia,
malignant melanoma

8
Drug class Drug Names Mechanism Use Toxicity Notes
Nucleoside Nucleosides: Competitive inhibition of nucleotide binding to reverse CHOOSE 2 for part 1 ● Bone marrow suppression – Choose 2, then use with 2 out of 3:
Reverse ● Lamivudine transcriptase  terminates DNA chain (lacks 3’ OH group) of triple therapy reverse with G-CSF and EPO! NNRT, protease inhibitor, integrase
Transcriptase ● Stavudine ● Peripheral neuropathy inhibitor
Inhibitors ● Zidovudine ● Nucleosides – lactic acidosis
● Emtricitabine The nucleosides need to be phosphorylated for activity, tenofovir ● Nucleotides – rash
● Didanosine doesn’t. ● Zidovudine – anemia
● Abacavir ● Didanosine - pancreatitis

Nucleotide:
Tenofovir

Non-nucleoside Efavirenz Bind to reverse transcriptase at a site different from NRTIs. Don’t CHOOSE 1 for part 2 Rash
Reverse Transcriptase Nevivirapine need phosphorylation to be active and don’t compete with or 3 of triple therapy Hepatotoxicity
Inhibitors Delavirdine nucleotides Efavirenz – CNS symptoms and rash,
avoid in pregnancy
Delavirdine – avoid in pregnancy
Protease Atazanavir Normally viral aspartate protease cleaves HIV protein into its CHOOSE 1 for part 2 Hyperglycemia Viral pol gene codes for protease,
Inhibitors Darunavir functional parts  assembly of virions. Protease inhibitors block or 3 of triple therapy GI intolerance – nausea, diarrhea integrase, and reverse transcriptase
-navir Fosamprenavir this process. Lipodystrophy
Indinavir
Lopinavir
Ritonavir Nephropathy
Saquinavir Hematuria - idinavir

Integrase Raltegravir Blocks HIV integration into host cell by reversibly inhibiting HIV CHOOSE 1 for part 2 Hypercholesterolemia
Inhibitor integrase or 3 of triple therapy

Fusion Enfuvirtide Enfuvirtide – binds gp41 to block fusion Skin reaction at injection sites
Inhibitor Maraviroc
Maraviroc – binds CCR-5 on T cells/monocytes to block
interaction with gp120

9
 Bug Treatment Notes
Psuedomonas Ticarcillin, pipercillin, cefepime – 4th generation, ceftazidime – 3rd
generation, aminoglycosides, others?

MRSA Vanco, daptomycin, linezolid, tigecycline, ceftaroline

VRE Linezolid and streptogramins (quinupristin, dalfopristin) – keep these

drugs pristine for hugely serious infections

PROTOZOA
Toxoplasmosis Pyrimethamine – inhibits protozoal dihydrofolate reductase

Trypanosoma brucei Suramin and melarsoprol

Trypanosoma cruzi Nifurtimox

Leishmaniasis Sodium stibogluconate

PLASMODIA
Plasmodium vivax, ovale, malariae Chloroquine. Plasmodium falciparum is resistant to chloroquine – membrane pump 
If life threatening – quinidine in the US, quinine elsewhere, or artesunate intracellular concentration

Plasmodium falciparum Artemether/lumefantrine or atovaquone/proguanil

If life threatening – quinidine in the US, quinine elsewhere, or artesunate

HELMINTHS
Nematodes (round worms): Enterobius vermicularis (pinworm), ascaris Mebendazole, albendazole, bendazole, pyrantel pamoate, ivermectin,
lumbricoides (giant roundworm), ancylostoma duodenale diethylcabamazine, praziquantel

Trematodes (flukes): schistosoma, clonorchis sinesis Praziquantel

10