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Pharmacology I > 2 - Antimicrobials II > Flashcards

2 - Antimicrobials II Flashcards

1
Q

All drugs that inhibit protein synthesis are ________

A

Bacteriostatic

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2
Q

What is the MOA of Tetracyclines?

A

Suppress bacterial growth by inhibiting protein synthesis

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3
Q

Why don’t tetracyclines alter mammalian protein synthesis?

A

They require an energy-dependent transport system to enter the cell, which mammalian cells (thankfully) do not have

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4
Q

In what disease are tetracyclines first line drugs?

A

Rickettsial disease (Rocky mountain fever, typhus)

Chlamydia

Cholera

Mycoplasmic Pneumonia

H Pylori

Lyme Disease

Anthrax

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5
Q

Two tetracyclines are used for periodontal disease:

A

Doxycycline

Minocycline

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6
Q

Tetracyclines should not be administered with:

A

Tetracycline = NO 2+ cations

No milk products, calcium supplements, iron supplements, mag laxatives, antacids

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7
Q

How do tetracyclines effect teeth in utero?

After birth?

A

In utero: cause staining of deciduous teeth, but not permanent teeth

4-8 years: stains permanent teeth

In other words, it only stains teeth that are actively developing

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8
Q

What happens if tetracyclines are taken with metal ions?

A

They chelate in the gut and aren’t absorbed

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9
Q

If a patient taking a tetracycline develops diarrhea, what should you suspect?

A

C. Diff. It’s a big cause of superinfections

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10
Q

As a rule, which patients should never receive tetracyclines?

A

Pregnant and Postpartum women

causes liver damage

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11
Q

What does clindamycin carry a black box warning for?

A

C. Diff

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12
Q

Aminoglycosides are used primarily against:

A

gram negative bacteria

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13
Q

What is the MOA of aminoglycosides?

A

Disrupt protein synthesis by binding to bacterial ribosomes

AND (more importantly) causes production of abnormal proteins

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14
Q

Are aminoglycosides polar?

A

Yes! Highly polar!

They cannot readily cross membranes, so they aren’t absorbed well from the GI tract, they don’t enter the spinal fluid, and they’re rapidly excreted by the kidneys

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15
Q

Most of the killing action of aminoglycosides is due to:

A

The production of abnormal proteins caused by binding to ribosomes, in addition to inhibition of protein synthesis

They lodge in the cell wall, weakening it and causing it to leak

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16
Q

Complete blockade of protein synthesis causes _______

A

bacteriostasis

IT IS NOT BACTERIOCIDAL

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17
Q

Aminoglycosides cannot kill:

A

Anaerobes

Transport of aminoglycosides across the cell membrane is oxygen dependent

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18
Q

The principle use of aminoglycosides is:

A

treatment of serious infections due to aerobic gram-negative bacilli

Pseudomonas

E. Coli

Klebsiella

Serrata

19
Q

Which aminoglycoside is sometimes used for gram positive cocci?

A

Gentamicin, in combination with Vanc or a beta lactam ABX

20
Q

Aminoglycosides can be absorbed ______ and _____

A

topically

Parenterally

21
Q

Aminoglycosides have a black box warning for:

A

ototoxicity (IRREVERSIBLE)

Nephrotoxicity

Neuromuscular Blockade

22
Q

What kind of drugs should never be given with aminoglycosides?

A

Drugs that hurt the eyes or kidneys

23
Q

What’s more important to monitor in patients taking aminoglycosides: peak or trough?

A

A high trough is what causes nephrotoxicity and ototoxicity

24
Q

Of all the aminoglycosides, Amikacin has two outstanding features:

A
  1. Has the broadest spectrum
  2. Is the least vulnerable to inactivation by bacterial enzymes
25
Q

Sulfonamides are primarily used to treat:

A

UTIs

26
Q

Sulfonamides are bacterio_____

A

static

27
Q

What is the MOA of sulfonamides?

A

Inhibit folate synthesis by mimicking PABA

Bacteria are unable to synthesize DNA/RNA and proteins

28
Q

Why don’t sulfonamides harm mammalian cells?

A

Because they acquire folate nutritionally

They don’t synthesize it

29
Q

Should sulfonamides be given during pregnancy?

A

Ideally not. They cross the placenta VERY easily and can cause toxicity in newborns, including kernicterus

30
Q

There is one subset of people who absolutely cannot take sulfonamides

A

G6PD deficiency. Can cause hemolysis

Most common among blacks and people of Mediterranean origin

31
Q

Why do sulfonamides cause kernicterus?

A

They bind with the same protein as bilirubin, kicking the bilirubin in to the blood stream. Since the BBB is poorly developed, it enters the brain and accumulates

32
Q

How do sulfonamides impact the kidneys?

A

Tend to crystallize in the kidneys, so have to be taken with LOTS of water to ensure dilution

33
Q

What is the mechanism of Trimethoprim?

A

Similar to Sulfonamides, just effects folate synthesis in a different part of the synthesis chain

34
Q

Patients taking trimethoprim should educated about early signs of:

Why?

A

blood dyscrasias! (sore throat, fever, pallor)

People with an unknown folic acid deficiency can sometimes develop megaloblastic anemia, thrombocytopenia, neutropenia

Folate = Anemia

35
Q

When Trimethoprim/Sulfamethoxazole are combined, what are they used to treat?

A

Most UTIs

Also otitis media, bronchitis, whooping couhg

36
Q

The common name for Trimethoprim/Sulfamethoxazole is:

A

Bactrim!

37
Q

There are two urinary tract antiseptics:

A

Nitrofurantoin

Methenamine

38
Q

What is the MOA of nitrofurantoin?

A

MACROBID

Prodrug that Injures bacteria by damaging DNA after undergoing enzymatic transformation

It’s selective because only bacterial cells have the converting enzyme

39
Q

Why is Macrobid ideal for UTIs?

A

It becomes concentrated almost entirely in the urine and is active against common UTI pathogens

40
Q

In which population of women should Nitrofurantoin and Methenamine be avoided?

A

In pregnant women

They should always be treated according to a complicated UTI regimen

41
Q

What is the MOA of methenamine?

A

prodrug that breaks down into ammonia and formaldehyde in acidic environments

Denatures bacterial proteins

42
Q

In order for methenamine to work, the urine must be at a pH of at most:

A

5.5 or lower

43
Q

Which drug should methenamine not be combined with?

A

Sulfonamides

Sulfonamides and formaldehyde form an insoluble complex that can cause crystalluria

Pharmacology I (29 decks)

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