Ambulatory drugs Flashcards
1
Q
List 7 considerations in the use of antibiotics
A
- Bacteriocidal vs bacteriostatic
- Penetration
- Time vs concentration dependent
- WHP
- Narrow vs broad spectrum
- Aerobic vs anaerobic organisms
- resistance
2
Q
What is meant by concentration dependent antibiotics?
A
Tissue or serum concentrations must exceed the minimum inhibitory concentration (MIC)
3
Q
Give an example of a concentration-dependent antibiotic
A
Aminoglycosides
4
Q
What is meant by a time-dependent antibiotic?
A
Tissue or serum concentrations must be above the minimum inhibitory concentration (MIC) for the dosing interval
5
Q
Give examples of time-dependent antibiotics
A
Beta lactams
Macrolides
Tetracyclines
Glycopeptides
6
Q
List 7 classes of antibiotics
A
Beta lactams and penicillans
Sulphonamides and trimethoprim sulphonamides
Tetracyclines
Aminoglycosides
Macrolides
Fluroquinolones
Others
7
Q
List four examples of beta lactams/penicillins
A
Penicillin
Amoxicillin
Cephalosporins
Ceftiofur
8
Q
What is the mechanism of action for beta lactams/penicillins?
A
Prevent bacterial wall synthesis
Rupture of cell wall integrity
Inhibit penicillin binding protein
9
Q
Are beta lactams/penicillins bacteriocidal or bacteriostatic?
A
Bacteriocidal
10
Q
Are beta lactams/penicillins more effective against gram +ve or -ve?
A
Usually Gram +ve
(Gram -ve = thinner cell wall)
11
Q
Are beta lactams/penicillins time or concentration dependent?
A
Time dependent
12
Q
What are the classes of penicillins?
A
Natural
Pencillinase-resistant
Beta lactamase inhibitors
Aminopenicillins
Extended spectrum
Narrow spectrum
13
Q
What is the spectrum for natural penicillins?
A
G -ve anaerobes and aerobes
14
Q
Give two examples of penicillinase-resistant penicillins
A
Cloxacillin
Methacillin
15
Q
What is the spectrum of activity for pencillinase-resistant penicillins?
A
Penicillinase-producing G-ve cocci (staph)
16
Q
Give an example of a beta-lactamase inhibitor
A
Clauvonic acid
17
Q
Give two examples of aminopenicillins
A
Amoxicillin
Ampicillin
18
Q
What is the spectrum of activity for aminopenicillins
A
Broad spectrum: G +ve and G -ve activity
19
Q
Give two examples of extended-spectrum penicillins
A
Carbenicillin
Ticarcillin
20
Q
What is the spectrum of extended spectrum penicillins
A
G -ve including Pseudomonas
21
Q
Describe the penetration of penicillins
A
Joint, plural, and peritoneal spaces
NOT milk and CSF
22
Q
How are penicillins eliminated?
A
Urine
23
Q
What are the indications for penicillin?
A
Abcess, foot rot, umbilical and joint infections, respiratory, urogenital
24
Q
What is the spectrum for amoxycillin?
A
Broad spectrum (G +ve & -ve)
25
What can you add to amoxycillin to extend its spectrum of activity?
Clavulanic acid (beta lactamase inhibitor)
26
Is amoxycillin bactericidal or bacteriostatic?
Bacteriocidal
27
Does amoxycillin penetrate cellular barriers?
No
28
What are the indications for amoxycilin?
Abscess, umbilical and joint infections, mastitis, metritis, calf enteritis (E. coli, salmonella)
29
Are cephalosporins bactericidal or bacteriostatic?
Bactercidal
30
How are celphalosporins elminated?
Urine (renal)
31
What is the spectrum of Ceftiofur sodium?
G +ve and -ve anaerobes
32
Discuss the penetration of Ceftiofur
poor penetration into tissues with a physiological/cellular barrier
33
Are sulphonomodes bactericidal or bacteriostatic?
Bacteriostatic
34
What is the mechanism of action of sulphonamides?
Competitive inhibition of para-aminobenzoic acid into folic acid molecule
35
What is the mechanism of action of trimethoprim sulphonomides?
Inhibit thmidine synthesis, blocks conversion of para-aminobenzoic acid, blocks conversion of DFA to tetra-hydrofolic acid
36
Discuss the spectrum of activity of sulphonamides + trimethoprim sulphonomides
Broad spectrum (G +ve and -ve aerobes)
37
Are sulphonomides and trimethoprim sulphonomide bactercidal or bacteriostatic?
Alone, bacteriostatic;
In combination, bacteriocidal
38
Discuss the penetration of sulphonomides + trimethoprim sulphonomide
Wide penetration: can penetrate cellular walls.
Soft tissue, CNS, synovial fluid, small concentration in milk, pleural peritoneal, joint, udder, prostate, CSF, ocular
39
How are sulphonamides and trimethoprim sulphonomides eliminated
Renal + some hepatic
40
Discuss the toxicity of sulphonamide + trimethoprim sulphonamide
If rapidly administered, can cause hypersensitivity reaction with collapse and temporary blindness
41
Are tetracyclines bactericidal or bacteriostatic?
Bacteriostatic, but bacteriocidal at higher doses
42
What is the spectrum of activity of tetracyclines?
Broad spectrum (G+ve & -ve)
43
Discuss the penetration of tetracyclines
Liver, spleen, kidney, lung
44
How are tetracyclines eliminated?
Excreted unchanged in urine and bile
45
What are the indication for oxytetracyclines?
metritis, mastitis, septicaemia, generalised infections, pneumonia, leptosporosis, anaplasma
46
Discuss the toxicity of oxytetracyclines
Rapid IV dosing -\> hypotension and colapse.
Foetal tooth discolouration in utero
Tissue irritation
47
Name four aminoglycosides
Streptomycin
Neomycin
Gentamycin
Framycetin
48
Are aminoglycocides bactericidal or bacteriostatic?
Bactericidal
49
What is the mechanism of action of aminoglycocides?
Inhibition of protein synthesis
50
What is the spectrum of activity of aminoglycocides?
Aerobic G -ves (+ some G +ve mycobacteria and mycoplasma spp)
51
Are aminoglycocides time or concentration dependent?
Concentration dependent
52
Describe the toxicity effects of aminoglycocides
ototoxicity
nephrotoxicity
53
Which aminoglycocides are not for use in food producing animals?
Streptomycin
Gentamicin
54
Name four macrolides
Erythromycin
Tylosin
Timicosin
Tulatrhomycin
55
What is the mechanism of action of macrolides?
Inhibition of protein synthesis
56
Are macrolides bactericidal or bacteriostatic?
Bacteriostatic, but bactericidal at higher doses
57
What is the spectrum of activity of macrolides
G +ve, mycoplasmas
Moderate effect on anaerobes
58
Discuss the penetration of macrolides
Transferred by macrophages, crosses cellular barriers
Lungs, liver, kidney, mammary gland, reproductive organs
59
How are macrolides eliminated?
Hepatic and renal
60
Discuss the toxicity of macrolides
Pain and swelling at injection site.
Human toxicity/death
61
What is the spectrum of activity of erythromycin?
Narrow spectrum: G +ve, spirochaetes
62
What are the indications for erythromycin?
Bovine respiratory disease, calf pneumonias, metritis, chronic mastitis
63
What is the spectrum of activity of tylosin?
Narrow spectrum: G +ve
64
What are the indications for tylosin?
Pneumonia, foot rot, mastitis
65
What are the side effects of tylosin?
Transient ptylism (overproduction of saliva), increased RR
66
What is the spectrum of activity of tilmicosin?
Narrow spectrum: G +ve and fastidious G -ve
67
What are the indications for Tilmicosin?
Bovine respiratory disease, calf pneumonia
68
What are the side effects of tilmicosin?
Localised swelling
IV can cause death in cattle and humans
69
Can tilmicosin be used in food producing animals?
Not for use in lactating dairy cows due to persistance in milk
70
What is the mechanism of action of tulathromycin?
impaired protein synthesis
71
Can tulathromycin be used in food producing animals?
Cannot be used in dairy cows, bobby calves
72
Name two fluoroquinolones
Enrofloxacin
Marbofloxacin
73
Are fluoroquinolones bactericidal or bacteriostatic?
Bactericidal
74
What is the mechanism of action of fluoroquinolones?
Inhibits bacterial DNA gyrase: prevent DNA synthesis and cell replication
75
What is the spectrum of activity of fluoroquinolones?
G -ve, some G +ve aerobes, mycoplasma
76
Which fluoroquinolones are not for use in food producing animals?
Enrofloxacin
77
What are the indications for fluoroquinolones?
Mycoplasma, respiratory disease, seminal vesiculitis
78
What are the side effects of fluoroquinolones?
Arthropathic effects in immature animals
79
What are the side effects of marbofloxacin?
Localised pain and swelling
80
What is the spectrum of activity of florfenicol?
Broad spectrum: G +ve cocci, G -ve bacilli, mycoplasma
81
Is florfenicol bactericidal or bacteriostatic?
Bacteriostatic
82
What is the mechanism of action of florfenicol?
Inhibits ribosomal protein synthesis?
83
What are the indications of florfenicol?
Foot rot, pink eye (infectious bovine keratoconjunctivitis), bovine respiratory disease
84
What is the mechanism of action of sodium iodide?
Antibacterial agent (not an antibiotic)
85
What are the indications for sodium iodide?
Woody tongue, Lumpy jaw
86
What are the side effects of sodium iodide?
Tearing/lacrimation, nasal discharge, diarrhoea, weight loss, abortion
87
Which anti-inflammatory is not for use in food producing species?
Phenylbutazone (affects bone marrow in humans producing aplastic anaemia and agranulocytosis)
88
Name five anti-inflammatory drugs
Phenylbutazone
Flunixin meglumine
Ketoprofen
Meloxicam
Tolfenamic acid
89
What is the mechanism of action of flunixin meglumine
Potent cox inhibitor
90
How is flunixin meglumine eliminated?
Hepatic and biliary
91
What are the side effects of flunixin meglumine
Long term gastrointestinal ulceration
Myonecrosis and injection site inflammation
92
What is the mechanism of action of ketoprofen?
Inhibits prostaglandin synthesis in tissue
93
How is ketoprofin eliminated?
Renal
94
What are the indications of ketoprofen?
Fever, pain, mastitis inflammation, calf pneumonia, dehorning, castration
95
What is the mechanism of action of meloxicam?
Inhibits synthesis of prostaglandins
96
Can meloxicam be used in food producing animals?
Yes, but WHP longer than ketoprofin, so use in lactating cattle is therefore limited
97
What is the mechanism of action of tolfenamic acid?
Potent COX inhibitor
98
What are the indications for tolfenamic acid?
acute mastitis, acute bovine respiratory disease, infectious arthritis
99
List 7 sedatives/anaesthetics
Xylazine
Ketamine
Detomidine
Midazolam
Acepromazine
Butorphanol
Azaperone
100
How is xylazine excreted?
Hepatic and renal
101
What are the side effects of xyalzine?
thermoregulatory depression
gastrointestinal stasis
salivation
polyuria
bradycardia
hypotension
respiratory depression
102
What is the mechanism of action of ketamine?
NMDA antagonist
103
What is the use of ketamine?
Dissociative anaesthetic
104
What is the mechanism of action of detomidine?
Alpha 2 adrenergic agonist
105
What is the use of detomidine
Dose dependent sedation and analgesia
106
What is the mechanism of action of midazolam?
Serotonin antagonist, increased GABA release, reduced ACh in CNS
107
What is the use of acepromazine?
Sedative/tranquiliser
108
What is the mechanism of action of acepromazine?
post-synaptic dopamine antagonist, suppress sections of RAS (controls thermoregulation, emesis, hormones, consciousness)
109
What is the mechanism of action of butorphanol?
Partial agonist/antagonist opiate (kappa, sigma)
110
How is butorphanol excreted?
renal, biliary, faeces
111
What is azaperone used for
Neuroleptic (neuronal suppression), sedation
112
Which two drugs can be used for epidural analgesia?
Lignocaine and xylazine
113
What are the indications for lignocaine?
Local blocks (castration, de-horning, suturing, etc)
Nerve block (lameness examination)
