Anti-infectives Flashcards
Anti-infectives can also be known as? a. antibiotics b. antivirals c. antifungals d. antiprotozoa e. all of the above
e. all of the above!
T/F? There are over 1000 different types of antibiotics which differ in their physical, chemical, and pharmacological characteristics.
False! There are over 100 different types (not 1000)
_________ is a chemical substance produced by various species of microorgs, including bacteria, fungus, actinomyces, that suppresses growth OR destroys other microorgs.
Antibiotics
T/F? Antibiotics are among the least safest, most toxic drugs used in medicine.
False! Safest and LEAST toxic drugs.
T/F? Some antibiotics can reduce the effects of birth control pills and cause them to be ineffective.
True!!
________ antibiotics suppresses growth of the target, rather than killing the target.
a. bactericidal
b. bacteriostatic
b. bacteriostatic
Resident flora in our GI tract is important for the uptake of what vitamin?
Vitamin B
Resident flora in our GI tract also deals with Vitamin K, which is important for what function?
co-agulation cascade
T/F? Gram(+) bacteria have thin peptidoglycan layer with lipoprotein and lipopolysaccharide, while Gram(-) bacteria have thick peptidoglycan layer.
False! Gram(-) has THIN peptidoglycan layer and Gram(+) has THICK layer.
Highest ocular concentrations of antibiotics are delivered locally in what 3 routes?
Topical, contact lens, and injections.
T/F? Weight, height, and cardiac function are the 3 factors used to determine the dose of antibiotics prescribed to a patient.
False. Weight, height, and RENAL (kidney) function.
Name two examples of Gram(+) ocular bacteria.
Staphlococcus and Streptococcus.
T/F? Staphlococcus aureus (MRSA) is more abundant, while Staphlococcus epidermidis (MRSE) is more virulent.
False!!! Staph Aureus (MRSA) is more VIRULENT than Staph Epidermidis (MRSE)
Where is staphlococci most often found on the human body?
skin and mucous membranes
T/F: Streptococcus _______ is a Gram(__) ocular bacteria seen in corneal ulcers and pediatric conjunctivitis.
a. aureus , (+)
b. epidermidis, (+)
c. aureus, (-)
d. pneumoniae, (+)
e. pneumoniae, (-)
d. pneumoniae, (+)
Gram(-) ocular bacteria can be cocci, rods, or enterics.
True!
“Serratia marcescens” and “Pseudomonas aeruginosa” are enteric, gram(-), ______-borne bacteria that can affect ocular health.
a. air-borne
b. water-borne
c. blood-borne
b. water-borne!!!
which of the following is NOT gram(-)?
a. E. coli
b. Neisseria gonorrhea
c. Pseudomonas aeruginosa
d. Streptococcus pneumoniae
e. Haemophilus influenzae
d. Streptococcus pneumoniae
Recall that Streptococcus and Staphlococcus are gram(+)
which is a gram(-) rod?
a. E. coli
b. Neisseria gonorrhea
c. Pseudomonas aeruginosa
d. Streptococcus pneumoniae
e. Haemophilus influenzae
e. Haemophilus influenzae
which of the following are ALL gram(-) Enterics?
a. E. coli, neisseria gonorrhea, serratia marcescens, proteus.
b. E coli, serratia marcescens, proteus, pseudomonas aeruginosa.
c. E coli, serratia marcescens, haemophilius influenzae, pseudomonas aeruginosa.
b!
which gram(-) bacteria causes hyperpurulent corneal ulcers?
a. Haemophilus influenza
b. Proteus
c. Neisseria gonorrhea
d. Pseudomonas aeruginosa
e. Staphlococcus epidermidis
c. neisseria gonorrhea
Which gram(-) bacteria causes pediatric otitis media and conjunctivitis?
a. Haemophilus influenza
b. Proteus
c. Neisseria gonorrhea
d. Pseudomonas aeruginosa
e. Staphlococcus epidermidis
a. haemophilus influenza
which of the following gram(-) bacteria can cause UTI’s and cornea ulcers (choose all that apply)?
a. Haemophilus influenza
b. Proteus
c. Pseudomonas aeruginosa
d. Staphlococcus epidermidis
e. E. coli
f. Serratia marcescens
b,c,e,f
Proteus, pseudomonas aeruginosa, serratia marcescens, and E. coli (all the gram(-)enterics)
T/F? Syphilis is the most common infection leading to ocular blindness in the world. It is estimated that over 1/2 billion people are affected.
False. chlamydia
Anything in the household that is capable of harboring bacterial infection and can transmit infection, such as bathroom towels, bedsheets, and pillow cases. What is this called?
Fomite
When a finger/fomite causes an eye infection, what is this called?
a. inclusion conjunctivitis
b. trachoma
c. syphilis
d. otitis media
b. trachoma
T/F?
C. trachomatis - chlamydia and Treponema pallidum - syphilis are both host-independent ocular bacteria.
False. they are both host DEPENDENT!
T/F? macrolides and tetracyclines are two of the safest antibiotics on the market often used in eyecare.
True!!!
T/F? macrolides and tetracyclines are broad spectrum bacteria.
False. tetracycline is, but macrolide is not. it is gram(+).
which antibiotic’s site of action is NOT the cell wall?
a. Bacitracin
b. Vancomycin
c. Sulfonamides
d. Penicillin
e. Cephalosporin
c. sulfonamide DOES NOT AFFECT THE CELL WALL. it affects cell metabolism.
What is the site of action of Fluoroquinolones?
a. cell membrane
b. DNA synthesis
c. protein synthesis
d. cell metabolism
e. cell wall
b. DNA synthesis
Which two antibiotics are “concentration-dependent” and must maintain a minimum concentration to be effective?
a. Aminoglycoside and tetracycline
b. Aminoglycoside and fluoroquinolone
c. Penicillin and cephalosporin
d. Penicillin and fluoroquinolone
b. Aminoglycoside and fluoroquinolone
Which of the following is NOT bactericidal?
a. penicillins
b. aminoglycosides
c. cephalosporins
d. tetracyclines
e. bacitracin
d. tetracyclines, is bacteriostatic.
Penicillin, aminoglycosides, cephalosporins, bacitracin, and flouroquinolones are all bactericidal.
true!!
Which of the following “PEARLS” of when to treat is false?
- Mucopurulent discharge: NO DISCHARGE = NO INFECTION
- +/- Diffuse conjunctival injection: DIFFUSE INJECTION= NO INFECTION
- If there is Potential Corneal Compromise
- is false. SECTORAL INJECTION = NO INFECTION
If it’s diffuse, there is infection.
T/F? Penicillin, cephalosporins, bacitracin, and vancomycin are all cell wall inhibitors.
True (x4 cell wall inhibitors)
Which antibiotic drug is given intravenously in hospitals and is used to treat MRSA and MRSE, which is indicative that the patient has a SERIOUS infection?
VANCOMYCIN (its a cell wall inhibitor)
Why are humans great targets for antibiotic therapy?
because humans lack cell wall and inner peptidoglycan layer that are found in bacteria.
PCN is a cell wall inhibitor because it inhibits _________, which is a PCN binding protein that creates peptide X links between polysaccharides.
transpeptidases
Which 3 PCNs are PCNase resistant?
a. Carbenicillin, Methicillin, and dicloxacillin.
b. Carbenicillin, Methicillin and ampicillin.
c. Flucloxacillin, Methicillin and dicloxacillin.
d. Flucloxacillin, Methicillin and ampicillin.
c. Flucoxacillin, Methicillin, and Dicloxacillin.
which of the following are sensitive to PCNase?
a. Amoxicillin
b. Ampicillin
c. Pen G
d. Ticaricillin
e. Carbenicillin
f. Pen V
PenG and PenV (x2 ONLY that are sensitive)
Generally, PCNs are _____ absorbed in the GIT, so they should be taken ______ food.
a. poorly, with
b. poorly, without
c. readily, with
d. readily, without
b. poorly, without
All of the following are bacteriostatic except:
a. tetracyclines
b. sulfonamides
c. trimethoprim
d. chloramphenicol
e. bacitracin
f. macrolides
e. bacitracin (this is bactericidal!)
T/F: It is possible to have an antibiotic that has both bacteriostatic and bactericidal properties.
True! Some antibiotics are combinations and can exhibit both profiles, depending on the dose used. ie. sulfamethoxazole + Trimethoprim => used to treat Ocular Toxoplasmosis infection.
Penicillin, Bacitracin, Vancomycin, and Cephalosporins have what in common?
All four are CELL WALL INHIBITORS
Genitals –> eye infection is caused by C. trachomatis, a gram (-) and host _______ ocular bacteria. This type of infection is called “________ conjunctivitis”
a. dependent, exclusion
b. dependent, inclusion
c. independent, inclusion
b. host DEPENDENT, “inclusion conjunctivitis”
T/F: C. trachomatis and T. Pallidum are both gram (-) host-dependent ocular bacteria. The first is associated with Chlamydia, and the latter Syphilis.
True!!!
C. trachomatis = chlamydia
T. (Treponema) pallidum = syphilis
Which of the following is not a “broad spectrum” antibiotic?
a. Tetracyclines
b. Cephalosporins
c. Chloramphenicol
d. Sulfonamides
e. Trimethoprim
f. Pyrimethamine
b. Cephalosporins (attacks the cell wall)
Polymyxin B is sensitive to gram (__) bacteria and targets what?
a. (-) cell wall
b. (-) cell membrane
c. (+) cell membrane
d. (+) cell wall
b. gram (-) and attacks cell membrane
Both clavulanate and sublactam inhibit what?
They are both PCNase inhibitors
What does the mnemonic “PAT an empty stomach” refer to?
Take PENICILLIN, AZITHROMYCIN and TETRACYCLINE without food (empty stomach) because PCNs in general are poorly absorbed in the GIT.
Hypersensitivity to which antibiotic can cause Steven’s Johnson Syndrome?
Penicillins!
If your patient is allergic to PCN, what other class of antibiotic would you not want to give, due to cross reactivity?
Do NOT give Cephalosporins ( esp. 1st generation)
Hypersensitivity to PCN can cause:
a. anaphylaxis
b. hemolytic anemia
c. serum sickness
d. steven’s johnson syndrome
e. all of the above
e. all of the above!
Methicillin hypersensitivity can cause interstitial nephritis.
true
Like PCN, cephalosporins have what type of ring structure?
beta lactam ring (with 6 members)
T/F: No topical formulations of cephalosporins are available.
True
Which of the following is true about cephalosporins?
a. Less PCNase susceptibility.
b. Hypersensitivity can cause vitamin K deficiency.
c. 3 out of the 4 generations have oral formulations.
d. has cross reactivity with PCNs
e. increasing gram (-) coverage comes in higher/newer generations.
f. all of the above
f. all of the above!
If patient has hemophilia, which antibiotic should you not give?
cephalosporin
Cephradine, Cefaclor, Cefzil, Cefixime, and Cefdinir are all what type of antibiotic? (pay attention to the prefix)
CEP or CEF prefix = Cephalosporins
AK-tracin and polysporin ointments are forms of bacitracin commonly used in eyecare.
True!
Why is bacitracin only used topically (ointment)?
Due to its profound nephrotoxicity.
Polymyxin B + Bacitracin = ???
This combination provides broad spectrum coverage
Polysporin!
The adverse reactions of ______ include ototoxicity, nephrotoxicity, and red man’s syndrome.
vancomycin (know that Red Man’s syndrome is associated with this)
Red Man’s syndrome is due to IV-induced mast cell degranulation, and simple release of histamine causes flushing of the skin.
True
Polymyxin B is an anionic detergent/surfactant.
False. It’s Cationic !!!
