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Ocular Pharmacology > Anti-infectives > Flashcards

Anti-infectives Flashcards

1
Q

What is an antibiotic?

A

a chemical substance produced for various species of microorganisms that suppress growth or destroys other microorganisms

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2
Q

What 3 things do you need to see in a patient to give an antibiotic?

A

mucopurulent discharge, diffuse conjunctival injection, potential for corneal compromise

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3
Q

what are the 5 antibacterial drugs that are bactericidal?

A

Penicillin’s, aminoglycosides, cephalosporins, bacitracin, fluoroquinolones

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4
Q

which 2 bactericidal antibiotics are concentration dependent?

A

Aminoglycosides and fluoroquinolones

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5
Q

what are 5 antibacterial drugs that are bacteriostatic?

A

tetracyclines, macrolides, sulfonamides, trimethoprim, chloramphenicol

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6
Q

What does a gram positive bacteria have?

A

thick peptidoglycan layer

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7
Q

what does a gram negative bacteria have?

A

thin peptidoglycan layer with lipoprotein and lipopolysaccharide (LPS)

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8
Q

what are the 4 antibacterial drugs that inhibit cell walls?

A

Penicillins (+>-), cephalosporins (+>-), bacitracin (+), vancomycin (+)

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9
Q

what are the 2 antibacterial drugs that inhibit cell membranes?

A

polymyxin B (-) and gramicidin(+)

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10
Q

what are 4 antibacterials that inhibit protein synthesis?

A

aminoglycosides (->+), tetracyclines (+ and -), macrolides (+), and chloramphenicol (+ and -)

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11
Q

what are 3 antibacterials that inhibit cell metabolism?

A

sulfonamides (+ and -), trimethoprim (+ and -), pyrimethamine (+ and -)

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12
Q

what is 1 antibacterial that inhibits DNA synthesis?

A

Fluoroquinolones (->+)

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13
Q

What are 3 antibacterials that you should take on an empty stomach?

A

PAT = penicillins, azithromycin, tetracyclines

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14
Q

what are 2 gram + spherical bacteria arranged in clusters? (most common ocular pathogens = 50% of ocular infections)

A

staphylococcus aureus and staphylococcus epidermidis

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15
Q

which staphylococcus bacteria, aureus or epidermidis, is more abundant? which is more virulent?

A 
aureus = more virulent
epidermidis = more abundant
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16
Q

what is a gram + streptococcus that causes corneal ulcers and pediatric conjunctivitis?

A

Streptococcus pneumoniae

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17
Q

what is an example of a gram negative cocci?

A

Neisseria gonorrhoeae = causes gonorrhea (hyperpurulent conjunctivitis)

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18
Q

what is an example of a gram negative rod that causes otitis media and conjunctivitis?

A

Haemophilus influenzae

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19
Q

what are 4 enteric gram negative rods that are typically found in the intestinal tract and can cause UTIs?

A

E. coli, serratia marcescens, proteus, pseudomonas aeruginosa

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20
Q

what are 2 water-borne bacteria that affect ocular health?

A

Serratia marcescens and pseudomonas aeruginosa

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21
Q

what are 2 examples of bacteria that depend on the host to survive?

A

Chlamydia and treponema pallidum (spirochete)

22
Q

what is chlamydia trachomatis?

A

gram negative = transmitted finger/fomite to eye and causes trachoma or by self-contamination from genitals to cause inclusion conjunctivitis

23
Q

what is treponema pallidum?

A

gram negative = caused by STD or mother to child (syphilis)

24
Q

what is the mechanism of action for antibacterials that inhibit cell walls?

A

inhibit transpeptidases which create peptide x-links between polysaccharide chains that form peptidoglycan in bacteria cell walls

25
Q

which PCN is acid stable and is a good oral formulation?

A

Dicloxacillin

26
Q

what are 2 PCNs that are PCNase sensitive?

A

PCN V (IV, IM) and PCN G (PO)

27
Q

what are 3 PCNs that are PCNase resistant?

A

Methicillin, flucloxacillin, dicloxacillin

28
Q

what are 2 aminopenicillins?

A

ampicillin (+/- sulbactam) and amoxicillin (+/- clavulanate)

29
Q

what are 3 PCNs that have anti-pseudomonal gram negative coverage?

A

carbenicillin, ticaricillin (+/-clavulanate), and piperacillin

30
Q

how are PCN typically administered?

A

need oral therapy - allergy/toxicity is too high risk with topical

31
Q

what are 4 hypersensitivity reactions seen with PCN?

A

anaphylaxis, hemolytic anemia, serum sickness, Steven’s Johnson syndrome

32
Q

what adverse effect can methicillin cause?

A

interstitial nephritis

33
Q

what two drugs can have cross reactions with because they have similar chemical structures?

A

Penicillins and cephalosporins (especially 1st generations)

34
Q

which antibacterial can cause birth control pills to fail?

A

PCN (especially Ampicillin)

35
Q

how are cephalosporins different than PCNs?

A

have a 6 membered beta-lactam ring (PCNs have a 5 membered ring)

36
Q

Are cephalosporins susceptible to PCNases?

A

they are less sensitive but if they are produced by gram negative bacteria they are affected

37
Q

how are cephalosporins typically administered?

A

3 out of 4 generations are oral formulations

38
Q

what is the trend seen with the different generations of cephalosporins?

A

each generation has increased gram negative coverage

39
Q

what are the 4 hypersensitivity reactions with cephalosporins?

A

anaphylaxis, hemolytic anemia, toxic epidermal necrolysis, Steven’s Johnson syndrome

40
Q

why are vitamin K deficiencies and blood dyscrasia adverse effects of cephalosporins?

A 
cephalosporins destroy normal flora in gut and vitamin K can't be metabolized = deficiency
blood dsycrasia (cytopenia) is a reduction in RBCs and without vitamin K to coagulate blood = loose blood if injured
41
Q

what is a contraindication for cephalosporins?

A

hemophilia (genetic disorder that impairs ability to control blood clotting)

42
Q

what is AK-tracin ointment?

A

bacitracin = narrow gram + spectrum

43
Q

what is polysporin ointment?

A

polymyxin B and bacitracin = additional gram negative coverage –> broader spectrum

44
Q

why is bacitracin only used topically?

A

due to profound nephrotoxicity

45
Q

what is the drug of choice for MRSA, MRSE, and bacterial endophthalmitis?

A

vancomycin (gram + coverage only)

46
Q

what are 3 adverse reactions for vancomycin?

A

ototoxicity, nephrotoxicity, red man’s syndrome (IV induced mast cell degranulation)

47
Q

what is the mechanism for cell membrane inhibitors?

A

they interact with the phospholipids of the bacterial cell membrane = disrupting the osmotic integrity and increases permeability and causes cell death

48
Q

what is polymyxin B?

A

a cationic detergent/surfactant for gram negative bacteria

49
Q

how is polymyxin B administered?

A

only topically due to systemic neuro/nephrotoxicity

50
Q

what is gramicidin?

A

same mechanism of action as polymyxin B

Ocular Pharmacology (10 decks)

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