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Pharmacology > anti-infectives > Flashcards

anti-infectives Flashcards

1
Q

what indicates response to anti-infective therapy?

A

reduced fever
normal white blood count
improved appetite
absence of symptoms such as cough

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2
Q

how are anti-infective drugs known as commonly?

A

antibacterial
antimicrobial
antibiotic
antifungal

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3
Q

what are the ways anti-infective drugs are classified?

A

chemical structures

mechanism of action

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4
Q

actions of anti-infective drugs

A

affect target organism’s structure, metabolism, or life cycle

goal is to eliminate pathogens.

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5
Q

what is the difference between bactericidal and bacteriostatic?

A 
bactericidal = kill bacteria
bacteriostatic = slow growth of bacteria
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6
Q

drug classes for treating bacterial infections

A 
penicillins
cephalosporins
tetracyclines
macrolides
aminoglycosides
fluoroquinolones
sulfonamides
miscelaneous antibacterials
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7
Q

penacilins

A

end in icillin….and there are a ton.

the “A”s are all BROAD and are aminopenicillins

the various penacilins are narrow and pencillinase sensitive …the penicillinase resistant narrow sepctrum are cloxacillin and didoxacillin.

extended spectrum are piperalcillins, carbenicillin and ticarcillin

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8
Q

therapeutic action of penicillin

A

most effective against gram-positive bacteria

kill bacteria by disrupting cell wall with betalactam ring

beta-lactamase or penicillinase is an enzyme allowing bacteria to be resistant

newer drugs are penicillinase resistant

combination drugs with beta-lactamase inhibitors!

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9
Q

penicillin G potassium

A

kills bacteria by disrupting their cell walls

primary use is streptococci, pneumococci, staphylococci, gonorrhea and syphilis treatment

adverse effects include anaphylaxis, diarrhea, nausea, vomitting, pain at injection site, superinfections, drug interactions

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10
Q

Cephalosporins

A

all are ceph or cef

there are four generations

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11
Q

therapeutic action of cephalosporins

A

similar in structure and function to penicillins

have beta-lactam ring; are bactericidal

widely prescribed anti-infective class

more than 20 cephalosporins are availableg

cross sensitivity with penicillins

classified by generations

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12
Q

what is the difference between the generations of cephalosporins?

A

first generation is oldest. bacteria producing beta-lactamase are resistant

second are more portent, broader spectrum, more resistant to beta-lactamase

third are longer in duration of action with an even broader spectrum. they are resistant to beta-lactamase

fourth generation is effective on organisms resistant to earlier generations

third and fourth capable of entering CSF

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13
Q

cefotaxime

A

cephalosporin prototype.
3rd generation

inhibits cell wall synthesis

primarily used for broad spectrum activity against gram-negative organisms; for serious infections of the lower respiratory tract, CNS, genitourinary system, bones, blood and joints

adverse effects are hypersensitivity, rash, itching, anaphylaxis, diarrhea, vomitting, nausea, pain at injection site, drug interactions

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14
Q

Do cephalosporince affect prothrombin

A

yes, they may

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15
Q

tetracyclines

A

demeclocycline
doxycycline
minocycline
tetracycline

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16
Q

therapeutic action of tetracyclines

A

some of broadest spectrums of any antibiotic class

large number of resistant bacterial strains

drug of choice for only a few diseases: rocky mountain spotted fever, typhus, cholera, lyme disease, peptic ulcers, chlamydial infections

inhibit bacterial protein synthesis with bacteriostatic effect

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17
Q

tetracycline

A

prototype of tetracycline

is broad-spectrum, effective against a broad range of gram positive and negative bacteria

primarily used for chlamydiae, rickettsiae, and mycoplasma

adverse effects are superinfections, nausea, vomitting, epigastric burning, diarrhea, discoloration of teeth, photosensitivity, drug interactions

not for pregnant or lactating women…damages linear skeletal growth of tiny person…not for kids under 8 either

decrease effectiveness of oral contraceptives

don’t take with milk products, iron supps, magnesium containing laxatives or antacids.

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18
Q

macrolides

A

azithromycin
clarithromycin
erythromycin

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19
Q

therapeutic action of macrolides

A

safe alternatives to penicillin

effective against most gram positve and negative bacteria

inhibit protein synthesis by binding to bacterial ribosome

bacteriostatic at low doses and bacterocidal at high doses

drug of choice for whooping cough and legionnaire’s disease. used for infections caused by mycoplasma pneumoniae, streptococcus, h.influenz, chlamydia

broad spectrum, no superinfections may occur

20
Q

erythromycin

A

prototype macrolide anti-infective

acts as spectrum similar to penicillins

effective against gram positive bacteria

preferred drug for whooping cough (bordetella pertussis)
cornebacterium diphtheria

adverse effects are hepatotoxicity, nausea, abdominal cramping, and vomitting

21
Q

aminoglycosides

A

gentamicin
neomycin
streptomycin
tobramycin

22
Q

therapeutic action of aminoglycosides

A

narrow spectrum

bactericidal, inhibit bacterial protein synthesis

reserved for serious systemic infections caused by aerobic gram negative bacteria (e.coli, serratia, proteus, klebsiella, and pseudomonas)

23
Q

why are aminoglycosides used under careful monitoring?

A

they have much more serious side effects than other antiinfectives/antibiotics

can cause ototoxicity(toxic to ear), nephrotoxicity (poisonus to kidney), neuromuscular blockade

24
Q

gentamicin

A

aminoglycoside, anti-infective

broad-spectrum, bactericidal

primarily used for serious urinary ,respirator, nervous or GI infections

often used parenterally or in eyedrops and used in combination with antibiotics

adverse effects are ototoxicity and nephrotoxicity

25
Q

fluoroquinolones

A

they are anti-infectives

first gen: cinoxacin

second gen: ciprofloxacin
norofloxacinth
ofloxacin

third gen: levofloxacin

fourth gen: gemifloxacin
moxifloxacin

26
Q

therapeutic action of fluoroquinolones

A

are bactericidal and affect dna synthesis by inhibiting two bacterial enzymes

all have activity against gram-negative pathogents

newer drug classes have activity against gram-positive microbes

27
Q

ciprofloxacin

A

an anti-infective; a fluoroquinolone

inhibits bacterial dna gyrase; effects bacterial replication and dna repair

primarily used for respiratory infections, bone and joint infections, GI infections, ophthalmic infections, sinusitis, prostatitis

adverse effects in GI system, headaches, dizziness, and drug interactions

need to monitor white blood count

28
Q

what may norfloxacin, a fluoroquinolone anti-infective, cause?

A

photophobia

29
Q

what can fluoroquinolone, an anti-infective drug class, affect, especially in children?

A

tendons

30
Q

Sulfonamides

A

sulfacetamide
sulfamethoxazole
sulfsoxazole
trimethoprim

31
Q

therapeutic action of sulfonamides

A

are bacteriostatic and act by inhibiting folic acid

are broad spectrum

widspread use leads to resistance

use in combination to treat UTIs

used to treat pneumocytis carinii and shigella

anti-inflammatory properties can help with rheumatoid arthritis and ulcerative colitis

32
Q

trimethoprim-sulfamethoxazole

A

a sulfonamide, anti-infective

kills bacteria by inhibiting bacterial metabolism of folic acid

primarily used to treat UTIs, pneumocytis carinii pneumondia, shigella, and bronchitis

adverse effects are skin rashes, nausea, vomiting, agranulocytosis or thrombocytopenia, causes photosensitvity

can induce steven-johnson syndrome, a skin abnormality

33
Q

Vancomycin

A

is a miscellaneous anti-infective

bactericidal, inhibits cell wall synthesis

primarily used for and reserved for severe or resistant gram positive infections

EFFECTIVE FOR MRSA INFECTIONS!

adverse effects are ototoxicity, nephrotoxicity, red man syndrome and anaphylaxis

34
Q

which anti-infectives inhibit rna synthesis?

A

rifampin

35
Q

which anti-infectives inhibit cell wall synthesis

A

penicillins
cephalosporins
vancomycin
isoniazide

36
Q

which anti-infectives inhibit dna synthesis

A

fluoroquinolones

37
Q

which anti-infectives inhibit metabolites?

A

sulfonamides

38
Q

which anti-infectives are protein synthesis inhibitors

A 
macrolides
aminoglycosides
tetracyclines
clindamycin
chloramphenicol
39
Q

what are super infections?

A

are secondary infections that occur when too many host flora are killed by an antibiotic

host flora prevented growth of pathogenic organisms by out competing it and producing antibacterial substances

signs and symptoms include diarrhea, bladder pain, painful urination, abnormal vaginal discharge

40
Q

Antituberculosis drugs

A 
first line:
ethambutol
isoniazid
pyrazinamide
ciprofloxacin
rifampin
rifater
streptomycin
second line agents
amikacin
ciprofloxacin
kanamycin
ofloxacin
41
Q

what is TB caused by?

A

mycobacterium tuberculosis

usually invades the lung, may enter other systems

immune response attempts to isolate TB by walling it off and so TB can be dormant for a life time in walled-off areas called tubercles OR can reactivate when immune system is suppressed

42
Q

how is TB different from other infections?

A

mycobacteria have a cell wall resistant to penetration by anti-infective drugs

at least two and up to four antibiotics are given concurrently

the drugs prevent and treat TB

43
Q

pharmacotherapy of TB

A

multidrug therapy, 2-4 administered concurrently

different combinations during course of therapy. this is required because mycobacterium grows slowly and is commonly resistant

44
Q

what is chemoprophylaxis and when is it used?

A

an antituberculosis drug used to prevent TB in high-risk populations (those close to someone with TB, those with AIDS, HIV or receiving immunosuppresent drugs

45
Q

For whom is antituberculosis therapy contraindicated?

A

those with AIDS, liver disease, kidney disease

used with caution in those with renal failure, pregnant or lactating or a history of convulsive disorders

46
Q

isoniazid

A

an antituberculosis drug

bactericidal for active organisms, bacteriostatic for dormant mycobacteria

drug of choice for TB

adverse effects are numbness of hands and feet, rash, fever and rarely hepatotoxicity

Pharmacology (9 decks)

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