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Ocular Pharm > Anti Infectives > Flashcards

Anti Infectives Flashcards

1
Q

_____ is a chemical substance originating from various species of microorganisms (bacteria, fungus, actinomyces) that suppresses growth or destroys other microorganisms. They are the safest, least toxic drugs used in medicine.

A

Antibiotics

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2
Q

Gram ____ bacteria have thin peptidoglycan layer with LPS. They release pyretic, heat stable, mildly antigenic endotoxin upon lysis

A

negative

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3
Q

Commonly indigenous flora thrive in a _____ perfused environement

A

poorly

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4
Q

An ab can be bactericidal or bacteriostatic. Describe what each does

A

Bacteriocidal: kill target cells; cells may lyse or remain intact

Bacteriostatic: Prevent target cell replication

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5
Q

When is GI flora reduced

A

people who have DM-2 and obesity

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6
Q

What are the routes of delivery

A

locally; topical, contact lens and injection

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7
Q

When should you use ophthalmic Ab’s

A
  1. Mucopurulent discharge
  2. Diffuse conjuntival infection
  3. Corneal compromise
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8
Q

What is associated with gram - bacteria

A
  1. marked lid edema
  2. conjunctival chemosis
  3. purulent exudate are commonly associated with gram -
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9
Q

A putrid infection is an ____ infection

A

anaerobic

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10
Q

Which Ab’s are gram + and its site of action is the cell wall?

A
  1. Penicillins
  2. Cephalosporins
  3. Bacitracin
  4. Vancomycin
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11
Q

Which Ab’s site of action is the cell membrane

A

Polymyxin B

Gramicidin

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12
Q

Which Ab’s site of action is protein synthesis

A
  1. Aminoglycosides
  2. Tetracylines
  3. Macrolides
  4. Chloramphenicol
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13
Q

What Ab site of action is cell metabolism

A
  1. Sulfanomides
  2. Trimethroprim
  3. Pyrimethamine
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14
Q

Which Ab’s site of action is DNA synthesis

A

Fluoroquinolones

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15
Q

Which are the broad spectrum Ab’s

A
  1. Tetracylines
  2. Chloramphenicol
  3. Sulfonamides
  4. Trimethroprim
  5. Pyrimethamine
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16
Q

Which Ab’s are gram +

A
  1. Bacitracin
  2. Vancomycin
  3. Gramicidin
  4. Macrolides
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17
Q

Which Ab’s are gram -

A
  1. Polymyxin B
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18
Q

Which Ab’s have both types of gram sensitivity but more positive

A
  1. Penicillins

2. Cephalosporins

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19
Q

Which Ab’s have both types of gram sensitivity but more negative

A

Aminoglycosides

Fluoroquinolones

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20
Q

Which ab’s are pregnancy Category B

A

Tobramycin
Erthryomycin
Ezythromycin

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21
Q

Which ab’s are bacteriocidal

A

Big ffing cap

  1. Penicillins
  2. Aminoglycosides
  3. Cephalosporins
  4. Bacitracin
  5. Fluoroquinolones
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22
Q

Which ab’s are bacteriostatic

A

(TMSTC)

  1. Tetracylines
  2. Macrolides
  3. Sulfonamides
  4. Trimethroprim
  5. Chloramphenicol
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23
Q

What are the types of staphylococcus bacteria

A
  1. Staph aureus: more virulent (MRSA); most coommon nosocomial infection
  2. Epidermis; more abundant (MRSE)
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24
Q

What type of streptococcus bacteria causes corneal ulcer, or pediatric conjunctivitis

A

pneumoniae

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25
Q

Which gram + bacteria is an oral microflora that deals with post Lasik keratitis

A

Nocardia; asteroides

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26
Q

Which gram - bacteria causes pediatric otitis media and conjunctivitis

A

haemophilus influenzae

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27
Q

What enterics cause UTI, or corneal ulcer

A
  1. E. coli
  2. Serratia marcescens
  3. Proteus
  4. Psudomonas aeruginosa
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28
Q

Which enterics are water borne bacteria affecting ocular health

A
  1. Serratia marcescens

2. Pseudomonas aeruginosa

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29
Q

Which bacteria is consider the 2nd most common nosocomial infection

A

psudomonas aeruginosa; seeks altered gut flora or a weakened immune system

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30
Q

Which gram negative bacteria cause gonorrhea

A
  1. neisseria gonorrhea; corneal ulcer, hyperpurulent
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31
Q

What are host dependent bacteria that cause sexually transmitted eye infections

A
  1. Chlamydia (finger/fomite to eye infection)

2. Syphilis

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32
Q

what is the most common infection leading to ocular blindness in the world

A

chlamydia

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33
Q

____ has 4 stages of infection

A

syphillis

34
Q

What are the stand alone Ab’s

A
  1. bacitracin

2. Vancomycin

35
Q

Penicillin are useful for treating gram ____ infection and ____ infections

A

+; anaerobic

36
Q

Which antibiotics should you have on an empty stomach

A

penicillin and tetracycline

37
Q

Which are Pcnase sensitive penicillins

A
  1. Pen G (IV, IM)

2. Pen V

38
Q

Which are Pcnase resistant

A
  1. Methicillin
  2. Flucloxacillin
  3. Dicloxacillin
39
Q

Which penicillins are amino penicillins

A
  1. ampicillin
  2. amoxicillin
    - Oral drugs or administered via IV, not topical
40
Q

_____ or ____ inhibit Pcnase and are therefore often combined with Pcnase sensitive formulas

A

Sulbactam; clavulonate

41
Q

No topical formulas exist for ____since allergy is too high

A

Penicillin

42
Q

What are the hypersensitivity reactions for type 1:

A

anaphylaxis

43
Q

what are the hypersensitivity reactions for type 2

A

hemolytic anemia

44
Q

what are the hypersensitivity reaction for type 3

A

serum sickness

45
Q

what are the hypersensitivity reaction for type 4

A

stenvens johnson syndrome

46
Q

there is a cross reactive with _____ especially the first generation

A

cephalosporins

47
Q

Cephalosporins have a 6 membered beta lactam ring instead of 5, and in contrast to Pcn, these drugs are less susceptible to ____

A

Pcnase; harder to break down

48
Q

____ gneration cephalosporins are cross reactive with penicillins

A

1st

49
Q

Vitamin ____ deficiency can result from destruction of bacterial flora that play a role in vitamin ___ absorption

A

K; K

50
Q

What are adverse reactions of cephalosporins

A
  1. Blood dyscrasia: cytopenia
51
Q

what is a contraindication of cephalasporin

A

hemophilia

52
Q

What is available in a topical ointment only due to profound nephrotoxicity

A

Bacitracin

53
Q

Which ointment is well suited for staphylococcus blepharitis

A

ak tracin ointment

54
Q

Which IV is drug of choice for MRSA and MRSE

A

Vancomycin; poor oral absorption

55
Q

What are adverse reactions of vancomycin

A
  1. ototoxicity & nephrotoxicity

2. Red man syndrome; IV induced mast cell degranulation

56
Q

Which Ab is a cationic detergent/ surfactant

A

Polymyxin B

57
Q

Detergents are _____

A

bacteriocidal

58
Q

Which Ab’s are given orally

A
  1. Penicillin

2. Cephalosprins

59
Q

Which Ab’s is given via IV

A

vancomycin

60
Q

Which Ab is often found in combination products

A

Gramicidin

61
Q

Which polytrim solutions used in combination are used for most common pediatric ocular infection

A

Polymyxin B and Trimethoprim

62
Q

Which infections do polymyxin B and trimethoprim target

A

H influenzae and S pneumoniae and an excellent option for resistant S. epidermis & MRSA infections

63
Q

Which polysporin ointments are used in combo together

A

Polymyxin B +bacitracin

64
Q

What is the combination of Ab’s used in neosporin solution or ointment

A

polymyxin B + neomycin + gramicidin

65
Q

Which Ab’s are protein synthesis inhibitors of the 30S ribosomal unit

A

Aminoglycosides + Tetracyclines

66
Q

Which Ab;s are protein synthesis inhibitors of the 50S ribosomal unit

A

Macrolides + chlramphenicol

67
Q

what is the oldest aminoglycoside that is used topically and is never stand alone. It is broad spectrum coverage except psudomonas

A

neomycin

68
Q

what amino glycoside is used for severe infections and has low bacterial resistance due to limited systemic usage

A

gentamicin

69
Q

This amino glycoside has similar use as gentamicin and is one of the few Ab;s with pregnancy rating B

A

Tobramycin

70
Q

What are amino glycoside adverse reactions

A
  1. SPK & delayed re epithelialization
  2. Potential inactivation with PCN/ cephalasporins
  3. Neurotoxicity; auditory/vestibular
  4. Nephrotixicity: accumulation in renal cortex
  5. Type IV delayed hypersensitivity rxn
    * Neomycin: contact dermatitis risk
    * Gentamycin: intracranial hypertension and corneal epithelial toxicity is most profound
71
Q

Tetracylines have an ____ ____ benefit through inhibition of MMPs and bacterial lipases

A

anti inflammatory

72
Q

what are the short acting tetracyclines

A
  1. tetracyclines

2. oxytetracycline

73
Q

what are the long acting tetracylines

A
  1. doxycycline: meibomiantitis/meiboian gland stasis
    - recurrent corneal erosions
    - acne rosacea
    - chlamydia
    - syphillis
  2. minocycline: acne, rosacea
74
Q

What are tetracycline adverse reactions

A
  1. photosensitivity
  2. impaired absorption w food due to divalent cation binding
  3. azotemia: elevated blood nitrogen compounds
  4. blood dycrasias: hemolytic anemia, thrombocytopenia
  5. Idiopathic intracranial hypertension
  6. Fanconi’s syndrome; renal toxicity from expired tetracyclines
  7. impaired bone growth, tooth development
  8. coumadin potentiation
  9. breast cancer
75
Q

what are distinct tetracycline adverse reactions of minocycline and doxycycline

A

Minocycline: vestibular toxicity within 2-3 days of therapy in up to 70%

Doxycycline: Exhibits least divalent chelation

  • Risk of erosive esophagitis
  • No azotemia due to fecal vs renal elimination
  • Excellent option for resistant S epidermis infection
76
Q

What are tetracycline contraindications

A
  1. pregnancy
  2. nursing mothers
  3. children under 8
  4. renal failure (except Doxycycline)
77
Q

What are the macrolides

A
  1. Erythromycin -QID ointment
    - Full oral dosing negates need for topical use . Unstable in gastric acid
  2. Azithromycin - Oral and Azasite solution. Clhamydia inclination conjunctivitis - 1 tablet
  3. Clarithromycin - BID: reduced dosing compared to erythromycin due to greater stability in GIT
78
Q

Which macrolides have pregnancy category B?

A

Erythromycin and Azithromycin

79
Q

What are macrolide adverse reactions

A
  1. Augment plasma levels of theophylline

2. breast cancer

80
Q

what are contraindications of macrolides

A

pregnancy- avoid clarithrymycin (category C)

81
Q

______ are highly toxic orally so now limited to topical use only

A

chloramphenicol

82
Q

Chloramphenicol can result in _____ ___ syndrome

A

grey baby

Ocular Pharm (12 decks)

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