Antibiotics Flashcards

1
Q

penecilins

mechanism of action
time or concentration dependant?
bacteriostatic vs bacteriocidal?
spectrum of action
tissue distribution
absorbtion
metabolism and excretion

A

mechanism of action: kills bacteria through binding of the beta-lactam ring to DD-transpeptidase, inhibiting its cross-linking activity and preventing new cell wall formation- b-lactam

time or concentration dependant?: Time

bacteriostatic vs bacteriocidal?: Bactericidal

spectrum of action: Gram + some gram - (not ecoli) and anerobes

tissue distribution: Serum, bile, tissues and synovial fluid

absorbtion: Rapidly absorbed SC, IM and orally

metabolism and excretion: renal with some hepatic metabolism, excreated in urine

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2
Q

Cephalosporins

mechanism of action
time or concentration dependant?
bacteriostatic vs bacteriocidal?
spectrum of action
tissue distribution
absorbtion
metabolism and excretion

A

mechanism of action: As penicillin
kills bacteria through binding of the beta-lactam ring to DD-transpeptidase, inhibiting its cross-linking activity and preventing new cell

time or concentration dependant?: Time

bacteriostatic vs bacteriocidal?: Bactericidal

spectrum of action: Broad spec of aerobes and anerobes

tissue distribution: Tissues and pleural fluid, synovial fluid and bone,

absorbtion: IV or IM, some can be administered orally

metabolism and excretion: Metabolised in liver, with renal and some hepaticexcreation

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3
Q

Tetracyclines

mechanism of action
time or concentration dependant?
bacteriostatic vs bacteriocidal?
spectrum of action
tissue distribution
absorbtion
metabolism and excretion

A

mechanism of action: inhibit the 30S ribosomal subunit, hindering the binding of the aminoacyl-tRNA to the acceptor site on the mRNA-ribosome complex, so the bacteria cannot grow or replicate

time or concentration dependant?: Concentration and time

bacteriostatic vs bacteriocidal?: Bacteriostatic

spectrum of action:
Broad spec gram + and - plus atypical bacteria
oxytetracycline- resistance in pneumonia pathogens common

tissue distribution:
Enter all tissues but most concentrated in kidneys, liver, bile, lungs, spleen, and bone

absorbtion:
IV or oral

metabolism and excretion:
About ⅓ of dose is excreated unchanged, metabolised in kidneys and GIT, excreated in urine, faeces and aprox 10% through bile

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4
Q

Aminoglycosides

mechanism of action
time or concentration dependant?
bacteriostatic vs bacteriocidal?
spectrum of action
tissue distribution
absorbtion
metabolism and excretion

A

mechanism of action:
bactericidal activity in which they bind to the bacteria ribosomal 30S subunit.

time or concentration dependant?:
concentration-dependent

bacteriostatic vs bacteriocidal?:
bactericidal

spectrum of action:
Aerobic gram negatives

tissue distribution:
polar at physiologic pH
limited distribution to: extracellular fluids, with minimal penetration into most tissues. Exceptions: renal cortex of kidneys
endolymph of the inner ear. ←sites at which aminoglycosides increasingly accumulate as ionization increases.

absorbtion:
poorly absorbed orally and typically are given parenterally, either by intravenous or intramuscular injection

metabolism and excretion:
the body does not metabolise aminoglycosides

Aminoglycosides are excreted by glomerular filtration and have a serum half-life of 2 to 3 hours

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5
Q

Fluoroquinolones

mechanism of action
time or concentration dependant?
bacteriostatic vs bacteriocidal?
spectrum of action
tissue distribution
absorbtion
metabolism and excretion

A

mechanism of action:
target DNA gyrase and topoisomerase IV with varying efficiency in different bacteria and inhibit their control of supercoiling within the cell, resulting in impaired DNA replication (at lower concentrations) and cell death (at lethal concentrations)

time or concentration dependant?:
concentration-dependent

bacteriostatic vs bacteriocidal?:
bactericidal

spectrum of action:
Broad-spectrum antibiotics that are active against both Gram-positive and Gram-negative bacteria, including mycobacteria, and anaerobes

tissue distribution:
After oral and parenteral administratio: fluoroquinolones are widely distributed in most extracellular and intracellular fluids and are concentrated in the prostate, lungs, and bile.

absorbtion:
Oral absorption is diminished by coadministration of polyvalent cations (aluminum, magnesium, calcium, zinc, and iron preparations).

IV and orally

metabolism and excretion:
Most fluoroquinolones are metabolized in the liver and excreted in urine, reaching high levels in urine. Moxifloxacin is eliminated primarily in bile.

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6
Q

Sulphonamides and potentiated sulphonamides

mechanism of action
time or concentration dependant?
bacteriostatic vs bacteriocidal?
spectrum of action
tissue distribution
absorbtion
metabolism and excretion

A

mechanism of action:
potentiated sulfonamides are Protein synthesis, metabolic processes, and inhibition of growth and replication occur in organisms that cannot use preformed (eg, dietary) folate. The effect is bacteriostatic, although a bactericidal action is evident at the high concentrations that may be found in urine. Diaminopyrimidines such as trimethoprim inhibit dihydrofolate reductase, which is further into the folic acid synthesis pathway. The combination of a sulfonamide and a diaminopyrimidine results in synergistic bactericidal actions on susceptible organisms; as such, the combination is referred to as a potentiated sulfonamide.

time or concentration dependant?:
time dependent

bacteriostatic vs bacteriocidal?:
Bacteriostatic

HOWEVER-
when combined with a pyrimidine potentiator, a sequential blockade of microbial enzyme systems occurs with bactericidal consequences.

spectrum of action:
broad spectrum antimicrobial agents that inhibit the growth of gram-positive and gram-negative bacteria, Actinomycetes, Chlamydiae, and of some protozoa, such as Toxoplasma and Plasmodia. Resistance to sulfonamides has increased among many of these organisms.

tissue distribution:
Sulfonamides are weak acids and hydrophilic, leading to distribution via the extracellular fluid. The distribution pattern depends on the ionization state of the sulfonamide, the vascularity of specific tissues, the presence of specific barriers to sulfonamide diffusion, and the fraction of the administered dose bound to plasma proteins. The unbound drug fraction is freely diffusible.
Sulfonamides are bound to plasma proteins to a greater or lesser extent, and concentrations in pleural, peritoneal, synovial, and ocular fluids may be 50%–90% of that in blood. Sulfadiazine is ≥90% bound to plasma proteins. Concentrations in the kidneys exceed plasma concentrations, and those in the skin, liver, and lungs are only slightly less than the corresponding plasma concentrations. Concentrations in muscle and bone are ~50% of those in the plasma, and those in the CSF may be 20%–80% of blood concentrations, depending on the particular sulfonamide.
Low concentrations are found in adipose tissue. After parenteral administration, sulfamethazine is found in jejunal and colonic contents at about the same concentration as in blood. Passive diffusion into milk also occurs; although the concentrations achieved are usually inadequate to control infections, sulfonamide residues may be detected in milk. Trimethoprim and ormetoprim are basic and tend to accumulate in more acidic environments such as acidic urine, milk, and ruminal fluid.
Trimethoprim diffuses extensively into tissues and body fluids. Tissue concentrations are often higher than the corresponding plasma concentrations, especially in lungs, liver, and kidneys. Approximately 30%–60% of trimethoprim is bound to plasma proteins.

absorbtion:
PO, IV, IP, IM, intrauterine, or topically, depending on the specific preparation. Most are rapidly and completely absorbed from the GI tract of monogastric animals. Absorption from the ruminoreticulum is delayed, especially if ruminal stasis is present. For sulfachlorpyridazine, bioavailability is greatly decreased via feeding. Therapeutic doses of sulfonamides are usually administered PO except in acute life-threatening infections when IV infusions are used to establish adequate blood concentrations as rapidly as possible

Sulfonamides are frequently added to drinking water or feed either for therapeutic purposes or to improve feed efficiency. A few highly water-soluble preparations may be injected IM (eg, sodium sulfadimethoxine) or IP (some irritation of the peritoneum can occur). Absorption is rapid from these parenteral sites. Generally, sulfonamide solutions are too alkaline for routine parenteral use.
Trimethoprim is rapidly absorbed after administration PO (plasma concentrations peak in ~2–4 hours) except in ruminants, in which it tends to be trapped in the ruminoreticulum and appears to undergo a degree of microbial degradation.
Absorption occurs readily from parenteral injection sites; effective antibacterial concentrations are reached in < 1 hour, with peak concentrations in ~4 hours.

metabolism and excretion:
Sulfonamides are usually extensively metabolized, mainly via several oxidative pathways, acetylation, and conjugation with sulfate or glucuronic acid. Species differences are marked in this regard. The acetylated, hydroxylated, and conjugated forms have little antibacterial activity. Acetylation (poorly developed in dogs) decreases the solubility of most sulfonamides except for the sulfapyrimidine group. The hydroxylated and conjugated forms are less likely to precipitate in urine

Most sulfonamides are excreted primarily in the urine. Bile, feces, milk, tears, and sweat are excretory routes of lesser importance. Glomerular filtration, active tubular secretion, and tubular reabsorption are the main processes involved. The proportion reabsorbed is influenced by the inherent lipid solubility of individual sulfonamides and their metabolites and by urinary pH. Urinary pH, renal clearance, and the concentration and solubility of the respective sulfonamides and their metabolites determine whether solubilities are exceeded and crystals precipitate. This can be prevented by alkalinizing the urine, increasing fluid intake, reducing dose rates in renal insufficiency, and using triple-sulfonamide or sulfonamide-diaminopyrimidine combinations

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7
Q

Metronidazole

mechanism of action
time or concentration dependant?
bacteriostatic vs bacteriocidal?
spectrum of action
tissue distribution
absorbtion
metabolism and excretion

A

mechanism of action:
diffuses into the organism, inhibits protein synthesis by interacting with DNA, and causes a loss of helical DNA structure and strand breakage

time or concentration dependant?:
concentration-dependen

bacteriostatic vs bacteriocidal?:
bactericidal

spectrum of action:
All obligate anaerobic bacteria (it is inactive against facultative anaerobic and aerobic bacteria)

Certain protozoan parasites (eg, Trichomonas vaginalis, Entamoeba histolytica, Giardia intestinalis [lamblia])

tissue distribution:
It is distributed widely in body fluids and penetrates into cerebrospinal fluid, resulting in high concentrations

absorbtion:
Oral metronidazole is absorbed well. It is usually given IV only if patients cannot be treated orally

metabolism and excretion:
Metronidazole is metabolized presumably in the liver and excreted mainly in urine, but elimination is not decreased in patients with renal insufficiency. However, because metronidazole metabolites may accumulate in patients with end-stage renal disease, these patients should be monitored for metronidazole-associated adverse effects

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8
Q

Macrolides

mechanism of action
time or concentration dependant?
bacteriostatic vs bacteriocidal?
spectrum of action
tissue distribution
absorbtion
metabolism and excretion

A

mechanism of action:
nterfere with protein synthesis

time or concentration dependant?:
time

bacteriostatic vs bacteriocidal?:
bacteriostati

spectrum of action:
gram +ve bacteria
tulathromycin- common on farm pneumonia drug
second line chouce for CODD

tissue distribution:
wide tissue distribution, tend to concentrate in spleen, liver, kidneys and lungs. Do not enter eye or CNS

absorbtion:
absorbed easily from GIT
also subcut or IM

metabolism and excretion:
Excreted in bile, also goes into milk

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9
Q

Lincosamides

mechanism of action
time or concentration dependant?
bacteriostatic vs bacteriocidal?
spectrum of action
tissue distribution
absorbtion
metabolism and excretion

A

mechanism of action:
suppress protein synthesis

time or concentration dependant?:
time

bacteriostatic vs bacteriocidal?:
bacteriostatic

spectrum of action:
broad spectrum against anaerobic bacteria

tissue distribution:
Lipid soluble - wide distribution including bone, poor CNS infiltration, can diffuse across placenta in some species

absorbtion:
absorbed from GIT
Also good absorption IM

metabolism and excretion:
metabolised in liver, excreted in bile and urine and milk

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10
Q

Phenicols

mechanism of action
time or concentration dependant?
bacteriostatic vs bacteriocidal?
spectrum of action
tissue distribution
absorbtion
metabolism and excretion

A

mechanism of action:
inhibits protein synthesis

time or concentration dependant?:
time

bacteriostatic vs bacteriocidal?:
bacteriostatic but can be bacteriocidal in high concentrations

spectrum of action:
most things. Especially anaerobes - MRSA, salmonella, pasteurella, mycoplasma, brucella

tissue distribution:
most tissues including the brain, highest concentrations in kidneys, liver and bile, reaches CNS and inside eye. Crosses placenta

absorbtion:
GIT, IM or IV

metabolism and excretion:
metabolised in liver, renal excretion

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11
Q

Polymyxin B

mechanism of action
time or concentration dependant?
bacteriostatic vs bacteriocidal?
spectrum of action
tissue distribution
absorbtion
metabolism and excretion

A

mechanism of action:
interact with cell membrane phospholipids to disrupt their permeability

time or concentration dependant?:
concentration

bacteriostatic vs bacteriocidal?:
bacteriocidal

spectrum of action:
more effective against gram negative, narrow spectrum

tissue distribution:
topical application of enteral for GI treatment only

absorbtion:
enteral for GI or topical

metabolism and excretion:
renal excretion - nephrotoxic

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12
Q

describe the b-lactam antibiotics

A

penecillan is narrow spec- only some gram neg and not e.coli- resisted by production of betalactamase- cat d

amoxicillan is broad- does more gram negs, clavulonic acid is a betalactamase inhibitor- cat c

cloxicillan- dry cow tubes- gram pos only, resistant to betalactamase- cat d

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13
Q

cat d antibiotics

A

antibiotics that should be used as first line treatments, whenever possible. These antibiotics can be used in animals in a prudent manner.

Aminopenicillins, without beta-lactamase inhibitors-
Cyclic polypeptides
Nitrofuran derivatives*
Nitroimidazoles*
Penicillins: Anti-staphylococcal penicillins (beta-lactamase-resistant penicillins)
Penicillins: Natural, narrow spectrum penicillins (beta-lactamase-sensitive penicillins)
Aminoglycosides: spectinomycin only
Steroid antibacterials*
Sulfonamides, dihydrofolate reductase inhibitors and combinations
Tetracyclines

penecillins- penecilin
clocicillan

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14
Q

c antibiotics

A

antibiotics for which alternatives in human medicine generally exist in the EU, but only few alternatives are available in certain veterinary indications. These antibiotics should only be used when there are no antimicrobial substances in Category D that would be clinically effective.

Aminoglycosides (except spectinomycin)
Aminopenicillins in combination with beta-lactamase inhibitors
Amphenicols
Cephalosporins: 1st- and 2nd-generation, and cephamycins
Macrolides (not including ketolides)
Lincosamides
Pleuromutilins
Rifamycins: rifaximin only

amoxciclav

macrolides g+—-
tilmicosin
tulathromycin
Gamithromycin

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15
Q

cat b antibiotics

A

Antibiotics in this category are critically important in human medicine and their use in animals should be restricted to mitigate the risk to public health

Cephalosporins: 3rd- and 4th-generation, except combinations with beta-lactamase inhibitors
Polymyxins
Quinolones: fluoroquinolones and other quinolones

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16
Q

cat a antibiotics

A

antibiotics in this
category are not
authorised as
veterinary medicines
in the EU
* should not be used
in food-producing
animals
* may be given to
companion animals
under exceptional
circumstances