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Pharmacology Test Two > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Name the beta lactams

A

Penicillins, cephalosporins, monobactams, carbapenems

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2
Q

Penicillins, cephalosporins, monobactams, and carbapenems are what type of agents

A

Beta lactams

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3
Q

What is the mechanism of B lactams

A

irreversibly inhibit peptidoglycan polymers in cell wall to cause them to burst, inhibit penicillin binding proteins whch are enzymes that form cross links in membranes

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4
Q

Are beta lactams time or concentration dependent

A

Time

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5
Q

What type of organism do beta lactams work best on

A

G+

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6
Q

How are most B lactams absorbed

A

Orally then rapidly distributed to ECF

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7
Q

What type of clearance do B lactams have?

A

Kidney

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8
Q

Do B lactams cross the BBB

A

No (Except in inflammation)

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9
Q

Are B lactams bound to plasma proteins

A

Not much

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10
Q

What are the three mechanisms of resistance to beta lactams

A
  1. b lactamase production via mutation or insertion
  2. change structure of PBPs
  3. Chance lack of penetration thru memb pores
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11
Q

What are the 5 subgroups of penicillins

A 
Natural
b-lactamase resistant
aminopenicillins
extended spectrum
augmented
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12
Q

What type of animals are natural penicillins mainly used in

A

Large animal (horses and intra-mammary in food animal)

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13
Q

How should natural penicillins be given

A

IM - NOT ORALLY because acid-labile

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14
Q

Are natural penicillins degraded by b-lactamase

A

YES!

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15
Q

What concerns are there for natural penicillin use

A

Long acting can cause residues in food animals, can cause CNS signs

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16
Q

What orgs do natural penicillins kill

A

G+ and G- (anaerobes only)

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17
Q

What is a drawback of B-lactamase resistant penicillins?

A

Narrower spectrum - confirm sensitivity

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18
Q

What is the first line of drugs for treatment in small animals

A

Aminopenicillins (amoxicillan/ampicillan)

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19
Q

What are the routes of administration of Aminopenicillins

A

Oral (amoxicillan), IV/IM (ampicillan)

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20
Q

What are the side effects of Aminopenicillins

A

GI flora disruption - nausea and V

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21
Q

What are the three classes of penicillins which are most broad spectrum

A

aminopenicillins, extended spectrum, augmented

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22
Q

What benefit exists in extended spectrum penicillins?

A

Improved Q3 (G- aer), especially pseudomonas! (IV use)

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23
Q

Are extended spectrum penicillins susceptible to b-l’ase?

A

Yes

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24
Q

Describe augmented penicillins

A

Combination of broad spectrum agent + b-l’ase inhibitor

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25
Q

What is the toxicity for augmented penicillins

A

GI toxicity in horses, rabbits, hamsters and guinea pigs

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26
Q

What type of effect do penicillins have on orgs

A

Bacteriocidal

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27
Q

What type of antibiotic are cephalosporins

A

B-lactam

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28
Q

What is the mechanism of action of cephalosporins

A

bacteriocidal cell wall inhibitors via PBP

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29
Q

Are cephalosporins time or conc dependent

A

Time

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30
Q

What is the form of excretion for cephalosporins

A

Renal

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31
Q

What cautions exist for cephalosporins

A

Can be cross reactive in penicillin sensitive animals

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32
Q

Are cephalosporins protein bound

A

No

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33
Q

Describe cephalosporin generations

A

Go in sequence of oldest to youngest, newer have better gram negative coverage and better resistance to b-l’ase

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34
Q

What spectrum do 1st generation cephalosporins cover

A

Q1 and Q2, some Q3

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35
Q

What type of drug is cefazolin

A

First generation cephalosporin

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36
Q

What kind of drug is cephalexin

A

1-cephalosporin

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37
Q

What is the first line of use cephalosporin in SA

A

1-gen

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38
Q

What spectrum do 2nd generation cephalosporins cover

A

Same as 1-gen but with greater Q3

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39
Q

Do 2-cephalosporins cover pseudomonas?

A

No

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40
Q

Do 1-cephalosporins cover pseudomonas?

A

No

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41
Q

What spectrum do 3rd generation cephalosporins cover

A

Q1 and 2 with better gram negative than 2-gen

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42
Q

What kind of antibiotic is cefpodoxime

A

3-cephalosporin

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43
Q

Name a 1-cephalosporin

A

Cephalexin, cefazolin

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44
Q

Name a 2-cephalosporin

A

Cephoxitin, cefotetan

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45
Q

Name a 3-cephalosporin

A

ceftiofur, cefpodoxime

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46
Q

What species is cephalexin approved in

A

Dogs only

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47
Q

What Rx should treat bacterial pyoderma

A

cephalexin (1-cephalosporin_

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48
Q

What method of admin should be used for 3-cephalosporins

A

parenteral depending on species

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49
Q

Restrictions on 1-gen cephalosporins

A

Food animals now may use- major use must follow route/dose/freq restrictions (no ELDU), minor ok to use

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50
Q

What are the toxicities of cephalosporins

A

Cross hypersensitivity with penicillins, GI upset (give with meal), chronic use causing overgrowth of candida/pseudomonas

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51
Q

What kind of agent is Imipenem?

A

Beta lactam from carbapenem class

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52
Q

What spectrum does Imipenem have

A

anaerobes and gram + aerobes

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53
Q

What mechanism of action does bacitracin have

A

Cell wall inhibitor by inhibiting phosphorylation (like vancomycin)

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54
Q

What organisms are killed by bacitracin

A

G+

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55
Q

What mechanism of action does vancomycin have

A

Cell wall inhibitor by inhibiting phosphorylation (like bacitracin)

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56
Q

What is the method of administration for vancomycin

A

IV (po for GI issues)

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57
Q

How is vancomycin excreted

A

Renally

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58
Q

What are the toxicities of vancomycin

A

Ototoxic, nephrotoxic, tissue irritant

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59
Q

What are the restritions on vancomycin?

A

NO food animal use, last resort for MRSA in dogs

60
Q

What mech of action does polymixin have

A

Cell wall inhibitor via detergent like action

61
Q

What kind of organisms are killed by polymixin

62
Q

Why are penicillins used for UTI

A

High urine concentration due to clearance

63
Q

What type of agents are aminoglycosides

A

Bacteriocidal

64
Q

What are two examples of aminoglycosides

A

Amikacin and gentamycin

65
Q

Are aminoglycosides time or conc dependent

A

Concentration

66
Q

Describe aminoglycosides

A

Highly water soluble, positively charged at bio pH, not lipophilic, low body distribution

67
Q

What is the mechanism of aminoglycosides

A

Irreversible inhibition of protein synthesis via binding to 30S subunit of ribosome which is lethal to most bacteria

68
Q

What is the route of administration for aminoglycosides

A

IV/IM because not orally absorbed (used PO in gastroenteritis)

69
Q

Where are aminoglycosides distributed

A

ECF- not intracellular, accumulates in renal cortex and inner ear

70
Q

What is the elimination of aminoglycosides

71
Q

What are the toxicities for aminoglycosides

A

With long term use:
Nephrotoxic- necrosis of tubules
Ototoxic- can be irreversible
Neuromuscular weakness, anaphylaxis

72
Q

Describe aminoglycoside resistance

A

Usually limited to a few drugs, not the whole group; enhanced enzyme degradation, decreased membrane transport, altered ribosome binding site

73
Q

What is unique about how aminoglycosides enter organisms

A

Must be transported by an energy requiring transporter that requires oxygen

74
Q

What are the contraindications of aminoglycosides

A

renal disease, pregnant, fever, myasthenia gravis, neuromuscular disorders

75
Q

What are pseudomonas most susceptible to?

A

Quinolones and aminoglycocides

76
Q

What kind of organisms are most sensitive to aminoglycosides

A 
Gram negatives (esp. aerobic like pseudomonas)
(a few G+ orgs- staph!)
77
Q

What drug are aminoglycosides synergistic with

78
Q

What kind of drug is gentamycin

A

aminoglycocide

79
Q

What kind of drug is amikacin

A

Aminoglycocide

80
Q

What kind of effect do tetracyclines have

A

Bacteriostatic

81
Q

What is the mechanism of tetracyclines

A

reversible inhibition of protein synthesis by 30S ribosome

82
Q

How do tetracyclines enter an organism

A

Transporter via active transport (determines spectrum of activity)

83
Q

Are tetracyclines acid or base?

A

Amphoteric- both acid and base

84
Q

Name an amphoteric abx

A

tetracyclines

85
Q

How are tetracyclines subclassified?

A

Duration of action

86
Q

What makes a tetracyclines short or fast acting

A

Short: H20 soluble
Long: lipid soluble

87
Q

Name two examples of tetracyclines

A

Doxycyclin, oxytetracyclin

88
Q

What kind of organisms are killed by tetracyclines

A

Gram +, GrNeg Anaer, mycoplasmas, rickettsials and spirochetes

89
Q

What are the mechanisms of resistance for tetracyclines

A

ALtered bacterial transporter, active excretion via pump, enzymatic degradation

90
Q

What abx do tetracyclines show cross resistance with

A

Aminoglycosides and sulfonamides

91
Q

Are tetracyclines protein bound?

A

Yes- some highly

92
Q

What is the best route of administration for tetracyclines

A

Oral- well absorbed - food reduces absorption

93
Q

What is the excretion of tetracyclines? Name exceptions

A

Renal except doxy (hepatic

94
Q

Describe tetracyclines’ toxicity

A

GI, superinfections, ruminal dysfunction, photosensitizing, IM pain/swelling, IV arryhthmias, teeth/bone discoloration in young, hypersensitivity, (expired: nephrotoxic)

95
Q

What restrictions should be used in tetracyclines

A

Pregnant animals; (remember drug interactions

96
Q

Name interactions for tetracyclines

A

Muscle relaxants, food, antacids (oral), IV fluids, loop diuretics, toxic digoxin

97
Q

What species cant use doxycycline

A

LA (use in dog/cat)

98
Q

What species cant use oxytetracyclines

A

Dog/cat (use in beef and non-lactating dairy cattle)

99
Q

What special actions mst be taken in administration of tetracyclines

A

Cats- must follow with water- can cause strictureI

100
Q

What class of tetracycline is doxy

A

Long acting

101
Q

What class of tetracyclines is oxytetra

A

intermediate acting

102
Q

What route should doxy be given?

103
Q

What is the drug of choice for erilchia

104
Q

Is doxy lipo or water philic/

105
Q

What are side effects of oxytetracycline

A

diarrhea and shock in horses

106
Q

Describe macrolides

A

highly lipid soluble (hard to get rid of), all contain a lactone ring

107
Q

What is the mechanism of action for macrolides

A

Bacteriostatic - Reversible inhibition of ribosome protein synthesis in 50S

108
Q

What kind of organisms are sensitive to macrolides

A

Gram +, few gram neg, intracellular orgs like rickettsials and mycoplasma

109
Q

Do macrolides cross BBB

110
Q

Elimination of macrolides

A

liver, biliary

111
Q

What are the toxic effects of macrolides

112
Q

What restrictions should be used in macrolides

A

Caution of colitis and D in horses, guinea pigs, rabbits. Rectal swelling in sheep

113
Q

Describe the resistance of macrolides

A

Alteration of ribosome binding sites

114
Q

What are the drug interactions for macrolides

A

May precipitate and decrease efficacy by binding with many drugs, prolongs effect of warfarin, elevates digoxin levels in dogs

115
Q

What kind of drug is clindamycin

116
Q

What kind of drug is azithromycin

117
Q

What kind of drug is tylosin

118
Q

What is an advantage of azithromycin

A

Less GI effects

119
Q

What drug is best for toxoplasma and resistant R. equi

A

Macrolides

120
Q

Describe the resistance to chloramphenicol

A

Readily transmitted plasmid

121
Q

What is the MOA of chloramphenicol

A

Reversible inhibition of 50S protein synthesis

122
Q

Does chloramphenicol cross the BBB

123
Q

What is the elimination of chloramphenicol

124
Q

Toxicitiy- chloramphenicol

A

Human toxicity- major concern
GI disturbances esp. cats
Reduced liver metabolism and diminished clearance
Irreversible bone marrow suppression (aplastic anemia) in humans and dogs

125
Q

Restrictions- chloramphenicol

A

NO food animals

126
Q

What is florfenicol

A

Synthetic derivative of chloramphenicol that is allowed in food animals

127
Q

How are sulfonamides classified

A

Water solubility, duration and tissue distribution

128
Q

What are the side effects of sulfonamides

A

keratoconjunctivitis sicca, IMHA, renal crystallization

129
Q

What is the MOA of sulfonamides

A

Interference with folic acid synthesis in DNA synthesis

130
Q

Sulfonamides- bacterio-

A

static at ther. levels

131
Q

What orgs killed by sulfonamides

A

Gram neg and pos, not good in anaerobes nor pseudomonas

132
Q

What two drugs are not good treating abscesses

A

Sulfonamides and aminoglycocides

133
Q

Describe resistance in sulfonamides

A

High cross resistance, diverse mechanisms

134
Q

Elimination- sulfonamides

A

kidney and liver

135
Q

What are the drug interactions of sulfonamides

A

Disrupted protein binding and renal tubular secretion with many drugs, antagonized by PABA, oral antacids reduce absorption

136
Q

What is the newest group of antibiotics

A

Fluoroquinolones

137
Q

What kind of drugs are similar to fluoroquinolones

A

Weak organic acids- penicillins, cephalosporins, sulfas

138
Q

Time or conc- Fluoroquinolones

A

Concentration

139
Q

MOA- Fluoroquinolones

A

Inhibit bacterial DNA gyrase (topoisomerase II) to block DNA transcription

140
Q

What drugs are good for respiratory tract?

A

Fluoroquinolones

141
Q

What is the spectrum for Fluoroquinolones

A

Broad Gram neg and aerobes

142
Q

QRDR

A

Quinolone resistance determining region-

143
Q

What is the excretion of Fluoroquinolones

A

Hepatic and renal

144
Q

Better FQ in dogs

A

Marbofloxacin - higher AUC and Cmax

145
Q

What are teh side effects of FQs

A

Mild! Gi, nephro if dehydrated

146
Q

What are the contraindications of FQs

A

Pregnany, young (damage to growth plates), retinopathy in cats, off label in food animal

147
Q

What are the main interactions of FQs

A

Antacids, food, sucralfate, NSAIDs (Seizure)

Pharmacology Test Two (6 decks)

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