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pharm exam 3 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Penicillin G

A
  • beta lactam
  • degraded by beta-lactamases
  • mainly used in large animals
  • acid labile so do not give PO
  • contains K and procaine salts
  • procaine salt is long acting and can cause CNS sings
  • used for UTI
  • also does gram “-“ anaerobes
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2
Q

Aminopenicillins (amoxicillin)

A
  • beta lactam antibiotic
  • disrupts GI flora
  • no CNS signs
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3
Q

Extended spectrum penicillins ( ticarcillin)

A
  • beta lactam
  • improved Q3 activity (good for Pseudomonas)
  • susceptible to beta-lactamase
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4
Q

Cephalosporins

A

-beta lactam
-very similar to penicillins (cross-hypersensitivity)
-NOT highly protein bound
1st gen: oldest, better gram + coverage (Cephalexin)
2nd gen: not used often because we lose some gram + effects
3rd gen: greater Gram - spectrum but lose some Gram + coverage, greater resistance to b-lactamase, more expensive (Ceftiofur) -BBB penetration

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5
Q

Imipenem

A
  • beta lactam
  • belongs to the Carbapenem family
  • anaerobes and Gram +
  • limit use to high resistant cases
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6
Q

Beta-Lactamase inhibitors (clavulanic acid)

A

-beta lactam

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7
Q

*Beta Lactam Drugs

A
  • penicillin (UTI) and cephalosporins
  • biggest problem = resistance (beta-lactamase production, changes in penicillin binding protein structures, impenetrable membrane pores on the bug, mutations and plasmid)
  • contain a 4 member beta-lactam ring (antibacterial activity, hydrostatic instability, microbial resistance)
  • bacteria cell wall needs to be replenished all the time, these drugs add peptidoglycan polymers to the cell wall and causes it to burst
  • TIME dependent
  • safe
  • acidic, hydrophilic (short half life)
  • only penetrates BBB when meningitis is present
  • most effective against Gram +
  • most are PO, cleared by kidney
  • not very protein bound
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8
Q

Cephalexin

A
  • beta lactam
  • first generation Cephalosporins
  • DOGS only
  • PO
  • treatment for pyoderma
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9
Q

Ceftiofur

A
  • beta lactam
  • 3rd generation Cephalosporin
  • used in food animals
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10
Q

*Aminoglycosides

A
  • concentration dependent
  • first isolated from Strep
  • synergistic with beta-lactams, but clinical effect is not predictable
  • hydrophilic base
  • attack Gram - aerobes, some gram + (staph)
  • can be nephrotoxic (high levels accumulate in the renal cortex), neurotoxic, ototoxic
  • causes irreversible inhibition of protein synthesis by binding to ribosomal subunit 30s, which is lethal to many bacteria
  • drugs must be transported into organism by energy and O2 dependent transporter (ineffective against anaerobes)
  • NOT orally absorbed
  • renal elimination
  • used for UTI in combination with Penicillins
  • resistance is limited (decreased membrane transport, altered ribosomal binding site)
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11
Q

Gentamycin

A
  • Aminoglycosides

- DOGS and CATS

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12
Q

Amikacin

A
  • Aminoglycosides

- Dogs, horses, neonatal foals

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13
Q

*Phenicols

A
  • all are organic bases, lipophilic

- great tissue distribution

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14
Q

Chloramphenicol (SA)

A
  • Phenicols
  • reversible inhibitor of ribosomal 50 protein synthesis
  • bacteriostatic
  • enzyme-catalyzed
  • resistance: plasmid, frequently in multi-drug resistant organisms
  • absorbed via all routes
  • hepatic elimination
  • species dependent half life
  • major concern is human toxicity (bone marrow suppression)
  • NEVER use in food animals
  • gives cats GI issues
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15
Q

Flophenicol (LA)

A
  • Phenicol

- OK for food animals

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16
Q

*Lincosamides

A
  • reversible inhibition of ribosomal protein 50 synthesis

- effective against anaerobes

17
Q

Linconmycin

A

-Lincosamides

18
Q

*Tetracyclines

A
  • bacteriostatic agents
  • reversible inhibition of protein synthesis by 30s ribosomal subunit
  • accumulated in macrophages
  • resistance = alteration in transporter
  • amphoteric compounds
  • most observed PO but can hurt esophagus so must follow it with water, painful injection
  • classified according to actions (short acting/H2O soluble, long acting/ lipid soluble, intermediate acting)
  • gram -/+ and mycoplasmas
  • cross-resistance to aminoglycosides and sulfonamides
  • effective for gram - UTIs
  • can really hurt esophagus if not given with water
19
Q

Oxytetracyclin

A
  • Tetracyclines
  • renal elimination
  • only for LA
  • intermediate acting
20
Q

Doxycyclin

A
  • Tetracyclines
  • NOT IN COWS / SHEEP
  • hepatic elimination
  • long acting
  • used for ehrlichiosis in dogs
  • BBB penetration
21
Q

*Fluoroquinolones

A
  • newest group
  • weak organic acids
  • also called quinolones
  • inhibits bacterial DNA gyrase
  • accumulates in phagocytes (prolongs the effects)
  • concentration dependent
  • broad spectrum with Gram - and aerobes
  • ineffective against anaerobes and most streps
  • mixed renal and hepatic elimination
  • safe in most species, high doses can cause nephrotoxicity, local tissue irritations, and mild GI upsets
  • contraindications: can cause blindness in cats
  • promotes its own resistance
  • avoid combinations with NSAIDs
22
Q

Enrofloxacin

A

-Fluoroquinolones

23
Q

Marbofloxacin

A
  • Fluoroquinolones

- best one

24
Q

*Macrolides

A
  • all contain a lactone ring (basic) and lipophilic
  • reversible inhibition of ribosomal protein 50 synthesis
  • bacteriostatic
  • gram +, few gram - and intracellular organisms
  • accumulated in neutrophils
  • well absorbed in all routes
  • mixed elimination
  • major side effects include the GI system
  • CAUTION in adult horses
  • strong cross resistance, usually involves alteration of ribosomal binding site
  • binds directly to many other drugs
25
Q

Clindamycin

A
  • Lincosamide

- used in dogs and cats for oropharyngeal infections

26
Q

Azithromycin

A
  • Macrolides
  • less GI effects
  • good for respiratory infections
27
Q

Tylosin

A
  • Macrolides

- develops slow resistance

28
Q

*Polypoptides

A

-

29
Q

Vancomycin

A

-Polypoptides

30
Q

Bacitracin

A

-Polypoptides

31
Q

Polymixin

A

-Polypoptides

32
Q

*Potent Sulfonamides

A
  • oldest group of synthetic antibiotics
  • organic acids
  • classified according to water solubility (systematic infections), lipid solubility, tissue distribution, duration of action
  • interfere with folic acid synthesis necessary for pyrimidine synthesis
  • bacteriostatic at usual levels
  • gram +/-
  • resistance really limits it’s effects, high cross resistance, altered PABA levels, altered DHP synthesis, microbial breakdown uses sulfas for its own synthesis
  • elimination via kidney and liver
  • interfere with folic acid metabolism
  • side effects: local tissue irritation, keratoconjunctivitis sicca, renal crystallization, idiosynchratic immune reactions, acute reactions are rare but severe
  • fucks up protein binding on renal secretion of acid drugs
33
Q

Sulfas + Trimethoprim

A
  • Potent Sulfonamides

- bacterial combination of the two drugs

34
Q

Rifampin

A

-antibiotic

35
Q

Metronidazole

A
  • antibiotic
  • concentration dependent
  • active against anaerobes, protozoal organisms
  • used for Giardia
  • PROHIBITED in food animals !
  • very lipophilic
  • unknown mechanism of action, most likely generates reactive O2 species that disrupt DNA
  • food increases bioavailability in dogs
  • use it in shunt patients before surgery to decrease bacterial load and ammonia production
  • Common GI issues come with it, neurotoxicity is a big deal with it (mostly in cats)
  • competes for the same CYP450 family
  • BBB penetration
36
Q

Antibiotics that cross BBB (per his slide)

A

Chloramphenicol
Doxycycline
Metronidazole
3rd gen Cephalosporins in case of meningitis

37
Q

concentration dependent

A

fluoroquinolones
aminoglycosides
metronidazole

pharm exam 3 (6 decks)

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