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pharma > Antimicrobial agent 1 > Flashcards

Antimicrobial agent 1 Flashcards

1
Q

we choice the antimicrobial agent according to what?

A 
1_pharmacokinetics profile 
2_cost
3_route ofadministration 
4_type of activity
5_spectrum of activity 
6_sensitivity of the organism
7_relative toxicity
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2
Q

Mention the different type of actions of antimicrobial agents

A

1_inhibition of cell wall synthesis
2_inhibition of pn synthesis
3_inhibition of DNA replication and transcription
4_injury to plasma membrane «polymixin B»
5_inhibition of synthesis of essential metabolites

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3
Q

Mention the antimicrobial agents inhibiting cell wall synthesis

A

1_B. lactam drugs
B. lactam antibiotics: pencillin, cephalosporins, carbapenems, monobactams.
B. lactmase inhibitors:
clavulanic acid, Tazobactam, Sulbactam.

2_Glycopeptides: vancomycin

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4
Q

What’s the type of action of B. lactam antibiotics, and how bacteria resist it?

A

1_bactericidal
2_Inactivation of antibiotics by B. lactmase.
modification of pBps«R. PBP2x from beta lactam resistance strain of S. pnemonia.
decrease drug penetration «dec porins».
Efflux pumps.

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5
Q

Mention the classification of pencillin according to its activity.
talk about Antipsedumonal.

A 
1_pencillinase sensetive pencillin: 
Benzyl pencillin 
procaine pencillin 
Benzathine pencillin 
phenoxy methyl pencillin 
2_pencillinase resistance pencillin 
cloxacillin 
methicillin
nafcillin
dicloxacillin 
oxacillin
3_Broad spectrum pencillin 
Ampicillin, Ampicillin +cloxacillin, Amoxacillin 
4_Antipsedumonal pencillin 
pipracillin«about 8 times more active than carbencillin 
carbencillin.«neither pencillinase resistance nor acid resistance»
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6
Q

Describe the different characters of pencillinase sensetive pencillin

A

1_Benzyl pencillin «G» Acid and water unstable, I. V 6 hourly
2_procaine pencillin: Acid unstable, only IM once or twice a day, Allergen اكثر واحد له hypersensitivity
3_Benzathine pencillin; Acid unstable, only IM for prphylaxis every 21 day.
4_phenoxy methyl pencillin «V», Acid resistance, orally 6 hourly.

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7
Q

Describe the different characters of broad spectrum pencillin

A

1_Ampicillin: orally
low bioavailability, but enough for action.
short half life 6 hours.
absorption decrease with food

2_Amoxacillin: orally
better absorption 
not affected by food 
longer half life 8 hours 
therapeutic index is wide, less toxicity. 
50 mg /kg/day.
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8
Q

Mention the pharmacokinetics properties for pencillin

A

1_vary in acid resistance and oral bioavailability
2_excreted unchanged in urine; Ampicillin and naficillin excreted partly in bile
3_half life vary
4most pencillin cross BBB only when manenges are inflammed.
5

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9
Q

Mention the uses of pencellin.

A

1_Rheumatic fever.
2_SABE
3_Gonorrhea, syphilis
4_diphetria, tetuns, gas gangrene, Anthrax
5_leptospirosis, lisriosis, lyme Ds
6_Actinomycosis
7_Gingivostomatitis, Rat bite fever, erispeloid

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10
Q

What are the adverse effects of pencellin?

A 
1_Allergy, Jarisch-Herxheimer reaction. 
2_Nephritis     methicillin 
3_Neutropenia.   nafcillin
4_increase in prothrombin time leading to bleeding
5_GIT disturbance specially Ampicillin 
6_cation toxicity
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11
Q

Describe the different categories of pencellin drug interactions.

A

1_Antagonism: tetracycline, chloramphenicol, Erythromycin
2_Synergism: Aminoglycosides
3_inactivate each other pharmacutically: pencillin with aminoglycosides or with hydrocortisone
4_high incidence of non urticarial maculpapular rash: Ampicillin with Allupurinol
5_prolog action by decrease tubular secretion: prbenecid

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12
Q

Mention the different generations of Cephalosporins.

A

1_first; Cefazolin, Cephalexin, Cefadroxil.
2_Cefuroxime, cefaclor, Cefprozil, Cefoxitin, Cefuroxime axetil
3_Ceftriaxone, Cefixime, Cefotaxime, Ceftizoxime cefpodoxime proxetil,
cefdirin, ceftazidime, ceftibuten, cefoperazone.
4_Cefepime, Cefpirome

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13
Q

Mention the characters of each cephalosporin generation

A

1_Active against G+ cocci( except enteroccoci, MRSA) srept, staph, E. coli.
indicate for S. pharyngitis(cephalexin)
prophylaxis for surgical procedures (cefazolin).
less activity against G- bacteria
2_Its affectivity against G- increased
3_have enhanced G- activity, H. influenza,N. meningitis, N. Gonorrhea, p. aeruginosae, M. catarrhalis, E. coli, most klebsiella
4_highly resistant to B Lactimase produced by G- organism

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14
Q

describe the pharmacokinetics of Cephalosporins.

A

1_most of them parentral but several are available for oral use
2_have hepatic metabolism
3_major elimination by kideny
4_most of 1+2 generations don’t penetrate CSF even in inflammation
5_binding to plasma pn vary; cefazolin 80% pn bound, cehalexin10-15%

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15
Q

Mention the adverse effects of Cephalosporins

A

1_Hypersensitivity
2_Neprotoxicity
3_Neutropenia, thrombocytopenia with ceftazidime
4_bleeding; Ceftriaxone, cefoperazone due to hypoprothrombenemia
5_pain after Im injection, thrombophlebitis of injected vein
6_Diarrhea with orally administrated; cephalexin, Cefixime and paretenal cefoperazone wich is excreted in bile
7_disulfiram like interaction with cefoperazone

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16
Q

Mention the uses of Cephalosporins

A

1_Respiratory tract infection
2_E. N. T infection
3_Enteric fever
4_soft tissue infection (furanclosis-pyoderma impetigo)
5_Geitourinary tract infection (pyelonphritis, cystitis, urethritis, Gonorrhea).

17
Q

describe breifly monobactams and crbapenems

A

1_mono; active against G- «klebsiella, pseudomonas, serratia»
administration: IV
2_Carb; active against G+ cocci
drug of choice for enterobacter
administration: parentally in combination with cilastatin«impenem»

18
Q

Mention the Beta lactamase inhibitors

A

1_clavulanic acid (klamox)
2_Tazobactam (zosyn;pip/tazo)
3Sulbactam(Amp/sulb)
4(sulb/Ceftriaxone)

19
Q 
Regarding vencomycin: 
1_type of action
2_spectrum
3_general use
4_route and use
5_absorption 
6_elimination
7_toxicity
A

1_bactericidal
2_narrow
3_for serious infections caused by G+ organism resistance to pencillin or Cephalosporins
4_Oral for severe clostridium defficile colitis
Iv for: treatment of complicated skin infections, bloodstream infections, bone and joint infections, endocarditis, meningitis caused by MRSA
5_not absorped from GIT
6_by urine
7_chills, fever, philebitis, ototoxicity, nephrotoxicity, red man syndrome on rapid infusion
8_cardiac arrest

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