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Pharmacology > Antimicrobial - Chemo Principles > Flashcards

Antimicrobial - Chemo Principles Flashcards

1
Q

Prototype of antibiotics is from this source

A

Biological source

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2
Q

Prototype of antimicrobials is from this source

A

Synthetic source

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3
Q

5 factors that affect patient-drug-pathogen interactions

A

Pharmacokinetics
Pharmacodynamics (ideal is no response)
Immunity
Sepsis
Resistance

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4
Q

Factor that affects patient-drug-pathogen interactions:
Drug must be delivered to pathogen at clinically meaningful concentrations and durations with acceptable toxicity

A

Pharmacokinetics

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5
Q

Factor that affects patient-drug-pathogen interactions:
Ideal is no response
Selective toxicity
Toxic reactions from high doses, drug interactions, undesired effects, idiosyncratic reactions, allergic reactions

A

Pharmacodynamics

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6
Q

Ability of the antimicrobial agent to exploit some different between the bacteria and human cells to provide effective antibacterial action with minimal or tolerable toxicity

A

Selective toxicity

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7
Q

A systemic inflammatory response to microbial infection
Complex signaling leads to release of inflammatory mediators

A

Sepsis

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8
Q

Define sepsis

A

A systemic inflammatory response to microbial infection

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9
Q

3 Sepsis-associated pathologies can impact antibiotic pharmacokinetics

A

Hypotension
Edema endothelial injury
Organ damage

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10
Q

The ability of bacteria or other microbes to resist the effects of an antibiotic
Occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections
The microorganisms survive and continue to multiply causing more harm

A

Resistance

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11
Q

2 primary forms of resistance

A

Natural and acquired resistance

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12
Q

Form of resistance:
Inherent property of the microorganism to be unaffected by agent
For example, a microorganism with no cell wall would not be affected to by agent that interferes with cell wall synthesis

A

Natural resistance

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13
Q

Form of resistance:
Has 3 mechanisms: mutation, adaptation, and gene transfer

A

Acquired resistance

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14
Q

3 mechanisms of acquired resistance

A

Mutation
Adaptation
Gene transfer

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15
Q

Gene transfer (involved in acquired resistance) occurs via these extra chromosomal genetic elements

A

R(esistance) Plasmids

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16
Q

Two factors that affect resistance emergence

A

Evolution
Clinical/environmental practices

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17
Q

To acquire resistance, bacteria can develop fewer, none, or mutated _______, reducing drug entry into pathogen

A

Porins

18
Q

5 major efflux systems

A

Multidrug and toxic compound extruder (MATE)
Major facilitator superfamily (MFS) transporters
Small multidrug resistance (SMR) systems
Resistance nodulation division (RND) exporters
ATP binding cassette (ABC) transporter

19
Q

Refers to a subset of microbial population that is resistant when the majority is susceptible
Frequently associated with baseline chromosomal mutation rates
Essentially there is always a resistant microorganism

A

Hetero-resistance

20
Q

Expected profile of activity against infectious organism
Imprecise reference

A

Spectrum of action

21
Q

Spectrum of action that is therapeutically useful against one of the major groups of infectious agents easily characterized

A

Narrow spectrum of action

22
Q

Spectrum of action that is more extensive compared to prototype of class

A

Extended spectrum of action

23
Q

Agent that kills sensitive organisms

A

Cidal agents

24
Q

2 typical cidal mechanisms of action

A

Disruption of cell wall or membrane activity
Inhibition of DNA or RNA structure or function

25
Q

Agents that stop organism growth but may not kill sensitive organism
Typical action is reversible

A

Static agents

26
Q

Disruption of cell wall or membrane activity and inhibition of DNA or RNA structure or function are examples of mechanisms of action of this type of agent

A

Cidal

27
Q

Reversible inhibition of enzymatic processes or protein synthesis/function are examples of mechanisms of action of this type of agent

A

Static

28
Q

2 static mechanisms of action

A

Inhibition of enzymatic processes
Inhibition of protein synthesis or function

29
Q

Laboratory test for antimicrobial sensitivity used to identify which drugs inhibit bacterial growth and the drug concentrations required for that inhibition

A

Antimicrobial sensitivity test (AST)

30
Q

What does MIC stand for in the context of antimicrobial sensitivity tests?

A

Minimal inhibitor concentration

31
Q

3 reasons why earlier treatment is better

A

Rapidly dividing bacteria are more sensitive
Number of resistant organisms is low
Usually a single infectious agent

32
Q

3 requirements for choosing a drug

A

Must be active against the microorganism
Must be able to reach effective levels
Must be safe

33
Q

4 scenarios when to use combination therapy

A

Mixed bacterial infections requiring multiple drugs
Additional therapeutic benefits provided
Will result in enhanced antibacterial activity
Prevention of resistance

34
Q

These two drugs are used in combination therapy because they have a synergistic effect against enterococci

A

Ampicillin and gentamycin

35
Q

Predetermined change in empiric therapy (changing to a different drug)
Typically directed at preventing or reducing resistance
Proactive by design, reactive by need

A

Antimicrobial switching

36
Q

A change in route of administration of the same agent

A

Antimicrobial switch therapy

37
Q

Is short or long term fever usually viral?

A

Short term

38
Q

Is short or long term fever usually bacterial?

A

Long term

39
Q

Describes how during illness when host resistance is reduced, organisms of normally low virulence can become highly pathogenic
Increasingly common with some treatment regimens (cancer, inflammatory conditions, transplant rejection)

A

Opportunistic pathogens

40
Q

During pregnancy, there is enhanced _______ and ______ clearance

A

Renal and hepatic clearance

41
Q

Meds that have cardiac risk in geriatrics
Age must be considered when selecting a treatment

A

Quinolones

42
Q

Quinolone, tetracycline, trimethoprim, and sulfonamides are avoided during pregnancy due to their _________ risk

A

Teratogenic

Pharmacology (14 decks)

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