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RUSVM Pharmacology > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

What is antimicrobial stewardship?

A

Choosing antimicrobials wisely to we have optimal dose, therapy, and route of admin targeting specific bacterial to reduce the emergence of resistant bacteria

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2
Q

A nonselective, toxic chemicals which are safe to be applied to the skin to kill microorganisms, but not safe to be given orally or parenteraly

A

Antiseptics

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3
Q

What are the components of efficacy?

A

Spectrum - gram (+ or -), ability to treat specific organism

Resistance

Can the drug get to the site of action

Concentration vs time-dependent

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4
Q

To maximize clinical efficacy doses should be ________________ for concentration dependent drugs and ________________ for time dependent drugs

A

High; regular

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5
Q

How does drug efficacy relate to a time-dependent drugs?

A

T>MIC

Amount of time that the drug remains above the minimum inhibitory concentration

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6
Q

T/F: for time-dependent drugs, higher concentrations at the site of infection will improve efficacy of the drug

A

F

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7
Q

What antimicrobials are considered to be time-dependent

A

Penicillins and cephalosporins

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8
Q

How does efficiency relate to concentration-dependent drugs

A

Peak concentration being very high concentration at the site of infection
Cmax 10x the MIC

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9
Q

Do time-dependent or concentration-dependent drugs usually exhibit long post-antibiotic effect

A

Concentration dependent

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10
Q

What antimicrobials are considered to be concentration dependent?

A

Aminoglycosides

Fluoroquinolones

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11
Q

What type of drug does efficacy relates to both time and concentration

A

AUC/MIC

Dosage combined with frequency is important

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12
Q

What are the antimicrobials that have AUC/MIC index

A

Macrolide s
Lincosamides
Tetracycline
Fluoroquinolones

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13
Q

What are the antimicrobials that are distributed to the ECF

A

Beta-lactams (penicillins and cephalosporins )

Aminoglycoside

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14
Q

What. Are the antimicrobials that are distributed through the total body water

A 
Chloramphenicol 
Clindamycin 
Doxycycline 
Doxycycline 
Quinolones
Sulfonamides
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15
Q

What antimicrobials will concentrate in the urine?

A

B-lactams
Aminoglycoside
Quinolones
Sulfonamides

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16
Q

What antimicrobials concentrate in the bile?

A

Doxycycline
Erythromycin
Rifampin

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17
Q

What antimicrobial accumulate in WBCs?

A

Clindamycin
Erythromycin
Quinolones
Rifampin

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18
Q

What antimicrobials will cross the BBB?

A 
Chloramphenicol 
Doxycycline
Quinolones 
Metronidazole 
Rifampin 
Potentiated sulfonamides

Inflammation-> penicillins and some cephalosporins

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19
Q

What antimicrobials do NOT penetrate the BBB?

A

Aminoglycoside
Some cephalosporins
Clindamycin
Erythromycin

20
Q

How can inflammation alter antimicrobial drug delivery to site of infection?

A

Increase blood flow
Higher capillary permeability

Chronic inflammation -> decrease efficacy if there is puss/fibrosis

Change in pH

Reduced local oxygen-> reduced function of some drugs

21
Q

What are adverse effects that can occur due to a drug?

A 
Toxicity 
Idiosyncratic/ dose-dependent 
Species specific 
Irritant or life-threatening 
Reversible or not ?
22
Q

Can B-lactams have a toxic effect? Why? Why not?

A

Generally not

Target the cell wall of the bacterium

23
Q

Can sulfonamides and fluoroquinolones have a toxic effect? Why or Why not?

A

Generally non toxic

Have a higher affinity for the bacterial target enzyme than the mammalian enzymes

24
Q

Can animoglycosides have a toxic effect? Why or why not?

A

Yes

Accumulate in renal cells and otic hair cells causing damage to those organs

25
Q

Can doxycyline cause toxicity? Why or why not?

A

Yes

Can cause severe irritation to the esophagus from direct tissue irritation leading to esophageal stricture

26
Q

How does therapeutic index usually relate to adverse events?

A

Wide therapeutic index -> rarely significant adverse effects (eg amoxicillin)

Narrow therapeutic index-> significant risk (e.g. aminoglycoside cause renal toxicity)

27
Q

What adverse effect with enrofloxacin cause in cats?

A

Retinopathy

28
Q

Enrofloxacin (fluoroquinolones) can cause what adverse effect in young animals?

A

Joint damage

29
Q

What breed has a higher incidence of hepatotoxicity caused by sulfonamides?

A

Doberman retrievers

30
Q

What adverse effect will penicillins have on small herbivores (guinea pig, rabbits)

A

GI microflora disruption

31
Q

What are the classes of antibiotics commonly used in veterinary medicine (12)

A 
Aminoglycosides 
Amphenicols 
B lactams 
B lactamase inhibitors 
Cephalosporins 
Fluoroquinolones 
Lincosamides 
Macrolide 
Nitroimidazoles 
Penicillins 
Sulfonamides and DHFR inhibitors 
Tetracyclines
32
Q

What are the MOAs of antibiotics?

A

Inhibit the cell wall synthesis
Disrupt the cell membrane
Inhibition of protein synthesis
Inhibition of DNA/RNA synthesis

33
Q

What are characteristics of antibiotics that inhibit cell wall synthesis ?

A

Bactericidal
Greatest effect on actively dividing bacteria
Often good against gram positive bacteria

34
Q

What antibiotics inhibit cell wall synthesis ?

A

B-lactams: penicillins, cephalosporins, carbapenems
Bacitracin
Glycopeptides (vancomycin)

35
Q

What are the general characteristics of antimicrobials that disrupt the cell membrane ?

A

Bactericial
Good against gram negatives
More risk of toxicity (when given systemically-> only use topically)
Do not require actively dividing bacteria

36
Q

What antimicrobials works by disrupting the cell membrane?

A

Polymixin

37
Q

What are the general characteristics of antimicrobials that inhibit protein sysnthesis?

A

Often bacteriostatic
May be more effective during replication
Toxicity varies between drugs (unrelated to MOA)

38
Q

What are the antimicrobials that inhibit protein synthesis?

A

Macrolide and lincosamides
Amphenicols
Tetracyclines
Aminoglycosides

Nitrofurans

39
Q

What are the general characteristics of antimicrobials that inhibit DNA or RNA synthesis

A

Toxicity variable
Generally considered relatively safe
Microbial targets are more sensitive than mammalian enzymes

40
Q

What are the antimicrobials that target DNA or RNA synthesis ?

A

Fluoroquinolones
Sulfonamides

Nitroimidazoles
Rifamycins

41
Q

You see a cat with esophageal stricture, what antimicrobial might be related?

A

Doxycyline or clindamycin

-> causes irritation to the esophagus –> chase with water

42
Q

Pulmotil and Micotil both have the active tilmocosin, are these drugs interchangeable in treating cattle for respiratory disease?

A

Nope

Pulmotil is mixed into food for pigs-> not approved in cattle because it will go to rumen and just sit there, will not be distributed to the tissues

Micotil is given SQ to cattle

43
Q

You need to treat your pet bunny named Bugs for a respiratory infection. You have the following availaiable for your prescribing needs, which shhhould you give?

Enrofloxacin (fluoroquinolones )
Cephalexin (cephalosporins )
Amoxicillin (penicillin)
Clindamycin (lincosamides)

A

Enrofloxacin

The others will disrupt the bunny GI microflora (disbiosis) -> fatal x_x

44
Q

Why would it be acceptable treatment to give Tulathromycin (macrolide) as a single dose rather than over a few days to treat respiratory disease?

A

Macrolide have a serum half-life of 60-90hrs

They accumulate in the pulmonary system and phagocytes where there half-life is 6days.

45
Q

Can ampicillin and amikacin be used in the same patient to synergistically treat an infection?

A

Yes

Ampicillin (penicillin) and amikacin (aminoglycoside) have synergistic effects

BUT…
Cannot be mixed in the same syringe -> aminoglycoside will inactivate penicillin in vitro

46
Q

Can you used amphenicol to treat your moo cows with bovine respiratory disease? What about in a dog?

A

Well you could… but then you might kill the person who eats that cow.. (you win some, you lose some)

Amphenicol s are banned in food animals -> residues -> fatal aplastic anemia in humans

You can use this is dog

RUSVM Pharmacology (18 decks)

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