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Pharm Exam II > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

T/F: All antimicrobials are antibiotics but not all antibiotics are antimicrobials

A

FALSE, all antibiotics are antimicrobials but not all antimicrobials are antibiotics

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2
Q

therapeutic use

A

when diseased animals are treated to cure infection

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3
Q

prophylactic use

A

when healthy herds or animals are treated to prevent infection

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4
Q

metaphylactic use

A

when diseased herds are treated to cure infection in some individuals and prevent infection in others

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5
Q

chemotherapeutic drugs

A

selectively toxic to the causative agent of disease (AMDs)

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6
Q

what are the two most important factors in determining what AMD to use?

A

efficacy and toxicity

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7
Q

intrinsic resistance

A

resistance due to structural or functional traits present in all members of a given bacterial species or group

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8
Q

mutant prevention concentration (MPC)

A

concentration of AMDs you give to avoid creating mutants

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9
Q

T/F: for time-dependent AMDs efficacy depends on amount of time that the drug concentration stays above the MIC

A

TRUE, aim to be above MIC for at least 50% of the dosing interval

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10
Q

T/F: if you give a higher concentration of a time-dependent AMD you can improve efficacy

A

FALSE, higher concentrations at the site of infection for time-dependent AMDs does NOT improve efficacy

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11
Q

danny tanner is tired of pilling comet 20 mg of amoxicillin TID, he asks if you can prescribe him a dose for BID. what do you tell him?

A

sorry danny! upping the dose so you can pill comet less is going to effect the efficacy of the drug! because amoxicillin is a time-dependent drug, it’s important to maintain your drug concentration

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12
Q

are penicillins and cephalosporins time-dependent or concentration-dependent?

A

time-dependent (T > MIC)

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13
Q

what is efficacy related to in concentration-dependent drugs?

A

the peak concentration being very high concentration at the site of infection, aim for Cmax that is 10x MIC!! (Cmax/MIC)

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14
Q

what kind of effect do you often see with concentration-dependent AMDs?

A

a long post-antibiotic effect (PAE)

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15
Q

you are working with a 100 year old vet who prescribes amikacin (aminoglycoside) to a patient with the directions to give small doses BID but you being a baby Dr. remember learning in class that this might not give you the best efficacy. how do you explain this to him?

A

when they first made amikacin they only looked at mg/kg how ever many times a day, its actually more efficacious when given at a larger dose once a day because it’s a concentration-dependent AMD, even though you’re technically going extra-label

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16
Q

name two major concentration-dependent AMDs

A

aminoglycosides and fluoroquinolones

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17
Q

what kind of group of AMDs are you describing when efficacy relates to both concentration and time, and is measured by looking at the AUC compared to MIC?

A

drugs that don’t fit into time-dependent or concentration-dependent nicely, AUC/MIC (overall drug exposure), tablet/capsule size, adverse effects, and owner compliance dictate dosing regimen

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18
Q

what AMDs would you look at AUC/MIC for measuring efficacy?

A

macrolides, lincosamides, tetracyclines, fluoroquinolones

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19
Q

how do you optimize dosage regimens?

A

shoot high, shoot low, shoot fast

20
Q

drugs that distribute to the ECF

A

beta-lactams, aminoglycosides

21
Q

drugs that distribute through the total body water

A

chloramphenicol, clindamycin, doxycycline, quinolones, sulfonamides

22
Q

drugs that concentrate in the urine

A

beta-lactams, aminoglycosides, quinolones, sulfonamides

23
Q

drugs that concentrate in the bile

A

clindamycin, doxycycline, erythromycin, rifampin

24
Q

drugs that accumulate in WBCs

A

clindamycin, erythromycin, quinolones, rifampin

25
Q

drugs that penetrate the BBB

A

chloramphenicol, doxycycline, quinolones, metronidazole, rifampin, potentiated sulfonamides

26
Q

drugs that do not penetrate the BBB

A

aminoglycosides, some cephalosporins, clindamycin, erythromycin

27
Q

what three AMDs accumulate in phagocytic cells?

A

macrolides, lincosamides, fluoroquinolones

28
Q

what AMD is known to excrete unchanged in the bladder and therefore show high concentrations in the lumen of the bladder?

A

penicillins

29
Q

T/F: inflammation can decrease drug delivery to the site of infection

A

FALSE, inflammation will result in increased blood flow, higher capillary permeability, etc. which will increase drug delivery to the site of infection

30
Q

T/F: chronic inflammation may decrease efficacy of an AMD

A

TRUE, i.e. sulfas don’t work well in presence of pus which is high in PABA

31
Q

in what type of patient would you want to use a bactericidal over a bacteriostatic drug?

A

immunocompromised

32
Q

T/F: sulfonamides and fluoroquinolones are relatively safe as they have a much higher affinity for the bacterial target enzymes than mammalian enzymes

A

TRUE

33
Q

what AMD can cause severe irritation to the esophagus and lead to esophageal stricture?

A

doxycycline

34
Q

what AMD accumulates in renal cells and otic hair cells causing nephrotoxicity and ototoxicity?

A

aminoglycosides

35
Q

what two AMDs more frequently stimulate immune mediated or allergic responses than other classes?

A

sulfonamides and penicillins

36
Q

T/F: aminoglycosides have a wide TI, rarely significant adverse effects

A

FALSE, that is amoxicillin. aminoglycosides have a narrow TI, significant risk of renal toxicity

37
Q

what AMD can cause retinopathy in cats?

A

enrofloxacin (fluoroquinolone)

38
Q

what AMD can cause joint damage in young, growing animals?

A

enrofloxacin

39
Q

what AMD has a higher incidence of hepatotoxicity in dobermans?

A

sulfonamides

40
Q

what AMD can cause fatal GI microfloral disruptions in small herbivores?

A

penicillins (think guinea pig case based)

41
Q

T/F: baytril (enrofloxacin) is approved in cattle but not dogs

A

FALSE, opposite

42
Q

what are common AMDs that inhibit the cell wall?

A

beta-lactams (penicillins, cephalosporins)

43
Q

what are common AMDs that disrupt the cell membrane?

A

polymyxins

44
Q

what are common AMDs that inhibit protein synthesis?

A

macrolides and lincosamides, amphenicols, tetracyclines, aminoglycosides

45
Q

what are common AMDs that inhibit DNA/RNA synthesis/function?

A

fluoroquinolones and sulfonamides

Pharm Exam II (6 decks)

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