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Pharmacology > Block 3 > Flashcards

Block 3 Flashcards

1
Q

what is selective toxicity

A

a drug that kills harmful microbes without damaging the host

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2
Q

how do bactericidal agents work

A

kill bacteria leading to a faster decline in bacteria cell number

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3
Q

what are 4 examples of bactericidal drugs

A

penicillin
cephalosporins
aminoglycosides
fluoroquinolones

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4
Q

how do bacteriostatic agents work

A

inhibit bacterial growth

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5
Q

why are bacteriostatic agents not preferred in immunocompromised patients

A

bacteria will resurface because intact immunity is required to get rid of the static bacteria

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6
Q

what are 3 examples of bacteriostatic agents

A

sulfonamides
tetracyclines
erythromycin

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7
Q

what is an example of a drug which is bactericidal against one set of bacteria but bacteriostatic against another

A

chloramphenicol

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8
Q

what is the downside of use of broad spectrum drugs

A

they can cause superinfections by organisms whose growth is normally kept in check by presence of normal flora

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9
Q

what is minimum inhibitory concentration of drugs

A

the lowest antibiotic concentration that prevents visible growth of an organism after 24 hours of incubation

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10
Q

based on minimum inhibitory concentration, how can you determine if a bacteria is resistant or susceptible

A

low MIC to suppress growth= sensitive
high MIC to suppress growth= increased resistance= increased risk of toxicity

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11
Q

what is antibiotic concentration dependent killing

A

as concentration of the drug increases from 4 to 64 fold, there is an increase in bacteria killing

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12
Q

what type of antibiotic dosing and frequency do you use for concentration dependent killing
(high/low dose, frequent/less frequent)

A

high dose
less frequent

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13
Q

do daptomycin, aminoglycosides, and fluoroquinolones exhibit a concentration or time dependent killing

A

concentration

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14
Q

what is antibiotic time dependent killing

A

killing continues as long as the concentration is above MIC (increasing concentration very high above MIC does not result in proportionate increase in killing)

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15
Q

what type of antibiotic dosing and frequency do you use for time dependent killing
(high/low dose, frequent/less frequent)

A

low
more frequent

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16
Q

beta lactams (such as penicillin) and vancomycin use what type of dependent killing (concentration or time)

A

time

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17
Q

what is post antibiotic effect

A

suppression of bacterial growth persists following removal of the antibiotic

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18
Q

what type of drug shows a post antibiotic effect against gram + cocci

A

penicillin

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19
Q

what type of drugs show a post antibiotic effect against gram - bacilli

A

aminoglycosides

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20
Q

the higher the lipid solubility of a drug the __ better it will be able to reach the BBB

A

higher

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21
Q

are 2 examples of drugs that are able to pass the BBB due to their high lipid solubility

A

chloramphenicol and metronidazole

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22
Q

bactericidal drugs are used in __ (larger/smaller) dose for a __ (longer/shorter) duration in immunocompromised patients

A

larger
longer

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23
Q

what are 2 drugs that are contraindicated for patients with hepatic dysfunction

A

erythromycin
doxycycline

*primarily cleared by liver

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24
Q

what are 6 main drugs to avoid during pregnancy

A

tetracycline (impaired bone growth, teeth dysplasia)
aminoglycosides (ototoxic effects-ear)
erythromycin estolate
clarithromycin
fluoroquinolones
sulfonamides

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25
what route of administration is used for serious infection
parenteral (other than GIT)
26
what is pre-emptive therapy
treatment of an infected but asymptomatic patient
27
what is specific (definitive) therapy
treatment started after identifying the organism and finding out what drug it is sensitive to
28
what is empiric therapy
treatment after speciman has been obtained but before results of culture are available
29
what in an example of when empiric therapy is used
in patients in meningitis where delay could be fatal
30
what are 4 factors that determine choice of drug for empiric therapy
hospital vs community acquired immune status of patient patient's travel record age
31
why are antibiotics used prophylactically in acute rheumatic fever
for the prevention of streptococcal reinfection and rheumatic heart disease
32
how can you identify a cell wall synthesis inhibitor based on the name
ceph- cef- -cillin -vancin
33
how do beta lactam drugs work
they interfere with cell wall synthesis by binding to penicillin binding protein and inhibiting transpeptidase
34
what are the 2 mechanisms of antibiotic resistance with beta lactam antibiotics
beta lactamase structural change in penicillin binding protein
35
what penicillins are included in standard/natural penicillins
penicillin G (IM) and phenoxymethyl penicillin V (oral)
36
anti-staphylococcal penicillins are resistant to what
beta lactamase
37
what are 5 examples of anti-staphylococcal penicillin drugs
methicillin nafcillin oxacillin cloxacillin dicloxacillin
38
what are 2 examples of aminopenicillins
ampicillin amoxicillin
39
what are 3 examples of antipseudomonal penicillins
carbenicillin ticarcillin piperacillin
40
how is penicillin G administered, why
parenterally, it is destroyed by gastric acid
41
when does penicillin G cross the BBB
during inflammation in meningitis
42
does penicillin G have a short or long half life
short (30 minutes)
43
90% of penicillin G is eliminated by __
tubular secretion in urine
44
how can the concentration of penicillin G in plasma be increased
addition of probenecid
45
penicillin G is also known as what
benzyl penicillin
46
penicillin G is used against what 6 bacteria
staphylococci neisseria meningiditis corynebacterium diptheriae clostridium tetani clostridium perfringes treponema (syohilis)
47
how do beta lactamases work
they hydrolyze of beta lactam rings, making them ineffective
48
penicillin G is used for prophylaxis for what infection
acute rheumatic fever
49
what is an advantage of nafcillin
it's excreted in the bile so it can be given to patients with renal impairment
50
what penicillinase is no longer used due to it's nephrotoxicity
methicillin
51
what drugs are used for methicillin resistant staph aureus
vancomycin/daptomycin
52
what is the preferred antibiotic for listeria infection
ampicillin
53
what in interferes with ampicillin absorption
food
54
how is ampicillin excreted
in the bile and partially undergoes enterohepatic circulation
55
what is a side effect of ampicillin
diarrhea
56
what are the advantages of amoxicillin use over ampicillin use
less diarrhea less risk for pseudomembranous colitis
57
ampicillin and amoxicillin are used for what therapeutic uses
upper respiratory tract infections urinary tract infections meningitis salmonella (ampicillin)
58
what drug is given for prophylactic use in patients with abnormal or prosthetic heart valves undergoing dental surgery/procedure
amoxicillin or ampicillin
59
high doses of what drug can cause bleeding by interfering with platelet formation
antipseudomonal penicillins (piperacillin, carbenicillin, ticarcillin)
60
antipsudomonal penicillins are used against what bacteria species
pseudomonas aeruginosa enterobacteriaceae klebsiella
61
piperacillin is used in combination with what other drug
tazebactam
62
antipseudomonal penicillins are used in __ infections by gram - bacteria (what type of setting)
nosocomial (hospital acquired)
63
what is the Jarisch-Herxheimer reaction
penicillin is injected in a syphilitic patient and produces fever, chills, headache, hypotension, etc
64
are penicillins safe to use in pregnancy
yes
65
do penicillins have high or low therapeutic index
high they are safe drugs
66
clavulanic acid is used in combination with what 2 drug
amoxicillin ticarcillin
67
sulbactam and tazobactam are used in combination with what drugs
ampicillin piperacillin
68
what are 5 mechanisms of drug resistance
inactivation of microbial enzymes (beta lactamases) decreased accumulation (decreased uptake, increased efflux) reduced affinity of the target macromolecule for the drug altered metabolic pathway
69
what inactivated aminoglycosidases and chloramphenicol
acetyltransferases
70
what spectrum type of antibiotics can cause superinfection
broad

Pharmacology (16 decks)

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