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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
Q

what route of administration is used for serious infection

A

parenteral (other than GIT)

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26
Q

what is pre-emptive therapy

A

treatment of an infected but asymptomatic patient

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27
Q

what is specific (definitive) therapy

A

treatment started after identifying the organism and finding out what drug it is sensitive to

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28
Q

what is empiric therapy

A

treatment after speciman has been obtained but before results of culture are available

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29
Q

what in an example of when empiric therapy is used

A

in patients in meningitis where delay could be fatal

30
Q

what are 4 factors that determine choice of drug for empiric therapy

A

hospital vs community acquired
immune status of patient
patient’s travel record
age

31
Q

why are antibiotics used prophylactically in acute rheumatic fever

A

for the prevention of streptococcal reinfection and rheumatic heart disease

32
Q

how can you identify a cell wall synthesis inhibitor based on the name

A

ceph-
cef-
-cillin
-vancin

33
Q

how do beta lactam drugs work

A

they interfere with cell wall synthesis by binding to penicillin binding protein and inhibiting transpeptidase

34
Q

what are the 2 mechanisms of antibiotic resistance with beta lactam antibiotics

A

beta lactamase
structural change in penicillin binding protein

35
Q

what penicillins are included in standard/natural penicillins

A

penicillin G (IM) and phenoxymethyl penicillin V (oral)

36
Q

anti-staphylococcal penicillins are resistant to what

A

beta lactamase

37
Q

what are 5 examples of anti-staphylococcal penicillin drugs

A

methicillin
nafcillin
oxacillin
cloxacillin
dicloxacillin

38
Q

what are 2 examples of aminopenicillins

A

ampicillin
amoxicillin

39
Q

what are 3 examples of antipseudomonal penicillins

A

carbenicillin
ticarcillin
piperacillin

40
Q

how is penicillin G administered, why

A

parenterally, it is destroyed by gastric acid

41
Q

when does penicillin G cross the BBB

A

during inflammation in meningitis

42
Q

does penicillin G have a short or long half life

A

short (30 minutes)

43
Q

90% of penicillin G is eliminated by __

A

tubular secretion in urine

44
Q

how can the concentration of penicillin G in plasma be increased

A

addition of probenecid

45
Q

penicillin G is also known as what

A

benzyl penicillin

46
Q

penicillin G is used against what 6 bacteria

A

staphylococci
neisseria meningiditis
corynebacterium diptheriae
clostridium tetani
clostridium perfringes
treponema (syohilis)

47
Q

how do beta lactamases work

A

they hydrolyze of beta lactam rings, making them ineffective

48
Q

penicillin G is used for prophylaxis for what infection

A

acute rheumatic fever

49
Q

what is an advantage of nafcillin

A

it’s excreted in the bile so it can be given to patients with renal impairment

50
Q

what penicillinase is no longer used due to it’s nephrotoxicity

A

methicillin

51
Q

what drugs are used for methicillin resistant staph aureus

A

vancomycin/daptomycin

52
Q

what is the preferred antibiotic for listeria infection

A

ampicillin

53
Q

what in interferes with ampicillin absorption

A

food

54
Q

how is ampicillin excreted

A

in the bile and partially undergoes enterohepatic circulation

55
Q

what is a side effect of ampicillin

A

diarrhea

56
Q

what are the advantages of amoxicillin use over ampicillin use

A

less diarrhea
less risk for pseudomembranous colitis

57
Q

ampicillin and amoxicillin are used for what therapeutic uses

A

upper respiratory tract infections
urinary tract infections
meningitis
salmonella (ampicillin)

58
Q

what drug is given for prophylactic use in patients with abnormal or prosthetic heart valves undergoing dental surgery/procedure

A

amoxicillin or ampicillin

59
Q

high doses of what drug can cause bleeding by interfering with platelet formation

A

antipseudomonal penicillins (piperacillin, carbenicillin, ticarcillin)

60
Q

antipsudomonal penicillins are used against what bacteria species

A

pseudomonas aeruginosa
enterobacteriaceae
klebsiella

61
Q

piperacillin is used in combination with what other drug

A

tazebactam

62
Q

antipseudomonal penicillins are used in __ infections by gram - bacteria (what type of setting)

A

nosocomial (hospital acquired)

63
Q

what is the Jarisch-Herxheimer reaction

A

penicillin is injected in a syphilitic patient and produces fever, chills, headache, hypotension, etc

64
Q

are penicillins safe to use in pregnancy

A

yes

65
Q

do penicillins have high or low therapeutic index

A

high
they are safe drugs

66
Q

clavulanic acid is used in combination with what 2 drug

A

amoxicillin
ticarcillin

67
Q

sulbactam and tazobactam are used in combination with what drugs

A

ampicillin
piperacillin

68
Q

what are 5 mechanisms of drug resistance

A

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
Q

what inactivated aminoglycosidases and chloramphenicol

A

acetyltransferases

70
Q

what spectrum type of antibiotics can cause superinfection

A

broad

Pharmacology (16 decks)

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