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Treatment > Block 6 > Flashcards

Block 6 Flashcards

1
Q

What type of antibiotic is penecillin?

A

Beta Lactam

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2
Q

What is a cephalosporin?

A

Beta lactam

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3
Q

What type of antibiotic are beta lactams?

A

Time-dependent bactericidal

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3
Q

What does a time dependent dosing frequency mean?

A

Need to dose often

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4
Q

Are beta lactams time or concentration dependent?

A

Time!

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5
Q

What makes a beta lactam a beta lactam?

A

The beta ring that forms

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6
Q

General rule: Keep abx concentration above MIC for ________ of dosing interval

A

50%

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7
Q

How does the MOA work?

A

Beta lactams bind the penicillin-binding proteins cause the cell wall instability

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8
Q

What is the mechansim of action of beta lactams?

A

Inhibits bacterial cell wall synthesis
Disrupts cell wall integrity

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9
Q

What is the mechansim of resistance of beta lactams?

A

Hydrolyze the beta-lactam ring

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10
Q

What is a beta-lactamase inhibitor?

A

It is a drug that works alongside beta lactams to prevent the drug from being inactivated

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11
Q

What are 3 beta lactamase inhibitors?

A

clavulanate acid, tazobactam, and sulbactam

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12
Q

What bacteria produce the beta lactamases that inactivate beta lactams?

A

Gram + - staph
Gram - - enterobacterales

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13
Q

What does ESBLs stand for?

A

Extended-spectrum beta-lactamases

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14
Q

What do ESBLs act upon?

A

Hydrolyses penicillins, monobactams, and 1st, 2nd, 3rd, and 4th generation cephalosporins

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15
Q

What is a secondary mechanism of resistance of beta lactams?

A

Altering the binding site of the penecillin binding protein (PMP)

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16
Q

Which bacteria have a modified PMP?

A

Methicillin-resistant staphylococci (MRSP and MRSA)

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17
Q

What does the altered PMP confer resistance to?

A

Penecillins, cephalosporing, and carbapenems

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18
Q

What is the exception to the PMPs for cephalosporins?

A

5th generation cephalosporins

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19
Q

What is the 3rd mechanism of resistance of beta lactams?

A

Decreased penetration
Block entry
Increase efflux to pump them out

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20
Q

What bacteria type is this mechanism of resistance mostly seen in/?

A

Gram -

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21
Q

How do you never administer Penecillin G?

A

IV NEVER!

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22
Q

Why is penecillin not absorbed orally?

A

Inactivated in low pH

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23
Q

How is amoxicillin/ampicillin given?

A

Oral, IM, or IV

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24
Q

Where are penecillin concentrations highest?

A

Kidneys, synovial fluid, liver, lung, skin, soft tissues

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25
Q

How are penecillins metabolized?

A

Hydrolysis of beta lactam ring

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26
Q

Does penecillin penetrate the BBB?

A

No

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27
Q

How is penehat is half life of penecillin?

A

0.5-1 hour

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28
Q

How is penecillin eliminated?

A

Urine (kidneys)

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29
Q

Do penecillins work on MRSA?

A

No

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30
Q

What are the 3 penecillin/beta lactamase combos used?

A

Ampicillin / sulbactam (unasyn)
Amoxacillin / clavulamic acid (clavamox)
Piperacillin / Tazobactam

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31
Q

Oral penecillins cause serious / fatal diarrhea in horses

A
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32
Q

What are 3 adverse side effects of penecillin?

A

GI (V, D, inappetance)
Hypersensitivity
Pain or tissue rxn

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33
Q

How are cephalosporins given?

A

Oral or parental

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34
Q

Which generation of cephalosporins penetrate the CNS?

A

Gen 3

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35
Q

What is half life of cephalosporins?

A

1-2 hrs

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36
Q

How are cephalosporins metabolized?

A

Renally

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37
Q

What is a general rule about the generations of cephalosporins?

A

Higher the generation, higher the Gram - coverage

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38
Q

What is teh exception to the above rule?

A

Gen 5 (MRSA coverage)

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39
Q

What is 1st gen oral?

A

Cephalexin, cefadroxil

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40
Q

What is 1st gen parental?

A

Cefazolin

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41
Q

What is 3rd gen oral?

A

Cefpodoxime

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42
Q

What is 3rd gen parental (long acting)?

A

cefovecin

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43
Q

What is 2nd and 3rd gen parental?

A

cefoxitin (2), ceftiofur (3), cefotaxime(3), ceftazidime(3)

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44
Q

What are the adverse affects of cephalosporins?

A

Same as penecillin

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45
Q

*****What bacteria class are intrinsically resistant to cephalosporins?

A

Enterococci on exam!

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46
Q

What do 1st gen cover?

A

Great Gram + coverage
Strep and Staph
Good for UTIs and skin infections

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47
Q

How is absorption of cephalexin and cefadroxil (1st gen) in horses and ruminants?

A

Low

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48
Q

What 1st gen is used in farm animals?

A

Cephapirin

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49
Q

What does cephapirin treat in farm animals?

A

Mastitis for intrmammary infusions

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49
Q

When do you use anything above 1st gen cephalosporins?

A

When there is resistance to 1st gens

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50
Q

When is 2nd gen cefoxitin and cefotetan good?

A

Septic peritonitis (anaerobic)

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51
Q

What is simplicef?

A

3rd gen cefpodoxine

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52
Q

What is Convenia?

A

Cefvecin 3rd gen

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53
Q

What is Convenia used for?

A

UTIs, skin and soft-tissue infections

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54
Q

What is ceftiofur?

A

3rd gen

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55
Q

What is ceftiofur used for?

A

Respiratory infxns in farm animal

56
Q

What is the only way to administer carbapenems?

A

IV

56
Q

What are the 2 carbapenems used in vet med?

A

Imipenem
Meropenem

56
Q

What are carbapenems?

A

Last resort antibiotics

57
Q

What are carbapenems reserved for?

A

Multidrug resistant infections

58
Q

What are Methicillin-resistant Staph resistant to?

A

All cephalosporins EXCEPT 5th gen!!

58
Q

What are enterococcus resistant to?

A

cephalosporins

58
Q

Strep are susceptible to _____ beta-lactams

A

ALL

59
Q

How to lincosamides act?

A

Bacteriostatic time dependent!

59
Q

What is the most widely used antimicrobial?

A

BEta lactams

59
Q

What was lincomycin isolated from?

A

Streptomyces

60
Q

Beta lactams are bactericidal and time dependent

A
61
Q

What are the 3 categories of lincosamides?

A

lincomycin
clindamycin (mostly food animal)
pirlimycin

62
Q

Is lincomycin affected by food intake

A

Yes

62
Q

In terms of distribution where are therapeutic levels achieved?

A

Synovial fluid, bile, pleural fluid, peritoneal fluid, skin

62
Q

Is clindamycin or lincomycin better absorbed in GI?

A

Clindamycin

62
Q

How are lincosamides absorbed?

A

Oral and parental

63
Q

Is clindamycin affected by food intake?

A

No

63
Q

How are they excreted?

A

Through bile, urine, and feces

63
Q

Where are they metabolized?

A

In the liver

63
Q

Do lincosamides enter the brain?

A

Roughly 40% penetration

63
Q

What is teh mechansim of action of lincosamides?

A

Binding of 50s ribosomal subunit
Prevents peptide synthesis, similar to macrolides

64
Q

What are constitutive resistance (MLSBc)?

A

Bacteria that show high-level resistance to all MLSB antibiotics

64
Q

What are inducible cross-resistance (MLSBi)?

A

Bacteria resistat to macrolides but initially fully susceptible to clindamycine (lincosamides)

65
Q

What are MLSB antibitoics?

A

Those that act on teh 50s ribosome subunit

65
Q

What is the mechanism of resistance?

A

Alter the binding site

66
Q

What are the 2 types of resistance?

A

Constitutive resistance
Inducible cross-resistance

66
Q

What must be done if during the antibiotic susceptibility test clindamycin is susceptible but erythromycin is resistant ?

A

A D -test (inducible cross-resistance)

67
Q

What is the gene that causes resistance?

A

erm gene

68
Q

Are lincosamide broad spectrum?

A

Yes
Gram - usually resistant

69
Q

What does pirlimycin have an FDA label for?

A

Staph and strep for INTRAmammary infusion
clinical and subclinical mastitis

70
Q

Is lincosamide a broad spectrum?

A

Moderate-broad

71
Q

What animals are lincomycin labeled for?

A

Swine, honeybees, dogs, and cats

72
Q

What can linco treat in pigs?

A

Erysipelas (penecillin G is best tho I think

73
Q

What can linco treat in chickens?

A

Pododermatitis - bublefoot - (staph)

74
Q

What can linco treat in honeybees?

A

American foulbrood
Paenibacillus (USDA monitored disease)

75
Q

Why is clindamycin better?

A

Better absorbed, more active, and less toxic than linco

76
Q

What does clindamycin treat?

A

Skin and dental infections

77
Q

What should you avoid the use of lincosamydes on?

A

Enterococcus
ALL GRAM - and Campylobacter
- Enterobacterales
-pseudomonas aeruginosa
-pasteutella
-bordetella

78
Q

What are side effects of clindamycine?

A

Fatal diarrhea in horses, rabbits, and other herbivores

79
Q

What happens in cats with clindamycine?

A

Esophageal strictures

80
Q

Like linocosamides, macrolides are what?

A

Bacteriostatic and time dependent

81
Q

How do you administer macrolides?

A

ORAL and parenteral

82
Q

Do macrolides cross the BBB?

A

No

83
Q

For macrolides, tissue concentration can be higher than serum

A
84
Q

Do macrolides cross the placenta?

A

Yes

85
Q

Where are macrolides metabolized?

A

Liver

86
Q

What is the mechanism of action for macrolides/

A

Binding of 50s ribosomal subunit

87
Q

What enzyme is responsible for the methylation of adenine?

A

erm

88
Q

What is the mechanism of resistance for macrolides?

A

Enzymatic inactivation

89
Q

What is a Gram + macrolide that is a use?

A

***Rhodococcus equi

90
Q

What are Gram - that macrolides work on?

A

Bovine respiratory complex (Mannheimia, Pasteurella, Haemophilus) and Bordatella

91
Q

What is a good antibiotic for mycoplasma and bordetella

A

Azithromycin

92
Q

What is a good antibiotic for Bovine respiratory disase, mastitis, and foot rot?

A

Tulathromycin
Tilmicosin
Erythromycin

93
Q

What are good antibiotics for equines for rhodococcus equi, strep equi, lawsonia?

A

Azithromycin
Clarithromycin
Erythromycin

94
Q

What is a good antibiotic to treat swine respiratory diseases?

A

Tulathromycin

95
Q

What is ineffective in treating mycoplasma and chlamydophila in cats?

A

Azithromycin

96
Q

Do not use macrolides on enterococcus

A
97
Q

What bacteria are resistent to macrolides?

A

Enterobacterales (E. Coli, Klebsiella)
Pseudomonas aeruginosa

98
Q

Should macrolides be used in horses, rabbits, and other small mammals?

A

No - used in foals

99
Q

What percent of veterinarians were aware of opioid misuse by a staff member or client?

A

44%

100
Q

Has gabapentin been described to demonstrate analgesic efficacy in cat’s joints?

A

No!

101
Q

Opioid prescription has increase ____ in vet hospitals?

A

41.2%

102
Q

The number of vet patients with controlled substance prescriptions from 4 or more vets more than _______ from 2024-2019

A

Tripled

103
Q

How do you treat staph?

A

First gen cephalosporin

104
Q

How do you treat strep?

A

First gen cephalosporin or amoxacillin

105
Q

What can oxytet not be used on?

A

Lactating dairy cows

106
Q

In addition to beta lactams
Macrolides and lincosamides what are 3 more antibiotic categories?

A

Tetracyclines
Phenicols
Aminoglycosides

107
Q

What are tetracyclines?

A

Broad spectrum, bacteriostatic, time dependent

108
Q

What additional things can tetracyclines treat?

A

Blood borne pathogens

109
Q

What is something in dogs that oxytet can treat?

A

Salmon poinsoning (Neorickettsia helminthoeca)

110
Q

Can you use oxytet in nonlactating dairy cows

A

Yes!

111
Q

What are the 3 types of tetracyclines?

A

Oxytet
Doxy
Mynocycline

112
Q

Shoud you use doxy for UTIs?

A

no

113
Q

What are 2 things that are intrinsically resistant to tetracyclines?

A

Pseudomonas aeruginosa
Proteus mirabilis

114
Q

Is E. coli resistant?

A

Mostly, yes

115
Q

What are 3 adverse side effects of tetracyclines?

A

Nephrotoxic
Yellowing of teeth
Esophageal stricture in cats

116
Q

What are the 2 types of phenicols?

A

Chloramphenicol and florfenicol

117
Q

What are the characteristics of phenicols?

A

Bacteriocidal/bactericidal and time dependent

118
Q

Do phenicols cross the BBB?

A

Yes!

119
Q

What can you not use chloramephenicols in?

A

Food animal!!!

120
Q

What can you use flofenicol in for cattle?

A

BRD
Foot rot

121
Q

What can chloramphenicols cause in humans?

A

Aplastic anemia

122
Q
A

Treatment (11 decks)

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