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Pre-pharmacology > Chapter 11a (antibacterials) > Flashcards

Chapter 11a (antibacterials) Flashcards

1
Q

most common cause of death in world

A

infectious disease

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2
Q

many antibiotics originally came from…

A

natural sources

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3
Q

Louis Pasteur discovered…

A

anthrax and rabies vaccines; that microorganisms inhibit replication of other microorganisms

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4
Q

Dr. Ehrlich

A

discovered “magic bullet”; an organic arsenic compound (Salvarsan) used to treat syphilis and trypanosomiasis

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5
Q

Salvarsan

A

organic arsenic compound used to treat syphilis and trypanosomiasis; discovered at turn of 20th century

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6
Q

Gerhard Domagk

A

discovered first sulfa drug from injecting dye into daughter with sepsis; Prontosil (sulfanilamide)

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7
Q

Prontosil

A

sulfanilamide; pro-drug sulfa antibiotic. First named sulfa drug. Gets converted into sulfanilamide in body.

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8
Q

sulfa drugs

A

sulfonamide based drugs; some have antimicrobial properties while others are antiinflammatory or anticonvulsant
Rarely used now as antibiotics b/c of resistance, but many diabetic and diuretic medications use sulfa compounds

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9
Q

sulfa drugs or penicillin on skin

A

never used b/c they are too sensitizing

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10
Q

sulfonamide antibacterials

A

stop folic acid synthesis so bacteria cannot synthesize DNA

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11
Q

sulfonamide antibacterials often mixed with…

A

trimethoprim, because both stop folic acid synthesis so synergism occurs.
trimethoprim stops dihydrofolatase and sulfa drugs inhibit tetrahydrofolatereductase

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12
Q

qualities of a good antibiotic

A
  1. reaches site of infection
  2. penetrates cell
  3. reaches target and kills it
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13
Q

mercury compounds

A

used to be injected intraurethrally to treat syphilis

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14
Q

mechanisms of resistance

A
  1. decreased permeability (eg pseudomonas)
  2. antibiotic efflux pump (S. pneumonia vs. quinolones and macrolides)
  3. drug inactivation (eg B-lactamase from H. influenzae, staph, E.coli, and Klebsiella)
  4. altered target site (eg S. pneumonia with altered PBPs, S. pneu against macrolides with ribosomal methylase, S pneu against quinolones with GyrA and Topo4)
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15
Q

porin channels found in what bacteria?

A

gram negative

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16
Q

B lactamase…

A

breaks open B-lactam ring which renders penicillins, cephalosporins, monobactams, and carbepenems useless

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17
Q

PBPs

A

penicillin binding proteins; penicillin binds to these and then prevents cell wall synthesis

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18
Q

sulfadiazine

A

modern sulfa antibiotic; one of main ingredients in silver sulfadiazine cream which is used extensively for burns

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19
Q

sulfamethoxazole

A

one of time ingredients in Septra and Bactrim combination antibacterials

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20
Q

Alexander Flemming

A

recognized the importance of the antibiotic action of penicillin

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21
Q

Penicillins

A

kill bacteria by interfering with cell wall synthesis and by destabalizing transmembrane potential to cause cell lysis; all have common beta-lactam ring structure

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22
Q

first penicillins

A

could not be given orally b/c they were inactivated by gastric acids

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23
Q

penicillin V

A

stable in acid so can be given orally;

“pen-vee”

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24
Q

aminopenicillins

A

penicillin base with amino group added; like amoxicillin or ampicillin

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25
Q

broad-spectrum penicillins

A

from resistance, now only some of the newer, more expensive penicillins are broad-spectrum; those in the 3rd and 4th generation

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26
Q

Bicillin

A

penicillin G; not acid stable so can’t be given orally; given by IM or IV, first mass-produced antibiotic in US (in 1940s)

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27
Q

ampicillin is very similar to

A

amoxicillin; both are aminopenicillins

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28
Q

ticarcillin

A

has extended spectrum of action against gram negative bacteria beyond that of earlier penicillins
4th gen; antipseudomonal penicillin; given by IM or IV

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29
Q

Augmentin

A

amoxicillin/clavulanate combination used against penicillinase producing bacteria; oral

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30
Q

increased antibiotic resistance comes from…

A

overuse of antibiotics; inappropriate antibiotic given; low dose given (subinhibitory exposure or not long enough time taking antibiotic)

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31
Q

Quinolones

A

interfere with genetic duplication of bacteria by interfering with DNA gyrase and topoisomerase IV (the enzymes that untwist DNA so it can be read and then fold it back up)

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32
Q

penicillin hives

A

true drug allergy to penicillin (raised welt-like bumps), just a rash w/o raised bumps is not an actual allergy and it is okay to take penicillin again, unlike if person actually has allergy then 2nd exposure could cause bronchoconstriction and serious allergy response

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33
Q

aminoglycosides

A

inhibit bacterial protein synthesis; most have to be administered parenterally or topically, usually in the hospital with blood level monitoring b/c of kindey and hearing toxicities

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34
Q

streptomycin

A

first aminoglycoside discovered

35
Q

gentamicin

A

modern prototype aminoglycoside; used systemically by parenteral admin for gram negative sepsis

36
Q

cephalosporins

A

have B-lactam ring that interferes with bacterial cell wall synthesis

37
Q

Keflex

A

cephalexin; first generation cephalosporin

38
Q

Ceclor

A

cefaclor; second generation cephalosporin

39
Q

first and second gen penicillins and cephalosporins

A

good at treating staphylococcus and strep infections

40
Q

Rocephin

A

ceftriaxone; 3rd gen cephalosporin that is good at treating STIs like chlamydia and gonorrhea; however the admin is painful so it is mixed with lidocaine

41
Q

carbapenems and monobactams

A

B lactam antibacterials, and are therefore bacterial cell wall inhibitors; used for complicated infections caused by organisms that are resistant to other agents
None exist in oral form; only parenteral

42
Q

B-lactam antibiotic classes

A

penicillins, cephalosporins, carbepenems, and monobactams

43
Q

Azactam

A

aztreonam; best known monobactam, works great against gram negative, but not positive

44
Q

penicillin allergy and cephalosporins

A

b/c they are so similar in structure, someone who has allergy to one may be allergic to both

45
Q

tetracyclines

A

inhibit protein synthesis (the original broad-spectrum antibiotics)

46
Q

tetracycline

A

one specific drug in the tetracycline family; sometimes used to treat acne but it causes GI upset often so not well tolerated usually.
Has a strong affinity for Ca2+ and can cause teeth staining in young children

47
Q

Minocin

A

minocycline; tetracycline antibiotic that causes less side effects than tetracycline and used much more often

48
Q

Vibramycin

A

doxycycline; tetracycline antibiotic that causes less side effects than tetracycline and used much more often

49
Q

fluorouinolones

A

broad spectrum antibiotics that inhibit DNA synthesis directly (not through folic acid inhibition); some of best outpatient antibiotics for infections that are not “run of the mill”. Used for severe eye infections, kidney, sinus, or anthrax infections
Can be given orally and well tolerated, but expensive
*but are conclusively linked to tendinitis and tendon rupture

50
Q

Cipro

A

ciproflaxacin; fluoroquinolone antibiotic

51
Q

Levaquin

A

levofloxacin; fluoroquinolone antibiotic

52
Q

Macrolides

A

erythromycin-like drugs; broad-spectrum antibiotics that interfere with bacterial protein synthesis (have large ring structures)
Used when people are allergic to penicillins
Used mostly in oral form for treatment of common infections of skin and upper respiratory tract

53
Q

erythromycin

A

macrolide antibiotic; not used much anymore

54
Q

Ketolide antibacterials

A

work by inhibiting bacterial protein synthesis

55
Q

spinoff macrolides

A

synthetically produced and are much better drugs than macrolides

56
Q

Zithromax

A

azithromycin; a synthetic macrolide

57
Q

Biaxin

A

clarithromycin; a synthetic macrolide

58
Q

vancomycin

A

used to treat MRSA (methicillin resistant S. aureus); oral or IV, kind of toxic to use otherwise

59
Q

Flagyl

A

metronidazole; for anaerobic infections (such as those that cause some type of vaginitis or skin infections). Will also treat protozoa infecting the GI tract (like Giardia lamblia, “Beaver Fever”); but it is an awful drug to take because it causes so much GI upset

60
Q

Cleocin

A

clindamycin; bacterial protein synthesis inhibitor
common component of topical acne drugs; another alternative for penicillin allergic people (have very large ring structures)
Treat anaerobic infections (such as those that cause some type of vaginitis or skin infections)

61
Q

alternatives to penicillin for allergic people

A

clindamycin and macrolides

62
Q

clavulanic acid

A

structurally looks just like penicillin (B-lactam); a suicide substrate for penicillinase and has even greater binding affinity than penicillin so can block B-lactamase so B lactams can still work w/o being destroyed

63
Q

Septra DS

A

trimethoprim and sulfamethoxazole (a sulfa drug); combination antibiotic used for uncomplicated UTIs

64
Q

Bactrim

A

trimethoprim and sulfamethoxazole (a sulfa drug); combination antibiotic used for uncomplicated UTIs

65
Q

spectrum of action

A

refers to the different kinds of bugs that can be killed by the antibiotic

66
Q

locality to resistance

A

a drug that might be effective in geographic area may be overused in another so it is ineffective there

67
Q

broad spectrum

A

means that the drug works well against a variety of gram negative and gram positive bacteria

68
Q

broad spectrum antibiotics

A

tetracyclines, 2+3+4th gen cephasporins, fluoroquinolones, cabepenems, and monobactams

69
Q

narrow spectrum antibiotics

A

sulfa drugs (like sulfonilamide), penicillins, aminoglycosides (like streptomycin), and glycopeptides (like vancomycin)

70
Q

imipenem-cilastatin

A

carbapenem antibiotic; given by IM or IV

71
Q

timentin

A

combination antibiotic; ticarcillin/clavulanic acid mix

72
Q

trimethoprim

A

stops dihydrofolatase

73
Q

sulfisoxazole

A

sulfonamide antibiotic

74
Q

chloramphenicol

A

bacterial protein synthesis inhibitor

75
Q

antibiotic families and mechanisms

A

fluoroquinolones; direct inhibition of DNA/RNA synthesis
sulfonamide; folate synthesis inhibition to stop DNA synthesis
Tetracycline, macrolides, aminoglycosides; inhibition of protein synthesis
Penicillins, cephalosporins, carbapenems, monobactams; cell wall synthesis inhibitors

76
Q

methicillin

A

synthetic drug resistant to penicillinase

77
Q

neomycin

A

aminoglycoside antibiotic; used in many antibiotic ointments (too toxic for internal use)

78
Q

bacitracin

A

topical antibiotic in ointments

79
Q

polymyxin B

A

topical antibiotic in ointments

80
Q

Claforan

A

cefotaxime; third gen cephalosporin used in ED a lot for treating STIs

81
Q

piperacillin

A

4th gen penicillin

82
Q

tazobactam

A

B-lactamase inhibitor like clavulanate

83
Q

TB cause

A

tuberculosis is caused by Mycobacterium tuberculosis

84
Q

4th generation penicillins

A

ticarcillin and piperacillin; semi-synthetic modifications of natural penicillin that have more effect on gram negative bacteria than before, especially pseudomonas, enterbacter, proteus, and klebsiella species

Pre-pharmacology (27 decks)

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