Chemotherapy part 1 (1) Flashcards

1
Q

Ludwigs angina

  • a serious, _____ or _____ infection of the floor of the mouth, usually occuring in adults with concomitant _____ infections
  • may obstruct the airways, necessitating _____
  • mixed infections: _____ and _____
  • alpha hemolytic streptococci, staphylococci and bacteroides groups
  • facial space infection with involvement of _____, _____, and _____ spaces
  • external signs may include bilateral _____ facial edema around _____ and upper _____
  • dysphagia, odynophagia, difficulty breathing, and pain
A
life threatening cellulitis 
connective tissue
dental
tracheotomy 
aerobes 
anaerobes
submandibular
sublingual
submental 
lower
mandible 
neck
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2
Q

past and present

  • US centers for disease control estimates that 90000-200000 deaths occur annually due to nosocomial infections
  • staph aureus resistant to _____, _____, _____ due to specific genes
  • bacteria cold transfer these resistant genes among themselves
  • hospitals today are plagued with MRSA and VRE
  • viral disease
A

penicillins
erythromycin
tetracycline

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3
Q

future
drug resistance is becoming a worldwide concern
-gonorrhea and typhoid fever are becoming more difficult to treat
-TB and malaria are growing more resistant to Rx
-60% nosocomial infections are MDR

only 5 new classes of antibiotics in the past 40 years!

  • _____ (linezolid)
  • _____ (daptomycin)
  • _____ (retapamulin
  • _____ (dalfopristin)
  • _____ (tigecycline)
  • linezolid is most promised
  • combination therapy to treat TB to avoid resistance
A
oxazolidinones
lipopeptides
pleuromutalins
streptogramins
glycylcyclines
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4
Q

history of antibiotics

  • 1900 paul ehrlich
  • ‘Magic Bullet’
  • salvarsan: fuchsin and mercury to treat _____
  • sir alexander flemming: _____
    domagk: _____ from ‘Prontosil’ - _____
A

syphilis
penicillium notatum (a fungus)
sulfonamides
red dye

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5
Q

definitions

  • _____: substances that act against or destroy infections (_____/_____/_____)
  • antibiotics: substances produced by _____ that can destroy or suppress the growth or multiplication of bacteria to prevent the _____ of _____
  • antimicrobials/antibacterial: _____ or _____ substances used to suppress growth or kill _____/ _____ cell organisms
  • antivirals/antifungals/antiprotazoans/antihelminths
A
anti-infective agents
fungal
viral
bacterial 
bacteria
action
bacteria
natural 
synthetic
bacteria
single
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6
Q

MOA of antibacterial action

  • inhibition of _____ synthesis
  • alteration of the _____
  • inhibition of ribosomal _____ synthesis
  • suppression of _____ synthesis
  • inhibition of _____ synthesis
A
cell wall
cell membrane permeability
protein
DNA
folic acid
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7
Q

inhibition of cell wall synthesis

  • cell walls contain alternating _____ units, cross linked with _____ linkages
  • bacterial enzymes termed _____ (PBP) catalyze the formation of the wall by incorporating new _____ strands
  • _____ antibiotics competitively inhibit this final process, thus preventing a _____ cell wall forming
  • internal osmotic pressure causes _____
  • -_____ (amoxicillin; penicillin V)
  • -_____ (cephalexin)
A
peptidoglycan
amide
penicillin binding proteins 
peptidoglycan 
beta-lactam
rigid
lysis
penicillins 
cephalosporins
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8
Q

alteration in cell membrane

  • bacterial cell membranes contain a _____ component
  • this maintains cell membrane integrity
  • antibiotics such as polymyxin B displace _____ and _____ from the cell membrane and disrupt membrane
A

lipopolysaccharide
Ca++
Mg++

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9
Q

inhibition of protein synthesis

  • bacterial ribosomes have subunits such as _____ and _____ where proteins are synthesized
  • antibiotics bind to the _____ site of these subunits and inhibit _____
  • this inhibits binding of _____ to _____
  • 30S: _____, _____
  • 50S: _____, _____
A
30S
50S
p
peptidyl transferase
tRNA
mRNA
tetracyclines
aminoglycosides
macrolides
clindamycin
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10
Q

inhibition of nucleic acid synthesis

  • _____ of DNA, DNA _____, recombination and DNA repair occurs by _____ and _____ enzymes
  • _____ and _____ inhibit these enzymes
  • results: vacuoles, filamentation and cell lysis
A
supercoiling 
replication 
DNA gyrase 
topoisomerase 
fluoroquinolones 
metronidazole
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11
Q

inhibition of folic acid synthesis

  • humans fo not produce folic acid, it is available from _____ sources
  • bacteria synthesize their own _____ from _____ (Para amino benzoic acid)
  • PABA converts into _____ acid by enzyme _____
  • _____ are structural analogues of PABA and block the conversion
  • _____ and _____

–trimethoprim prevents eventual production of folic acid

A
dietary 
folic acid
PABA
dihydrofolic 
dihydrofolate reductase 
sulfonamides 
sulfamethoxazole 
trimethoprim
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12
Q

antibiotic resistance

  • give patient antibiotics and it goes into the bacteria which creates its own _____. it can throw antibiotic right out of the structure
  • modifies the _____. creates an _____ to the antibiotic and it cannot be taken up
  • formation of _____- can transmit genetic info (can transmit genetic code from one bacterial to another)
  • bacteria which has a target where antibiotic would’ve acted requires a _____ for that target
  • inactivate the drug through _____
A
efflux pump
cell wall
impermeable protein
plasmids
receptor 
drug-inactivating enzyme
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13
Q

superinfections
-a _____ infection while patient is being treated for a _____ infection
–more likely with _____
–may also be opportunistic infections with fungi such as Candida albicans and histoplasmosia
may occur due to inhibition of normal flora such as _____ and _____
-often difficult to treat
-drug resistant microbes usually involved
-genetic messages (plasmids, transposons) transferred to new bacteria

A
new
primary
broad spectrum antibiotics
clostridium difficile
pseudomembranous colitis
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14
Q

antibiotic adverse effects

  • antibiotic teratology: FDA class B or C
  • _____: genetic or acquired by drug use. _____, _____ may cause sudden syncope and cardiac arrest
  • _____: reduced neutrophil counts with septicemia and shock. may be caused by _____ and _____
  • superinfections: destruction of normal flora (diarrhea and pseudomembranous colitis)
  • _____: CYP 450 induction or decreased GIT absorption of OC (loss of contraception)
  • photosensitivity, stevens johnson syndrome, allergy and toxicity
A
long QT syndrome 
fluoroquinolones 
macrolides
agranulocytosis 
sulfonamides
penicillins 
oral contraceptives
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