Drugs: Antibiotics/Anesthetics Flashcards by Megan Mathews

true/false: Concentration dependent drugs are usually bactericidal

true

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Name drugs that can be combined to broaden spectrum without causing antagonism

Aminoglycoside or fluroquinolones WITH B-lactams, metronidazole, or clindamycin

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Which antibiotics work by affecting metabolic pathways? (2)

Trimathoprim or sulfonamide combos (folic acid synthesis)

Nitrofurans (acetyl CaA)

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Which antibiotics interfere with cellular DNA/ division? (3)

FLamingoes RIde MEtros

Metronidazole, fluroquinolones, rifampin

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Which antibiotics affect the cell wall? (4)

Bears play baseball viciously

B lactam (peptidoglycan interfere with transpeptidase)
Vancomycin (elongation)
polymixin, bacitracin (cell membrane)

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Which antibiotics affect Protein synthesis? (5)

Mad CHeetahs CLimb African TrEes

macrolides 50 (erythromycin, azithromycin)
chloramphenicol 50
clindamycin 50
aminoglycoside 30/50
tetracyclines 30

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What is the mechanism of resistance and mode of action of beta-lactams?

inactivation by bacterial B lactamases (chromosomal mutations (gram +) or plasmid mediated resistance (gram +/-)
change in porin size
change in penicillin binding protein structure

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what is a good antibiotic choice for a gram - aerobe and why?

Aminoglycosides are associated with least endotoxin release

fluoroquinoloneshave excellent distribution, wide therapeutic range

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What are conditions that penicillins, cephalosporins and imipenum used for?

(B-lactamases)

urinary (1st gen), skin, respiratory

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What drug is inactive in acidic environment and in low oxygen tension?

aminoglycoside (e.g. neomycin, gentamycin, amikacin, streptomycin)

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Which drug has irreversible ototoxicity?

aminoglycosides

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What can you do to prevent renal toxicity with aminoglycosides?

maintain hydration
once a day dosing
reduce conditions that affect renal prostaglandins (hypotension, shock, endotoxemia, renal or cardiac dz, NSAID, metabolic acidosis

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What spectrum does the fluoroquinolones group have? e.g. enrofloxacin, marbo, cipro, orbi, difloxicin

broad gram -

aerobes

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what are 2 side effects of using fluoroquinolones?

cartilage damage if < 9-18 mo

acute blindness in cats

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Which drugs can be used for the prostate?

Desperate Times Call For CHocolate Milkshakes

doxycycline, Trimethoprim/sulfonamide combos

clindamycin, flouroquinolones, chloramphenicol, erythromycin=macrolide)

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what are 2 side effects of TMS?

KCS

hypersentivity reaction

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What antibiotics cross the BBB?
Timid DOgs Rarely MElt CHeese (For 3 Cents)
or Dirty Minds require full soap cleaning

Chloramphenicol (LIPID soluble and distributes many places), Metronidazole; TMS, doxycycline, rifampin,
flouroquinolones (sometimes)
3rd gen cephalosporin (if inflammation)

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How does the acidic, hyperosmolar hypoxic environment of purulent exudate affect antibiotic efficacy?
A. inactivates aminoglycosides (O2)
B. impaired efficacy B-lactams (hyerosmol)
C. slower growth microorganisms = decreased efficacy of bactericidal drugs
D. impaired phagocytic activity of leukocytes
E. all of the above

E =ALL
inactivates aminoglycosides (O2/acid)
impaired efficacy B-lactams (hyerosmol)
slower growth microorganisms = decreased efficacy of bactericidal drugs
impaired phagocytic activity of leukocytes

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Which drugs are affected by an acidic pH?

Erythromycin (macrolide) inhibited
B-lactams less activity (penicillins inactivated at (<6.0)
Aminoglycosides and fluoroquine less effective

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What antibiotics are good for urine? ACIDIC? basic?

BaTq v…

acid urine: B-lactams and TMS
basic urine (FQ, aminoglycosides, mac and linc)

BATQV have good concentration in urine (vancomycin)

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True/False: As the generation increases, the efficacy against gram positive and anaerobes increases.

FALSE

higher generation = less effective against gram (+) and anaerobes

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Antibiotics for the GB?
CRED
CLever Racroons MAke Drinks/Milk

Clindamycin, rifampin, macrolides(e/g erythromycin), doxycycline/minocycline

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What antibiotics can enter WBC?

Frogs CLimb Moutain Ridges

fluroquinolone, Clindmamycin, erthrymcin/macrolide, rifampin,

Which benzodiazepine is better for a patient with liver disease? why?

Midazoam

Diazepam metabolites are active/potent and may cause excessive sedation

Which of the following statements is true? A. Sighthounds take longer to recover when benzodiazepines are used. B. Propofol has a low lipophilicity, and does not distribute well C. Halothane induces more direct myocardial depression and sensitizes to catecholamine-induced arrhythmias D. Glycopyrrolate has the most ocular effects, and should not be used with narrow-angle glaucoma

A. thiobarbituates --> sighthounds B Propofol= highly lipid soluble, distributes C TRUE D scopolamin>atropine>glycopyrrolate ocular effects (no atropine for glaucoma)

True/False: Alfaxalone and propofol interact with the GABA receptor, increases chloride influx --> hyperpolarization = inhibition of arousal/awareness

true

Which inhalant produces compound A which can lead to renal injury in rats

sevofluorane

What is the order of inhalant MACs | Never Do Silly Dinosaurs Eat Icy Hot Medications

Never Do Silly Dinosaurs Eat Icy Hot Medications= | nitrous oxide> desfluorane> sevofluorane> diethylether> enflurane> isoflurane> halothane> methoxyflurane

What are the effects of anticholinergics on GI motility?

decrease LES function in monogastrics (GI has M3 muscarinic receptors) High dosese decreased motility for up to 30 min

What is the difference between atropine and glycopyrrolate?

glyco is 4x more potent, does NOT cross the BBB or the placenta, (poorly lipid soluble), takes longer to take effect, cardiac effects last longer (heart has M2 muscarinic R)

What anticholinergics can prolong sedation due to effects at the M1 receptor (brain)?

scopalamine and atropine can cross the BBB

How does pimobendan work?

PDE II inhibition --> vasodilation | increased calcium sensitization with troponin C --> inotrope

Which vasopressor has a Beta affinity at an intermediate dose and an alpha effect at a high dose?

Dopamine

True/false: The LOWER the pKa, the GREATER the degree of ionization or proportion of local anesthetic in the ionized, charged, hydrophilic form at a physiologic pH and therefore a SLOWER onset of action

False: the HIGHER the pKa the greater ionization, and the slower the onset of action

What kind of neuromuscular blocking agent is succinylcholine?

Depolarizing

Name a short, moderate, and long acting local anesthesic?

``` short = procaine, benzocaine, chlorprocaine Moderate = lidocaine, mepivacaine (2hrs longer than lido) lon = bupivacaine, ropivacain ```

How does bupivacaine compare to lidocaine?

B = 4x as potent | Bup is highly lipophilic

True false: Are these in order of neuro/cytotoxicity? lidocaine< procaine< ropivacaine< mepivacaine< chlorprocaine< buprenorphine?

FALSE cytotoxicity = | pro

What nerves are you targetting when you approach with bupivacaine 0.5% and dexmedetomidine 0.5-2 ug/ml for a brachial plexus nerve block via a lateral approach, inserting cranial to acromion and medial to subscapularis

``` C6 = suprascapular C7 = Msculocutaneous C8* = radial and axillary want to see extension fo the elbow (contrction of triceps brachii) T1= median and ulnar ```

where do dissociative work?

NMDA (noncompetitive antagonists), opiod, monoaminergic and muscarinic receptors interacts with voltage gated Ca channels

What are the main endogenous agonists for NMDA receptors?

glutamate, aspartate | glycine is a CO-agonist required to opent he channel efficiently

What is the first prostaglandin?

PGG2

which NSAIDs have the highest selectivity for COX-2?

Coxibs | carprofen and meloxicam somewhat preferential

What drugs target COX-1? and in what cell is this a dominant enzyme?

Aspirin, ketoprofen, etodolac | platelets

What prostaglandin is misoprostol an analogue of?

PGE1 increases bicarb production, mucus production, mucosal blood flow, decrease gastric acid secretion through decrease in intracellular cAMP

True/False: NSAIDs can directly insult gastric mucosa due to its lipophilic nature and diffusion, and indirect effects from prostaglandin inhibition

true

why is endogenous PGE2 important to the stomach? (4)

maintain gastric mucosal layer quality of gastric mucus mucosal blood flow production of gastric acid

What two prostaglandins play an important role for renal blood flow and ion transport?

PGI2 (prostaacyclin) and PGE2

How do opioids affect the presynaptic membrane? the post-synaptic membrane?

pre: block release of glutamate, substance P and others post: inhibit neuronal depolarization

``` Which of the following is NOT a dose-dependent effect of an opiate? A. GI motility B. Ventilation C. Sedation D. MAC reduction ```

A. GI motility is a receptor/species effect Dose-dependent = vent, sed, MAC red, immune system Species effects: thermoregulation, nausea, and GI Route: urinary tract

True/False: fentanyl has a ceiling effect where higher doses produce longer duration, not higher effect.

FALSE: buprenorphine

Put the opiates in order of most to least lipophilic? | Big fat hippos mope

buprenorphine/fentanyl > hydromorphon> morphine (hydrophilic) Lipophilic = absorbed well in IM, SC morphin effects are delayed and pea 45 min after injection with prolonged effect (3-4 hrs)

how does gabapentin work?

pre-synap: voltage gated Ca channels --> dec. NT release | post-synpatic inhibition by hyperpolarizing inhibitory potentials (K or Cl) in dorsal horn

Which of the following is true? a. Tramadol is an analogue of pregabalin b. Tramadol and its metabolite are serotonig and norepi reuptake inhibitors c. Tramadol binds strongly to the mu receptor d. Horses and dogs are able to metabolize tramadol well

a. codeine b. TRUE c. weakly

What do neurokin-1 (NK1) receptor antagoinsts accomplish?

competitive binding --> antinausea, antidepressant, anxiolytic

What kind of drug is ondansetron?

5HT3 receptor antagonists (serotonin)

Endovaniolloids and capscasin (agonists) bind to what receptor?

TRPV1