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RUSVM LAM I > E2: Antimicrobials > Flashcards

E2: Antimicrobials Flashcards

1
Q

What is the goal of antimicrobial stewardship?

A

To achieve minimum unintentional consequences

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2
Q

Order from broadest to most narrow spectrum of activity: Primary use drugs, secondary use drugs, tertiary use drugs

A

Tertiary (broadest) - Secondary- Primary (most narrow)

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3
Q

What do antibiotics target and block in bacteria?

A

Cross-linking reaction (on the cell wall)

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4
Q

Which classes of AMs disrupt the bacterial cell wall?

A

B-lactams (e.g. Penicillins)

Glycopeptides

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5
Q

Which classes of AMs disrupt inhibit bacterial DNA synthesis?

A

Quinolones

Fluroquinolones (e.g. Enrofloxacin)

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6
Q

Which classes of AMs inhibit protein biosynthesis in bacteria (2 that affect the 30s ribomal subunit and 2 that affect 50s)?

A

30s: Tetracycline, Aminoglycosides
50s: Macrolides, Chloramphenicol

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7
Q

Which classes of AMs interferes the bacterial metabolic pathway?

A

Trimethoprim

Sulfonamides

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8
Q

Which mode of administration is counterindicated for penicillin? What types of bacteria is this AM effective against?

A

IV

Gram-positive

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9
Q

How do third generation cephalosporins differ from earlier generations?

A

Third have a wider spectrum of activity

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10
Q

How do third generation cephalospirns differ from penicillins?

A

3rd gen cepha: more stable in face of change pH and temperature

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11
Q

What type of antibiotic is Imipenem? What is it used to treat in horses?

A

Broad/wide spectrum Carbapenem (B-lactamase), Tertiary use drug

Severe joint infections, MRSA

(works agaist anaerobes incl B. fragilis)

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12
Q

What type of antibiotic are gentamycin, tobramycin and amikacin? What is a significant side effect and at what dose does this occur? When will you be able to detect this side effect and when will you see overt signs?

A

Aminoglycosides

Side effect: Tubular necrosis at low doses over long time, dectected in 3-5 days, overt in 7-10days

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13
Q

What are fluroroquinoloes often used for in foals?

What side effect must you look out for?

A

Salmonellosis

Side effect: Lameness (cartilage damage)

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14
Q

What comboination of AMs is used against Rhoddococcus? What is a common side effect?

A

Azithromycin + Rifampin

Side effect: Hyperthermia when exposed to sunlight (caution owner to keep foal in cool barn, or monitor closely when outside)

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15
Q

What class of AM is found in high concentrations in urine where it has a bactericidal effect? Where else can it be found in high concentrations?

A

Sulfonamides

CSF

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16
Q

Give an example of a short acting, intermediate acting and long-acting tetracycline.

A

Short: Oxytetracycline, tetracycline, chlortetracycline

Intermediatre: Methacycline, Desmethylchortetracycline

Long: Doxycycline, minocycline

17
Q

What are major side effects associated with tetracyclines?

A

Severe diarrhea

Calcium chelation (discolored teeth, impairs bone healing)

Hypotension, collapse w/rapid IV injection

Nephrotoxic (potentially)

WBC chemotacis and phagocytosis inhibition

18
Q

What does chloramphenicol cause in humans?

A

Aplastic anemia

19
Q

What is the drug of choice to treat Rickettsia and Mycoplasma?

A

Tetracyclines

20
Q

What are some Primary use Drugs commonly used?

A

Gentamycin

Penicillin

21
Q

What is one commonly used Secondary use Antimicrobials?

A

Enrofloxacin

22
Q

What are some Tertitary use Antimicrobial? What disease group warrents the use of these?

A

Vancomycin (Glycopeptide)

Chloramphenicol (Phenicol)

Septic joint disease

23
Q

List a few considerations for antimicrobial choice.

A

Agent present

Antimicrobial susceptibility of agent

Penetration of antimicrobial

Owner compliance with regimen prescribed

Route of administration

Host factors

Cost

Withdrawal time (e.g. competition or race horse)

24
Q

With which drug do B-lactams have a synergistic effect which may prevent replases and failures in serious infections with frequent tolerant organisms?

A

Aminoglycosides

25
Q

T/F: B-lactams are only active against growing bacteria, static organisms are unaffected and may persist.

A

True

26
Q

What antiboitic type is used for Pseudomonas aeruginosa? When may this antibiotic be ineffective?

A

Aminoglycosides

With anaerobes in a low-oxygen environment

Also not great for Strep

27
Q

What antibiotic is potent against aerobic gram-negative infections?

A

Fluoroquinolones

28
Q

Which drugs when combined with sulfonamides, produce a sequential blockade of microbial enzyme systems resulting in a bactericidal action?

A

Trimethoprim

Pyrimethamine

(added to sulfa = Potentiated sulfonamides)

29
Q

What is required in the host for successful therapy with sulfonamides, due to their bacteriostatic nature?

A

Adequate cellular and humoral defense mechanisms

RUSVM LAM I (19 decks)

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