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Pharmacology > Exam 2:Antibiotics Part 1 (background, sulfa, penicillin) > Flashcards

Exam 2:Antibiotics Part 1 (background, sulfa, penicillin) Flashcards

1
Q

A _______ antibiotic is only effective against a

small number of bacteria…_______ is a prime example!

A

Narrow Spectrum…Penicillin

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2
Q

A _______ antibiotic is effective against MANY bacteria. A great example of this is ______.

A

broad spectrum….tetracycline

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3
Q

Never combine bacteri_____ and bacteri_____ antibiotics, the _________ antibiotic (antagonist) will inhibit or diminish the effects of the _______ antibiotic!!

A

the bacterioStatic will inhibit the effects of the bacteriCidal

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4
Q

Why would we never give penicillin with tetracycline?

A

tetracycline = bacteriostatic (antagonist)….penicillin = bactericidal,,,,if given together, penicillin will not be effective

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5
Q

ALL antibiotics are bacteri_____, but not all antibiotics are bacteri______!!!

A

All antibiotics are bacteriostatic….Not all antibiotics are bactericidal at therapeutic doses

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6
Q

What is used to determine the bactericidal concentration of an antibiotic?

A

MIC-Minimum Inhibitory Concentration (concentration of antibiotic that kills 100% of a bug in a test tube)

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7
Q

If we gave the MIC of an antibiotic it might be toxic to the human taking the drug, therefore we lessen the dose and it becomes more bacteri_____.

A

bacteriostatic

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8
Q

Antibiotic _______ can happen when 2 antibiotics work together for a more positive effect when given to the same patient.

A

synergism

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9
Q

Choosing an antibiotic-ID the bastard…the predominant microorganism in the ORAL CAVITY is going to be gram ___, _____ or ______. This occurs ___-___% of the time.

A

gram + strep or staph..90-95%

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10
Q

Choosing an antibiotic-ID the bastard…All oral/facial infections occur from ________ microorganisms which are already in the mouth. UNLESS the Pt has experienced ______ that introduced new microbes.

A

RESIDENT…trauma

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11
Q

Choosing an antibiotic-most effective antibiotic for THAT organism…._______=MOST EFFECTIVE ANTIBIOTIC AGAINST GRAM + STREP OR STAPH.

A

penicillin

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12
Q

Choosing an antibiotic-low host toxicity…._______ is the least toxic antibiotic, it cannot kill the host at ANY ________, and ___% of the population is allergic to it but it is NOT TOXIC to them.

A

Penicillin, concentration..10%

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13
Q

Choosing an antibiotic-bactericidal…we use a bactericidal so we don’t have to rely on the patient’s ________. Penicillin is bacteri_____.

A

defense mechanisms…bactericidal

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14
Q

Choosing an antibiotic-low resistance…What are the 4 ways to minimize resistance?

A
  1. give an adequate dose 2.take for an adequate duration 3.avoid repeated administration 4.avoid topical administration
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15
Q

Choosing an antibiotic-low resistance…we give an adequate dose that will _____ the bacteria, don’t worry about allergy if giving a high dose, because allergies are not _____ dependent.

A

KILL….dose

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16
Q

Choosing an antibiotic-low resistance…TAKE FOR adequate time, many patients stop taking their antibiotics when their ______ go away. Write “__________” on EVERY Rx!!! and then educate the patient with the _______ method.

A

symptoms….”take until gone”….teach back

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17
Q

Choosing an antibiotic-low resistance…avoiding repeated administration. Bacteria develop mechanisms to become _______. Do NOT give the patients same ________ week after week. This will also help Pt’s from _____-medicating.

A

resistant…antibiotic…self-medicate

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18
Q

Choosing an antibiotic-low resistance…avoid _______ administration, like ointments applied to the face. Bacteria can get “_______” the presence of the antibiotic.

A

topical….”used to”

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19
Q

BIG PICTURE: What are the 9 Classes of Antibiotics?

A

1.Sulfa 2.Penicillin 3.Cephalosporins 4.Macrolide 5.Tetracycline 6.Quinolones 7. MetroNiDazole 8.Miscellaneous 9.AminoGlycoSides

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20
Q

Sulfa Drugs have no indications for use in _______, but they are used primarily for ________.

A

dentistry…Urinary Tract Infections

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21
Q

________ was the FIRST ANTIBACTERIAL AGENT!!!!

A

Sulfanil-Amide

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22
Q

Sulfa Drugs-block the final step in the conversion of _____ to _______, thus blocking nucleotide and protein synthesis in bacteria.

A

PABA to folic acid

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23
Q

What is an example of a generic sulfa drug?

A

tri-meth-o-prim

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24
Q

Penecillin is produced by the mold _______ _______.

A

Penicillium ChrysoGenum

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25
Q

All Penicillin is bacteri_____!

A

bacteriCidal

26
Q

Penicillin blocks _________ synthesis by interfering with structural glycopeptides. And bacterial cell death results from ______.

A

bacterial cell wall…lysis

27
Q

What is the MAIN structural component of Penicillin?

A

Beta-Lactam Ring

28
Q

What is the enzyme secreted by penicillin-resistant bacteria?

A

beta-lactamase

29
Q

Penicillin-the beta-lactam antibiotics bind to and inhibit ______ needed for the synthesis of the peptidoglycan wall. Therefore they have little effect on bacteria that are _______, but they are effective against bacteria that are ________.

A

enzymes! ….resting…dividing

30
Q

Which bond does the penicillinase/beta-lactamase break?

A

the C-N bond in the beta-lactam ring

31
Q

____% of the normal, healthy ambulatory population does not have penicillinase- producing microorganisms!!! So its usually limited to immunocompromised, immuno-supressed, malnourished, and institutionalized people.

A

99%

32
Q

Absorption of Penicillin-Oral absorption of Natural penicillins (penicillin ___) is incomplete and variable due to destruction by _______ (given parenterally). But semi-synthetic is more acid stable (penicillin __).

A

Penicillin G…..gastric juices….Penicillin V

33
Q

Does Penicillin enter the cerebrospinal fluid?

A

yes

34
Q

Penicillin is excreted very quickly, 70% is excreted in ___ hours. In the kidney is it mainly active, tubular secretion or passive, glomerular filtration?

A

4 hours..90% tubular secretion (active transport)…think size of penicillin. prob too big to be filtered in the glomerulus

35
Q

What can we use to TRICK the kidneys and SLOW down the excretion of Penicillin? How much does this drug elevate the blood level of penicillin?

A

Pro-ben-e-cid (Bene-mid)…It out competes penicillin for secretion in to the blood….3-4x elevation

36
Q

For ORALFACIAL infections, _______ is the drug of choice.

A

Penicillin

37
Q

What are the two prophylactic uses for penicillin?

A

Bacterial Endocarditis y Prosthetic Joints & Valves

38
Q

What was the first penicillin produced, is the only NATURAL penicillin commercially available? What is its spectrum? Bacteriostatic or cidal?

A

Penecillin G (green like nature!) Narrow Spectrum. bactericidal (ALL FREAKING PENICILLIN)

39
Q

Penicillin G is considered _____-labile because it can be broken down by gastric acid and ______-labile because is can be broken down by penecillinase. Indications-used for ______!

A

acid-labile…penicillinase-labile… STDs!!

40
Q

Penicillin given IM makes blood levels rise _____.

A

rapidly

41
Q

_______ penicillin G = bond penicillin molecule to ______ molecule, which is an oil base. This will slow down penicillin release over a ___-___ hour period. Best used for the treatment of ______.

A

Pro-Caine…12-24 hour…ANTHRAX

42
Q

Which penicillin has the trade name Bi-Cillin? How long does this drug last in the blood? Where is this administered?

A

Benzathine Penicillin G…3 freggin WEEKS!..Bicillin=Buttocks

43
Q

What helps Benzathine Penicillin G’s slow release?

A

its dissolved in oil!

44
Q

What is the primary indication for Benzathine Penicillin G?

A

STDs!

45
Q

Which penicillin produces the LONGEST therapeutic blood level after parenteral administration?

A

Benzathine penicillin G (3 freggin weeks yo)

46
Q

What is the semi-synthetic penicillin? What was INITIALLY added to it to make it more acid tolerable (and therefore Oral admin?)

A

Penicillin V…Sodium

47
Q

Penicillin has better bioavailabiliy when paired with _____ instead of sodium.

A

K+

48
Q

When you write “penicillin V” on the script, the pharmacist will fill it with the ______ form.

A

potassium

49
Q

If you write the prescription for penicillin VK, the pharmacist has to fill the prescription with that _______ drug. SO just write the Rx for ______.

A

brand name,,,(cannot substitute with a generic)..”penicillin V”

50
Q

Penicillin ___: Bactericidal, Narrow spectrum, Acid stabile, Penicillinase labile, Better bioavailability in potassium form

A

Penicillin V

51
Q

the CDC says USE the MOST _______ spectrum antibiotic available for the infection… therefore ________ IS THE BEST CHOICE FOR OROFACIAL INFECTIONS!!!

A

NARROW….PENICILLIN V

52
Q

Big Gun Penicillins: Do NOT use penicillinase-resistant drugs all of the time because: Promotes _______ microorganisms (e.g. methicillin resistant staph aureus), More expensive, More toxic, Not as effective as penicillin V, Only use these drugs when culture shows that microorganisms are producing ________.

A

resistant….penicllinase

53
Q

What penicillin am I???Bactericidal, Acid stable, Not penicillinase-resistant. Spectrum includes more gram negative bacteria (BROAD), Available for oral administration in 250 mg and 500 mg capsules, Must be prescribed every 6 hours so that blood level does not drop below therapeutic blood level.

A

AMPicillin (amplify!) broad spectrum!

54
Q

Which penicillin am I? One of the most commonly prescribed drugs in the United States, Better bioavailability than ampicillin, Not penicillinase-resistant Combined with _______ acid to broaden spectrum (drug known as _______)

A

Amoxicillin (Amoxil)….cla-vul-anic acid…(Augmentin)

55
Q

How does Cla-vul-anic Acid work? When do you give Augmentin (clavulanic acid + amoxicillin)?

A

Acts as a shield against penicillinase..36-48 hours after no pt response to penicillin V

56
Q

What are three factors why a pt might not be responding to Penicillin V?

A

1.Pt Compliance 2.Penicillinase 3. Spectrum too narrow

57
Q

When prescribing Augmentin, a _____ dose is better. The more clavulanic acid, the more side effects (diarrhea).

A

smaller

58
Q

In augmentin, the concentration of ______ remaines constant (___mg)while the concentration of amoxicillin can vary. So always prescribe less pills for less diarrhea!

A

clavulanic acid….125mg

59
Q

____% of the population is allergic to penicillin!

A

10%

60
Q

Chronic use of Penicllin is associated with opportunistic infections, especially _____ infections like ________ seen in the oral cavity and vagina. Then of coarse there is ______ in the mouth too…

A

fungal infections…candidiasis….black hairy tongue

61
Q

If a Pt is freaking out about black hairy tongue what 3 things can you tell them that will calm them down? (assuming they are on antibiotics)

A
  1. its just benign hyperkeritinization (and chromatic bacteria) 2. it can be improved with hygiene 3.subside when drug is over!
62
Q

___% of the population has a TOXIC reaction to Amoxicillin! They will show a _______ on their forearms. Even though it is not an allergic reaction, it responds to ______. (If you are allergic to one penicillin, you are allergic to all)

A

10%….maculopapular rash…Benadryl

Pharmacology (23 decks)

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