Gram + thumpers

Question 1

Which bacteria specifically are susceptible to Gram + thumpers?

Answer 1

Staph, Strep, Enterococci, MRSA, VRE

Question 2

What are the gram + thumpers?

Answer 2

Cyclic lipopeptides, glycopeptides (vancomycin), oxazolidinones, streptogramins, polypeptides (Bacitracin), Mupirocin

Question 3

Which form of vancomycin is in the KSU pharmacy?

Answer 3

Injectable

Question 4

Which topical Gram + thumpers are in the KSU pharmacy?

Answer 4

Mupirocin, Bacitracin

Question 5

What is the most commonly used glycopeptide?

Answer 5

Vancomycin

Question 6

Can you use vancomycin in food animals? Why?

Answer 6

Nope, resistance

Question 7

What is the MOA of vancomycin?

Answer 7

Inhibit cell wall peptidoglycan synthesis

Question 8

Is vancomycin bacteristatic or bactericidal?

Answer 8

Cidal

Question 9

Vancomcyin is primarily active against gram +…?

Answer 9

Aerobic cocci & bacilli

Question 10

Vancomycin is considered the first line defense against?

Answer 10

MRSA

Question 11

What does VRE stand for?

Answer 11

Vancomycin Resistant Enterococci

Question 12

What does VRSA stand for?

Answer 12

Vancomycin resistant staph aureus

Question 13

Is vancomycin well absorbed orally?

Answer 13

No, only given IV

Question 14

What is a drawback of IV administration?

Answer 14

irritating

Question 15

Why is vancomycin administered slowly?

Answer 15

To avoid Redman syndrome which is large release of histamine

Question 16

Vancomycin is thought to be synergistic against gram+ cocci with aminoglycosides, what do you need to be concerned about? Especially if what disease is present?

Answer 16

Ototoxicity

Renal impairment

Question 17

Is vancomycin a nephrotoxin?

Answer 17

Yes

Question 18

The streptogramin (Virginiamycin)is similar to which other abx? What is the concern with streptogramins concerning other abx?

Answer 18

Macrolides & lincosamides (MLS)
Cross resistance

GROUP B ONLY (not A)

Question 19

Are streptogramins bioavailable?

Answer 19

No

Question 20

What is the main spectrum for virginiamycin?

Answer 20

Gram + and anaerobic bacteria

Question 21

When might you use Synercid (streptogramin)?

Answer 21

Enterococci resistant to vancomycin/macrolide/linosamide
Streptococcus pneumoniae resistant to B-lactams/macrolides
MRSA

Question 22

What is the MOA of polypeptides (Bacitracin)?

Answer 22

Inhibition of peptidoglycan in bacterial cell wall

Question 23

What spectrum is bacitracin activity limited to?

Answer 23

gram +

Question 24

What other 2 abx is bacitracin often combined with for topical use?

Answer 24

Aminoglycosides & polymixin B

Question 25

Is bacitracin used in food animals? Labeled as what?

Answer 25

Yes as growth promotant | Also swine dysentery

Question 26

What is the major adverse effect of bacitracin?

Answer 26

Highly nephrotoxic

Question 27

Why is bacitracin only used topically or orally & not systemically? Is it well absorbed via either of these routes?

Answer 27

Highly nephrotoxic | No

Question 28

Which bacteria is mupirocin used for?

Answer 28

Staphylococcus & streptococcus

Question 29

Is mupirocin used to treat MRSA?

Answer 29

Used to be for nasal carriage in humans but resistance

Question 30

Why is mupirocin only for topical use?

Answer 30

Rapid metabolism after systemic administration

Question 31

What is a reported side effect of mupirocin?

Answer 31

Epidermal necrolysis after intranasal application

Question 32

What is Bambermycin used for primarily?

Answer 32

Growth promotant

Question 33

What is Fosfomycin primarily used for?

Answer 33

UTI in small animal

Question 34

What is unique about Fosfomycin in regards to VRE?

Answer 34

Effective against VRE

Question 35

In which patients would Fosfomycin be contraindictaed?

Answer 35

Metabolic acidosis

Question 36

Are there safety studies for Fosfomycin in veterinary medicine?

Answer 36

No

Question 37

What are the 2 ionophores?

Answer 37

Monensin, Lasalocid

Question 38

What is the MOA of ionophores

Answer 38

Complexes with cell-wall Na & causes export of K and H+ to be pumped in which drops pH.

Question 39

How are ionophores growth promotants?

Answer 39

Drops population of gram + population in rumen which shifts lactic acid production towards proprionic acid production

Question 40

How do ionophores affect fog fever (AIP?)

Answer 40

Decreases fromation of 3-methylindole

Question 41

Which bacteria are ionophores active against?

Answer 41

Gram + & coccidia

Question 42

Other than growth promotion what are ionophore used for?

Answer 42

Anti-coccidial

Question 43

Which species will die from eating ionophores? What muscle does it affect?

Answer 43

Horses, cardiac muscle necrosis | Sheep, skeletal muscle

Question 44

What is the LD50 of monensin in horses?

Answer 44

2 -3 mg/kg

Question 45

What is a potent antitubercular drug that is used in vet med for Actinomyces bovis?

Answer 45

Isoniazid

Question 46

Which drug is used as a long term maintenance of refractive UTI in dogs?

Answer 46

Methenamine

Question 47

Can you use Nitrofurans (DMSO) in food animals?

Answer 47

NO

Question 48

What are nitrofurans (DMSO) used for?

Answer 48

UTI

Question 49

Do nitrofurans have good bioavailability?

Answer 49

No, almost 0

Question 50

Why are nitrofurans banned in food animals?

Answer 50

Mutagenic & procarcinogenic

Question 51

What is the MOA of novobiocin?

Answer 51

Inhibits DNA supercoiling by inactivating DNA gyrase

Question 52

How are pleuromutilins (Tiamulin) administered?

Answer 52

Feed or water

Question 53

What bacteria is Tamulin active against?

Answer 53

Actinomyces pleuropneumoniae, Brachyspira hyodysenteriae

Question 54

What is a concern with systemic administration of polymyxin B?

Answer 54

Nephrotoxic neuromuscular blockade CNS toxicity

Question 55

Can polymyxin B be used to bind endotoxin?

Answer 55

Yes, at a low dose

Question 56

Do polymyxins affect gram - or gram + bacteria?

Answer 56

gram -

Question 57

What is the spectrum of Carbadox?

Answer 57

Gram +, Clostridia, Serpulina hyodysenteriae

Question 58

Why is Carbadox banned in the UK?

Answer 58

Carcinogen in lab animals

Question 59

Carbadox is allowed in the USA in what animal? What is the withdrawal period?

Answer 59

Swine | 42 days

Question 60

Rifampin is used to treat what in people? Vet med?

Answer 60

Tuberculosis in people | Rhodococcus equi in vet med

Question 61

Which gram - strain is susceptible to rifampin?

Answer 61

Brucella

Question 62

Rifampin may cause a change in the color of body fluids to what color?

Answer 62

Orange