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Pharmacology > Kumar's Final Review - Anti-Microbials - AH > Flashcards

Kumar's Final Review - Anti-Microbials - AH Flashcards

All the highlighted material from Kumar's review of Anti-microbials and nothing else.

1
Q

Name the 5 major categories of Antimicrobials based on MOA

A
  1. Folic Acid synthesis inhibitors, 2. Beta-lactam antibiotics, 3. Protein Synthesis inhibitors (30s/50s) 4. Nucleic acid synthesis inhibitors, 5. Misc. (cell wall, nucleic acid synthesis 20s, cell membrane)
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2
Q

Sulfonamides MOA?

A

PABA analoge: Inhibit folic acid synthesis by irreversibly blocking dihydroperoic acid

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3
Q

Metabolism for Sulfonamides?

A

metabolized in liver (also in lungs). Acetylation = major pathway (poor in dogs)

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4
Q

*What happens as a result of poor acetylation of sulfunamides in dogs?

A

*Urine precipitates = crystalluria (Tx by alkalizing the urine)

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5
Q

Which class of sulfonamides exerts local action on the GIT?

A

Enteric sulfonamides (not absorbed in the GIT)

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6
Q

What are some examples of enteric sulfonamides and what are they used for?

A

Sulfasalazine – colitis in dogs. Sulfaquinoxaline – coccidiosis in chickens. Sulfacetamide – eye (neutral pH)

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7
Q

What are the topical sulfonamides?

A

Silver sulfadiazine and Mafenide

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8
Q

Sulfonamide breed sensitivities ?

A

Dobermans → polyarthritis, fever, cutaneous eruptions, hepatitis. Duck&Dog → hypoglycemia (decreased thyroid hormone production)

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9
Q

What are potentiated sulfonamides?

A

Combination of sulfonamide and diaminopyrimidine

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10
Q

What is the spectrum for potentiated sulfonamides?

A

Broad spectrum, bacteriaCIDAL – synergisism between sulfonamides and diaminopyrimidine

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11
Q

Prep of potentiated sulfonamides has what ratio?

A

Sulfamethoxazole + Trimethoprim (5:1)

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12
Q

Side effect of potentiated sulfonamides in dogs?

A

Reversible hypothyroidism

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13
Q

Sulfonamide Immunological SE?

A

Heptaic necrosis, Keratoconjumctivitis Sicca

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14
Q

List 3 Diaminopyrimidines and how they are used

A

Primethamine – protozoa. Trimethoprim – used with sulfonamides (5 sulfa:1 trimeth). Ormethoprim – ruminants

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15
Q

Major categories of Beta-lactam antibiotics?

A

Penicillin, Chephalosporin, Carbapenems, Monobactam

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16
Q

Beta-lactam MOA?

A

Inhibits cell wall synthesis via penicillin binding protein interference – bactericidal action

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17
Q

What are the natural Penicillins?

A

Penicillin V/G

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18
Q

How is Penicillin V administered?

A

Oral (acid stable)

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19
Q

Penicillin G drugs

A

Benzathine and Procaine

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20
Q

How is procaine and procaine formulations administered?

A

Only by parenteral route, no IV (procaine → IM)

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21
Q

What is the admin route that prolongs Benzathine action?

A

Reposatory prep. Lasts for 7days

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22
Q

SE of Procaine?

A

Anaphylaxis and CNS in guinea pigs and chinchillas. Excitement in horses.

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23
Q

List the Semi-Synthetic Penicillins with good oral absorption

A

Oxacillin Cloxacillin and DicIoxacillin (all are acid stable)

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24
Q

List the semi-synthetic B-lactamase sensitive Penicillins

A

Amoxicillin and Ampicillin

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25
Q

Which B-lactamase sensitive drug is more orally bio-available?

A

Amoxicillin

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26
Q

Which B-lactamase sensitive drug is a prodrug?

A

Ampicillin

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27
Q

<p>Spectrum of action for extended spectrum penicillins?</p>

A

<p>Anti-pseudomonal </p>

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28
Q

How are extended spectrum penicillins administered?

A

Parenterally w/ B-lactamase inhibitors

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29
Q

List 5 ext. spec. penicillins

A

Azlocillin, Carbenicillin, Mezlocillin, Ticarcillin, Piperacillin

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30
Q

List the beta-lactamase inhibitors

A

Clavulanic acid, Sulbactam

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31
Q

Beta-lactamase inhibitor MOA?

A

Competative inhibitor of B-lactamase binding sites.

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32
Q

Where do cephalosporins accumulate?

A

in the extracellular fluid

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33
Q

What 1st generation cephalosporin is administered via parenteral route to small animals?

A

Cefazolin

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34
Q

Which Cephalosporin has the broadest spectrum of action, is most potent and is stable against B-lactamase?

A

Cefeprim

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35
Q

Other B-lactams that are not susceptible to B-lactamase enzyme degredation?

A

Carbapenems and Monobactams

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36
Q

What is the spectrum of Carbapenems?

A

Broad

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37
Q

List the 2 Carbapenems

A

Imipenem and Meropenem

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38
Q

<p>Give the Monobactama drug and when it is used?</p>

A

<p>Aztreonam – used in patients allergic to penicillin</p>

39
Q

2 drug groups that are 30s protein synthesis inhibitors

A

Aminoglycosides and Tetracyclines

40
Q

Name 3 drug groups that are 50s protein synthesis inhibitors

A

Macrolides, Lincosamides, Chloramphenical

41
Q

<p>Which of the protein synthesis inhibitors is bacteriaCIDAL? What are the rest?</p>

A

<p>Aminoglycosides are -CIDAL, the rest are -STATIC</p>

42
Q

What is the spectrum of action for aminoglycosides?

A

Narrow spectrum – kills G-ve Aerobic bacteria

43
Q

List 2 Aminoglycosides

A

Amikacin: Broadest spectrum. Paromomycin: G-ve and G+ve, protozoans

44
Q

<p>Why is a single does of Aminoglycoside drugs efficacious?</p>

A

<p>Has biphasic penetration via concentration dependent passive diffusion via porin channels. → post antibiotic effect</p>

45
Q

How are aminoglycocides administered?

A

Parenterally – 100% BA. Not given orally due to low BA

46
Q

Where in the body do aminoglycosides tend to bind?

A

Inner ear and renal cortex

47
Q

Vd of Aminoglycosides?

A

Extracellular. Vd is increased in lean/ cachectic animals

48
Q

Aminoglycoside toxicity?

A

Nephrotoxic to cortex (excretion without metabolism) Ototoxicity – reversible. Neuromuscular Blockade

49
Q

Which tetracycline is best absorbed in the GIT (orally)

A

Doxycycline

50
Q

Are natural Tetracyclines metabolized?

A

No

51
Q

List the natural Tetracyclines

A

Tetracycline, Chlortetracyclin, Oxytetracycline

52
Q

How is Oxy administered?

A

Oral or parenteral

53
Q

List the semi-Synthetic Tetracyclines

A

Minocycline, Doxycycline

54
Q

How is minocycline metabolized?

A

Oxidation

55
Q

Where is Doxy absorbed and why?

A

Lipid soluble (80-90% protein binding) → large intestine → is excreted in bile

56
Q

What animal does Doxy kill?

A

Fatal in horses due to alterations to GIT flora

57
Q

Adverse reactions of Chloramphenicol?

A

affects mammalian ribosome → reversible BM suppression, inhibition of mammalian mitochondrial synthesis.

58
Q

What should you never give with Chloramphenicol?

A

Macrolides

59
Q

Vd of Chloramphenicol?

A

Wide volume of distribution: eye, CNS, heart, lung, prostate, salivary glands, liver& spleen. Crosses the placental barrier and is in milk.

60
Q

How is Chloramphenicol metabolized?

A

Glucoronidation – (cats = slow)

61
Q

Why might you go to jail for administering chloramphenicol?

A

If you give it to food animals

62
Q

<p>While Chloramphenicol in food animals will land you in jail, what derivatives can be given to FA?</p>

A

<p>Thiamphenicol or Florfenicol</p>

63
Q

MOA of Florfenicol?

A

Inhibits peptidyl transferase enzyme

64
Q

What is florfenicol more resistant to?

A

Bacterial resistance

65
Q

Microlide Drugs (5)

A

Erythromycin, Tylosin, Tilmicosin, Tiamulin, Azithromycin

66
Q

<p>What is Erythromycin used to Tx?</p>

A

<p>Campylobacter jejuni in dogs</p>

67
Q

Which Macrolide Is fatal to horses but can be used to Tx mycoplasma?

A

Tylosin

68
Q

What Macrolide treats respiratory infections due to high conc in lung tissues?

A

Tilmicosin

69
Q

What is a SE of Tilmicosin?

A

Cardiotoxic if given via IV

70
Q

Tiamulin is used to treat what?

A

Pinkeye, Mycoplasma

71
Q

Which microlide has PAE?

A

Azithromycin

72
Q

<p>What do you not combine with Lincosamides?</p>

A

<p>Macrolides</p>

73
Q

MOA of Clindamycin?

A

Blocks translocation process of bacterial protein synthesis

74
Q

What is Clindamycin used to Tx?

A

G-ve anaerobes and T. gondii

75
Q

SE of lincomycin?

A

Enterocolitis in rabbits, horses and ruminats = fatal

76
Q

MOA of Flouroquinolones?

A

DNA synthesis inhibition via Topoisomerase II

77
Q

SE of flouroquinolones in the CNS?

A

Excitement (GABA) – don’t give to animals with seziers

78
Q

Flouroquinolones Adverse Effects

A

CNS excitement via GABA → don’t give to animals with seizures. Arthropathy from chelation of MG. Retinal degeneration in cats. Accumulates in phagocytic cells.

79
Q

Flouroquinolone drug?

A

Enrofloxacin → Tx pyoderma, ehrlichiosis

80
Q

MOA of metronidazole?

A

DNA inhibition – is reduced by oxidoreductase enzyme in mitochondria → impairs bacterial DNA structure → cidal

81
Q

Metronidazole metabolism?

A

Ocidoreductase enzyme

82
Q

<p>Metronidazole treats what microbes?</p>

A

<p>protozoans and anaerobes</p>

83
Q

MOA of rifampin?

A

Inhibits DNA dependent RNA synthesis

84
Q

Why do you combine Rifampin with other drugs?

A

Susceptible to bacterial resistance. Add other drugs to avoid resistance

85
Q

Which Antimicrobial drugs should not be used in Food producing animals?

A

Chloramphenicol –> aplastic anemia. Metronidazole → carcinogenic. Nitrofuran → furazolidone carcinogenic. Vancomycin

86
Q

What antimicrobial is a growth promoter and prophylaxis in swine?

A

Carabadox (suppresses aldosterone production)

87
Q

Drug used to Tx UTI in acidic urine?

A

Methnamine (do not give with sulfonamides)

88
Q

Polymyxin B MOA?

A

Cationic, binds to phopholipids and disrupts cell membrane

89
Q

<p>What is given to sterilize the bowel before surgery? </p>

A

<p>Polymyxin B. Is also a topical</p>

90
Q

What antimicrobials are associated with aplastic anemia?

A

Sulfonamides and Chloramphenicols

91
Q

Which antimicrobials reach the CNS/Brain

A

Chloramphenicol, Clindamycin, Metronidazole, Pot. Sulfonamides, Cephalosporin

92
Q

Which antimicrobials are narrow spectrum?

A

Beta lactams, Aminoglycosides, polymyxins

93
Q

Which antimicrobials are bacteriostatic?

A

Sulfonamides, Diaminopyrimidines, tetracyclines, Chloramphenicol, Macrolides and Lincosamides

Pharmacology (21 decks)

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