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Pharm Exam 1 > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

semisynthetics

A

abx which have been chemically altered (eg. Penicillin V)

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2
Q

synthetics

A

abx that are completely man-made (eg. cephalosporin)

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3
Q

spectrum

A

describes “breadth of activity” of abx

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4
Q

normal flora

A

humans are colonized with many species of org’s soon after birth, these org’s usually DONT cause disease (symbiotic relationship)
may prevent overgrowth of pathogens

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5
Q

cardinal signs of local infection

A

redness (rubor), swelling (tumor), heat (color), pain (dolor

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6
Q

symptoms of systemic infection

A

leukocytosis (inc WBC), fever (>101F), altered structure or loss of function, pure cultures of pathogens from infn site

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7
Q

pathogen

A

org with inc ability to cause infn (e.g.. strep pneumonia, staph aureus, etc)

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8
Q

virulence

A

microbial factors that inc likelihood of infn (eg. adhesions, toxins, etc)
high virulence - few org –> infn
low virulence - many org’s –> infn

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9
Q

antimicrobials vs abx

A

antimicrobials are broader, includes elements and may be anti-vitals, anti-fungals, etc
abx are found in nature and are equivalent to antibacterials

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10
Q

bacteriostatic

A

inhibits bacterial growth allowing the body’s immune system to act

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11
Q

bacteriocidal

A

results in bacterial cell death by cell wall lysis, altered memb permeability, etc

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12
Q

narrow spectrum abx

A

preferred, minimizes the development of resistance

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13
Q

natural resistance

A

native to an org

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14
Q

acquired resistance

A

usually associated with abx use, develops after exposure

can occur if pt does not complete their course of therapy

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15
Q

prophylactic abx

A

used to prevent infn (eg. peri-sx abx is MC, others are heart valve dx, neutropenia, recurrent UTIs and transplant recipients)

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16
Q

Penicillin

A

inhibits GRAM + CELL WALL SYN
allows inc water to go into cell causing lysis and death (bacteriocidal)
resistance to this medication by penicillinase/B-lactamase has been around the longest
time-dependent killing
anaphylaxis: 0.2% of 10,000 courses
fatality rate: 0.001% in 100,000 courses

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17
Q

Penicillinase Inhibitors

A

Clavulanic acid (Augmentin is the only PI that is PO), Tazobactam, Sulbactam and Avibactam (newest)

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18
Q

Cephalosporin xxx

A 
structurally related to PCN
small amount of cross-sensitization with PCN allergy pt's
1st gen: mainly gram +
2nd and 3rd gen: less gram +, inc gram -
4th gen: best gram -
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19
Q

Macrolides

A

inhibits PROTEIN SYN, static in usual dose and cidal in higher dose
eg. erythromycin, clarithromycin and azithromycin xxx
side effects of GI upset, cramping and diarrhea

20
Q

Tetracyclines

A

1st broad spectrum abx, inhibits PROTEIN SYN
SE’s: photosensitivity, stains developing teeth
can bind cations (antacids and milk) inhibiting absorption xxx
avoid if <8 yo or preg xxx

21
Q

Aminoglycosides

A 
inhibits PROTEIN SYN (static or cidal depending on dose) 
used for gram - infn 
used with PCN/cephalosporins
exhibit post-abx effect (PAE)
renally eliminated 
SE: nephrology and oto toxicity
poor CNS penetration
22
Q

quinolones/fluoroquinolones

A

broad spectrum, inhibits BACTERIAL DNA SYN (cidal)
good oral abs (PO and IV)
renally eliminated (except Moxi- which is hepatic)
good tissue penetration
SE: inhibit cartilage syn, achilles tendon rupture, skin rash, antacids inhibit abs

23
Q

chloramphenicol xxx

A

broad spectrum, limiting toxicity is BM suppression

little use, reserved for bad pt’s in ICU who are resistance to many

24
Q

Aztreonam/Azactam xxx

A

used in pt’s with PCN allergy

25
Q

Vancomycin/Vancocin xxx

A

used for MRSA and C diff from other broad spectrums, poor oral abs

26
Q

Metronidazole/Flagyl xxx

A

used for anaerobic/protozoal infn

27
Q

Sulfonamides

A

not true abx, bacteriostatic or cidal dep on dose
inhibits folate son required for microorganism growth
UTIs are major use xxx
used in combo with trimethoprim IV/PO (TMP/SMX) xxx

28
Q

urinary antiseptics

A

minimal [] in blood/tissue, commonly used for UTIs
e.g. Nitrofurantoin (Furadantin, Macrodantin, Macrobid) - dose dep, taken orally, pulmonary toxicity with long use in elderly, may discolor urine to dark, contraindicated for CrCl <60 (won’t work, but will not harm) xxx

29
Q

TB tx

A

first line ex’s are most effective and least toxic
isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), ethambutol (ETH)
used in combo to prevent resistance

30
Q

systemic antifungals xxx

A

flucanozole (diflucan) - IV/PO, old and cheap

31
Q

HIV tx target - reverse transcriptase

A

nucleoside reversal transcriptase inhibitors (NRTIs) and non-nucleoside RTIs (NNRTIs)

32
Q

HIV tx target - Protease

A

protease inhibitors (PIs)

33
Q

HIV tx target - Fusion inhibitors

A

Newest category

34
Q

significant bacteriuria

A

numbers of bacteria in voided urine that exceed numbers commonly seen due to contamination of urethra

35
Q

cystitis

A

term to describe the syndrome involving dysuria, freq, urgency, and occasionally suprapubic tenderness

36
Q

uncomplicated UTI

A

infection in a structurally and neurologically normal urinary tract

37
Q

complicated UTI

A

infection in a urinary tract with abnormalities (men, preg women, kids)

38
Q

relapse vs reinfection

A

relapse is recurrence of bacteriuria with the SAME org, while reinfection is recurrence with a DIFF org

39
Q

symptoms of UTIs

A

in adults: dysuria, inc freq/urgency, maybe flank pain, suprapubic heaviness/pain
in elderly: often asymptomatic

40
Q

Diagnostic techniques of UTIs

A

urine microscopic exam, dipstick leukocyte esterase, dipstick urine nitrite, urine culture (GOLD STANDARD)

41
Q

dipstick leukocyte esterase

A

sensitive to 10 WBC/mm, these enzymes are normally intracellular but once WBCs move into urine they lyse releasing the enzymes

42
Q

distick urine nitrite

A

false - for bacteria < 100-1000
false + is rare
gram - org use nitrate and covert to nitrite so this can be measured (high is abnormal)

43
Q

significant bacteriuria

A

> 10^5 bacteria/mL in asymptomatic patients on 2 consecutive specimens

44
Q

antimicrobial resistance

A

sig inc over last decade, most significant for TMP/SMX, before 1990 E coli resistance was <5%
data suggests inc clinical failures

45
Q

nitrofurantoin

A

renewed interest secondary to inc resistance

less active than T/S and FQ

46
Q

Fosfomycin

A

long half life, used for non adherent pt’s

single dose tx of cystitis, inferior to 1st line agents though mainly for pt’s susceptible to E coli and E faecalis

Pharm Exam 1 (3 decks)

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