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Ocular Pharm lectures 6-9 final > Lecture 6 anti-infectives > Flashcards

Lecture 6 anti-infectives Flashcards

1
Q

Which gram + bacterium is commonly associated with corneal ulceration?

a) staph. aureus
b) strep. pneumoniae
c) neisseria gonorrhea
d) e. coli

A

b) strep. pneumoniae

c and d are gram negative

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2
Q

Which antibiotic is NOT considered highly specific for gram + infections?

a) macrolides
b) vancomycin
c) polymixin B
d) bacitracin

A

c) polymixin B (gram neg only)

a, b, and d are strictly for gram +

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3
Q

Fanconi’s syndrome (pseudotumor cerebri) is associated with which 2 kinds of antibiotic?

A

tetracyclines and gentamycin

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4
Q

(T or F) most ocular infections are gram positive

A

true

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5
Q

(T or F) Antibiotics are among the safest, least toxic drugs used in medicine?

A

true

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6
Q

If the pt has a fever, the infection is _____ and will require _____ antibiotics

A

systemic, oral

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7
Q

is broad spectrum antibiotic use ideal?

A

no, ideally you would want to get a culture of the bacteria and treat it as specifically as possible so it creates the least harm to the natural flora. in the meantime you can get pt started on an antibiotic based on your best guess.

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8
Q

name the 4 types of antibiotics that target the cell wall

A

penicillins, cephalosporins, bacitracin, vancomycin

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9
Q

name the 2 types of antibiotics that target the cell membrane

A

polymixin B, gramicidin

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10
Q

name the 4 types of antibiotics that target protein sysnthesis

A

(30S ribosomes: aminoglycosides, tetracyclines), (50S ribosomes: macrolides, chloramphenicol)

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11
Q

name the 3 types of antibiotics that target cell metabolism

A

sulfonamides, trimethoprim, pyrimethamine

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12
Q

name the 1 type of antibiotics that targets DNA synthesis

A

fluoroquinolones

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13
Q

which class of antibiotic is considered the safest?

A

macrolides

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14
Q

which class of antibiotic is the only one that is specific for gram negative only?

A

Polymixin B

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15
Q

Name the 4 classes of antibiotics that are specific for gram positive bacteria only.

A

Bacitracin, vancomycin, gramicidin, macrolides

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16
Q

syphillis, chlamydia, and gonorrhea are all gram ____

A

negative

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17
Q

H. influenza and E.coli are gram ____

A

negative

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18
Q

name the 2 classes of broad spectrum antibiotics that favor gram negative over gram positive

A

aminoglycosides and fluoroquinolones (also, for these drugs to work they need to be in the body at a certain concentration (MIC))

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19
Q

name the 5 bacteriostatic classes of antibiotics

A

tetracyclines, macrolides, sulfonamides, trimethoprim, chloramphenicol

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20
Q

name the 5 bacteriocidal classes of antibiotics

A

penicillins, aminoglycocides, cephalosporins, bacitracin, fluoroquinolones

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21
Q

(T or F) an infection can be present even without discharge

A

false: no discharge=no infection

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22
Q

(T or F) sectoral injection is a sign of NO infection

A

true: sectoral injection=no infection, must be diffuse

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23
Q

What senario could be used for preventative ocular antibiotic treatment?

A

in a very dry cornea where an infection is likely to occur

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24
Q

Which 3 classes of antibiotics are best taken on an empty stomach?

A

penicillins, azithromycin (macroides), and tetracyclines [pat an empty stomach]

25
Q

penicillin is _____ _____, whereas methicillin, flucoxacillin, and dicloxacillin (semi-synthetic penicillins) are ____ ____

a) PCNase sensitive
b) PCNase resistant

A

a, b

26
Q

of all the penicillins, which is most stable in acid (meaning, you can take with food)

A

dicloxacillin

27
Q

if a drug is unstable in acid, should you take it with or without a meal?

A

you should take it without a meal because eating food stimulates acid pumps and acid secretion.

28
Q

What is likely the first question you should ask when a patients presents with a red eye?

A

Is there any discharge? no discharge=no infection

29
Q

Your pt is allergic to penicillin, is there any reason you cannot give this pt cephalosporin?

A

Yes, do not give cephalosporin to a penicillin allergic patient. Since cepahlosporin uses the same mechanism of action as penicillin (cell wall inhibition) it is considered cross-reactive

30
Q

Your patient is taking a daily birth control pill and you wish to start her on an oral antibiotic. Would it be appropriate to tell her to “use a back up method of protection”?

A

yes, because antibiotics interfere with the absorption of birth control pills, since antibiotics kill the natural flora used to absorb the hormones.

31
Q

Can you find bacitracin in an oral formulation?

A

NO, due to high nephrotoxicity, bacitracin is only used topically

32
Q

Redman’s syndrome (a person will look flushed from head to toe due to sudden mast cell degranulation) is assoc. with which medication?

A

Vancomycin (used for MRSA and MRSE)

33
Q

What is the main difference in treatment when it comes to anterior vs posterior segment infections?

A

anterior segment infections are easily treatable with topicals, while posterior segment infections should be treated with oral antibiotics. (in the case of an aphakic patient, a topical will have enhanced absorption from the surface to the retina)

34
Q

gentamycin, neomycin, tobramycin are part of which antibiotic class?

A

aminoglycosides: 30S ribosome protein inhibitors

35
Q

what is the difference between tobrex and tobradex?

A

tobrex contains tobramycin only and tobradex contains tobramycin plus the steroid dexamethasone. (also tobrex has a pregnancy B rating)

36
Q

what is the additional benefit associated with tetracycline?

A

it has an anti-inflammatory property

37
Q

what is trachoma? what antibiotic can you use to treat it?

A

ocular chlamydia, doxycycline

38
Q

you dont want to take tetracyclines with ____ because they bind with ____

A

milk, calcium

39
Q

which 2 tetracyclines are short acting and which 2 are long acting?

A

short=tetracycline and oxytetracycline, long=doxycycline and minocycline

40
Q

name the 3 main macrolides. which 2 have a pregnancy rating of B and which 1 is contraindicated in pregnancy

A

class B= erythromycin and azithromycin, contraindicated with pregnancy=clarithromycin.

41
Q

is tetracycline contraindicated in pregnancy? in children? why or why not?

A

yes, tetracycline is contraindicated in both pregnancy, while nursing, and in children under 8 yrs old due to the fact it binds calcium. This adverse effect is detrimental to bone and teeth growth.

42
Q

All tetracyclines are contraindicated in patients with renal failure except….

A

doxycycline, since this one is eliminated thru fecal waste and not thru urine.

43
Q

tetracyclines are among those that are to be taken without food execpt….

A

doxycycline should be taken with food

44
Q

which antibiotic class is associated with grey baby syndrome?

A

chloramphenicol

45
Q

sulfonamides are ____ structural analogs

A

PABA

46
Q

sulfonamides are usually paired with ____ or _____ to disrupt what pathway?

A

pyrimethamine or trimethoprim to disrupt

“PABA–>DHF–>THF”. to disrupt this pathway is inhibit folic acid.

47
Q

what disrupts PABA–>DHF? What disrupts DHF–>THF

A

sulfonamides disrupt PABA–>DHF, pyrimethamine or thrimethoprim disrupt DHF–>THF

48
Q

the suffix -oxacin is synonymous with which class of antibiotic?

A

fluoroquinolones

49
Q

fluroroquinolones interact with _____

A

antacids

50
Q

what is the best ocular antibiotic for children?

A

Polytrim (polymixin B/trimethoprim) and azasite (azithromycin) ointment formulations are best for drug delivery

51
Q

what are 4 factors involved when determining to use a steroid/antibiotic combination therapy vs a stand alone antibiotic therapy?

A

1) extent of inflammation 2) severity of infection 3) tissue integrity 4) lymphadenopathy

52
Q

what are the 3 main viral infections discussed in this lecture?

A

adenovirus=cold virus that is most common cause of viral eye infections, herpes=simplex vs zoster, HIV=increased risk of secondary infection (cytomegalovirus)

53
Q

which type of herpes presents as oral and genital? which type of herpes presents as chicken pox and shingles?

A

oral and genital is simplex, chicken pox and shingles is zoster

54
Q

antivirals are broken down into which 2 categories?

A

pyrimadine and purine analogs

55
Q

Herplex and Viroptic, 2 brands of antivirals, are which kind of analog?

A

pyrimidine analogs

56
Q

Zovirax, Zirgan, Famvir, and Valtrex, 4 brands of antivirals, are which kind of analog?

A

purine analogs

57
Q

which anti-viral is 1st line of therapy for reoccurring HSV1 and HSV2?

A

Viroptic

58
Q

what are the 4 classes of anti-fungals?

A

polyenes, pyrimidines, azoles, and echinocandins

59
Q

what is “the great imposter”

A

acanthamoeba, mostly assoc. with contact lens wearers, can also be from trauma. found in homemade saline solutions.

Ocular Pharm lectures 6-9 final (4 decks)

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