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mpharm year 3 sem 1 > MP321 week 2 > Flashcards

MP321 week 2 Flashcards

1
Q

where do drug molecules come from

A

bacteria, plants, fungi, animals, inorganic (lab)

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2
Q

why would you use a broth micro dilution assay

A

cheap, reproducible and robust giving accurate results

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3
Q

define cytotoxicity assay

A

assay test to measure the ability of cytotoxic compounds to cause cell damage or cell death

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4
Q

what do antibacterial drugs do

A

kill or inhibit the growth of microbes at low concentrations

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5
Q

what is B-lactam mode of action

A

stop bacterial cell wall being formed, because human (host) cells do not have cell walls it does not affect the host

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6
Q

do antibiotics kill or inhibit growth of bacteria

A

kill only

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7
Q

name one difference between gram positive and gram negative bacteria

A

gram negative have a much thinner cell wall than gram positive thus making them more vulnerable

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8
Q

explain how enzymes are used to make the bacterial cell wall more rigid

A

enzymes called transpeptidases or penicillin binding proteins link 2 strands of sugars together forming a bridge that is more rigid

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9
Q

what is called peptidoglycan

A

the bacterial cell wall, this is because it is made of peptides and sugars

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10
Q

name the 4 classes of B-lactams

A

penicillin
cephalosporin
carbapenem
monobactam

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11
Q

describe the structure of a penicillin type B-lactam

A

cyclic amide is fused to 5 membered ring with sulphur atom inside

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12
Q

describe the structure of a cephalosporin type B-lactam

A

cyclic amide is fused to a 6 membered ring with sulphur atom inside

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13
Q

describe the structure of a carbapenem type B-lactam

A

cyclic amide is fused to 5 membered ring with sulphur atom on the side (NOT inside ring)

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14
Q

describe the structure of a monobactam type B-lactam

A

there is no ring attached to the cyclic amide

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15
Q

how to spot if the B-lactam has lost antibacterial properties

A

if there is no longer the N, C double bond O square functional group

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16
Q

in which kind of medium are B-lactams the most degradable

A

acidic medium- ie stomach

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17
Q

why can some B-lactams not be administered orally

A

they are very degradable in acidic medium- ie stomach and so have lost their antibacterial properties by the time they reach the bloodstream

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18
Q

describe the mode of action of B-lactams

A

inhibit cell wall synthesis of bacteria

B-lactam mimic natural substrate for bacteria
when B-lactam bind to bacterial enzyme this is irreversible and so the bacteria cannot bind with real substrate

because the bacteria then do not have a rigid cell wall to protect them they go into cell lysis and die

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19
Q

why are B-lactams highly reactive

A

they have a cyclic amide which unlike normal amides are not planer therefore the movement of electrons make B-lactam unstable and very reactive

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20
Q

define narrow spectrum

A

these target a specific class of bacteria, normally only working on gram positive

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21
Q

define broad spectrum

A

normally work on both gram positive and gram negative but not always on antipseudomonal

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22
Q

what are antipsudomonal penicillins

A

antimicrobial agents, which are used to treat pseudomonal infections- gram negative

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23
Q

name one penicillin that does not work on gram negative bacteria

A

benzylpenicillin

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24
Q

how to bacteria try to protect themselves against B-lactams

A

produce a chemical called B-lactamase which inactivates B-lactams

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25
Q

how do we try to combat B-lactams instability in acidic medium

A

attach an electronegative group to minimise neighbouring group attack on the B-lactam carbonyl

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26
Q

Which one is true?
1. Benzylpenicillin can be given orally
2. Amoxicillin and piperacillin are both effective against pseudomonas
3. Cefuroxime is B-lactamase resistant
4. Cefaclor cannot be taken orally

A

3

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27
Q

how is phenoxymethyl penicillin administered

A

orally

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28
Q

what is the most appropriate antibiotic to treat strep

A

phenoxymethyl penicillin

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29
Q

what kind of bacteria is flucloxacillin used to treat

A

gram positive

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30
Q

what kind of B-lactam must be administered with another antibiotic

A

B-lactamase inhibitors like tazobactam and clavulanic acid

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31
Q

name 2 antibiotic that work on gram positive and gram negative but not pseudomonas

A

amoxicillin and ampicillin

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32
Q

name 2 antibiotics that are active against pseudomonas

A

ticarcillin
piperacillin

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33
Q

name 4 antibiotics active against gram positive

A

cefalexin
cefradine
cefadroxil
cefaclor

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34
Q

what are cefotaxime, cefriaxone, cefixime and cefpodoxime all effective on

A

gram negative
B-lactamase resistant

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35
Q

name 2 cephalosporins that can be given orally

A

cefalexin and cefaclor

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36
Q

name 4 parenteral administration routes

A

Subcutaneous (under the skin)
Intramuscular (in a muscle)
Intravenous (in a vein)
Intrathecal (around the spinal cord)

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37
Q

which of the following is true
1- The peptidoglycan in Gram-positive bacteria is thicker than the one in Gram-negative bacteria
2- Ticarcillin is a cephalosporin with antipseudomonal activity
3- Amoxicillin is active against Pseudomonas aeruginosa
4- Flucloxacillin is degraded by beta-lactamases
A beta-lactamase inhibitor can only be given parenterally

A

1

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38
Q

name the 4 main structural classes of antifungals

A

polyenes
azoles
echinocandins
allylamines

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39
Q

name the main functional group in polyenes

A

alkene groups

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40
Q

name the main functional groups in imidazoles

A

ring with 2 nitrogens- called imidazole group
this is basic (can accept hydrogen)
the nitrogen that is attached to amide accepts hydrogen, the other nitrogen is making the ring aromatic

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41
Q

name the main functional group in triazoles

A

ring with 3 nitrogens (tri=3)

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42
Q

give one example of a polyene drug

A

nystatin

43
Q

name an example of a imidazole drug

A

clotrimazole
miconazole
econazole
ketoconazole

44
Q

name an example of a triazole drug

A

fluconazole
itraconazole

45
Q

name a structural component of echinocandins

A

long lipophilic tail

46
Q

name an example of an echinocandin

A

caspofungin

47
Q

name an example an allylamine

A

terbinafine

48
Q

describe the mechanism of action of polyenes

A

bind directly with ergosterol in the cell membrane causing leakage and cell death

49
Q

describe the mechanism of action of azoles

A

competitively inhibits lanosterol (an enzyme involved in ergosterol biosynthesis

50
Q

describe the mechanism of action of echinocandins

A

non competitively inhibit B-1,3-D-glucan biosynthesis in cell wall causing cell lysis and death

51
Q

describe the mechanism of action of allylamines

A

inhibit squalene epoxidase required for ergosterol biosynthesis

52
Q

describe the mechanism of action griseofulvin

A

binds to polymerised microtubules in nucleus and prevents mitosis

53
Q

describe the mechanism of action of flucytosine

A

an antimetabolite which interferes with RNA and DNA synthesis in the cell nucleus causing cell death

54
Q

where in the body is the imidazole ring sensitive to metabolism

A

the liver

55
Q

structure governs what?

A

PK, PD, spectrum range, oral availability and preparation

56
Q

what antibiotic would be most suitable for this case ?

Mrs CP brings her 8 year old daughter into her GP’s surgery. The child has a high temperature and a sore throat. No cough or runny nose is present. Swabs taken from the tonsils and the roof of the mouth are sent for culture and sensitivity. Streptococcal pharyngitis is diagnosed.

A

phenoxymethyl penicillin

57
Q

what antibiotic would be most suitable for this case

Mrs AM has a high temperature and her knee is painful, red and swollen. A sample of knee aspirate is sent for culture and sensitivity testing. A diagnosis of septic arthritis is made and
Pseudomonas aeruginosa isolated.

A

ceftazidime

58
Q

what is the purpose of streaking on an agar plate

A

allows you to see distinct colonies

59
Q

do capsules form on flagella?

A

bacteria normally have one or the other

60
Q

what is mutants

A

a species of the genus streptococcus causing dental plaque

61
Q

will gram positive bacterium show on Mackey agar

A

growth of gram positive bacteria is inhabited on this medium

62
Q

what is a nosocomial pathogen

A

one that is encountered and causes infection in hospitals

63
Q

are gram negative bacteria more harmful than gram positive

A

no just much harder to treat

64
Q

is flucloxacillin stable in acidic medium

A

yes

65
Q

will phenoxymethylpenicillin be degraded by B-lactamases

A

yes

66
Q

is phenoxymethylpenicillin broad or narrow spectrum

A

narrow spectrum

67
Q

is amoxicillin B-lacatmase resistant

A

no

68
Q

what is a way to tell if an antibiotic is can be used orally

A

look for an electronegative group on the left side chain- this generally means it can be used orally

69
Q

how does phenoxymethylpenicillin work if it is degraded by B-lactamase

A

if b-lactamase is present it it no longer active
however it will work if the microbes do not produce B-lactamases

70
Q

what is tazobactam

A

b-lactamase inhibitor

71
Q

can tazobactam be given orally

A

only available for IV

72
Q

would you use flucloxacillin on MRSA

A

no it doesn’t work

73
Q

what is a good choice for MRSA

A

vancomycin

74
Q

does cefalexin work on pseuodomonas?

A

no

75
Q

how to tell from the structure if an antibiotic is effective on gram negative

A

if it has a bulky side chain it will not work
too big to get through the small porins

76
Q

what is neighbouring group attack?

A

Neighbouring group attack is when the acyl side chain attacks the nearby b-lactam ring. The electrons in search of a positive centre (carbon of the carbonyl b-lactam) can come from the N (also from the O).

77
Q

define algophobia

A

fear of pain

78
Q

what percentage of working adults struggle to understand how to calculate a paracetamol dose for a child

A

43%

79
Q

what do vaccines contain

A

a weakened or inactive antigen which can be live

80
Q

name 3 common routes of administration for vaccines

A

injectable, oral or nasal

81
Q

is active or passive immunity longer lasting?

A

active

82
Q

name a medical procedure or treatment that means the patient must receive all childhood immunisations again

A

bone marrow transplant

83
Q

name some pharmacy aspects of vaccination programmes

A

o Manufacturing
o Procurement
o Distribution
o Logistics of endpoint supply (final mile delivery)
o Storage
o Legal mechanism of administration – POM but no prescription is written- PGD
o Recording of administration and analysis of uptake
o Incident reporting/ handling

84
Q

what can pharmacists do about vaccine hesitancy

A

provide correct information
cultural sensitivity
incentive programmes (like requiring vaccine to travel or attend events)

85
Q

name some factors which contribute to vaccine hesitancy

A

misinformation
safety concerns
fear of needles
malpractice
vaccine myths

86
Q

what would you do if it was thought a vaccine had been left out of the fridge or not stored at the correct temperature?

A

quarantine vaccines
find out how long they have been at the incorrect temperature
contact SPC- they will clarify storage and handling requirements
contact manufactures for further clarification

87
Q

name some common childhood immunisations

A

6 in 1
MMR

88
Q

who decides which vaccines go into programmes

A

JCVI (joint committee on vaccine and immunisation)

89
Q

what is herd immunity

A

when the majority of a population is vaccinated it helps prevent the spread of a virus to those who are not vaccinated for whatever reason (too vulnerable, don’t have access, allergic etc)

90
Q

define teratogenesis

A

failure to develop limbs correctly, congenital malformations

91
Q

name a drug that was used and what it was used for that caused teratogenesis

A

thalidomide, used for morning sickness

92
Q

define what a medicinal product is

A
  • any substance or combination of substances presented as having properties of preventing or treating disease in human beings
  • any substance or combination of substances that may be used or administered to human beings with a view to
    • restoring, correcting or modifying a physiological function by exerting a pharmacological, immunological or metabolic action or
      • making a medical diagnosis
  • things such as oxygen and testing strips are also medicinal products
93
Q

POMs can only be supplied if:

A
  • a person is lawfully conducting a retail pharmacy business
  • the product is sold, supplied or offered for sale or supply on premises that are a registered pharmacy and
  • if the transaction is carried out on behalf of the person by another person that other person is or acts under the supervision of a pharmacist
94
Q

what does the general pharmaceutical council do

A

-registration and regulation of pharmacists and technicians
-restricts titles to practising pharmacists and technicians
-premises register/ inspection
-educational accreditation
-guidance

95
Q

when may a pharmacist refuse supply

A

-when they reasonably believes the prescription is forged
-where to supply would be contrary to the pharmacists clinical judgement
-where the pharmacist or others on the premises are subject to or threatened with violence
-where the person presenting the prescription commits or threatens to commit a criminal offence
-where irregularities or deficiencies in a repeat dispensing service mean that a repeat supply is not appropriate

96
Q

provision of pharmaceutical services- key points

A
  • not allowed to accept Rx for dispensing that has been received by pharmacy not on pharmaceutical list
  • can only supply a NHS Rx from registered pharmacy included in pharmaceutical list
  • where details are missing from Rx (strength, dosage), pharmacist can supply medication considered most appropriate
  • if no quantity, give up to 5 days supply or minimum pack size
97
Q

define HSCP

A

health and social care partnerships

98
Q

name the three stages of production of antibiotics at GSK

A

fermentaion
extraction
isolation

99
Q

name the four stages of fermentation of antibiotics at GSK

A

spore preparation
seed fermentation
product fermentation
harvest

100
Q

what is the ideal pH for fermenting antibiotics

A

6-7

101
Q

name the five stages of extraction of antibiotics at GSK

A

ultrafiltration
reverse osmosis
resin
forward extraction
carbon

102
Q

name the four stages of isolation of antibiotics at GSK

A

back extraction
tBA salt isolation
tBA salt converted to K salt of clav
pre mix blend

103
Q

define the enzymatic stage of antibiotic production at GSK

A

penicillin G is converted to 6-APA by enzymatic cleavage of the amide side chain

mpharm year 3 sem 1 (10 decks)

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