Pharm II Test 1 Flashcards

1
Q

Which antibiotics are not eliminated by non-renal mechanisms?

A

Think D-CRIMES
Doxycycline
Clindamycin
Rifampin –> inducer of P450 (hepatotox)
Isoniazid –> genetic polymorph (hepatotox)
Metronidazole –>interacts c etoh
Erythromycin-like (macrolides) - inhibits P450
Sulfonamides - risk of renal crystalluria

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2
Q

Selective toxicity: inhibit pathway found in bacteria but not in humans

A

Folate metabolism

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3
Q

Selective Toxicity: Pathway exists in both, difference in enzyme structure.

A
  • protein synthesis –> bact have 30s and 50s units

- Nucleic acid synthesis - DNA gyrase vs topoisomerase (humans)

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4
Q

Selective Toxicity: Macromolecular structure does not exist in humans.

A

Cell wall synthesis –peptidoglycan

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5
Q

Selective toxicity: macromolecular structure differs between microbes and humans.

A

Cell membrane: Ergosterol (fungi) vs cholesterol (human)

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6
Q

Modes of resistance

A
  • natural
  • escape
  • acquired resistance
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7
Q

Types of acquired resistance

A
  • Spontaneous mutational (chromosomal) resistance

- Plasmid mediated (MDR gene)

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8
Q

How to minimize abx resistance?

A
  • use only when needed
  • select based on susceptibility tests
  • use adequate concentration / duration
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9
Q

Bactericidal

A
  • inhibit cell wall synthesis
  • disrupt cell membrane function
  • interfere with DNA function or synthesis
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10
Q

Bacteriostatic

A
  • inhibition of protein synthesis

- inhibition of intermediary metabolic pathways

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11
Q

Common gram + cocci

A

Strep
Staph
Enterococci

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12
Q

common gram - cocci

A

Neisseria

M. catarrhalis

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13
Q

Common gram - Rods

A

E.coli
Pseudomonas aeruginosa
H. influenzae

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14
Q

Common gram + rods

A

Listeria

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15
Q

Anaerobes, gram + rods

A

Clostridium difficile

H. pylori

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16
Q

Anaerobes, gram - rods

A

Bacteroides fragilis

17
Q

Common atypicals

A

Chlamydia
Mycoplasma
Rickettsia

18
Q

Advantages of Oral administation

A
  • ease
  • patient acceptance
  • lower cost
19
Q

Disadvantages of oral admin

A
  • GI upset b/c alteration of normal intestinal flora
  • incomplete or lack of absorption
  • not ok for NPO pts
20
Q

Which drug has beneficial accumulation in the bone?

A

Clindamycin

Osteomyelitis

21
Q

Which drug class has beneficial accumulation into pulmonary cells?

A

Macrolides

URI or pneumonia

22
Q

Which drug class has beneficial accumulation into gingival crevicular fluid and sebum?

A

Tetracyclines

Periodontitis
acne

23
Q

Which drug has beneficial accumulation into urine?

A

Nitrofurantoin

UTIs

24
Q

Which drug class harmfully accumulates in cells of inner ear and renal brush borders?

A

Aminoglycosides

  • ototoxicity
  • nephrotoxicity
25
Q

Which drug class harmfully binds Ca++ in developing bone and teeth?

A

Tetracyclines

  • abnormal bone growth
  • tooth discoloration