Pharmacology & Antibiotic Use - Corrigan SAM Flashcards

1
Q

What 10 Questions do you ask when considering an antibiotic?

A
  1. Time vs Concentration dependent
  2. Bacteriostatic vs. Cidal
  3. MOA - appropriate against bug?
  4. Water vs Fat soluable
  5. Can it get to the site? - cross BBB? Blood-prostate barrier?
  6. Can it reach therapeutic levels? - maybe drug will reach the site but has poor bioavailability
  7. Toxicity
  8. Owner compliance
  9. Owner safety
  10. $$$ cost
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2
Q

What 3 questions do you ask about the infecting organism?

A
  1. Gram + vs Gram -
  2. Aerobic vs Anaerobic
  3. Intracellular vs. Extracellular
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3
Q

Gram Postitive organisms

A

“BC - CARELESS - DAMN”

Bacillus
Clostridium

Corynebacterium
Archanobacter
Rhodococcus
Enterococcus
Lysteria
Erysipelothrix
Streptocococcus
Staphylococcus 

Dermatophilus
Actinomyces
Mycobacterium
Nocardia

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4
Q

Anaerobes

A
Actinomyces
Bacteroides
Clostridium
Eubacterium
Fusobacterium
Peptostreptococcus
Porphyromonas
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5
Q

What parts of the body have anaerobes as normal flora?

A

Mouth
Vagina
Intestines

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6
Q

Anerobes are found in infections. What type of infections?

A
  1. immunocompromised
  2. Abscesses
  3. Multi-bug infections
  4. infection with Gas Production - gas indication its an anaerobe
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7
Q

Abx of choice when dealing with anaerobes?

A

Clindamycin

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8
Q

Abx of choice when dealing with anaerobes of the GI

A

Metronidazole

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9
Q

Organisms difficult to culture?

These organisms are often missed bc culture difficulty and TREATMENT SHOULD BE STARTED EMPIRICALLY IMMEDIATELY

A
  1. Ehrlichia
  2. Borrelia/Lyme
  3. Hemoplasmas
  4. Bartonella
  5. Mycoplasmas
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10
Q

When should you use drugs empirically?

A
  1. first instance of infection
  2. Emergency tx/ Critical Illness
  3. Difficult organisms to culture (Ehrichia, Borrelia, hemoplasmas, Bartonella, mycoplasmas)
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11
Q

Drugs used for critical illness:

  1. Route of administration?
  2. Length of time to give drug?
A
  1. Parenteral administration at
    Highest dose &
    Highest Frequency
  2. 7-10 days (minimum 3-5)
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12
Q

Adverse SE of Aminoglycosides?

A
  1. Nephrotoxic

2. Ototoxic

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13
Q

What should you always check for before administration of an otological (ear) drug?

A

INTACT tympanic membrane

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14
Q

Adverse SE of Cephalosporins and Penicillins?

A

Immune mediated dz

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15
Q

What drugs should you not use on an animal with history of IMHA?

A

Cephalosporins & Penicillins

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16
Q

Adverse SE of Doxycycline?

A

Esophageal stricture in CATS

Tablets are caustic to esophagus - compound doxy to syrup form

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17
Q

Adverse SE of Tetracyclines?

A
  1. Renal Tubular dz

2. Highlighter yellow tooth enamel in animals < 6 months
OK once teeth erupt

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18
Q

Adverse SE of Sulfonamides?

A
  1. Keratoconjunctivitis Sicca
  2. Blood Dyscrasias (anything can go wrong with bone marrow)
  3. Polyarthritis in BLACK & TAN dogs
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19
Q

Adverse SE of Enrofloxacin

A
  1. Blindness in CATS (use Marbofloxacin instead of Enrofloxacin)
  2. Seizures
  3. failure of CARTILAGE DEVELOPMENT in puppies
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20
Q

Tx for histiocytic ulcerative colitis in boxers?

A

Enrofloxacin

21
Q

Adverse SE of Ciprofloxacin?

A

Poor bioavailability & poor absorption PO

22
Q

What drug should be used for cats instead of Enrofloxacin?

A

Marbofloxacin

23
Q

Adverse SE of Chloramphenicol?

A

Aplastic Anemia in Humans

24
Q

What is Unison?

A

Potentiated Penicillin “Big Gun Drug”

25
Q

Adverse SE of Metronidazole?

A

Neurologic Side effects:

  • weakness
  • ataxia
  • vestibular signs
26
Q

Infections that REQUIRE culture & susceptibility (c/s)?

A
  1. Chronic inf
  2. Bone inf
  3. Immunocompromised patients
  4. Complicated inf - UTI in BOY cat
27
Q

Drug used for Staph Pyoderma?

A

Cephalosporin (Cephalexin)

28
Q

Drug used for Abscesses?

A
  1. Clavamox
  2. Clindamycin –> anaerobes & good bone penetration
  3. Cephalosporins
29
Q

Drug used for Nocardia?

A

Penicillin + Potentiated sulfa (both)

30
Q

What must you rule out when there is fluid in lungs? Why?

A
  1. CHF
  2. Pneumonia

Why: Tx is complete opposite!
CHF tx is get rid of fluids
Pneumonia tx is give fluids

31
Q

Drug used for Bacterial Pneumonia?

A
  1. Ampicillin + Enrofloxacin (both! corrigans fav high dose combos – cats use marbofloxacin)
  2. Tricarcillin + Clavulanate
32
Q

Drug used for Pyothorax?

A
  1. Penicillins

+/- Potentiated Sulfa if Nocardia present

+/- Metronidazole

33
Q

Drug used for Upper Respiratory Dz?

ex: snotty cat w herpes causing 2nd bacterial infection

A
  1. Clavamox

2. Clindamycin

34
Q

Drug used for Cholangiohepatitis?

A
  1. Clavamox

+/- Metranidazole if you think you have a gram negative component

35
Q

Drug used for Bacterial overgrowth in GI?

A
  1. Metronidazole BEST

2. Tylosin

36
Q

Drug used for Hepatic encephalopathy? Portal Systemic Shunts?

A

Neomycin

  • only time you will use Aminoglycoside as 1st choice
  • not absorbed systemically, stays in GI and ↓ bacteria in GI making ammonia
  • amikacin and gentamicin ARE absorbed systemically and will kill your kidneys/deaf
37
Q

Drug used for Diskospondylitis?

A
  1. Cephalosporin
  2. Clavamox

+/- enrofloxacin
+/- chloramphenicol

38
Q
  1. What is the most common cause of diskospondylitis?

2. What is the most common co-morbitity with diskospondylitis?

A
  1. Skin infection/ wound - enters the disk space or goes systemic
  2. UTI - culture the urine probably the same bug whats causing diskospondylitis
39
Q

Drug used for Osteomyelitis?

A
  1. Clindamycin - anaerobic infection & great bone penetration (teeth)
  2. Clavamox
40
Q

Drug used for Toxoplasmosis?

A

Clindamycin

41
Q

Drug used for Encephalitis?

A

Chloramphenicol - great BBB penetration!

42
Q

Drug used for Otitis Media/ Interna?

A
  1. Clavamox

2. Chloramphenicol

43
Q

Drug used for Polyarthritis from Bartonella?

multiple joints = tick born dz

A
  1. Enrofloxacin + Clavamox
  2. Enrofloxacin + Rifampin
    * Bartonella resistant to Azithromycin since 2017*
44
Q

Drug used for Polyarthritis from Borrelia?

multiple joints = tick born dz

A

Doxycycline

45
Q

Drug used for Polyarthritis from Ehrichia?

multiple joints = tick born dz

A

Doxycycline

46
Q

Drug used for UTI?

A

Clavamox

47
Q

Drug used for Leptospirosis?

A

Ampicillin + Doxycycline (both)

ampicillin –> bacteremia
doxy –> renal carriers

48
Q

Drug used for Prostatitis?

A
  1. Chloramphenicol
  2. Enrofloxacin (baytril)

both GREAT for Prostate!

49
Q

Drug used for Pyometra?

A

Ampicillin + Enrofloxacin (both) “big gun med”