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D1 Spring > Pharmacology - Antibiotics Part 2 (Exam 2) > Flashcards

Pharmacology - Antibiotics Part 2 (Exam 2) Flashcards

1
Q

Name the major classes of antibiotics (5)

A
  1. Beta Lactams
  2. tetracylcines
  3. aminoglycosides
  4. macrolides
  5. fluoroquinolones
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2
Q

Mechanism of action of B-lactams

A

inhibit cell wall synthesis by covalently binding to active site of PBPs

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3
Q

Most important B-lactams

A

penicillins
cephalosporins

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4
Q

T/F: B-lactams have a linear arrangement

A

False! They have a B-lactam ring (an amide)

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5
Q

What does PBP remove when forming peptidoglycan cell wall?

A

terminal D alanine

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6
Q

What are the natural penicillins?

A

Penicillin G
Penicillin V

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7
Q

What are the anti-staphylococcal penicillins?

A

Nafcillin
Dicloxacillin

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8
Q

What are the extended spectrum penicillins (antipseudomonal)?

A

Piperacillin
Ticarcillin

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9
Q

What are the extended spectrum penicillins (aminopenicillins)?

A

Ampicillin
Amoxicillin

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10
Q

Spectrum of natural penicillins

A

Gram + and gram - cocci
gram + bacilli
spirochetes

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11
Q

Spectrum of anti-staphylococcal penicillins

A

penicillinase-producing stapylococci

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12
Q

Spectrum of extended spectrum penicillins (antipseudomonal)

A

pseudomonas aeruginosa

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13
Q

Spectrum of extended spectrum penicillins (aminopenicillins)

A

same as penicillin G and more Gram -

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14
Q

Penicillin ___ and _________ are orally adminstered

A

V; amoxicillin

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15
Q

Adverse effects of penicillins

A

-allergy
-amoxicillin rash
-GI upset
-hyperexcitability, seizures, hallucinations
-rare side effects (acute pancreatitis)

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16
Q

Which immunoglobulin is involved in allergic rxn with penicillin?

A

IgE

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17
Q

T/F penicillin allergies are more common than penicillin rash

A

False! Rashes are more common

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18
Q

Oral penicillin is antagonized by?

A

bacteriostatic antibiotics (tetracycline and erythromycin)

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19
Q

What do NSAIDS and probenecid do to penicillin?

A

increase half-life by decreasing renal excretion

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20
Q

When penicillin interacts with this drug, there can be anaphylactic bronchospasm

A

B-adrenergic blocking drugs

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21
Q

Penicillin interacts with allopurinol which leads to?

A

non-urticarial rash

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22
Q

Cephalosporins are classified by

A

generations

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23
Q

As cephalosporin generation increases, you lose ________ action and gain _________ action

A

gram +; gram -

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24
Q

First generation cephalosporins are very sensitive to?

A

B-lactamase hydrolysis

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25
Q

T/F first generation cephalosporins have best gram-positive activity

A

True

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26
Q

Cephalosporin general use chart

A
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27
Q

Cephalosporins indications in dentistry are good against __________ but limited activity against ____________

A

orofacial pathogens; oral anaerobes

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28
Q

Adverse effects of cephalosporins

A

-allergy
-cross allergy w/ penicillins
-anaphylactic runs are rare
-rare stuff like increase in liver enzyme, nephrotoxicity, thrombocytopenia

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29
Q

Cephalosporins have drug interactions with these drugs so you want to reduce oral absorption of these

A
  1. antacids
  2. H2 histamine receptor antagonists
  3. proton pump inhibitors
  4. iron supplements
  5. food
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30
Q

Combination of cephalosporins with ______________ or ______ _________ leads to Nephrotoxicity

A

aminoglycosides or loop diuretics

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31
Q

If you combine cephalosporins with ethanol, what is the result?

A

disulfiram-like reaction and possible hypoprothrombinemia

32
Q

Contraindications of cephalosporins

A

Allergy to these drugs
* A history of severe penicillin reactions or a positive skin test reaction to the penicillin minor determinant mixture

33
Q

Which B-lactams cause serious infections

A

carbapenems
monobactems
Carbacephems

34
Q

Carbapenems use is for?

A

highly resistant gram - and some anaerobes

35
Q

Symptoms of toxicity of carbapenems

A

GI distress, skin rash, CNS toxicity (seizures) at high plasma levels

36
Q

Erythromycin, azithromycin, and clarithromycin are examples of

A

macrolides

37
Q

Mechanism of action of macrolides

A

Inhibit protein synthesis by binding to 50S ribosomal subunit & preventing translocation

38
Q

Use of eryhtromycin in dentistry?

A

acute orofacial infections
gram + aerobic/facultative cocci

39
Q

Use of clarithromycin in dentistry?

A

gram + anaerobes

40
Q

Use of azithromycin in dentistry?

A

gram - anaerobes

41
Q

Name some adverse effects of macrolides

A
  1. Epigastric pain (most common serious AE)
  2. Ototoxicity (deafness)
  3. Ventricular arrhythmias (torsades de pointes)
  4. Long QT syndrome
  5. Acute pancreatitis
  6. Cholestatic hepatitis (erythromycin estolate
  7. Hypersensitivity syndrome
42
Q

Name some drug interactions of macrolides

A

-inhibit liver enzyme (cytochrome P450) -> can affect GI microbial flora
-avoid medications that prolong QT

43
Q

Contraindications of macrolides

A

-allergy
-history of allergic cholestatic hepatitis

44
Q

Mechanism of action of ketolides

A

Inhibits bacterial protein synthesis (50S + formation of 50S and 30S).

45
Q

Name the activitiy of ketolides

A

wide spectrum of respiratory pathogens

46
Q

Adverse effects of ketolides

A

diarrhea, nausea
inhibit CytP450
Long QT syndrome

47
Q

Mechanism of action of tetracycline

A

Reversible binding to 30s, preventing charged tRNA from binding to acceptor site

48
Q

T/F tetracyclines are bacteriostatic

49
Q

Use of tetracyclines in dentistry

A

-managing localized aggressive periodontitis
-sub-gingivally

50
Q

Adverse effects of tetracyclines

A

-photosensitiviy,
-liver dysfunction
-teeth staining
-pigment changes in hair skin and nails

51
Q

Tetracyclines orał absorption can be impaired by

52
Q

Tetracycline metabolism is mostly?

A

hepatic (CYP3A4)

53
Q

______ dose adjustment is required for tetracycline

54
Q

Contraindications of tetracycline

A

known drug allergies, avoid for pregnany and nursing women, should not be given to children younger than 8 yrs old

55
Q

Drug interactions of tetracycline

A

warfarin
iron
barbituates

56
Q

Mechanism of action of aminoglycosides

A

Bactericidal.

Irreversible inhibition of initiation complex through binding of the 30S subunit to inhibit protein synthesis

concentration-dependent

57
Q

Clinical use of aminoglycosides

A

-good against gram - aerobic
-no indication for orofacial infection

58
Q

Adverse effects of aminoglycosides

A

ototoxicity and nephrotoxicity

59
Q

Drugs interactions of aminoglycosides

A

-increased toxicity by loop diuretics
-increase neuromuscular blocking effect of curare-type drugs

60
Q

The root floxacin tells you the drug is a….

A

fluroquinolone

61
Q

Mechanism of action of fluroquinolones

A

Blocks DNA synthesis by interfering with bacterial DNA gyrase & topoisomerase

62
Q

Clinical use for fluroquinolones

A

-pnuemonia
-UTI
-intraabodominal infections

63
Q

Adverse effects of fluroquiolones

A
  • Nausea/vomiting
  • Dyspepsia
  • Abdominal pain
  • PMC and diarrhea
  • Headache
  • Phototoxicity
  • QTc interval prolongation
  • Chondrotoxicity
64
Q

Drugs interactions of fluoroquinolones

A

-don’t combines with:
other drugs that increase CNS toxicity like TCAs, phenothiazines, and erythromycin
-warfarin
-antacids

65
Q

Contraindications of fluoroquinolones

A

allergy
-under 18 yrs

66
Q

This class of drugs has high oral bioavailability and the metabolism is hepatic

A

fluoroquinolones

67
Q

One of the first groups of antibiotics

A

Sulfonamides

68
Q

Mechanism of action of sulfonamides

A

Inhibit the synthesis of folic acid (folate)

69
Q

Clinical use for sulfonamides

A

-UTI
-acute bronchitis
-pneumonia
-traveler’s diarrhea

70
Q

Adverse effects of sulfonamides

A
  • Nausea/vomiting
  • Blood dyscrasias
  • Crystalluria
  • Photosensitivity
  • Stevens-Johnson syndrome (skin eruptions)
71
Q

Mechanism of action of chloramphenicol

A

Inhibits protein synthesis by reversibly binding to the 50S subunit
bacteriostatic
-aerobic and anaerobic Gram + and Gram -

72
Q

T/F Chloramphenicol are commonly prescribed in the US

A

False! They’re rarely used bc there are better alternatives

73
Q

Mechanism of action of vancomycin

A

Binds D-Ala-D-Ala to inhibit a rxn in peptidoglycan synthesis to inhibit cell wall synthesis
bactericidal

74
Q

Clinical use of vancomycin

A

gram + infections

75
Q

Name some topical antibiotics (neosporin)

A
  • Bacitracin
  • Neomycin
  • Polymyxin B
  • Mupirocin

D1 Spring (47 decks)

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