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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
T/F first generation cephalosporins have best gram-positive activity
True
26
Cephalosporin general use chart
27
Cephalosporins indications in dentistry are good against __________ but limited activity against ____________
orofacial pathogens; oral anaerobes
28
Adverse effects of cephalosporins
-allergy -cross allergy w/ penicillins -anaphylactic runs are rare -rare stuff like increase in liver enzyme, nephrotoxicity, thrombocytopenia
29
Cephalosporins have drug interactions with these drugs so you want to reduce oral absorption of these
1. antacids 2. H2 histamine receptor antagonists 3. proton pump inhibitors 4. iron supplements 5. food
30
Combination of cephalosporins with ______________ or ______ _________ leads to Nephrotoxicity
aminoglycosides or loop diuretics
31
If you combine cephalosporins with ethanol, what is the result?
disulfiram-like reaction and possible hypoprothrombinemia
32
Contraindications of cephalosporins
Allergy to these drugs * A history of severe penicillin reactions or a positive skin test reaction to the penicillin minor determinant mixture
33
Which B-lactams cause serious infections
carbapenems monobactems Carbacephems
34
Carbapenems use is for?
highly resistant gram - and some anaerobes
35
Symptoms of toxicity of carbapenems
GI distress, skin rash, CNS toxicity (seizures) at high plasma levels
36
Erythromycin, azithromycin, and clarithromycin are examples of
macrolides
37
Mechanism of action of macrolides
Inhibit protein synthesis by binding to 50S ribosomal subunit & preventing translocation
38
Use of eryhtromycin in dentistry?
acute orofacial infections gram + aerobic/facultative cocci
39
Use of clarithromycin in dentistry?
gram + anaerobes
40
Use of azithromycin in dentistry?
gram - anaerobes
41
Name some adverse effects of macrolides
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
Name some drug interactions of macrolides
-inhibit liver enzyme (cytochrome P450) -> can affect GI microbial flora -avoid medications that prolong QT
43
Contraindications of macrolides
-allergy -history of allergic cholestatic hepatitis
44
Mechanism of action of ketolides
Inhibits bacterial protein synthesis (50S + formation of 50S and 30S).
45
Name the activitiy of ketolides
wide spectrum of respiratory pathogens
46
Adverse effects of ketolides
diarrhea, nausea inhibit CytP450 Long QT syndrome
47
Mechanism of action of tetracycline
Reversible binding to 30s, preventing charged tRNA from binding to acceptor site
48
T/F tetracyclines are bacteriostatic
True
49
Use of tetracyclines in dentistry
-managing localized aggressive periodontitis -sub-gingivally
50
Adverse effects of tetracyclines
-photosensitiviy, -liver dysfunction -teeth staining -pigment changes in hair skin and nails
51
Tetracyclines orał absorption can be impaired by
chelation
52
Tetracycline metabolism is mostly?
hepatic (CYP3A4)
53
______ dose adjustment is required for tetracycline
Renal
54
Contraindications of tetracycline
known drug allergies, avoid for pregnany and nursing women, should not be given to children younger than 8 yrs old
55
Drug interactions of tetracycline
warfarin iron barbituates
56
Mechanism of action of aminoglycosides
Bactericidal. Irreversible inhibition of initiation complex through binding of the 30S subunit to inhibit protein synthesis concentration-dependent
57
Clinical use of aminoglycosides
-good against gram - aerobic -no indication for orofacial infection
58
Adverse effects of aminoglycosides
ototoxicity and nephrotoxicity
59
Drugs interactions of aminoglycosides
-increased toxicity by loop diuretics -increase neuromuscular blocking effect of curare-type drugs
60
The root floxacin tells you the drug is a....
fluroquinolone
61
Mechanism of action of fluroquinolones
Blocks DNA synthesis by interfering with bacterial DNA gyrase & topoisomerase
62
Clinical use for fluroquinolones
-pnuemonia -UTI -intraabodominal infections
63
Adverse effects of fluroquiolones
* Nausea/vomiting * Dyspepsia * Abdominal pain * PMC and diarrhea * Headache * Phototoxicity * QTc interval prolongation * Chondrotoxicity
64
Drugs interactions of fluoroquinolones
-don't combines with: other drugs that increase CNS toxicity like TCAs, phenothiazines, and erythromycin -warfarin -antacids
65
Contraindications of fluoroquinolones
allergy -under 18 yrs
66
This class of drugs has high oral bioavailability and the metabolism is hepatic
fluoroquinolones
67
One of the first groups of antibiotics
Sulfonamides
68
Mechanism of action of sulfonamides
Inhibit the synthesis of folic acid (folate)
69
Clinical use for sulfonamides
-UTI -acute bronchitis -pneumonia -traveler's diarrhea
70
Adverse effects of sulfonamides
* Nausea/vomiting * Blood dyscrasias * Crystalluria * Photosensitivity * Stevens-Johnson syndrome (skin eruptions)
71
Mechanism of action of chloramphenicol
Inhibits protein synthesis by reversibly binding to the 50S subunit bacteriostatic -aerobic and anaerobic Gram + and Gram -
72
T/F Chloramphenicol are commonly prescribed in the US
False! They're rarely used bc there are better alternatives
73
Mechanism of action of vancomycin
Binds D-Ala-D-Ala to inhibit a rxn in peptidoglycan synthesis to inhibit cell wall synthesis bactericidal
74
Clinical use of vancomycin
gram + infections
75
Name some topical antibiotics (neosporin)
* Bacitracin * Neomycin * Polymyxin B * Mupirocin

D1 Spring (47 decks)

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