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Respiratory system > Pharmacology Antimicrobials > Flashcards

Pharmacology Antimicrobials Flashcards

1
Q

Treatment regime for common cold (acute rhinitis)

A

Symptomatic:

-NSAIDs and/or paracetamol
-Nasal Decongestant ( a1- adrenergic agonist)
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2
Q

Nasal decongestants used for acute rhinits

A

Phenylephrine (short-acting)
Oxymetazoline (longer-acting)

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3
Q

Cautions with Intranasal α1-adrenergic agonists?

A

rebound nasal congestion (rhinitis medicamentosa).
When used for more than 3 days

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4
Q

Treatment of Allergic Rhinitis

A

Antihistamine (H1 receptor antagonists)
1st gen

Diphenhydramine
Chlorpheneramine

		short/intermediate acting
		cross BBB — sedation and psychomotor impairment
		atropine -like effect

		
2nd gen

	Cetrizine 
	Loratidine

	longer acting
	low incidence of sedation
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5
Q

Topical intranasal antihistamine for Allergic Rhinitis

A

Azelastine

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6
Q

Intranasal corticosteroids for Allergic Rhinitis

A

Beclomethasone
Bbbudesonide

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7
Q

Empiric antimicrobial therapy for Acute bacterial sinusitis

A

Amoxycillin + Clavulanic acid

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8
Q

Moa of Amoxycillin

A

Inhibits bacterial transpeptidases ⇒ inhibit crosslinking & cell wall synthesis⇒ lysis & cell death

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9
Q

Examples of β-Lactamase Inhibitors

A

Clavulanic acid (with amoxycillin & ticarcillin)
Sulbactam (combined with ampicillin)

Tazobactam (combined with piperacillin)

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10
Q

Cephalosporins drugs

A

1st generation: Cephalexin
2nd generation: Cefaclor
3rd generation: Ceftazidime

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11
Q

Pharyngitis/Tonsillitis: Antibiotics regimen

A

S. pyogenes - highly susceptible to penicillins
• Amoxycillin 8hrly for 10 days

Patients with a history of acute rheumatic fever • Benzathine penicillin (IM – single dose)

For penicillin-sensitive (allergic) patients : ▪ Macrolide or Clindamycin

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12
Q

Macrolides drugs

A

❑ Erythromycin

❑Clarithromycin

❑ Azithromycin

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13
Q

Moa of Macrolides

A

Bind 50S subunits of bacterial ribosomes & inhibit protein synthesis

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14
Q

Uses of macrolides

A

-Penicillin-sensitive (allergic) patients

– Infections caused by mycoplasma, legionella & chlamydial

– Clarithromycin: Infections (M avium complex, H. pylori)

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15
Q

Tetracyclines drugs

A

❑ Doxycycline

❑ Tigecycline

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16
Q

MoA of Tetracyclines

A

Bind 30 S subunits of bacterial ribosomes & inhibit protein synthesis

17
Q

PK of Tetracyclines

A

Absorption↓↓ by food, cations (Ca2+, Mg2+, Fe2+ or Al3+) and byiron preparations like ferrous sulfate

Milk, dairy products, & antacids also ↓↓absorption

Chelate with calcium & get deposited in teeth & growing bones

Cross the placenta & also secreted in milk

Doxycycline & Tigecycline undergo biliary excretion

No dosage adjustment in renal failure
18
Q

Uses of Tetracyclines

A

Infections caused by gram-positive/negative bacteria, rickettsiae,
chlamydiae, legionella, and mycoplasms

• Tigecycline: Multidrug resistant organisms such as MRSA, VREF, PRE

19
Q

ADRs of Tetracyclines

A

• GI disturbances – direct irritation & effects on gut flora (Clostridium difficile associated diarrhea)

• Photosensitivity

• Teratogenic:

– Permanent yellow or brown discoloration of teeth in the fetus
– Impairment of fetal long bone growth
20
Q

Tetracyclines Contraindications:

A

▪ Pregnancy
Risk of hepatotoxicity in the mother
Teratogenicity

▪ Young children (< 8 years)

Discoloration of teeth & inhibition of bone growth in children

21
Q

Otitis externa treatment regimen

A

Antiseptic-olive oil: to cleanse the ears / drying agent

Antibacterial ear drops
Neomycin; Chloramphenicol

Topical antifungals: Clioquinol or Nystatin

Combined antimicrobial + corticosteroid ear drops
Dexamethasone + Framycetin & Gramicidin (antibact. anifungal)

22
Q

Alternatives for Amoxicillin+clavulanic acid for Otitis media

A

Cefuroxime, Cefaclor, Macrolides

23
Q

Bronchitis treatment regimen

A

Treatment: largely symptomatic
• Consider antimicrobials if:
• Pertussis (whooping cough)
Use a macrolide

24
Q

Anti-influenza drugs

A

Adamantane derivatives:
Amantadine

Neuraminidase inhibitors:
Oseltamivir: Prodrug given orally
Zanamivir (inhalation)

25
Q

Amantadine MOA:

A

Block the M2 proton ion channel of the virus particle and inhibit uncoating of the viral RNA (influenza A) thus preventing their replication

26
Q

Neuraminidase inhibitors MOA:

A

Inhibit neuraminidase, thereby prevent the release of new virions and their spread from cell to cell

27
Q

ADRs of NA inhibitors

A

GI discomfort and nausea (oseltamivir)

Cough and bronchospasm (zanamivir)

Caution: Asthma & COPD (zanamivir)

28
Q

Pneumonia: Treatment

A

CAP:
Uncomplicated:
• Benzylpenicillin or amoxicillin
• Macrolides (azithromycin) if patient allergic to penicillins

Severe:
▪ Cefuroxime or cefotaxime + azithromycin
▪ Vancomycin, Linezolid or Ceftaroline (if MRSA suspected)

❑ Atypical pneumonia:

Macrolide or tetracycline (doxycycline)
29
Q

HAP Pneumonia: Treatment

A

Pseudomonas: Ceftazidime + Fluoroquinolone, Imipenem

MRSA: Vancomycin, Linezolid, Ceftaroline

Aspiration pneumonia:
Beta-lactam/beta-lactamase inhibitor or clindamycin or metronidazol plus amoxicillin.

30
Q

COVID-19: Specific Therapy

A

Low-dose dexamethasone

Remdesivir:
Nucleotide analogue that inhibits viral RNA polymerases Must be given within 7 days of when symptoms start
Used for severe COVID-19

31
Q

ANTI TUSSIVES Drugs

A

(opioids): Centrally acting
Codeine
Pholcodeine

Dextrometharphan:
• Centrally acting NMDA receptor antagonist.

Benzonatate
- Local anesthetic
-Acts by anesthetizing the stretch receptors in the respiratory passages, lungs, & pleura ↓ cough reflex

32
Q

MUCOLYTICS drugs

A

ACETYLCYSTEINE:
• viscosity of mucus and sputum by cleaving disulfide
bonds of mucoproteins
Uses: Cystic fibrosis & chronic bronchitis

BROMOHEXINE:
• Depolymerises mucopolysaccharides of mucus &
lysosomal activity that breaks fibre-network of tenacious
sputum

AMBROXOL – (derivative of bromohexine)

DORNASE – alfa:
• Depolymerizes DNA of purulent airways secretions &
the viscosity of sputum.
• Given by nebulization.

33
Q

Expectorants drugs:

A

GUAIFENESIN
Stimulates gastric mucosa (vagal receptors) which
initiate the reflex secretions of respiratory tract fluid.

Respiratory system (7 decks)

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