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Pharmacology > Pharmacology Chapter 33 > Flashcards

Pharmacology Chapter 33 Flashcards

1
Q

Antibacterial Drugs need what to work?

A

Selective toxicity

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2
Q

Selective Toxicity

A

selective killing of the invading organism without damaging the host

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3
Q

Why do bacteria invade human tissue?

A

To replicate they must have a supply of amino acids, sugars, and other substances

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4
Q

Factors of bacterial infection that are harmful

A

The replicating bacteria compete with the host for essential nutrients
Release of toxins within the host
Signal immune response

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5
Q

In what types of patients are bacterial most severe?

A

immunocompromised patient or those that are debilitated (ex. AIDS, cancer, transplant patients)

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6
Q

Factors that affect the utilization of antibiotics

A

Spectrum
Patient Tolerance
Bacterial Resistance
Provider preference

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7
Q

Cidal vs. Static

A

Cidal- kills or destroys bacteria

Static- halts the progression and allows the body to kill

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8
Q

Mechanism of action: (all in this case have a greater affinity for bacterial components than mammalian or human cellular components)

A
  1. Inhibition of cell was synthesis and function
  2. Inhibition of bacterial protein synthesis
  3. Inhibition of bacterial DNA/RNA
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9
Q

Cell Wall Synthesis Inhibitors

A

peptidoglycans makes the bacterial cell wall rigid. Drugs can reduce production of this, thus weaken the cell wall, causing loss of hyperosmotic pressure
bacterial hydrolysis “beta lactam antibiotics”

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10
Q

Most effective and important antibiotics currently available

A

Penicillins

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11
Q

Penicillins

A

semisynthetic (broader spectrum); penicillinase resistant (amoxicillin/Clavulanate)

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12
Q

Cephalosporins

A

1-4th generations- the > the # (generation) to more broad spectrum it becomes (can be used for those allergic to penicillins)

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13
Q

Polymixin: MOA & AE

A

MOA: Punch holes in the bacteria cell walls via attraction to negatively charges phospholipids in the bacterial cell wall. Like a detergent. (Ex: polymixin B in topical Neosporin creams)

AE: Nephrotoxic (highly kidney damaging) - thus never administered orally

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14
Q

Bacittracin

A

Activity: Mainly used for topical skin infections broad spectrum activity

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15
Q

Aztreonam

A

Activity: narrow spectrum; only covers gram negative organisms (Ex. Enterobacter and pseudomonas)

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16
Q

Carbapenems

A

broad spectrum antibiotics aka “big guns”; activity against gram positive, gram negative, and anaerobic bacteria; reserved for last line use; all administered IV

Three Kinds: Ertapenem, Imipenem, & Meropenem

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17
Q

Ertapenem

A

broad spectrum; great for intra-abdominal infections; no pseudomonas coverage

18
Q

Imipenem is given with what? and for what reason?

A

Given with Cilastatin to prevent breakdown in the kidney

19
Q

Vancomycin

A

“Big Gun” antibiotic for severe gram positive infections or in cases of penicillin allergic patients.

20
Q

Adverse Effects of Cell Wall Synthesis Inhibitors

A

Hypersensitivity, rash, itching, anaphylaxis, gastrointestinal problems (diarrhea, nausea)

21
Q

Bacterial Protein Synthesis Inhibitors

A

Bacterial Protein Synthesis Inhibitors: block bacteria from making life sustaining proteins via binding to bacterial ribosomes.

22
Q

Aminoglycosides

A

Activity: mainly target gram negative organisms but have some activity for gram positive and anaerobic bacteria; narrow therapeutic index
AE: Use is limited due to adverse effects: kidney toxicity and ototoxicity (ringing or fullness in ears), and dizziness

23
Q

Tetracycline

A

Activity: activity against gram positive, gram negative, and atypical bacteria (rickettsia, spirochetes (lyme disease), chlamydia)
Anti-inflammatory and immunomodulatory effects for use in acne and rheumatoid arthritis
AE: GI distress, hypersensitivity, skin rashes, photosensitivity, teeth discoloration in children; not used in pregnancy

24
Q

Macrolides

A

Broad spectrum activity against gram positive and gram negative organisms
Drugs of choice in respiratory infections
“cidal” at high doses
AE: gastrointestinal disorders (azithromycin < clarithromycin < erythromycin) and hypersensitivity reactions (rash, itching)

25
Q

Chloramphenicol

A

broad activity against both gram positive and gram negative organisms
Activity:Used last line for severe infections (haemophilus, osteomyelitis, rickettsial infections); only administered IV
AE: blood dyscrasias, thrombocytopenia, and aplastic anemia

26
Q

Clindamycin

A

Activity: mainly gram positive and anaerobic activity
AE: Diarrhea, nausea

27
Q

Linezolid

A

Activity: mainly works against serious gram positive cocci infections (skin and soft tissue and respiratory)
AE: nausea, diarrhea, blood dyscrasias

28
Q

Bacterial DNA/RNA Synthesis Inhibitors

A

inhibit bacterial DNA and RNA and arrest growth and reproduction

29
Q

Fluoroquinolones

A

Activity:broad spectrum activity against gram positive and gram negative organisms. Ideal for UTI respiratory, STIs, GI infections, anthrax, & osteomyelitits
AE: **causes tendon pain and inflammation; hold exercise until source of tendinopathy is determined (high risk in patients with kidney impairment, elderly patients, or concomitant steroid use)

30
Q

Sulfonamides

A

Activity: broad activity against gram positive and negative organisms
MOA: disrupts folic acid production
UTI, topical skin infections, burns (sulfadiazine, silver nitrate)

31
Q

Trimethoprim

A

MOA: Used with sulfonamide for UTI (can’t be used by itself)
Activity: specifically block folate pathway in bacterial cells

32
Q

Dapsone

A

Activity: combined with rifampin for leprosy
AE: causes hypersensitivity rxn

33
Q

Metronidazole

A

Activity: excellent for anaerobic infections; used for C. Diff
AE: causes neuropathies, GI distress, reactions with alcohol

34
Q

Ethambutol

A

Activity: for tuberculosis
AE: causes visual disturbances

35
Q

Rifampin

A

Activity: for tuberculosis and leprosy
AE: causes red secretions (pee, cry red)

36
Q

Mupirocin

A

Activity: commonly used topical antibiotic for skin infections
AE: may cause skin irritations

37
Q

Isoniazid

A

MOA: not fully understood; may possibly interfere with macronutrient metabolism in bacteria
Activity: primary tuberculosis drug
AE: peripheral neuropathy most common side effect

38
Q

Nitrofurantoin

A

MOA: produces toxic metabolite that destroys bacteria
Activity: commonly used for UTI; safe to use for those with sulfa allergies
AE: GI distress, headache numbness and fatigue

39
Q

Selection of an Antibiotic depends on

A 
Organism
Location and type of infection 
Patient factors (age, organ function, allergies)
Prior drug exposure (resistance)
Culture sensitivity 
Medication formulary
40
Q

What are the 4 Bacterial resistance mechanisms

A

Destruction of antibiotic by enzyme (ex. beta lactamases)
Modification of target receptors (ex. Mutation of penicillin binding protein target site)
Reduced cell penetration (aminoglycosides)
Drug efflux pumps (macrolide antibiotics)

Pharmacology (14 decks)

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