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
Chloramphenicol
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
Clindamycin
Activity: mainly gram positive and anaerobic activity AE: Diarrhea, nausea
27
Linezolid
Activity: mainly works against serious gram positive cocci infections (skin and soft tissue and respiratory) AE: nausea, diarrhea, blood dyscrasias
28
Bacterial DNA/RNA Synthesis Inhibitors
inhibit bacterial DNA and RNA and arrest growth and reproduction
29
Fluoroquinolones
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
Sulfonamides
Activity: broad activity against gram positive and negative organisms MOA: disrupts folic acid production UTI, topical skin infections, burns (sulfadiazine, silver nitrate)
31
Trimethoprim
MOA: Used with sulfonamide for UTI (can’t be used by itself) Activity: specifically block folate pathway in bacterial cells
32
Dapsone
Activity: combined with rifampin for leprosy AE: causes hypersensitivity rxn
33
Metronidazole
Activity: excellent for anaerobic infections; used for C. Diff AE: causes neuropathies, GI distress, reactions with alcohol
34
Ethambutol
Activity: for tuberculosis AE: causes visual disturbances
35
Rifampin
Activity: for tuberculosis and leprosy AE: causes red secretions (pee, cry red)
36
Mupirocin
Activity: commonly used topical antibiotic for skin infections AE: may cause skin irritations
37
Isoniazid
MOA: not fully understood; may possibly interfere with macronutrient metabolism in bacteria Activity: primary tuberculosis drug AE: peripheral neuropathy most common side effect
38
Nitrofurantoin
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
Selection of an Antibiotic depends on
``` Organism Location and type of infection Patient factors (age, organ function, allergies) Prior drug exposure (resistance) Culture sensitivity Medication formulary ```
40
What are the 4 Bacterial resistance mechanisms
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)