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MOD (year 3) > Therapeutics > Flashcards

Therapeutics Flashcards

1
Q

what are common groups of antimicrobials used in equine medicine?

A 
beta-lactams
cephalosporins
aminoglycosides
chloramphenicol
potentiated sulphonamides
tetracyclines
fluroquinolones
macrolides
rifampin
metronidazoles
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2
Q

why are beta-lactams commonly used?

A

safety, efficacy and low cost

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3
Q

what is the mechanism of action of beta-lactams?

A

interfere with bacterial cell wall production causing cell lysis

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4
Q

what are the indications for beta-lactams?

A

gram positive bacteria
Streptococcal infections (horses)
most anaerobic infections

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5
Q

what indication do beta-lactams have limited efficacy in?

A

abcesses

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6
Q

what drugs do beta-lactams have a synergistic effect with?

A

aminoglycosides

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7
Q

what drugs do beta-lactams have an additive effect with?

A

fluoroquinolone

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8
Q

what is the main way beta-lactams are eliminated from the body?

A

via kidney

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9
Q

what are the two types of beta-lactam penicillins?

A

Na and K (IV)

procaine (IM)

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10
Q

what are the adverse effects of beta-lactams?

A

anaphylaxis (type I hypersensitivity)
haemolytic anaemia
thrombocytopenia

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11
Q

what is the mechanism of action of cephalosporins?

A

interfere with bacterial cell wall production causing lysis (more resistant to bacterial defences than beta-lactams)

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12
Q

how and where are cephalosporins excreted?

A

unchanged in urine

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13
Q

what are the adverse effects of cephalosporins?

A

anaphylaxis (type I hypersensitivity)
haemolytic anaemia
thrombocytopenia

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14
Q

why should cephalosporins never be used as a first line drug?

A

they are critically protected

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15
Q

what is the mechanism of action of aminoglycosides?

A

penetrate bacteria and bind to 30S ribosomal subunit leading to misreading of genetic codes

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16
Q

do aminoglycosides work best in gram positive or negative bacteria?

A

negative - only these have the ability to get the drugs inside of them

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17
Q

are aminoglycosides bacteriocidal or bacteriostatic?

A

bacteriocidal

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18
Q

how are aminoglycosides removed from the body?

A

glomerular filtration (kidneys)

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19
Q

what are the adverse effects of aminoglycosides?

A

nephrotoxicity
endotoxaemia
ototoxicity
neuromuscular blockade

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20
Q

what is the mechanism of action of chloramphenicol?

A

binds to 50S ribosomal subunit to inhibit protein synthesis

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21
Q

is chloramphenicol bacteriostatic or bacteriocidal?

A

bacteriostatic

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22
Q

what animal can chloramphenicol not be used in?

A

food producing animals

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23
Q

where are chloramphenicols metabolised and excreted?

A

metabolised in liver

excreted renally

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24
Q

why are chloramphenicols not commonly used?

A

painful IM injection

expensive

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25
Q

what drugs should chloramphenicol not be used with? and why?

A

penicillin, aminoglycosides, fluoroquinolnes, macrocodes

shouldn’t mix bacteriostatic and bacteriocidal drugs

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26
Q

what is the mechanism of action of potentiated sulphonamides?

A

inhibit folic acid pathway to block bacterial nucleic acid synthesis

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27
Q

why are potentiated sulphonamides very safe to use in mammals?

A

mammals don’t create their own folic acid so will have no effect

28
Q

when are potentiated sulphonamides ineffective?

A

anaerobes

in pus and necrotic tissue

29
Q

where are potentiated sulphonamides metabolised and excreted?

A

liver metabolism

renal excretion

30
Q

what are the adverse effects of potentiated sulphonamides?

A

agranulocytosis, anaemia, thrombocytopenia
diarrhoea
crystalluria

31
Q

what is the mechanism of action of tetracyclines?

A

binds to 30S ribosomal subunit to inhibit protein synthesis

32
Q

is tetracycline bacteriocidal or bacteriostatic?

A

bacteriostatic

33
Q

why are tetracycline very safe to use in mammalian species?

A

mammalian cells cannot transport the drug into themselves

34
Q

what are the indication of tetracycline use?

A

broad spectrum gram positive and negative

contracted tendon in foals

35
Q

how and where are tetracyclines excreted?

A

unchanged in urine and bile

36
Q

what property of tetracyclines means they penetrate cells very well?

A

very lipid soluble

37
Q

what are the adverse effects of tetracyclines?

A

fatal colitis
diarrhoea
teeth discolouration
collapse/death if given rapidly IV

38
Q

what is the mechanism of action of fluoroquinolones?

A

inhibits bacterial DNA gyrase leading to incomplete configuration of DNA

39
Q

are fluoroquinolone bacteriocidal or bacteriostatic?

A

bacteriocidal

40
Q

what are the indication of fluoroquinolone use?

A 
broad spectrum (better against gram negative)
very effective against gram negative enteric bacteria
41
Q

how and where are fluroquinolones excreted?

A

unchanged in the urine

42
Q

what are the adverse effects of fluoroquinolone?

A

cartilage lesions (foals)

43
Q

what types of drugs do fluoroquinolone antagonise?

A

antimicrobials that inhibit bacterial protein synthesis (chloramphenicol, rifampin)

44
Q

why should fluoroquinolone never be first line drugs?

A

they are critically protected

45
Q

what is the mechanism of action of macrolides?

A

binds to 50S ribosomal subunit to inhibit protein synthesis

46
Q

are macrolides bacteriostatic or bacteriocidal?

A

bacteriostatic

47
Q

when should macrolides never be used?

A

adult horses - diarrhoea and death

48
Q

when is the only time macrolides are used in equine medicine?

A

foals with Rhodococcus equi

49
Q

what is the mechanism of action of rifampin?

A

inhibit bacterial RNA polymerase leading to decrease RNA synthesis

50
Q

what are the main indications of rifampin use in horses?

A

staphylococcus
rhodococcus equi
mycobacteria

51
Q

where is rifampin excreted?

A

in the bile

52
Q

what is the main adverse effect of rifampin?

A

stains everything red - urine, tears, faeces, saliva

53
Q

what is the mechanism of action of metronidazole?

A

anaerobic bacteria take it up and break it into small free radicals leading to DNA damage

54
Q

what are the adverse effects of metronidazole?

A

mutagenic
neurotoxicity
depression
decreased appetite

55
Q

what does therapeutics rely upon?

A

a correct diagnosis (better diagnosis means better treatment)

56
Q

why do turkeys have a higher amount of antibiotic usage than other poultry?

A

grown in high concentrations with high risk so are treated if there is any doubt

57
Q

what are the categories for the new EU antibiotic classification?

A

A - human critically important (not used in food producing animals)
B - critically important in food producing animals
C - may lead to resistance in category A/B so use cautiously
D

58
Q

what is the sequence for the cascade for a non-food producing animal?

A

veterinary medicine authorised for use in another species or for different condition in same species
medicine authorised for human us in UK or product authorised in another state
medicine made up at the time on a one-off basis

59
Q

what are the rules that apply to the cascade for food producing animals?

A

restricted use to a single holding
medicine imported must be authorised for food-producing species on other states
active substance must be in Table 1 (regarding maximum residue limits (MRLs))
vet must specify appropriate withdrawal period

60
Q

what are some points that must be evaluated for prescribing therapeutics?

A 
define what it wrong with the animal
identify the targets for therapy
critically evaluate the information
what therapies are available and how does it work
alternatives to therapy
cost of treatment
what are the risks
how is it administered
61
Q

what are some alternative to prescribing therapeutics?

A

euthanasia

surgery

62
Q

what are some ways antibiotics work?

A

disrupt cell wall production
DNA action inhibitors
protein synthesis inhibitors
effect cell membrane function

63
Q

what are some examples of antibiotics that disrupt cell wall production?

A

beta lactams
penicillins
cephalosporins

64
Q

what are some examples of antibiotics that inhibit DNA action?

A

potentiated sulphonamide

fluroroquinolones

65
Q

what are some examples of antibiotics that inhibit protein synthesis?

A

tetracyclines
macrolides
florphenicol
streptomycin

66
Q

what is an example of an antibiotic that effects cell membrane function?

A

monensin

MOD (year 3) (45 decks)

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