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Pharmacology > Topical Antibacterial Agents > Flashcards

Topical Antibacterial Agents Flashcards

1
Q

Bacitracin MoA

A

Inhibits phospholipid receptors involved in peptidoglycan synthesis

Complexes with the carrier protein C55- prenol pyro phosphate which is involved in cell wall synthesis

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2
Q

T/F

Bacitracin has good gram negative coverage

A

False
Minimal G-
Not active against pseudomonas , Nocardia, enterobacteriaceae, candida or cryptococcus

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3
Q

T/F

Bacitracin is minimally effective at eliminating nasal carriage of S. Aureus

A

True

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4
Q

T/F

Bacitracin is a frequent allergen in patients with chronic stasis derm or keratoconjunctivitis

A

True

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5
Q

T/F

Anaphylaxis to bacitracin is possible with application to an ulcer bed

A

True

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6
Q

Polymyxin B

MoA

A

Increases permeability of bacterial cell membrane , interacts with phospholipid components of membrane (detergent like mechanisms)!

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7
Q

T/F

Polymyxin B is effective against fungi and gram positive organisms

A

False

Ineffective

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8
Q

T/F

Bacitracin often co-reacts with neomycin such that patch testing to both may uncover neomycin allergy

A

T

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9
Q

T/F

Bacitracin is bactericidal against G+ and Neisseria species

A

True

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10
Q

Which organisms are Polymyxin B useful for treating ?

A

Gram negative Bacteria only

Effective against P.aeruginosa

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11
Q

How does Polymyxin B work ?

A

Increased the permeability of bacteria cell wall membrane

Occurs by interacting with phospholipid components of membrane

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12
Q

Neomycin MoA

A

Bactericidal
Inhibits protein synthesis
Occurs by binding to 30S subunit of ribosomal RNA

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13
Q

What bacteria does neomycin cover

A 
Bactericidal - most of clinically important G-
Some G+ including 
S. Aureus 
Proteus
H influenzae
E. coli
Klebsiella
Serratia

SPHECKS

Doesn’t cover p.aeruginosa or anaerobes (eg bacteroides)

Only weak activity against strep

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14
Q

Neomycin adverse effects

A

Like aminoglycosides, ototoxicity and nephrotoxicity

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15
Q

Mupirocin MoA

A

Bactericidal

Hinders bacterial RNA, protein and cell wall synthesis .

Inhibits bacterial isoleucyl t- RNA synthetase

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16
Q

Mupirocin antibacterial coverage

A 
S aureus
S epidermidis
S pyogenes
B-haemolytic strep
MRSA

NOT EFFECTIVE AGAINST ANAEROBES, FUNGI OR NORMAL SKIN

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17
Q

T/F

Mupirocin ointment is equivalent to oral erythromycin in the treatment of impetigo

A

T

18
Q

Retapamulin MoA

A

Bacteriostatic
Inhibits protein synthesis via three mech
- binds to protein L3 on the 50s ribosomal subunit
- inhibiting ribosomal peptidyltransferase
- preventing translation initiation by blocking interaction of fmet-tRNA to p site of ribosome

19
Q

Retapamulin coverage

A

S pyogenes
Mupirocin resistant
MRSA
ANAEROBES

SpAMM

20
Q

Gentamicin topical MOA

A

Bactericidal

Inhibits protein synthesis by IRREVERSIBLE binding to 30S ribosomal subunits

21
Q

Gentamicin coverage

A

Some G+
Eg . s aureus

and -

Eg . E. coli
Proteus
P auruginosa

22
Q

Silver sulfadiazine MoA and coverage

A

Binds to bacterial DNA and inh replication

Gram + and - including p aeruginosa and MRSA

Most frequent use is in burns

23
Q

Iodoquinol

Coverage

A 
Mechanism unknown 
Broad spectrum 
Eg. P. Acnes
P. Auruginosa 
Corynebacterium 
MRSA
Dermatophytes and yeasts

PaPaCMDY

24
Q

Bacitracin is a polypeptide antibacterial agent produced by the Tracey I strain of bacillus subtilis

A

T

25
Q

What organisms is bacitracin active against ?

A 
Minimal gram negative cover
Effective against 
S. Aureus,
S. Pneumoniae 
Neisseria
H. Influenzae
Treponema pallidum
Actinomyces
Fusobacterium

SapHATFuN

26
Q

When complexed with zinc , bacitracin becomes more water soluble and shelf life diminishes

A

False

Less water soluble and shelf life increases from 2-5 years

27
Q

Bacitracin can be combined with polymyxin B and possibly neomycin to provide a wider spectrum of bacterial coverage

A

T

28
Q

Bacitracin in combo with cetrimide or polymyxin B significantly reduces S aureus in wounds

A

T

29
Q

Bacitracin is minimally effective at eradicating nasal staph

A

T

30
Q

No systemic absorption of bacitracin occurs after bladder irrigation

A

T

31
Q

Neomycin is produced by strotomyces fradiae

A

T

32
Q

Neomycin may inhibit bacterial DNA polymerase

A

T

33
Q

Neomycin resistance has been reported in gram Neg and pos - therefore almost always used in combo

A

T
Bacitracin typically added for gram positive coverage
Polymyxin B added for pseudomonas coverage

34
Q

Neomycin is the most common cause of post op ACD and should be avoided

A

T

35
Q

Contact allergy to neomycin in patients with Rosacea is uncommon

A

T

36
Q

Mupirocin is formerly known as pseudomonic acid

A

T

37
Q

Mupirocin is a major metabolite of P. Fluorescens

A

T

38
Q

How protein bound is mupurocin?

A

95%

Therefore may be less effective on weeping wounds

39
Q

Iodoquinol is a halogenated quinolone derivative

A

T

40
Q

Sodium sulfacetamide inhibits bacterial dihydropteroate synthetase , preventing conversion of PABA to folic acid
(Same mechanism as dapsone)

A

T

41
Q

Mupurocin cross reacts with gentamicin and neomycin.

A

F

Unique structure so does not cross react

42
Q

Metronidazole enhances cell mediated immunity

A

F

Suppresses

Pharmacology (63 decks)

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