Term
| Which aspects of modern medicine are made practical by antimicrobials? |
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Definition
| cancer chemotherapy, gut surgery |
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Term
| Asian fish, shrimp, and shellfish test repeatedly positive for... |
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Definition
| nitrofuran, malachite green, flouroquinolones |
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Term
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Definition
| new delhi metallo-lactimase 1 found in E coli and klebsiella pneumonia; confers resistance to antibiotics |
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Term
| Name the beta lactam drugs. |
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Definition
| penicllins, cephalosporins, carbapenems |
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Term
| Name the nonbeta lactam antibiotics that are inhibitors of cell wall synthesis? |
|
Definition
| cecloserine, vancomycin, bacitracin |
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Term
| Which antimicrobials work by disrupting cell membranes? |
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Definition
|
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Term
| What antibiotics are reversible inhibitors of protein synthesis (bacteristatic)? |
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Definition
| chloramphenicol, tetracyclines, macrolides (erythromycin), clindamycin, linezolid |
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Term
| What antibiotics are irreversible inhibitors or protein synthesis? |
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Definition
| the bacteriocidal aminoglycosides |
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Term
| ____ concentrations are what determine susceptibility of resistance to drug. |
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Definition
| achievable serum concentrations |
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Term
| What are some pharmacokinetic considerations that must be taken into account when treating an infection? |
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Definition
| location of infection (some antibiotics may or may not reach therapeutic concentrations in certain bodily fluids), and the degree to which antibiotic binds serum proteins (excessive binding can affect passive diffusion from serum to tissue) |
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Term
| Sulfonamides are analogues of... |
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Definition
|
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Term
| What is the MOA of sulfonamides? |
|
Definition
| competitive inhibitors of dihydropteroate synthase--needed for folic acid synthesis |
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Term
| Are sulfonamides bactericidal? |
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Definition
|
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Term
| What is the mech of resistance for sulfonamides? |
|
Definition
| altered affinity of enzyme for drug, decreased permeability or active efflux, new pathway of folic acid syntehsis |
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Term
| Are sulfonamides easily absorbed from teh GI tract? |
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Definition
|
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Term
| What is the distribution pattern of sulfonamides in the body? |
|
Definition
| binds variably to serum albumin, wide tissue distribution, including trans-placentally |
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Term
| What is the metabolism and excretion of sulfonamides? |
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Definition
| variably inactivated in liver by acetylation and then excreted in urine |
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Term
| At what pH are sulfonamides at risk for precipitating out of the urine? |
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Definition
|
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Term
| Name some rapidly abosrbed and eliminated sulfonamides. |
|
Definition
| sulfisoxazole, sulfamethoxazole, sulfadiazine |
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|
Term
|
Definition
| sulfamethoxazole combined with trimethoprim |
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|
Term
|
Definition
| sulfamethoxazole combined with trimethoprim |
|
|
Term
| What are the pharmacokinetics of rapidly absorbed and eliminated sulfonamides? |
|
Definition
| binds extensively to plasma proteins and are highly concentrated in the urine (cidal) |
|
|
Term
| Name a poorly absorbed sulfonamide. |
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Definition
|
|
Term
| What is sulfasalazine used for? |
|
Definition
| poorly absorbed in the GI tract so used to treat ulcerative colitis and irritable bowel syndrome |
|
|
Term
| How is sulfasalazine metabolized? |
|
Definition
| by gut flora into 2 compounds: 1 toxic, 1 therapeutic (5-aminosalicylate) |
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|
Term
| Which sulfonamide has good penetration int he eye? |
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Definition
|
|
Term
| Which sulfonamide is used for prevention and treatment of burn wound infections? |
|
Definition
| silver sulfadiazine; mafenide is used for prevention of burn wound infections |
|
|
Term
| Name a long acting sulfonamide. |
|
Definition
|
|
Term
| What is the half life of sulfadoxine? |
|
Definition
|
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Term
| What is the use of sulfadoxine? |
|
Definition
| combined with pyrimethamine to treat malaria |
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|
Term
| What are the therapuetic uses of sulfonamides? |
|
Definition
| urinary tract infections, nocardiosis, toxoplasmosis (avoid using in pregnant women) |
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Term
| How do you prevent sulfonamides from forming crystals? |
|
Definition
| alkalize urine or increae hydration |
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Term
| What are the toxicities of sulfonamides? |
|
Definition
| acute hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency, agranulocytosis, aplastic anemia, hypersensitivity reactions, nausea, anorexia, vomiting, kernicterus |
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|
Term
| What are the different types of hypersensitivity reactions associated with sulfonamides? |
|
Definition
| skin and mucous membrane manifestations, serum sickness, focal or diffuse necrosis of the liver |
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|
Term
| What are the very common side effects of sulfonamides? |
|
Definition
| nausea, anorexia, vomiting |
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|
Term
| In what patient populations are sulfa drugs contraindicated? |
|
Definition
| those with G-6PD deficiency or pregnant or lactating women |
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Term
| Why should sulfa drugs enver be given to a pregnant or lactating woman? |
|
Definition
| causes displacemnt of bilirubin from plasma albumin to brain resulting in encphalopathy |
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|
Term
| Sulfonamides cause potentiation of which drugs |
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Definition
| oral coagulants, sulfonylureas, and hydrantoin anticonvulsants |
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|
Term
| What compounds are all quinolones dervied from? |
|
Definition
|
|
Term
| What is the MOA of quinolones? |
|
Definition
| targets DNA gyrase (G-) and topoisomerase IV (G+) |
|
|
Term
| What causes resistance against quinolones? |
|
Definition
| resistance due to efflux and mutations in targets |
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|
Term
| What are the first generation flouroquinolones? |
|
Definition
| nalidixic acid, cinoxacin, oxolinic acid |
|
|
Term
| What arethe second generation flouroquinolones? |
|
Definition
| ciprofloxacin, enoxacin, lomefloxacin, ofloxacin |
|
|
Term
| What are the favorable pharmacological attributes of quinolones? |
|
Definition
| quickly absorbed from GI, even with a full stomach, excellent bioavailability in a wide range of tissues and body fluids (including inside cells) |
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|
Term
| How are quinolones excreted? |
|
Definition
| mostly by the kidneys; exceptions are perfloxacin and moxifloxacin which are metabolized by the liver |
|
|
Term
| Which quinolones are excreted in breast milk? |
|
Definition
| ciprofloxacin, ofloxacin, perfloxaci |
|
|
Term
| What are the therapeutic uses of quinolones? |
|
Definition
| UTIs, prostatitis, STDs (chalmydia, chancroid), GI and abdominal (travelers diarrhea, shigellosis, typhoid fever), respiratory tract (all work well against atypicals, new agents for strep pneumo); bone/joint/soft tissue, ideal for osteomyelitis, good against polymicrobial infections like diabetic foot ulcers, cipro for anthrax and tularemia, in combo for mycobacterium |
|
|
Term
| Quinolones are good for chronic osteomyelitis but resistance is developing in.... |
|
Definition
| S. aureus, Paeuroginosa, and S. marcesens |
|
|
Term
| What are the GI side effects of quinolones? |
|
Definition
| nausea, vomiting, abdominal discomfort, diarrhea and antibiotic associated colitis |
|
|
Term
| What are the CNS side effects of quinolones? |
|
Definition
| mild headache and dizziness, hallucinations, delirium, and seizures |
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|
Term
| What are the risks of giving quinolones to children? |
|
Definition
|
|
Term
| T/F Quinolones can cause arrhythmias. |
|
Definition
|
|
Term
| What toxic side effects do quinolones have on the blood? |
|
Definition
| leukopenia and eosinophilia |
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