Anti-infective Agents - Module 3

Question 1

common infectious diseases

Answer 1

Aid
chiken Pox
Cholera
Leprosy
Mad Cow disease
Measles
Polio
Pneumonia

Question 2

uncommon infectious diseases

Answer 2

Anthrax
Lockjaw
Rabies
Runny nose
SARS
Stomach Ulcers
Diarrhea
Ebola

Question 3

3 Anti-infective Agents

Answer 3

• Antibacterials (Antibiotics - treat bacterial infections
• Antivirals - use in viral infections
• Antifungal agent - use for fungi

Question 4

Antibiosis meaning

Answer 4

against life

drug that kill or inhibit the growth of bacteria

Question 5

All organisms are split into 5 kg

Answer 5

1. Animal kingdom - organisms that usually move around and find their own food
2. Plant kingdom - organisms that make their own food and do not actively move around
3. Fungi kingdom - organisms that absorb food from living and non-living things
4. Protist Kingdom - organisms that have single, complex cells
5. Moneran kingdom - organisms that have single, simple cell

Question 6

Salvarsan

Ehrlich - from Germany

Answer 6

• • the organic arsenic compound. first modern antibacterial drug - 1910
• drug for treating syphilis until penicillin became available in the 1940.

Question 7

Sulfanilamide(Prontosil)

Gerhard Domagk - from Germany

Answer 7

Sulfa antibiotics
the sulfa drugs that have anitbacterial properties work by interfering with “folic acid synthesis” - thereby inhibiting the growth of some bacteria.

Question 8

Penicillin

Answer 8

The antibacterial properties of the common bread mold

• discovered in 1928 by Alexander Flemming - USA and Scottish biologist.
• used for the allies in WWII 1942

Question 9

Penicillins are

Answer 9

“bactericidal” meaning they kill bacteria by interfering with cell wall synthesis

• they all share a common ring structure (the beta lactam ring)
• work best on “gram-positive” bacteria

Question 10

Gram-Positive

Answer 10

• Thick cell wall more peptidoglycan
• Teichoic acid
• bluish purple color of crystal violet
• Penicillins work well with gram-positive

Question 11

Gram-negative

Answer 11

• Thinner layer of peptidoglycan cell wall
• High lipoprotein - lipopolysaccharides LPS
• gram-negative cells are resistant to penicillin attack.

Question 12

Gram-positive and Gram-negative

Answer 12

both have a cell wall made up of a sugar called peptidoglycan and a fat-based phospholipid membrance bilayer with membrane-spanning proteins to hold it all together.

Question 13

Mechanism of Action (MOA) for penicillin type drugs

Answer 13

is to inhibit cell wall synthesis

Beta-lactam antibacterials inhibit the synthesis of components of the cell wall

Question 14

Antimicrobial Activity

Answer 14

1. the drug must reach the site of infection
2. must be able to penetrate the cell
3. Reach the target and kill the organism…and not kill the host

Question 15

Sulfonamide antibacterials

Answer 15

work by inhibiting Folic Acid (FA) synthesis. Bacteria need to make their own FA, humans ingest it
***inhibiting the growth of some bacteria

Question 16

Sulfonamide Antibioltics

Answer 16

the first named sulfa drug, Prontosil, is a prodrug: it is converted in the body to sulfanilamide

Question 17

Modern examples of sulfa antibiotiecs

Answer 17

• Sulfadiazine is one of the ingredients in silver sulfadiazine cream, which is extensively used tor burns
• Sulfamethoxazole is one of two ingredients in the combination antibacterial drug Septra

Question 18

Sulfa allergies

Answer 18

are common, cause hypersensitivity reations

Question 19

Sulfates and Sulfites

Answer 19

are chemically unrelated to the sulfonamide group, and do not cause the same hypersensitivity reactions seen in the sulfonamides.

Question 20

Antibiotic (ABX) Resistance

Answer 20

Over use of Abx and indiscriminate use in animals has led to a serious problem world wide.

ABX resistant infections cause illnesses and deaths in the USA more than drug overdoses, car accidents, or fire arm assaults

Question 21

Mechanisms of Resistance - 4 main types

Answer 21

1. Decreased Permeability - ex. Pseudomonas
2. antibiotic Efflux Pump - ex. S. pneumoniae vs quinolones, macrolides
3. Drug Inactivation - ex. Beta-lactamase from H. influenzae, Staph, E. Coli, Klebsiella
4. Altered Target Site
   ex. S. pneumoniae (altered PBPS), S. pneumonia vs macrolides (ribosomal methylase), S. pneumoniae vs quinolones (GyrA, Topo $)

Question 22

Penicillin Rash

Answer 22

Occasionally penicillin type drugs can case a rash but not the allergic dangerous rash. RED WELT that looks like hives

Question 23

Penicillin Allergy

Answer 23

Confirm by doing skin testing

The raised RED rash of hives - penicillin that produces these types of reactions should be taken seriously.

Question 24

The Penicillins

Answer 24

are “bactericidal”, meaning they kill bacteria by interfering with cell wall synthesis.
* they all share a common righ structure (the beta-lactam ring)

Question 25

Beta-lactam antibacterials

Answer 25

inhibit the synthesis of components of the cell wall - inhibiting folate synthesis

Question 26

Traditional antibiotic function by

Answer 26

inhibiting DNA or RNA synthesis

Question 27

Fluoroquinolones

Answer 27

are "broad spectrum" drugs that interfere with the synthesis of bacteria DNA

Question 28

aminoglycoside antibacterilas work | MOA

Answer 28

by inhibiting bacterial protein systhesis

Question 29

sulfa drugs or depolarizing membrane

Answer 29

potential (daptomycin)

Question 30

Methicillin resistant Staphylococcus aureus (MRSA)

Answer 30

is a major problem around the world, causing hospital-acquired infections and more recently, infections in the coomunity

Question 31

The glycopeptides, particularly vancomycin

Answer 31

have been the mainstays of therapy for MRSA

Question 32

Penicillin V

Answer 32

was developed that was stable in acid and could be taken orally. **first broad spectrum penicillins

Question 33

Ampicillin and Amoxicillin

Answer 33

later became available for the broad spectrum penicillins

Question 34

Broad spectrum penicillins

Answer 34

including those of the 3rd and 4th generation are call broad spectrum. Pnicillin V, Ampicillin, Amoxicillin, and Ticarcillin

Question 35

Penicillin G (Bicillin)

Answer 35

I.M, I.V

Question 36

Penicillin V or "pen-vee"

Answer 36

oral

Question 37

Ticarcillin

Answer 37

is one of the newer 3rd - 4th generation drugs

Question 38

Aminoglycosides

Answer 38

were discovered next (1943) from studying species of soil bacteria that secrete chemicals that kill other bacteria

Question 39

Aminoglycosides administered

Answer 39

most of them have to be administered parenterally (or topically) - usually in the hospital with monitoring of blood levels (due to kidney and hearing toxicities)

Question 40

Streptomycin or gentamicin

Answer 40

the first drug discovered in this class of Aminoglycosides

Question 41

Aminoglycoside mechanism of action

Answer 41

work by inhibiting bacterial protein synthesis

Question 42

Beta- lactam (penicillin-like)

Answer 42

Cephalosporins - drug developed later on in 1949. * secretion from a mold that inhibited nearby bacteria * have a beta-lactam ring like penicillins that interferes with bacterial cell wall synthesis

Question 43

the fungus Cephalosporium

Answer 43

was first discovered in a sewer outlet in Sardinia (off the coast of Italy - this is were the first generation cephalosprorins came from

Question 44

Sulfonamide group

Answer 44

* Antidiabetec properties ( Chlorpropamide, Diabinese and glipizide * * Diuretics - thiazide and loop diuretics

Question 45

Tetracyclines MOA

Answer 45

ANTIBACTERIALS INHIBIT BACTERIAL PROTEIN sysnthesis. **used to be used to treat the STI gonorrhea and syphilis.

Question 46

Generic Tetracyclines cause

Answer 46

has a strong affinity of Ca++ and it can cause staining of the teeth in young children.

Question 47

Fluoroquinolones MOA

Answer 47

Inhibit DNA/RNA synthesis directly

Question 48

Fluoroquinolones - black fox warning by FDA

Answer 48

pt on fluoroquinolone antibiotics are at risk of tendinitis and tendon rupture.

Question 49

Fluoroquinolones Adverse Effects

Answer 49

Tendon rupture | Children

Question 50

Macrolides

Answer 50

are the erythromycin-like" drugs. broad spectrum ABX that interfere with bacterial protein systhesis * can be used in people who are allergic to penicillins

Question 51

Macrolides and Ketolide MOA

Answer 51

antibacterials work by inhibiting bacterial protein sysnthesis

Question 52

Narrow-spectrum

Answer 52

* it only owrked against either gram + or gram - organisms. Ex. Penicillin first came out like the sulfonamides. Aminoglycosides like streptomycin, Glycopeptides like vancomycin

Question 53

Broad Spectrum

Answer 53

worked equally well against a variety of gram + and gram- | Ex. Tetracycline, Cephalosporins, Fluroquinolones, carbapenems and Monobactams