Anti Infectives Flashcards
(82 cards)
1
Q
_____ is a chemical substance originating from various species of microorganisms (bacteria, fungus, actinomyces) that suppresses growth or destroys other microorganisms. They are the safest, least toxic drugs used in medicine.
A
Antibiotics
2
Q
Gram ____ bacteria have thin peptidoglycan layer with LPS. They release pyretic, heat stable, mildly antigenic endotoxin upon lysis
A
negative
3
Q
Commonly indigenous flora thrive in a _____ perfused environement
A
poorly
4
Q
An ab can be bactericidal or bacteriostatic. Describe what each does
A
Bacteriocidal: kill target cells; cells may lyse or remain intact
Bacteriostatic: Prevent target cell replication
5
Q
When is GI flora reduced
A
people who have DM-2 and obesity
6
Q
What are the routes of delivery
A
locally; topical, contact lens and injection
7
Q
When should you use ophthalmic Ab’s
A
- Mucopurulent discharge
- Diffuse conjuntival infection
- Corneal compromise
8
Q
What is associated with gram - bacteria
A
- marked lid edema
- conjunctival chemosis
- purulent exudate are commonly associated with gram -
9
Q
A putrid infection is an ____ infection
A
anaerobic
10
Q
Which Ab’s are gram + and its site of action is the cell wall?
A
- Penicillins
- Cephalosporins
- Bacitracin
- Vancomycin
11
Q
Which Ab’s site of action is the cell membrane
A
Polymyxin B
Gramicidin
12
Q
Which Ab’s site of action is protein synthesis
A
- Aminoglycosides
- Tetracylines
- Macrolides
- Chloramphenicol
13
Q
What Ab site of action is cell metabolism
A
- Sulfanomides
- Trimethroprim
- Pyrimethamine
14
Q
Which Ab’s site of action is DNA synthesis
A
Fluoroquinolones
15
Q
Which are the broad spectrum Ab’s
A
- Tetracylines
- Chloramphenicol
- Sulfonamides
- Trimethroprim
- Pyrimethamine
16
Q
Which Ab’s are gram +
A
- Bacitracin
- Vancomycin
- Gramicidin
- Macrolides
17
Q
Which Ab’s are gram -
A
- Polymyxin B
18
Q
Which Ab’s have both types of gram sensitivity but more positive
A
- Penicillins
2. Cephalosporins
19
Q
Which Ab’s have both types of gram sensitivity but more negative
A
Aminoglycosides
Fluoroquinolones
20
Q
Which ab’s are pregnancy Category B
A
Tobramycin
Erthryomycin
Ezythromycin
21
Q
Which ab’s are bacteriocidal
A
Big ffing cap
- Penicillins
- Aminoglycosides
- Cephalosporins
- Bacitracin
- Fluoroquinolones
22
Q
Which ab’s are bacteriostatic
A
(TMSTC)
- Tetracylines
- Macrolides
- Sulfonamides
- Trimethroprim
- Chloramphenicol
23
Q
What are the types of staphylococcus bacteria
A
- Staph aureus: more virulent (MRSA); most coommon nosocomial infection
- Epidermis; more abundant (MRSE)
24
Q
What type of streptococcus bacteria causes corneal ulcer, or pediatric conjunctivitis
A
pneumoniae
25
Which gram + bacteria is an oral microflora that deals with post Lasik keratitis
Nocardia; asteroides
26
Which gram - bacteria causes pediatric otitis media and conjunctivitis
haemophilus influenzae
27
What enterics cause UTI, or corneal ulcer
1. E. coli
2. Serratia marcescens
3. Proteus
4. Psudomonas aeruginosa
28
Which enterics are water borne bacteria affecting ocular health
1. Serratia marcescens
| 2. Pseudomonas aeruginosa
29
Which bacteria is consider the 2nd most common nosocomial infection
psudomonas aeruginosa; seeks altered gut flora or a weakened immune system
30
Which gram negative bacteria cause gonorrhea
1. neisseria gonorrhea; corneal ulcer, hyperpurulent
31
What are host dependent bacteria that cause sexually transmitted eye infections
1. Chlamydia (finger/fomite to eye infection)
| 2. Syphilis
32
what is the most common infection leading to ocular blindness in the world
chlamydia
33
____ has 4 stages of infection
syphillis
34
What are the stand alone Ab's
1. bacitracin
| 2. Vancomycin
35
Penicillin are useful for treating gram ____ infection and ____ infections
+; anaerobic
36
Which antibiotics should you have on an empty stomach
penicillin and tetracycline
37
Which are Pcnase sensitive penicillins
1. Pen G (IV, IM)
| 2. Pen V
38
Which are Pcnase resistant
1. Methicillin
2. Flucloxacillin
3. Dicloxacillin
39
Which penicillins are amino penicillins
1. ampicillin
2. amoxicillin
- Oral drugs or administered via IV, not topical
40
_____ or ____ inhibit Pcnase and are therefore often combined with Pcnase sensitive formulas
Sulbactam; clavulonate
41
No topical formulas exist for ____since allergy is too high
Penicillin
42
What are the hypersensitivity reactions for type 1:
anaphylaxis
43
what are the hypersensitivity reactions for type 2
hemolytic anemia
44
what are the hypersensitivity reaction for type 3
serum sickness
45
what are the hypersensitivity reaction for type 4
stenvens johnson syndrome
46
there is a cross reactive with _____ especially the first generation
cephalosporins
47
Cephalosporins have a 6 membered beta lactam ring instead of 5, and in contrast to Pcn, these drugs are less susceptible to ____
Pcnase; harder to break down
48
____ gneration cephalosporins are cross reactive with penicillins
1st
49
Vitamin ____ deficiency can result from destruction of bacterial flora that play a role in vitamin ___ absorption
K; K
50
What are adverse reactions of cephalosporins
1. Blood dyscrasia: cytopenia
51
what is a contraindication of cephalasporin
hemophilia
52
What is available in a topical ointment only due to profound nephrotoxicity
Bacitracin
53
Which ointment is well suited for staphylococcus blepharitis
ak tracin ointment
54
Which IV is drug of choice for MRSA and MRSE
Vancomycin; poor oral absorption
55
What are adverse reactions of vancomycin
1. ototoxicity & nephrotoxicity
| 2. Red man syndrome; IV induced mast cell degranulation
56
Which Ab is a cationic detergent/ surfactant
Polymyxin B
57
Detergents are _____
bacteriocidal
58
Which Ab's are given orally
1. Penicillin
| 2. Cephalosprins
59
Which Ab's is given via IV
vancomycin
60
Which Ab is often found in combination products
Gramicidin
61
Which polytrim solutions used in combination are used for most common pediatric ocular infection
Polymyxin B and Trimethoprim
62
Which infections do polymyxin B and trimethoprim target
H influenzae and S pneumoniae and an excellent option for resistant S. epidermis & MRSA infections
63
Which polysporin ointments are used in combo together
Polymyxin B +bacitracin
64
What is the combination of Ab's used in neosporin solution or ointment
polymyxin B + neomycin + gramicidin
65
Which Ab's are protein synthesis inhibitors of the 30S ribosomal unit
Aminoglycosides + Tetracyclines
66
Which Ab;s are protein synthesis inhibitors of the 50S ribosomal unit
Macrolides + chlramphenicol
67
what is the oldest aminoglycoside that is used topically and is never stand alone. It is broad spectrum coverage except psudomonas
neomycin
68
what amino glycoside is used for severe infections and has low bacterial resistance due to limited systemic usage
gentamicin
69
This amino glycoside has similar use as gentamicin and is one of the few Ab;s with pregnancy rating B
Tobramycin
70
What are amino glycoside adverse reactions
1. SPK & delayed re epithelialization
2. Potential inactivation with PCN/ cephalasporins
3. Neurotoxicity; auditory/vestibular
4. Nephrotixicity: accumulation in renal cortex
5. Type IV delayed hypersensitivity rxn
* Neomycin: contact dermatitis risk
* Gentamycin: intracranial hypertension and corneal epithelial toxicity is most profound
71
Tetracylines have an ____ ____ benefit through inhibition of MMPs and bacterial lipases
anti inflammatory
72
what are the short acting tetracyclines
1. tetracyclines
| 2. oxytetracycline
73
what are the long acting tetracylines
1. doxycycline: meibomiantitis/meiboian gland stasis
- recurrent corneal erosions
- acne rosacea
- chlamydia
- syphillis
2. minocycline: acne, rosacea
74
What are tetracycline adverse reactions
1. photosensitivity
2. impaired absorption w food due to divalent cation binding
3. azotemia: elevated blood nitrogen compounds
4. blood dycrasias: hemolytic anemia, thrombocytopenia
5. Idiopathic intracranial hypertension
6. Fanconi's syndrome; renal toxicity from expired tetracyclines
7. impaired bone growth, tooth development
8. coumadin potentiation
9. breast cancer
75
what are distinct tetracycline adverse reactions of minocycline and doxycycline
Minocycline: vestibular toxicity within 2-3 days of therapy in up to 70%
Doxycycline: Exhibits least divalent chelation
- Risk of erosive esophagitis
- No azotemia due to fecal vs renal elimination
- Excellent option for resistant S epidermis infection
76
What are tetracycline contraindications
1. pregnancy
2. nursing mothers
3. children under 8
4. renal failure (except Doxycycline)
77
What are the macrolides
1. Erythromycin -QID ointment
- Full oral dosing negates need for topical use . Unstable in gastric acid
2. Azithromycin - Oral and Azasite solution. Clhamydia inclination conjunctivitis - 1 tablet
3. Clarithromycin - BID: reduced dosing compared to erythromycin due to greater stability in GIT
78
Which macrolides have pregnancy category B?
Erythromycin and Azithromycin
79
What are macrolide adverse reactions
1. Augment plasma levels of theophylline
| 2. breast cancer
80
what are contraindications of macrolides
pregnancy- avoid clarithrymycin (category C)
81
______ are highly toxic orally so now limited to topical use only
chloramphenicol
82
Chloramphenicol can result in _____ ___ syndrome
grey baby
