Antibacterial Agents I Flashcards Preview

Disease & Defense > Antibacterial Agents I > Flashcards

Flashcards in Antibacterial Agents I Deck (43):
1

To choose a good antibiotic, pick the most ________ and least _________.

most effective and specific; toxic

2

List some of the broad categories of antibacterial drugs.

Anti-cell wall synthesis, bacterial protein inhibitors, folic acid metabolism inhibitors, and bacterial transcription inhibitors

3

What enzymes are sufficiently different in bacteria to allow for targeting?

DNA gyrase (whereas eukaryotes have topoisomerase), and the 30S and 50S subunits of bacterial rRNA

4

What are the methods by which bacteria become resistant to drugs?

Expressing efflux pumps (to decrease the intracellular concentration), developing enzymatic degradation (such as beta-lactamase), bypassing the targeted pathway, decreasing entry, or altering the targeted receptor

5

Bacteriostatic agents ___________, while bactericidal agents ____________.

stop bacterial growth; kill bacteria

6

Bactericidal drugs are required in ___________.

infections of immune-privileged sites (such as the CNS), immunocompromised patients,

7

The advantages of oral antibiotics are ___________; the disadvantages are _________.

cost, convenience, and patient acceptance; GI upset, lack of absorption, and not possible in NPO patients

8

The advantages of IV antibiotic administration are that _________; the disadvantages are ___________.

it is required for some drugs and the bioavailability is more predictable; that it requirement for strict aseptic conditions, it is expensive, and greater provider training is needed

9

What anatomical site does clindamycin preferentially target?

Bones, so it is good for treatment of osteomyelitis

10

___________ is a good antibiotic for urinary tract infections, because it gets rapidly excreted in the urine.

Nitrofurantoin

11

Tetracycline lodges in the _________, where it _______.

gingiva and sebum; is good at targeting oral infections and acne, but has the downside of binding to Ca2++ and discoloring teeth

12

Again, the important formula for drugs that are renally excreted it __________.

(maintenance dose / dosing intervals) = (steady state serum concentration x clearance)
MD/tau = Cpss x Cl

13

For hepatically metabolized antibiotics, ______________.

there is no lab indicator of metabolism, so avoid drugs that are hepatically metabolized in patients with liver dysfunction

14

Bacteroides fragilis is a __________.

Gram-negative rod

15

Fluoroquinolones target _________.

DNA gyrase

16

Metronidazole targets ___________.

DNA synthesis, as does nitrofurantoin

17

Bacteria must _________ folate, while eukaryotes can ___________.

intracellularly synthesize; take it in from the environment

18

Many antibiotics cannot cross the outer membrane of ____________.

Pseudomonas aeruginosa

19

Explain the differences between conjugation, transduction, and transformation.

Conjugation is bacterial exchange of plasmids; transduction is bacteriophage-mediated DNA transfer; and transformation is uptake of free DNA from the environment

20

Give an example of alternative resistant metabolic pathway.

Bacteria overproduce thymine and become resistant

21

What three drugs/classes of drugs are susceptible to bacteria developing resistance by efflux pumps?

Tetracyclines, fluoroquinolones, and macrolides

22

The bacteriostatic drugs usually target ________.

metabolic pathways or protein synthesis

23

The batericidal drugs ____________.

target cell walls, cell membranes, or DNA

24

Antibiotics that are supposed to be taken on an empty stomach are _________.

susceptible to the acid that is present when we eat food

25

The antibiotics that readily enter the CSF are __________.

(cephalopods readily try chlorinated soup) cephalosporins (3rd/4th), rifampin, trimethoprim, chloramphenicol, and sulfonamides

26

The antibiotics that enter the CSF with inflammation are ______________.

Penicillins, vancomycin, ciprofloxacin, and tetracycline

27

Aminoglycosides are the most toxic to the _________.

inner ears and renal cells

28

Antibiotics that have a post-antibiotic effect are ____________.

aminoglycosides and fluoroquinolones

29

Narrow spectrum antibiotics target _________.

either Gram negative or Gram positive

30

Extended spectrum antibiotics target ___________.

Gram negative and Gram positive

31

Broad spectrum antibiotics target ___________.

Gram negative, Gram positive, and atypical bacteria

32

Trimethoprim and sulfonamides are _________.

folic acid synthesis inhibitors

33

_________ and _________ are evaded by bacteria that develop changes in the 50S ribosome subunit.

Erythromycin and clindamycin

34

_______ attacks the peptidoglycan side chain.

Vancomycin

35

DNA gyrase resistance occurs in ___________.

S. aureus and P. aeruginosa (to fluoroquinolone)

36

Strep pneumoniae becomes resistant to beta-lactams by __________.

modification of drug target

37

Macrolides get concentrated in the _________.

pulmonary cells

38

The hepatically metabolized drugs are __________.

DQ CRIMES (doxycycline, quinolones, clindamycin, rifampin, isoniazid, metronidazole, erythromycin-like (i.e., macrolides), and sulfonamides

39

__________ is a CYP inducer.

Rifampin

40

These three drugs work best when they are above their MIC for a long time: ________.

macrolides, beta-lactams, and vancomycin

41

Fluoroquinolones include ________.

levofloxacin

42

_______ is an aminoglycoside.

Tobramycin

43

When would you recommend a combination therapy?

For mixed infections (commonly intraabdominal), to prevent the emergence of drug resistant strains (AIDS patients with TB), and to obtain a synergistic effect

Decks in Disease & Defense Class (59):