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Vet Micro > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Beta Lactams Site and examples

A

Beta Lactam Ring is the active site

Examples include:
Penicillins
Cephalosporins
Carbapenems
Monobactams
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2
Q

Used for Gram Negative Bacteria resistant to other antimicrobials?

A

Carbapenems (imipenem and meropenem) and monobactams (aztreonam)

Used for treatment of gram - bacteria determined to be resistant to other antimicrobials
Reserverd for humans/last resort

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3
Q

Beta Lactam MOA

A

Disrupt cell wall synthesis by binding to Penicillin binding proteins (PBP’s) making them unavailable for cell wall synthesis

Effective only against actively replicating bacteria

Require cell wall to be effective

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4
Q

Inherent resistance to beta lactams

A

Mycoplasma and L-form bacteria

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5
Q

Why does the spectrum of activity for beta lactam drugs differ?

A

Bacteria can make numerous PBPs ( some e coli can make 9 distinct pbps)

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6
Q

Penicillin G

A

Gram + aerobes
Especially streptococcus and suceptible enterococci

Limited Gram - but effective against pasteurella multocida

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7
Q

Aminopenicillins

A

Ampicillin and amoxicillin
Expand on gram - activity of penicillins
Amoxi first line to treat UTI

Pseud aeruginosa inherently resistant

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8
Q

Ureidopenicillins and Carboxypenicillins

A

Piperacillin and ticarcillin

Expanded spectrum against organisms like pseud aeruginosa

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9
Q

Potentiated Penicillins

A

Contains inhibitor for beta-lactamase
Amoxiclav
Clavulonic acid is an antibiotic with limited activity but high affinity for some beta lactamases
Clavulonic acid STRONGER than beta lactamase inhibitor sulbactam in IV Unasyn

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10
Q

Most important small animal pathogen?

A

Staphylococcus pseudintermedius

Produces beta-lactamase (Gram - can produce many beta lactamases)

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11
Q

Cephalosporins

A

Beta-Lactams with variable activity
1st-3rd gens: 1st effective against gram +, limited gram - to 3rd effective against gram - , limited gram +
First : Cephalexin and cefazolin
Second: Cefamandole, cefmetazole
Third: Cefpodoxime, cefovecin, and ceftiofur
Fourth: cefquinome

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12
Q

Fluroquinolones

A

Gram - activity, limited gram +
Aerobic
Use based on culture and sens
Concentration dependent, dosed daily

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13
Q

Fluroquinolones MOA

A

Bind DNA gyrase and topoisomerase enzymes

Leads to cell death

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14
Q

Fluroquinolone Examples

A 
Enrofloxacin - Baytril
Marbofloxacin - Zeniquin
Difloxacin - Dicural
Orbifloxacin - Orbax
Pradofloxacin - veraflox
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15
Q

Fluroquinolone Exception?

A

Pradofloxacin has expanded gram + and anaerobic activity

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16
Q

Ribosome Binding Antimicrobials

A

Aminoglycosides, Tetracyclines, Chloramphenicol, and Macrolides/Lincosamides are protein synthesis inhibitors
Target 50s or 30s subunits (targeting same one with two will be antagonistic)
30s: Tetracyclines and Aminoglycosides
50s: Chloramphenicol and Macrolides/Lincosamides

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17
Q

Protein Synthesis inhibitors are Bacteri_____?

A

Bacteriostatic

EXCEPT for the aminoglycosides: Bactericidal

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18
Q

Aminoglycosides

A

Aerobic ONLY (oxygen dependent transport into cells)
Gram - primarily
Useful for MDR organisms
Only available in topical and parenteral formulations d/t low gut bioavailability

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19
Q

Tetracyclines

A

Relatively broad spectrum
Effective against atypicals: Reickkettsials, Leptospira, and Mycoplasma
Wide variety of aerobic bacteria, but resistance widespread among Staph pseuds, E. Coli’s

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20
Q

Chloramphenicol

A

Very broad spectrum
4 Quadrant:
One of few reliable for MRSP

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21
Q

Macrolides and Lincosamides

A

Mainly Gram +
Aerobic
Exception: Erythromycin is a macrolide— drug of choice for gram - camplyobacter

Clindmycin most widely used Lincosamide and also has anaerobic activity

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22
Q

Azolides

A

Derived from macrolides
Azithromycin
Off-label

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23
Q

TMS

A

Also Ormetroprim-sulfamethoxazole (Primor)
Each drug targets different portion of bacterial folic acid synthesis
Gram + and -
No Anerobic
Bacteristatic individually, together bactericidal

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24
Q

Rifampin

A

Rifamycin antimicrobial that targets RNA synthesis
Aerobic
Single point mutation can lead to resistance, always use in combo
Mycobacterial infections

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25
Q

Nitrofurantoin

A

Mechanism poorly understood
UTIs only
Aerobic
E. coli, staph, entero

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26
Q

Anaerobic infections are ____________ than aerobic infections

A

LESS COMMON

Think: Wounds, cholangiohepatitis, and tooth root abscesses

27
Q

Metronidzole

A

ANAEROBES
Inhibit nucleic acid synthesis (only occurs under anaerobic conditions)
Reduced form and free radicals cause DNA damage
Extremely effective anaerobic coverage, particularly clostridum and abcteroides

28
Q

Other Antimicrobials with Anaerobic coverage

A 
Penicllins (amoxi, amp)
Clindamycin
Chloramphenicol
Cefoxitin
Cefpodoxime
Cefovecin
Pradofloxacin
29
Q

Most Common cause of Skin infections? Treatment?

A

Staphylococcus Pseudintermedius
Gram + and aerobic
1st Gen cephalosporins and AmoxiClav
Cephalexin, Clavamox,
Clindamycin or TMS reasonable d/t beta lactam resistance common
+/- Cefpodoxime (3rd gen so expanded coverage)

30
Q

Most common cause of UTI? Treatment?

A

E. Coli
Often suceptible to amoxicillins
Concentrate in Urinary tract
Also TMS has excellent urinary pen, and good Gram - coverage

Pyelonephritis should be treated with fluroquinolone (less likely to be resisted)

31
Q

Most common cause of community acquired pneumonia or URT infections? Treatment?

A 
Dogs: Bordetella
Cats: Chlamydia and Mycoplasma
Doxycycline drug of choice
Therapy often not indicated/necessary
Life threatening pneumonia: broad spectrum (typically amp + enro)
32
Q

Fluoroquinolones should __________?

A

Not be used in young animals due to effects on cartilage.

33
Q

Beta Lactam Side Effects

A

GI Distress

Anaphylaxis

34
Q

Fluroquinolone Side Effects

A

Cartilage defects in growing animals
Enrofloxacin/all fluroquinolones cautioned for ARD in cats
Thought to be dose dependent, max dose 5 mg/kg in cats

35
Q

Macrolides/Clindamycin Side Effects

A

Safe, diarrhea
C. difficile infections in people
idiosyncratic cardiac/hepatic toxicity

36
Q

Aminoglycoside Side Effects

A

Nephrotoxicity and Ototoxicity
Dose once daily
If renal impairment + requires an amino, INCREASE dosing interval instead of decreased
Must have intact tympanic membrane for topical ear application

37
Q

Chloramphenicol Side Effects

A

Rare: Bone marrow suppression, hindlimb weakness, and hepatotoxicity
Irreversible aplastic anemia in people— gloves, don’t crush

38
Q

Tetracyclines Side Effects

A 
Enamel hypoplasia (calcium chelation)
Esophagitis + Stricture in cats
39
Q

Metronidazole Side Effects

A

Neurotoxicity

Carcinogenesis and mutagenesis in pregnant animals

40
Q

TMS Side Effects

A

Immune-Mediated: KCS, IMPA, IMHA, ITP, Hypothyroid
Baseline ortho + bloodwork should be done
May affect thyroid levels
Some supplement T4 when on it >3 weeks

Hepatoxicity

41
Q

Rifampin Side Effects

A

Change in urine/tear color

Up to 20% increase in liver enzymes

42
Q

Nitrofurantoin Side Effects

A

Peripheral neuropathy in dogs

43
Q

Beta Lactam Contraindications

A

History of hypersensitivity/allergic reactions

44
Q

Fluroquinolones Contraindications

A 
Young animals (cartilage)
Cats (Retinal degeneration)
45
Q

Aminoglycosides Contraindications

A

Renal insufficient, euhydration required (tx with additional fluids)

46
Q

Chloramphenicol Contraindications

A

Liver disease

Cats tend not to tolerate well

47
Q

Tetracyclines Contraindications

A

Young and pregnant animals

Difficult to pill cats

48
Q

Metronidazole Contraindications

A

pregnant animals

49
Q

TMS Contraindications

A

Predisposed to IMD

Doberman Pinschers, Samoyeds, and Miniature Schnauzers higher risk for side effects

50
Q

Rifampin Contraindication

A

Liver disease

51
Q

Nitrofurantoin Contraindication

A

Animals often have trouble ambulating with the drug

Renal Insufficiency

52
Q

Which Bacteria play significant roles in Canine Superfical Pyoderma

A

Staphylococcus Pseudintermedius or Schleiferi

also: S. Aureus, PS aeruginosa

53
Q

Which bacteria play a significant role as agents of Urinary Tract Infections?

A

Escherichia Coli
Enterococcus Faecalis
Staphylococcus Pseudintermedius

Also:
Proteus spp
Enterobacter spp
Klebsiella spp

54
Q

Which bacteria play a significant role in canine community acquired pneumonia?

A

Bordetella bronchiseptica
Mycoplasma Cynos
Streptococcus spp

also: Streptococcus equi ssp zooepidemicus, pasturella multocida, enteric organisms- aspiration

55
Q

SODAPOP

A 
SOURCE 
ORGANISM
DECIDE TO TREAT
ANTIMICROBIALS
PATIENT
OPTIONS
PLAN
56
Q

SODAPOP - Source

A

Appropriate source used? Likelihood of contamination?

57
Q

SODAPOP - Organism

A

Common agent for disease process isolated?

Was something unexpected/possible contaminant isolated?

58
Q

SODAPOP - Decide to Treat

A

Only treat if organism is potential pathogen from the source it was obtained from

59
Q

SODAPOP - Antimicrobials

A

List all antimicrobials the organism is susceptible

Identify the lowest-tier antimicrobials

60
Q

Lowtier antimicrobials for Skin, Urine, and Respiratory (chart)

A
61
Q

SODAPOP - Patient

A 
Determine if contraindicated in patient based on:
Species
Breed
Age
Pre-existing conditions

Determine if antimicrobials not effective at the site of infection, examples:
Urine- Clindamycin
Respiratory cefovecin, nitrofurans
Skin- nitrofurins

62
Q

SODAPOP - Options

A

List remaining antimicrobials, lowest-tier first
Include non-systemic therapy
Topical or local (beads)
Consider if disease self-limiting

63
Q

SODAPOP - Plan

A

Dose, route, frequency, duration

How to evaluate success?
Resolution, re-culture, radiographic improvement

Address underlying diseases?
Skin: Food/ environmental/ ectoparasitic
Urinary tract: anatomic abnormalities/ endocrinopathies
Respiratory tract: Immunosuppression/ vaccination

64
Q

Enterococci resistant to

A

Enterococci are inherently resistant to cephalosporins, fluoroquinolones, potentiated sulfonamides, aminoglycosides and macrolide/lincosamides.

Vet Micro (1 decks)

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