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Pharmocology > Antifungals And Antimicrobials > Flashcards

Antifungals And Antimicrobials Flashcards

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1
Q

What are the main gram positive aerobic cocci?

A

Staphylococcus and streptococcus,

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2
Q

What are the main gram positive aerobic rods?

A

Bacillus, listeria, Norcardia, corynebacterium

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3
Q

What’s are the clinically relevant gram pos anaerobic cocci?

A

Peptostreoptococcus (oral bacteria)

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4
Q

What’s the clinically relevant gram positive anaerobic rod bacteria?

A

Clostridium, actinomyces

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5
Q

what are the clinically relevant aerobic gram negative cocci?

A

None in companion animal

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6
Q

What’s are the clinically relevant gram neg aerobic rod bacteria?

A

Enterobacteriaceace ( E. coli, salmonella, proteus, klebsiella) psuedomonas

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7
Q

What are the clinically relevant gram negative anaerobic coccci?

A

None

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8
Q

What are the clinically relevant gram neg anaerobic rods?

A

Bactericides, fusibacterium, (periodontal bacteria) pasturella

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9
Q

What drug classes are in the beta lactams?

A

Carbopanems,monobactams, penicillins, cephalosporins

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10
Q

How to beta lactams work?

A

Block cross linking of peptide chains in bacterial cell was causing cell lysis

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11
Q

Gram-negative aerobe, most common cause of canine UTI

A

E.Coli

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12
Q

Gram-positive aerobe, most common cause of canine pyoderma

A

Staphylococcus pseudintermedius

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13
Q

Gram-positive anaerobe, one species of this genus can cause tetanus

A

Clostridium

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14
Q

Gram-negative aerobe, can be zoonotic

A

Salmonella

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15
Q

Gram-negative aerobe that causes disease in compromised animals

A

Pseudomonas aeruginosa

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16
Q

Periodontal bacteria

A

Gram-positive (Peptostreptococcus) and Gram-negative anaerobes (Bacteroides, Fusobacterium)

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17
Q

Gram-positive anaerobe that can be isolated from abdominal fluid samples in cases of peritonitis

A

Actinomyces

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18
Q

Infections that are commonly caused by aerobes

A

Infections of the skin, urinary tract, cornea, external ear and blood

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19
Q

Infections that can be caused from pathogens in any of the 4 quadrants

A

Peritonitis, pyothorax, aspiration pneumonia, and infections of the middle ear and CNS

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20
Q

Gentamicin

A

-Aminoglycoside
-Primarily G- and MDR Staph. sp. Do not use for anaerobes
-Unlike other drug families, resistance to one family member does not imply resistance to another.
-Mechanism of action requires aerobic environment –> poor choice for anaerobics
-Highly water soluble, poorly lipid soluble –poor penetration of bile, prostate, brain, eye, CSF
-Highly concentrated in urine–> useful in some drug-resistant UTI
-IV, IM, SC
Dose interval= 24 hr

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21
Q

What are the adverse effects of Gentamicin?

A

Low therapeutic index, Monitoring plasma concentrations may be indicated
Neprotoxicity (esp. treatment > 3days, elderly, prior renal impairment, dehydration, hyponatremia, hypokalemia, concurrent NSAIDs, liver impairment)
Ototoxicity, vestibular toxicity
Neuromuscular blockade w some anesthetics

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22
Q

Amoxicillin

A

-b-lactam/Aminopenicilllin
-G+ aerobes/Some G- aerobes/ G+G-anaerobes
-Orally bioavailable
Lactamase sensitive
-PO 8-12 hr

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23
Q

Adverse effects of Amoxicillin?

A

Vomiting, diarrhea, inappetance

Hypersensitivity: Anaphylaxis, cytopenias

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24
Q

Ampicillin

A

-b-lactam/Aminopenicilllin
-G+ aerobes/Some G- aerobes/ G+G-anaerobes
-Poor oral bioavailability
Lactamase sensitive
-IV,IM,SC 6-8 hrs
-

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25
Adverse effects of Ampicillin?
-Vomiting, diarrhea, inappetance | Hypersensitivity: Anaphylaxis, cytopenias
26
Amoxicilin-Clavulanate
- b-lactam/Aminopenicilllin + Lactamase inhibitor - G+ aerobes/Some G- aerobes/ G+G-anaerobes - Resistant to some lactamases - PO q 12 hr
27
Adverse effects of Clavamox?
Vomiting, diarrhea, inappetance | Hypersensitivity: Anaphylaxis, cytopenias
28
Cephalexin
-b-lactam/Cephalosporin 1st Gen -G+ aerobes (esp Staph, Strep), Some G- aerobes, Anaerobic activity unpredictable -Resistant to some lactamases Not active in MRS -PO q 12 hr
29
Adverse reactions to Cephalexin?
Vomiting, diarrhea, inappetance | Hypersensitivity: Anaphylaxis, cytopenias
30
Cefovicin
-b-lactam/Cephalosporin 3rd Gen -G- and G+ aerobes (more G- than 1st gen) G+G- anaerobes -More lactamase resistant than 1st gen. Not active in MRS -SC q 14 days
31
Adverse effects of Cefovecin?
Vomiting, diarrhea, inappetance | Hypersensitivity: Anaphylaxis, cytopenias
32
Cefpodoxime
-b-lactam/Cephalosporin 3rd Gen -G- and G+ aerobes (more G- than 1st gen) -More lactamase resistant than 1st gen. Not active in anaerobes Not active in MRS -PO q 24 hrs
33
Adverse effects of cefpodoxime?
-Vomiting, diarrhea, inappetance | Hypersensitivity: Anaphylaxis, cytopenias
34
Ceftiofur
-b-lactam/Cephalosporin 3rd Gen -G- and G+ aerobes (more G- than 1st gen) G+G- anaerobes -More lactamase resistant than 1st gen. Not active in MRS -SC q 24 hrs
35
AR to Ceftiofur?
Vomiting, diarrhea, inappetance | Hypersensitivity: Anaphylaxis, cytopenias
36
Penicillin G
- b-lactam/Natural Penicilllin - G+ aerobes/ G+G-anaerobes - IV,IM q 6-8 hr
37
AR to penicillin g?
Vomiting, diarrhea, inappetance | Hypersensitivity: Anaphylaxis, cytopenias
38
Ciprofloxacin
- Fluoroquinolone - G- and G+ aerobes, ineffective against anaerobes - Highly variable oral bioavailability in dog, low in cats (~25%). - IV, PO q 24 hr
39
Adverse effects of ciprofloxacin?
Inappetence, vomiting Rapid IV-> hypotension, tachycardia, erythema CNS signs (ataxia, tremor, siezure) esp at high doses Cartilage damage in young animals (esp > 7 days, 4-28 weeks of age)
40
Enrofloxacin
- Fluoroquinolone - G- and G+ aerobes, ineffective against anaerobes - Reduce dose/Increase interval w renal failure. Infuse diluted, and slowly for IV. Concentrated in urine. - IV, IM, PO q 24 hr
41
AE of Enrofloxacin?
Inappetence, vomiting Rapid IV-> hypotension, tachycardia, erythema CNS signs (ataxia, tremor, siezure) esp at high doses Blindness in cats (esp parenteral, high doses) Cartilage damage in young animals (esp > 7 days, 4-28 weeks of age)
42
Marbofloxacin
- Fluoroquinolone - G- and G+ aerobes, ineffective against anaerobes - Reduce dose/Increase interval w renal failure. Infuse diluted, and slowly for IV. Concentrated in urine. - PO q 24 hr
43
AE of Marbofloxacin?
Inappetence, vomiting Rapid IV-> hypotension, tachycardia, erythema CNS signs (ataxia, tremor, siezure) esp at high doses Manufacturer research: no feline blindness adverse effect Cartilage damage in young animals (esp > 7 days, 4-28 weeks of age)
44
Clindamycin
- Lincosamide - Primarily G+ aerobes, good anaerobic coverage - Similar coverage as erythromycin, also greater anaerobic coverage, and toxoplasmosis, neosporosis - PO, IV, IM q 12-24 hr
45
AE of clindamycin?
``` GI effects (inappetence, nausea, vomiting) Esophageal damage with oral dosing, recommend efforts to "chase" dose with water. ```
46
Erythromycin
-Macrolide -Primarily G+ aerobes, some anaerobes, intracellular bacteria -Effective against many intracellular bacteria Penetration good across tissues, except CNS and urine. Stimulates motilin receptors --> GI prokinetic effect -PO q 8 hrs
47
AE of Erythromycin?
``` GI effects (inappetence, nausea, vomiting) Inhibitor of P450 enzymes, risk of modifying clearance of other drugs' clearance ```
48
Tylosin
- Macrolide - Primarily G+ aerobes, some anaerobes - Used in antibiotic-responsive diarrhea - PO IM q 12-24 hrs
49
AE of Tylosin?
Do not administer orally to rodents, rabbits, horses
50
Chloramphenicol
-G+ and G-, aerobes and anaerobes, some rickettsia -Outstanding tissue penetration across tissues. Primarily metabolized in liver --> avoid in hepatic impairment Clients must be counseled/cautioned regarding PPE to avoid accidental exposure -IV, IM, PO q 6-12 hrs
51
AE of Chloramphenicol?
GI effects common (inappetence, hypersalivation, vomiting) Reversible bone marrow suppression (esp. high doses, prolonged treatment. Cats more susceptible vs dogs). Potent inhibitor of P450 enzymes, risk of modifying clearance of other drugs' clearance
52
Nitrofurantoin
- Nitrofuran - G+. G- aerobes - Primary use in UTI, where it concentrates - PO q 8 hrs
53
AE of Nitrofurantoin?
GI: vomiting Peripheral neuropathy (reversible) Pulmonary hypersensitivity Hepatotoxicity
54
Metronidazole
-Nitroimidazole -G+ and G- anaerobes, Giardia -Anaerobic activation of prodrug limits spectrum to anaerobes Resistance is rare. Unpalatable for cats, but more palatable benzoate preparation available via compounding. -PO q 12-24 hrs
55
AE of Metronidizole?
Neurotoxicity (lethargy, ataxia, tremors, head tilt, nystagmus, seizures), especially with high doses and/or hepatic impairment. Inappetence, vomiting, diarrhea
56
Trimethoprim-Sulfamethoxazole
-Potentiated sulfonamides -G+, G-, aerobes, some protozoa. Poor anaerobic activity -Good prostate penetration (ion-trapped by low pH) Highly concentrated in urine Dogs (esp Doberman, Samoyed, Min. Schnauzer) more prone to adverse effects due to lower metabolic clearance Poor anaerobic activity -PO, IV q 12 hrs
57
AE of trimethoprim-sulfamethoxazole?
vomiting, inappetence Hypersensitivity: KCS, pyrexia, polyarthritis, cutaneous lesions, ITP, IMHA, hepatitis, pancreatitis, nephritis, bone marrow suppression. Hypothyroidism
58
Rifampin
- Rifamycin - Staph, Strep, - High intracellular penetration - PO q 12 hrs
59
AE of Rifampin?
Vomiting, inappetence are common Imparts a (sometimes frightening) red-range color to urine, to a lesser degree sclera, saliva Increased liver enzymes, hepatopathy (esp high doses) Strong inducer of hepatic enzymes, potential for substantial modification of other drugs' clearance
60
Doxycycline
-Tetracycline -G+, G-, some anaerobes, protozoa, atypical and intracellular pathogens (spirochetes, Mycoplasma spp., rickettsiae) -Penetration good across tissues. Concentrated in bile, urinary concentrations sufficient to treat UTI Doxycycline can be administered with food (unlike other tetracyclines) Unlike other tetracyclines doxycycline has less binding to Ca++, thus lower risk of bone growth impairment and tooth discoloration PO, IV q 12-24 hrs
61
AE of Doxycycline?
``` GI effects (inappetence, nausea, vomiting) Esophageal damage with oral dosing, recommend efforts to "chase" dose with water. Potential to cause hepatic impairment and renal tubular necrosis ```
62
Itraconozole
-Azole -Used to treat several systemic mycoses, and Malassezia. -Resistance to one azole does not imply resistance to other azoles Bioavailability increased with food, but poor with concurrent gastric acid suppressant drugs Variable bioavailability --> therapeutic monitoring may be valuable Poor CNS, urine, eye penetration Accumulates in skin and claws --> drug of choice for dermatophytosis Good choice for fungal osteomyelitis PO q 12-24 hrs
63
AE to Itrakonozole?
GI: Inappetence, vomiting Lethargy Mild transaminase elevation, less commonly hepatitis Potent inhibitor of P450 enzymes, risk of modifying clearance of other drugs' clearance. This enzyme inhibition results in decreased testosterone and cortisol synthesis. Males may experience transient infertility.
64
Ketoconazole
Azole -Used to treat several systemic mycoses, and Malassezia. -Use has been largely replaced by itraconozole Resistance to one azole does not imply resistance to other azoles Bioavailability increased with food, but poor with concurrent gastric acid suppressant drugs Poor CNS penetration Ketoconazole P450 inhibition resulting in reduced metabolic clearance (see adverse effects) is sometimes used intentionally to reduce the required dose of more expensive drugs, ketaconazole + cyclosporine. The appropriateness of this practice is not universally considered appropriate use of an antimicrobial PO q 12 hrs
65
AE of Ketokonozole?
GI: Inappetence, vomiting, diarrhea Lethargy Mild transaminase elevation, less commonly hepatitis Potent inhibitor of P450 enzymes, risk of modifying clearance of other drugs' clearance
66
Terbinafine
-Allylamine -Primary activity in dermatophytes, some activity in Malassezia -Efficacy for invasive fungal infections is unclear. PO q 24 hrs
67
AE of Terbinafine?
GI: Vomiting Increased liver enzymes Facial pruritus (cats)

Pharmocology (8 decks)

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