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MMI 133 > lesson eight > Flashcards

lesson eight Flashcards

1
Q

two antiparasitic agents

A
  1. anti-protozoan drugs
  2. anti-helminthic drugs
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2
Q

quinine and derivatives for malaria

A

increasing resistance of malaria to the drugs

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3
Q

antifungal agents

A
  • fungi are eukaryotic organisms
  • most successful agents affect the plasma membrane of fungi- which contains ergosterol instead of cholesterol
  • all drugs have some toxicity (kidney)
  • most common drug used for systemic fungal illness: amphotericin B
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4
Q

amphotericin B

A

inhibits ergosterol synthesis in the cytoplasmic membrane of the fungal cell

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5
Q

antiviral agents

A
  • DNA/RNA synthesis inhibitors
  • entry inhibitors
  • uncoating inhibitor (M2 proton channel)
  • nucleoside analogue
  • protease inhibitors
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6
Q

antiviral agent: azidothymidine AZT or zidovudine

A

inhibits the reverse transcriptase (synthesis of DNA from RNA) treats HIV

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7
Q

bacteriostatic antibiotics

A
  • stop the replication of bacteria
  • do not kill the bacteria already present (erythromycin)
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8
Q

bactericidal antibiotics

A
  • kill the bacteria
  • stop bacterial metabolism (penicillin)
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9
Q

inhibition of cell wall synthesis

A

beta lactams:
- penicillins
- cephalosporins
- carbapenems
- monobactams
vancomycin bacitracin

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10
Q

inhibition of protein synthesis

A

30s subunit
- tetracyclines
- aminoglycosides
50s subunit
- macrolides
- clindamycin
- linezolid
- chloramphenicol

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11
Q

injury to the plasma membrane

A

polymyxins (topical)

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12
Q

inhibit nucleic acid synthesis

A

DNA gyrase
- quinolones
RNA polymerase
- rifampin
folate synthesis
- sulfonamides
- trimethoprim

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13
Q

inhibits the synthesis of essential metabolites

A
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14
Q

specific antibiotics

A
  • inhibit gram - or
  • gram + or
  • certain bacterial species
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15
Q

broad spectrum antibiotics

A
  • inhibits both gram - and gram + bacteria
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16
Q

most susceptible to bacterial infection

A
  • diabetics
  • children
    -elderly
  • burn wound: skin and soft tissue
  • immunocompromised
17
Q

effects of antibiotics

A
  • allergies (penicillin)
  • pregnant women (tetracycline)
  • children (pharmacokinetic and pharmacodynamic issues)
  • people with liver of kidney damage
18
Q

antimicrobial side effects

A
  • kidney
  • liver
  • rash, allergy
  • GI upsets
  • nerve damage
  • ototoxicity
  • teeth and bone formation in children
  • cartilage formation in children
19
Q

antibiotic=not effective if used too late

A
  • too many bacteria
  • too much tissue damage
  • formation of walled-off abscesses that can’t be penetrated by antibiotics
  • poor absorption of drug
20
Q

why are IV antibiotics sometimes used

A
  • GI problems
  • only drug possible (vancomycin)
  • rapid bioavailability
21
Q

clostridium perfringens

A
  • gram + bacilli
  • gangrene
  • bacteremia and sepsis
  • penicillin, clindamycin, metronidazole (anaerobic)
22
Q

pseudomonas aeruginosa

A
  • gram -
  • opportunistic pathogen
  • inhabit soil and water
  • needs very few nutrients
  • can infect many body sites
  • very common in burn patients and patients with cystic fibrosis
  • has endotoxin, also produces exotoxins
  • require broad spectrum drugs
23
Q

bacterial mutation to penicillin

A
  • produced enzyme beta-lactamase or penicillinase: inactivation of penicillin by breaking the beta-lactam ring
24
Q

counteracting bacterial mutation to penicillin

A
  • synthesis of semi-synthetic penicillins with a structure where the active portion of the antibiotics was protected from the enzymes
25
Q

4 ways bacteria become resistant to antibiotics

A
  1. prevent penetration
  2. destruction of drug
  3. target site alteration
  4. ejection of drug from bacterium
26
Q

r-factors

A
  • plasmids that confer genes for resistance to antimicrobials
  • Genes coded on small circular independently replicating pieces of DNA
    called plasmids located in the cytoplasm of bacteria
  • Can be transferred from one bacteria to another by conjugation
  • R-factors can be transferred between different bacterial species
27
Q

why do bugs become resistant

A
  • overuse
  • inappropriate treatment
  • incomplete treatment regimens
28
Q

what are superbugs

A

bacteria that can’t be controlled by antibiotics

29
Q

what did the staphylococci do after semisynthetic drugs began to be used

A
  • mutated again
  • MRSA: methicillin resistant s. aureus (superbug)
  • changes the penicillin binding site
  • penicillin binding protein 2 mutates to PBP2a
30
Q

superbug: VRE (vancomycin resistant enterococci)

A
  • genetic mutations-several: in genes Van A, Van B, Van C
  • resistance developed after use of avoparcin in animal feed
31
Q

superbug: ESBL (extended spectrum beta-lactamase)

A
  • Enterobacteriaceae like E. coli:
    genetic mutations, many
    resistance genes
  • Increasing problem in ICU,
    extended care
  • Resistance to penicillins and
    cephalosporins
  • ESBL can inactivate even the
    new really good beta-lactams
    like meropenem
  • NDM-1 (New Delhi
    metallobetalactamase is one of
    the latest enzyme variants)
32
Q

superbug: XDR-TB

A
  • first seen in tugela ferry, south africa
  • resistant to both first and second line anti-TB drugs
33
Q

MIC (minimum inhibitory concentration)

A
  • minimum amount of antimicrobial that will inhibit the growth of the microorganism
  • every important bacterial isolate must be tested
  • need to know for appropriate dosing levels and intervals
34
Q

what is a drug of choice

A

drug that is deemed to be the most effective with the least toxicity for a specific infection

35
Q

disk diffusion test

A
  • for antimicrobial susceptibility
  • routine test, primarily for rapidly growing bacteria as the antibiotics on the disc will deteriorate with time
    3 categories of sensitivity:
    S= sensitive or susceptible
    I= intermediate
    R= resistant
36
Q

kirby bauer or disk diffusion susceptibility test

A
  • Interpretation: measure the zones of inhibition and compare to standard charts to get S,I,R
  • This is a one shot concentration of the
    antibiotic in each disc
  • You use this for
    infections like urinary tract infections, skin infections, but not for infections in sterile sites (like blood).
37
Q

e-test for MIC determination

A
  • an easy way to determine MIC for a drug on a specific bacterial strain
38
Q

monitoring of serum antimicrobial levels

A
  1. attain effective levels (over MIC)
  2. prevent toxic side effects
  3. ascertain dosing intervals
39
Q

MIC and SIR

A

personalize and control the dose

MMI 133 (7 decks)

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