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Flashcards in pharmacology 1st quiz TS Deck (229):
0

which antimicrobial drugs act on bacterial cell membrane?

polymyxin b
colistin

1

which antimicrobial drugs interfere with bacterial cell wall synthesis?

beta lactams
bacitracin
vancomycin
cycloserine

2

which antimicrobial drugs interfere protein synthesis at 30s subunit?

tetracyclines
aminoglycosides

3

which antimicrobial drugs act on 50s subunit?

chloramphenicol
macrolides
lincosamides

4

which antimicrobials interfere with nucleic acid synthesis?

fluoroquinones
rifampin
metronidazole

5

which antimicrobials interfere with folic acid synthesis?

sulfonamides
diaminopyrimidines

6

which antimicrobials are narrow spectrum?

beta lactams
aminoglycosides
polymyxin b and colistin

7

which antimicrobials are bacteriostatic?

sulfonamides
tetracyclines
chloramphenicol
macrolides and lincosamides

8

what are the 3 efficacy predictors of antimicrobials?

type 1 - conc dependent
type. 2 time dependent
type 3 time dependent with pae (persistant suppression of bacteria)

9

what combo of antimicrobials produces additive effect?

bacteriostatic

10

what combo of drugs produces synergistic effect?

bactericidal drugs

11

what combo of drugs produces antagonistic effect?

bactericidal with bacteriostatic

12

what is transduction (antibiotic resistance)?

bacteria virus transfers genes

13

how do bacteria get antibiotic resistant from uptake of genes in environment?

transformation

14

what ways can bacteria decrease accumulation of drugs inside them?

decrease permeability thru cell membrane of gram negatives
energy dependent active efflux of drug

15

what is the prerequisite of folic acid in bacteria?

PABA

16

what are the 5 enteric sulfonamides?

succinylsulfathiazole
sulfasalazine
sulfquinoxaline
sulfaguanidine
phthalylsulfathiazole

17

what does a triple sulfa bolus consist of?

sulfinilamide, sulfathiazole, sulfamethazine

18

which sulfonamide is hydrolzyed in the bowl?

phthalylsulfqthiazole

19

which sulfonamide is split into 2 parts in intestine and treats dog coilitis?

sulfasalazine

20

ehat are the 2 moa of sulfonamides?

structural analog of PABA, gets substituted
act as antimetabolites and interfere with rna and dna

21

which. 2 sulfonamides can be used topically?

silver sulfadiazine
mafenide

22

which sulfonamide should be used for opthalmic apps because of neutral ph?

sulfacetamide

23

how are sulfonamides metabolized?

acetylation in liver

24

what effect does alkaline urine have on the excretion of sulfonamides?

increases fraction of dose eliminated in urine

25

what are the 2 immunological based toxicities of sulfonamides?

kcs ( dry eye)
hepatic necrosis

26

what is the non immunological effects of sulfonamide toxicity on kidney?

crystalluria
hematuria
renal tubular blockage

because of dehydration, keep well hydrated and aciduria protects

27

does a combination of sulpha drugs increase or decrease their solubility?

increase ( law of independent solubility)

28

which sulpha drug causes hypoprothrombinemia in dogs and chickens?

sulfaquinoxaline

29

what sulfa drug can cause aplastic anemia?

trimethoprim sulfadiazine ( potentiated sulfa)

30

which species can have hypoglycemia from taking sulfa drugs?

ducks and dogs

31

which breed of dog can get polyarthritis and hepatitis from sulfa drugs?

doberman pinschers

32

what gland may sulfonamides interfere with but is reversible?

thyroid gland

33

What group is sulfonamides in efficacy predictors?

type 2 antimicrobials, therefore ideal dosing maximizes duration of exposure

34

What type of molecule are diaminopyramidines?

lipid soluble organic bases

35

Are diaminopyramidines bacteriocidal or bacteriostatic?

bacteriostatic

36

How do diaminopyramidines block bacterial folate synthesis?

reversibly binds and inhibits dihydrofolate reductase

37

Which diaminopyramidine inhibits folate synthesis in protozoa?

pyrimethamine

38

Which diaminopyramidine can be given orally to ruminants?

ormetoprim

39

What are the 3 different diaminopyramidines?

Pyrimethamine, trimethoprim, and ormetoprim

40

Are potentiated sulfonamides bacteriostatic or bacteriocidal?

bacteriocidal (each one alone is bacteriostatic)

41

How do beta lactam antibiotics exert bactericidal activity?

interfere with transpeptidase enzyme that is responsible for formation of cross links (penicillin binding proteins - PBP)

42

What type of bacterial cell wall can beta lactams NOT penetrate?

gram negative

43

What 2 beta lactam drugs are "natural penicillins"?

Penicillin G
Penicillin V

44

Which natural penicilllin can be given orally?

Penicillin V

45

What are the 2 log acting formulations of Penicillin G?

Benzathine
Procaine

46

What bacteria are resistant to natural penicillins?

Pseudomonas, enterobacteriaceae and penicillinase producing staph

47

What are the 3 groups of semi synthetic penicillins?

Penicillinase resistant penicillins
Broad spectrum (aminopenicillins)
extended spectrum (carboxypenicillins)

48

What 3 penicillinase-resistant penicillins have good oral absorption?

Cloxacillin
Oxacillin
Dicloxacillin

49

What are penicillinase-resistant penicillins used to treat mostly?

staph infections
-bovine staph mastitis

50

What penicillinase-resistant penicillin can be formulated as an opthalmic ointment and treat staph and bacillus infections?

cloxacillin

51

What are the two drugs in the broad spectrum penicillins?

Amoxicillin
ampicillin

52

What are some related esters of ampicillin? (prodrugs)

bacampicillin
hetacillin
pivampicillin
talampicillin

53

What 5 penicillins are in the extended spectrum group?

ticarcillin, carbenicillin, piperacillin, mezlocillin, azlocillin

54

Why can't procaine penicillin G be administered IV?

affects cardiac conduction system

55

What can be used to competitively inhibit penicillin excretion?

another organic acid, such as probenecid

56

Which penicillin is not excreted in urine?

Nafcillin (bile)

57

What can sodium benzylpenicillin produce in dogs and cats?

ataxia and convulsions (inhibits GABA)

58

What drug can produce anaphylaxis and CNS disorders in small mammals and reptiles?

procaine

59

What can procaine and postassium penicillin salts administered IV as a rapid bolus induce?

acute cardiac toxicities

60

What salt form should you use when administering penicillins IV?

sodium salt

61

What are the 3 first generation cephalosporins that can be given orally?

cefadroxil
cephalexin
cephradine

62

What are the 3 first gen cephalosporins that can be given parenteral?

cefazolin
cephalothin
cephapirin

63

Which first gen cephalosporin has greatest gram negative activity?

cefazolin

64

What bacteria are 2nd gen cephalosporins better at killing than 1st gen?

gram negative because increased resistance to lactamases
also anaerobes

65

Which drug is a "new generation" of cephalosporins?

ceftiofur (broader gram + activity)

66

How does ceftiofur compare to other 3rd gen cephalosporins?

better at strept
less activity against pseudomonas

67

What cephalosporin is 4th gen?

cefepime

68

Which 2 cephalosporins have the best oral absorption?

cephalexin
cefaclor

69

What is the only 2nd gen cephalosporin that can penetrate cerebrospinal fluid?

cefuroxime

70

What 3rd generation cephalosprins can attain high concentration in cerebrospinal fluid when meninges are inflammed?

ceftriaxone
cefotaxime
ceftazidime
ceftizoxime

71

What 2 cephalosporins can decrease platelet aggregation?

cephalothin
cefinetazole

72

How does clavulanic acid and sulbactam potentiate penicillin?

competitive inhibitor of beta lactamases of bacteria

73

What are the two kinds of Cabapenems?

Imipenems
Meropenems

74

What must imipenems be administered with?

cilastatin (renal enzyme inhibitor)

75

What bacteria does imipenems have activity on?

broad spectrum
gram negative aerobic
anaerobic

76

What is the adverse effect of imipenems?

seizures

77

How is meropenems different from imipenems?

more soluble
decreased seizures

78

What can be used against gram negative bacteria or pseudomonas if patient is allergic to penicillin?

monobactams

79

How do antimicrobials that inhibit protein synthesis target bacterial ribosomes instead of the host?

affinity for 70s size (eukaryotes is 80s)

80

What 2 parts of protein synthesis can antibiotics interfere with?

initiation
elongation of polypeptide chain

81

What 2 groups of antibiotics act on the 30 S subunit to inhibit protein synthesis?

aminoglycosides
tetracyclines

82

What 3 groups of antibiotics act on 50S subunit to inhibit protein synthesis?

macrolides
lincosamides
chloramphenicol and derivatives

83

Are aminoglycosides bacteriostatic or bacteriocidal?

bactericidal

84

What are the 6 aminoglycoside drugs?

streptomycin
neomycin
kanamycin
gentamicin
amikacin
tobramycin

85

Why is one single dose of aminoglycosides q24 the same as many small ones?

post antibiotic effect (PAE)

86

What kind of bacteria do aminoglycosides act on?

aerobic gram negative bacteria

87

What aminoglycoside has the broadest spectrum?

amikacin

88

Which bacteria has natural permeability barrier to aminoglycosides?

streptococci

89

How are aminoglycosides administered?

parentally (never orally)

90

Where do aminoglycoside drugs concentrate in the body?

perilymph of the inner ear and in the renal cortex (attracted to phospholipids)

91

Why shouldn't aminoglycosides and diuretic agents be used concurrently?

dehydration --> nephrotoxicity

92

What can happen when aminoglycosides are in high plasma concentrations after bolus?

non depolarizing neuromuscular blockade

93

What are 3 ways bacteria can be resistant to aminoglycosides?

enzymatic inactivation
ribosomal alterations
reduced permeability to drug

94

What is the efficacy predictor of aminoglycosides?

Type 1 - concentration dependent killing kinetics

95

How can renal uptake of gentamicin be inhibited?

alkalinizing the urine with sodium bicarbonate

96

Which aminoglycoside is too toxic for systemic use and used in topical applications?

neomycin

97

Which aminoglycoside is effective against gram positive AND negative bacteria?

paromomycin

98

What aminoglycoside is effective against Pseudomonas in dogs and cats?

Tobramycin

99

What are the 3 natural tetracyclines?

chlortetracycline
tetracycline
oxytetracycline

100

What are the 2 semi-synthetic tetracyclines?

minocycline
doxycycline

101

Are tetracyclines bacteriostatic or bacteriocidal?

bacteriostatic

102

What do tetracyclines bind to?

30s ribosomal subunit

103

Which tetracycline is the treatment of choice for equine monocytic ehrlichiosis? (potomac horse fever)

oxytetracycline

104

What tetracycline is effective against penicillinase resistant strains of staph aureus?

minocycline

105

What microorganisms are resistant to tetracyclines?

Proteus vulgaris
Pseudomonas aeruginosa
Mycobacterium
some Mycoplasma

106

Which tetracycline is given IM?

oxytetracycline

107

Which tetracycline is more completely absorbed in GI tract?

doxycycline

108

What are the 2 most lipid soluble tetracyclines?

Minocycline and doxycycline

109

What two tetracyclines are metabolized in the body? How are they then removed?

mino (oxidation)
doxy (bile diffusion) - can be used in renal failure

110

Why should IV (oxy?)tetracycline be given slowly?

chelates calcium in blood

111

What can IV injections of doxy in horses do?

induces cardiac arrhythmia -- sudden death

112

How does oral tetracycline alter microflora in horses?

proliferation of clostridium perfringens or salmonella --> colitis

113

What group of efficacy predictors does tetracycline belong to?

type 3 - time dependent killing and PAE

114

What is the mode of action for chloramphenicol?

binds to 50s subunit

115

What can happen in prolonged admin of chloramphenicol?

bone marrow suppression (esp in cats) mitochondrial ribosome similar to bacterial one

116

What other antibiotic can chloramphenicol compete with and should not be administered with?

macrolides (erythromycin)

117

Which 2 types of bacteria are resistant to chloramphenicol?

Pseudomonas aeruginosa
enterobacteriaceae (readily acquired)

118

Which chloramphenicol drug is only available orally?

chloramphenicol base

119

Which chloramphenicol is hydrolyzed in small intestine by esterases?

chloramphenicol palmitate

120

Which chloramphenicol can be given IV/IM?

chloramphenicol succinate

121

How is chloramphenicol metabolized and therefore which animal has a slower clearance time?

conjugated with glucoronic acid
cats

122

Can you use chloramphenicol in food-producing animals?

NO!

123

Which chloramphenicols do not induce bone marrow stem cell damage?

thiamphenicol
florfenicol

124

What type of animals are most sensitive to chloramphenicol toxicity?

young animals
cats
impaired liver fxn

125

What is the side effect in newborn humans that are treated with high doses of chloramphenicol?

Gray baby syndrome

126

Which bacterial enzyme inactivates chloramphenicol and is acquired by plasmids?

acetyltransferase (florfenicol resistant to it)

127

What semi-synthetic chloramphenicol derivative is more water soluble?

thiamphenicol

128

Which chloramphenicol derivative is more potent and can be used in food producing animals?

florfenicol

129

What efficacy predictor group is chloramphenicol?

type 2 - time dependent

130

What are the 6 macrolide antibiotics?

erythromycin
tilmicosin
tylosin
tiamulin
azithromycin
clarithromycin

131

How do macrolides differ in their mode of action than chloramphenicols?

unable to cross mitochondrial membrane and do not effect bone marrow

132

Are macrolides bacteriostatic or bacteriocidal?

bacteriostatic at therapeutic levels
bacteriocial slowly against strep

133

How does pH effect the antimicrobial action of macrolides?

high pH - enhanced
low pH - suppressed

134

Which macrolide is used to treat pink eye?

tiamulin

135

What is the preferred route of admin of macrolides?

oral (injections painful)

136

Which macrolide is metabolized by the liver?

erythromycin

137

Which macrolide is fatal to horses?

tylosin

138

Which macrolide has a type 3 efficacy predictor?

azithromycin

139

What 2 drugs are lincosamides?

lincomycin
clindamycin

140

What bacteria are not effected by lincomycin?

gram negatives

141

Which lincosamide is more lipid soluble and can cross BBB?

clindamycin

142

How are lincosamides excreted?

bile

143

What animals should lincosamides not be used in?

chinchillas, guinea pigs, hamsters
horses, ponies
rabbits

144

What efficacy predictor group is lincosamides?

type 2

145

What 2 groups of antimicrobials inhibit DNA replication?

fluorquinolones
metronidazole

146

What antimicrobial drug inhibits RNA synthesis?

rifampin

147

What are the 3 first generation fluorquinolones?

naildixic acid
oxolinic acid
cinoxacin

148

What are the 4 third generation fluoroquinolones?

orbifloxacin
levofloxacin
sparfloxacin
grepafloxacin

149

What are the 7 2nd generation fluorquinolones?

ciprofloxacin
enrofloxacin
marbofloxacin
danofloxacin
difloxacin
norfloxacin
enoxacin

150

What bacterial enzyme is inhibited by fluoroquinolones?

DNA gyrase enzyme

151

Which fluoroquinolone may have activity on anaerobes?

difloxacin

152

What type of bacteria are more susceptible to fluoroquinolones in an alkaline environment?

Enterobacteriaceae and other gram negative aerobes

153

What three conditions is pradofloxacin effective for against anaerobes, gram positives and gram negatives?

pradofloxacin

154

What are the two "new" generation fluoroquinolones?

premafloxacin
pradofloxacin

155

What are the 2 factors that affect the action of fluoroquinolones?

Cations decrease activity
low pH decreases activity

156

Which fluoroquinolones can be given in water for poultry infections?

enrofloxacin
sarafloxacin

157

Which fluoroquinolone is not widely distributed in tissues?

first

158

Which 2 tissues do fluoroquinolones not achieve a high concentration?

Cns, eye

159

Which fluoroquinolone is well distributed in bone, prostate and skin and all horse tissues?

enrofloxacin

160

What tissue does enrofloxacin, marbofloxacin and orbifloxacin achieve good levels?

prostate

161

Which 2 fluoroquinolones are highly excreted in milk?

enrofloxacin
danofloxacin

162

Which fluoroquinolones have active metabolites?

Difloxacin
Enrofloxacin
Pefloxacin

163

Which fluoroquinolone exception is excreted through faeces instead of urine?

difloxacin

164

What are some of the side effects of fluoroquinolones?

Photosensitivity
CNS effects
Crystalluria
GI effects
Arthropathy/Joint Arthropathy
Ocular toxicities

165

What fluoroquinolone causes abnormalities in horses tendon cultures?

enrofloxacin

166

Why does fluoroquinolones given IV rapidly cause CNS effects?

inhibition of GABA
dont give to seizure patients

167

What is the most important bacterial resistance mechanism for fluoroquinolones?

increased efflux (alterations in gyrase enzyme and decreased uptake also mechanisms)

168

What efficacy group is fluoroquinolones?

Type 1 - max concentration

169

What is the MOA for bacitracin?

inhibits peptidoglycan synthesis

170

What are the indications for bacitracin?

topical tx of superficial infections in skin, mucosal surfaces, ear and eye

171

What is the MOA for novobiocin?

inhibits cell wall synthesis, RNA, DNA, protein, respiration

172

Do bacteria acquire resistance against novobiocin?

Yes, very quickly

173

What spectrum of activity does thiostrepton have? how is it administered?

gram + and some -
topical therapy

174

Which nitrofuran drug can have a carcinogec effect when administered chronically?

Furazolidone

175

How are nitrofurans administered?

Topically/orally
need acid environment to go into cell membrane

176

What is the MOA for virginiamycin and is it bacteriostatic or bacteriocidal?

Bacteriocidal
inhibits protein synthesis at 23s ribosomal subunit

177

What is the clinical use of virginiamycin?

growth promotion in swine, turkeys and laying hens

178

What clinical uses is carbadox used for?

growth promotant in swine
tx swine dysentery, bacterial enteritis

179

What happens if there is a toxicity of carbadox?

hypoaldosteronism (>100 ppm)

180

What is the MOA for vancomycin? Bacteriocidal or static?

inhibits peptidoglycan synthesis
bactericidal

181

What should vancomycin be combined with to treat enterococcal infections?

aminoglycoside (amikacin/gentamicin)

182

What are the 2 adverse effects of vancomycin?

nephrotoxicity
histamine release --> IV

183

What group of antibiotics is vancomycin in that is banned from using in food animals?

glycopeptides

184

Is methenamine bacteriostatic or bacteriocidal

depends on pH of urine

185

What condition is methenamine used to treat?

UTI in small animals

186

What other antibiotic should not be administered with methenamine?

sulfonamides

187

What 2 antibiotics interfere with the cell membrane?

polymyxin B
colistin (polymyxin E)

188

Are polymyxins bacteriostatic or cidal?

bacteriocidal

189

Why are polymyxins used for "bowel sterilization" before sx?

not absorbed from GIT when given orally

190

What is polymyxin B effective against in gram negative bacteria infections?

endotoxins

191

How are most polymyxins given?

topical use

192

What can polymyxins be combined with to act synergistically against gram negative bacilli?

sulfonamides

193

What is the MOA for metronidazole?

disrupts DNA structure
bacteriocidal

194

What type of bacteria is metronidazole most effective against?

systemic and enteric obligate anaerobic bacterial infections

195

What part of metronidazole can have a carcinogenic effect in rats?

a minor metabolite that evolved from splitting the metronidazole ring

196

Can nitroimidazoles be used in food producing animals?

NO - may be carcinogenic

197

What efficacy predictor group is metronidazole?

type 1 - concentration dependent

198

How is rifampin metabolized?

de-acetylation --> active metabolite
induces Cytochrome p450

199

How is rifampin excreted?

bile

200

What are some of the adverse effects of rifampin?

anemia/thrombocytopenia
hepatitis in dogs

201

what are the 5 bacteiostatic type drug groups?

sulfonamides
tetracyclines
chloramphenicol
macrolides
lincosamides

202

Which antibiotic causes bowel sterilization?

Polymyxin

203

What is it called when 2 static antibiotics work together?

additive effect

204

What group of antibiotics is effected by cations and pH?

fluoroquinolones

205

What cephalosporin is the only 2nd gen that can go into CSF?

cefuroxime

206

What antibiotic treats swine dysentery but has hypoaldosteronism toxicity?

carbadox

207

What are the antibiotics that are type 1 efficacy? (3)

aminoglycosides
fluoroquinolones
metronidazole

208

What are the 5 bacteriostatic antibiotics?

sulfonamides
tetracyclines
chloramphenicol, macrolides, lincosamides (50S)

209

Which beta lactam has low immunogenic profile?

monobactam (aztreonam)

210

Which cephalosporins are excreted in bile?

ceftriaxone
cefoperazone

211

Which bacteria are resistant to fluoroquinolones?

anaerobes

212

What is the first choice antibiotic for C. jejuni?

Erythromycin

213

What is the first choice drug for mycoplasma sp?

tiamulin

214

What bacteria are susceptible to metronidazole?

obligate anaerobes (clostridium, fusobacterium)
protozoa

215

Which antibiotics are carcinogenic?

Metronidazole
Nitrofuran

216

Which antibiotic has good effect on pseudomonas and proteus?

Polymyxin

217

Which drug group has arthropies and ocular toxicities?

fluoroquinolones

218

What bacteria are resistant to lincomycin?

gram negatives

219

What are the susceptible bacteria groups of each of the cephalosporin generations?

First - gram +
2nd - gram -
3rd - better gram -
Ceftiofur - more gram +

220

Which drug group chelates calcium in teeth and bone?

tetracyclines

221

What is the 4th generation cephalosporin?

cefepime

222

Which drug group causes fatal enterocolitis in hind gut fermenters?

lincosamides

223

What are the 4 antibiotic groups banned in food animals?

Metronidazole
Vancomycin
Nitrofurans (Furazolidone)
Chloramphenicol

224

Which antibiotics inhibit GABA?

Fluoroquinolones
Penicillin

225

What drug is combined with tetracycline for synergism against kennel cough?

novobiocin

226

Which antibiotics treat prostate infection?

Enrofloxacin
marbofloxacin
orbifloxacin
(fluoroquinolones)

227

Which macrolide causes cardio toxicity?

tilmicosin

228

How is bacterial resistance acquired against rifampin?

single step mutation --> happens quickly
use with other antimicrobials