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ClinPharm test 1
law, PK, anti-microbials
98
Veterinary Medicine
Professional
09/08/2011

Additional Veterinary Medicine Flashcards

 


 

Cards

Term
Tetracycline
Action
Definition
Protein synthesis inhibition
binds 30S ribosomal subunit
bacteriostatic
Term
Aminoglycoside action
Definition
protein synthesis inhibitor
binds 30S ribosomal subunit
bacteriocidal
Term
Amphenicol action
Definition
protein synthesis inhibitor
binds 50S ribosomal subunit
bacteriostatic
Term
Macrolides action
Definition
protein synthesis inhibitor
binds 50S ribosomal subunit
bacteriostatic
Term
Lincosamide action
Definition
protein synthesis inhibitor
binds 50S ribosomal subunit
bacteriostatic
Term
Potentiated sulfonamides
Definition
Metabolite inhibitor
Block 2 steps in folic acid synthesis pathway
Bacteriocidal
Term

Fluoroquinolones

mechanism of action

Definition
Nucleic acid synthesis inhibitors inhibit DNA gyrase bacteriocidal
Term
Beta lactam action
Definition
cell wall synthesis inhibitors
binds bacterial transpeptidases
bacteriocidal
Term
Vancomycin action
Definition
cell wall synthesis inhibitor
binds peptidoglycan precursors
Term
Requirements to sell OTC
Definition
layperson able to diagnose, monitor for side effects, if animal is responding to treatment
Term
Veterinarian responsibility with approved drugs, nutriceuticals, compounded drugs.
Definition
FDA approved: FDA responsible for safety and efficacy. Nutriceuticals, compounded drugs, extralabel use: veterinarian assumes responsibility.
Term
VCP relationship
Definition
Vet has assumed responsibility for clinical judgments, has sufficient knowledge to make preliminary diagnosis, available for followup exam.
Term
minimum label info
Definition
name and address of dispenser
serial number and date
name and address of veterinarian
directions for use
warnings/withdrawal times
Term
extralabel drug use
Definition
any use not on label, allowed with VCP relationship, if animal's health is threatened, suffering or death may result.
Term
Food animal extralabel prohibited drugs
Definition
Chloramphenicol, clenbuterol, diethylstilbestrol, dimetridazole, ipronidazole, nitroimidazoles, furazolidone (exc. topical), nitrofurazone (exc. topical), sulfas in lactaters, fluoroquinolones, glycopeptides, cephalosporins, adamantanes and neuraminidase
Term
compounded drug definition and allowed use
Definition
definition: any manipulation to make a new drug product.
Allowed use: health threatened, suffering or death may result. No FDA drug available. Made from FDA drug. Must be safe and effective. Compounded on individual patient basis. Food animal - extended withdrawal time.
Term
adv/disadv of compounded vs FDA drug
Definition
FDA: tested for safety and efficacy, quality and handling regulations, adverse event reporting system.
Term
Drug abbreviation errors to avoid
Definition
No SID, U, IU, mcg, ug, TIW, q hs, trailing zero. phoning in, parenteral syringes for oral administration. Always use leading zeros.
Term
absorption definition
Definition
Movement of drug from site of administration to systemic circulation.
Term
bioavailability definition
Definition
Fraction of administered drug that reaches systemic circulation. Lower bioavailability (oral) results in higher administered doses than IV.
Term
Distribution definition
Definition
movement of drug from systemic circulation to site of action and other tissues
Term
Clearance definition
Definition
volume of plasma cleared of a drug over time
Term
Metabolism definition
Definition
chemical modification of a drug generally resulting in a more polar, more easily excreted compound
Term
Elimination half-life definition
Definition
time required for plasma concentration of a drug to fall by half
Term
Volume of distribution
Definition
Low Vd: drug limited to plasma
High Vd: drug has distributed out of plasma
Term
Loading dose calculation
Definition
LD=target concentration * Vd
Term
Plasma tissue barrier organs
Definition
testes, placenta, prostate, eye, brain.
Term
Blood brain barrier
Definition
Glial cell layer interposed between capillary endothelial cells and nervous tissue. P-glycoprotein pumps transport drugs back into the capillary lumen.
Term
Dosage alterations with hepatic or renal disease
Definition
mild liver disease - no change
fulminant liver disease - dosage reduction
renal disease - dosage reduction for renal clearnce drugs
Term
Obligate anaerobes
Definition
Clostridium
Peptostreptococcus
Bacteroides
Fusobacterium
Term
G+ cocci
Definition
Streptococcus, Staphylococcus, Enterococcus
Term
Wimpy G-
Definition
Bordetella
Pasteurella
Mannheimia
Term
Enteric G-
Definition
E. coli
Klebsiella
Proteus
Enterobacter
Salmonella
Term
Supportive signs of infection
Definition
Fever, inflammation, clinical signs, cytology, culture, serology, PCR
Term
fever vs. hyperthermia
Definition
Fever: body raises set point: inflammation, drug-induced. Hyperthermia - hypothalamus will attempt to return body to normal temp.
Term
Host/agent interaction
Definition
a->h: commensal, normal flora, pathogen
h->a: adequacy of immune response
Term
agent/drug interaction
Definition
d->a: appropriate drug or dose kills or inhibit agent. Inappropriate dose won't kill, may develop resistance.
a->d: intrinsic or acquired resistance
Term
drug/host interaction
Definition
d->h: adverse reactions (allergic, GI, flora disruption)
h->d: pharmacokinetics
Term
empirical therapy
Definition
Antibiotic selection based on observation or experience without C&S.
Consider type of bug, general spectrum of drug
Term
Time dependent drug definition and examples
Definition
Greatest efficacy at >4x MIC for most of dosing interval.
Beta lactams, macrolides, lincosamides, sulfonamides
Term
Concentration dependent drug definition and examples
Definition
Greatest efficacy when Cmax reaches 8-10 MIC for part of dosing interval.
Fluoroquinolones and aminoglyosides
Term
Post antibiotic effect
Definition
Concentration dependent drugs have persistent antibiotic activity after falling below MIC
Term
antibiotic resistance: public health
Definition
Main factor in development of resistance is increased antibiotic use. Much ag animal use is OTC, but use in small animals is a risk as well.
Term
Categories of antibiotic resistance
Definition
Inherent resistance, internally acquired resistance (spontaneous mutation), externally acquired resistance (conjugation)
Term
Conjugation definition
Definition
pilus transfer of DNA plasmid between bacteria. Up to 8 types of resistance seen in a single plasmid
Term
Strategies to reduce development of resistance
Definition
Appropriate antimicrobial use
Infection control: decrease spread of resistant bacteria
Term
Beta lactam toxicities
Definition
Allergy, GI.
Vancomycin: IV hypersensitivity, renal, ototoxicity, bone marrow suppression
Term
Tetracycline toxicities
Definition
GI, allergy.
Staining of growing teeth
IV doxycycline fatal in horses!
Esophageal stricture in cats
Term
Aminoglycoside toxicity
Definition
nephrotoxic, ototoxic, neuromuscular blockade
Term
Amphenicol toxicity
Definition
chloramphenicols: aplastic anemia in humans. Florfenicol: severe diarrhea in horses.
Term
Macrolide toxicity
Definition
adult horses: severe colitis. Tilmicosin: fatal in horses, swine, primates. Labeled for IM use in cattle for resp disease, c/v collapse and death in cattle if given IV
Term
Lincosamide toxicity
Definition
pseudomembranous colitis in horses
Term
potentiated sulfonamide toxicity
Definition
hypersensitivity: dobermans and rottweilers. Liver, renal, skin, polyarthritis, KCS - immune mediated diseases
Term
fluoroquinolone toxicity
Definition
cartilage (dogs most sensitive), retinopathy (cats), CNS (rapid IV administration)
Term
rifampin toxicity
Definition
liver, red-orange urine
Term
metronidazole toxicity
Definition
vestibular toxicity
Term
gentamicin vs. amikacin
Definition
Gentamicin is less expensive. amikacin has fewer sites for attack and degradation by bacterial enzymes. Amikacin has slightly less toxicity
Term
Metronidazole drug interaction
Definition
ethanol interaction
Term
Beta lactam resistance mechanisms
Definition
Inactivation by beta lactamase
altered target: transpeptidase
Term
tetracycline resistance mechanisms
Definition
failure to reach site of action : efflux pumps
Term
aminoglycoside resistance mechanisms
Definition
inactivation by bacterial enzymes, failure to reach target (G-, altered porin size)
Term
Amphenicol, macrolide, lincosamide resistance mechanisms
Definition
inactivation by bacterial enzymes
Term
potentiated sulfonamide resistance mechanisms
Definition
many
Term
Fluoroquinolone resistance mechanisms
Definition
failure to reach target (altered DNA gyrase), altered target
Term
Rifampin resistance mechanisms
Definition
altered target, occurs rapidly, rifampin always used in combo with other drugs
Term
Metronidazole resistance mechanisms
Definition
unknown
Term
metronidazole spectrum
Definition
anaerobes only
Term
Rifampin spectrum
Definition
many G+ aerobes, some anaerobes. Used in combo with clarithromycin to treat rhodococcus equi in foals
Term
Fluoroquinolone spectrum and examples
Definition
Staph, G- aerobes (wimpy and enteric), pseudomonas. Ineffective against anaerobes.
enrofloxacin, marbofloxacin, orbifloxacin, difloxacin, danofloxacin
Term
Fluoroquinolone drug interactions
Definition
di and trivalent cations (sucralfate, Mg, Ca, Al, Fe) decrease absorption significantly.
Inhibits CYP - theophylline toxicity
Term
Potentiated sulfonamide spectrum and examples
Definition
Wimpy G-, Strep, *Nocardia,* UTI with enteric G-
trimethoprim sulfadiazine, trimethoprim sulfamethoxazole, ormetoprim sulfadimethoxine
Term
Lincosamide spectrum and examples
Definition
anaerobes, strep
clindamycin and lincomycin
Term
Macrolides spectrum and examples
Definition
aerobic G+, some wimpy G- resp infections
azithromycin, clarithromycin, erythromycin, tilmicosin, tulathromycin
Term
Amphenicol spectrum and examples
Definition
Broad spectrum. anaerobes, some G+ & G-, mycoplasma
Chloramphenicol, Florfenicol
Term
Aminoglycoside spectrum and examples
Definition
Aerobic G-, pseudomonas, aerobic G+
gentamicin, amikacin
Term
Tetracycline spectrum and examples
Definition
Broad spectrum, some G- & G+, lots of resistance, inconsistent against anaerobes, great for unusual organisms like anaplasma, ricketsia, ehrlichia, mycoplasma.
Oxytetracycline, doxycycline
Term
Natural penicillins spectrum and examples
Definition
Anaerobes, strep, wimpy G-
Penicillin G
Term
Aminopenicillin spectrum and examples
Definition
Wimpy G-, fewer anaerobes than Pen-G, strep, some enterococci
Ampicillin, amoxicillin
Term
Antistaph penicillins spectrum and examples
Definition
Staph!
Cloxacillin, dicloxacillin, oxacillin
Term
anit-pseudomonal penicillins spectrum and examples
Definition
pseudomonas, G+ except staph
ticarcillin, piperacillin, carbenicillin
Term
Beta lactamase inhibitor combo spectrum and example
Definition
Improved staph coverage
Clavulanate plus amoxicillin or ticarcillin
Sulbactam plus ampicillin
Term
1st generation cephalosporin spectrum and examples
Definition
+++ against G+, + against G-
Inconsistent against anaerobes
Cephalexin, cefadroxil
Term
2nd gen cephalosporin spectrum and examples
Definition
++ against both G- and G+
cefoxitin, cefaclor
Term
3rd gen cephalosporin spectrum and examples
Definition
+ against G+, +++ against G-
Ceftiofur, cefpodoxime, cefovecin
Term
Vancomycin spectrum
Definition
G+
no approved veterinary products
Term
Imipenem and vancomycin use in animals
Definition
'big guns' reserved for use in humans
Term
Anaerobic drugs
Definition
Penicillins, clindamycin, chloramphenicol, metronidazole.
Term
Staphylococcus infection drugs
Definition
Antistaph penicillins, clavamox, 1st gen cephalosporin
Term
Enterococcus drugs
Definition
Beta lactams
Aminoglycosides
Term
Streptococcus drugs
Definition
Natural penicillin, aminopenicillin
Macrolides, lincosamides, potentiated sulfas
Term
Wimpy G- drugs
Definition
Aminopenicillin, macrolides, lincosamides, tetracyclines, potentiated sulfas
Term
Pseudomonas drugs
Definition
Fluoroquinolones, 2nd and 3rd gen cephalosporins, aminoglycosides, antipseudomonal penicillins.
Term
Enteric G- drugs
Definition
Aminopenicillin +/- clavulanate, 1st gen cephalosporins, potentiated sulfas, tetracyclines, aminoglycosides, fluoroquinolones
Term
Rhodococcus equi treatment
Definition
Clarithromycin and rifampin
Term
Nocardia treatment
Definition
Potentiated sulfa at double dose
Term
Rickettsia and anaplasma treatment
Definition
Tetracyclines
Term
Mycoplasma treatment
Definition
Tetracyclines, macrolides, amphenicols
Term
Atypical mycobacteria treatment
Definition
Fluoroquinolones and macrolides
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