Term
| Differentiate between MIC and MBC |
|
Definition
MIC=Minimum inhibitory Concentration, refers to the amount required to inhibit the growth of bacteria
MBC=Minimum Bacteriocidal Concentration, refers to the amount required to kill bacteria. |
|
|
Term
| Describe what is meant by the term 'superinfection' |
|
Definition
| Overuse of antibiotics disrupts the natural, nonpathogenic flora in the body. This changes the chemical balance and allows uncontrolled growth of fungi and bacteria that are not susceptible to the antibiotic. |
|
|
Term
| What are some of the more difficult anatomical locations for antibiotics to reach? |
|
Definition
|
|
Term
| Which type of drug is contraindicated for children younger than 8 due to disrupted bone growth and teeth staining. |
|
Definition
|
|
Term
| Which two types of drug commonly cause allergic reactions |
|
Definition
| B-lactams (like penicillin) and sulfonamides |
|
|
Term
| Why are quinolones contraindicated for pregnant women? |
|
Definition
| May cause cartilage abnormalities in the baby |
|
|
Term
| Which drug has been known to cause Grey baby syndrome? |
|
Definition
|
|
Term
| How have sulfonamides been known to affect fetus'? |
|
Definition
May cause hemolysis in newborns with glucose-6-phosphate dehydrogenase deficiency
Increased risk of kernicterus (a neurological condition caused by high levels of bilirubin) |
|
|
Term
| How may vancomycin affect babies? |
|
Definition
|
|
Term
| Differentiate between conjugation, transduction and transformation |
|
Definition
Conjugation-Bacteria use pili to physically connect with another bacteria and transfer plasmids
Transduction-exchange of DNA via viruses/phages
Transformation-bacteria pick up exogenous DNA from the environment |
|
|
Term
| Which types of Antimicrobials work by inhibiting cell wall synthesis? |
|
Definition
Penicillins
Cephalosporins
Carbapenems
Monobactams
B-lactamase inhibitors |
|
|
Term
| Which types of antibiotics will bacteria with b-lactamase be resistant against? |
|
Definition
| Those with B-lactam rings, ie. Penicillins, Cephalosporins and Carbapenems |
|
|
Term
| Describe the possible adverse effects of penicillins |
|
Definition
Hypersensitivity
Diarrhea
Nephritis
Neurotoxicity
Hematologic toxicities
Cation toxicity |
|
|
Term
| Describe some adverse effects of vancomycin |
|
Definition
Fever
Chills
Flushing
Phlebitis (inflammation of a vein) |
|
|
Term
| Which drug types are protein synthesis inhibitors? |
|
Definition
Tetracyclines
Glycylcyclines
Aminoglycosides
Macrolides/Ketolides
(and Chloramphenicol, Linezolid, Clindamycin and Quinupristin) |
|
|
Term
| Which tetracycline is the drug of choice for eyecare and why? |
|
Definition
| Doxycycline, because it causes less GI upset |
|
|
Term
| What part of protein synthesis do tetracyclines interfere with? |
|
Definition
| They bind to the 30s ribosomal subunits, preventing the transfer of amino acids into the chain and thus the initiation of protein synthesis. |
|
|
Term
| What types of strains are glycylcyclines used to treat? |
|
Definition
| Strains that are resistant to tetracyclines |
|
|
Term
| Which class of drug can be used to treat lyme disease, chlamydia, cholera, mycoplasm pneumoniae infection and rocky mountain spotted fever? |
|
Definition
| Tetracyclines, specifically mentioned in the notes was doxycycline |
|
|
Term
| Describe the adverse effects of tetracyclines. |
|
Definition
GI disturbance
Deposition in teeth and bones
Liver failure
Phototoxicity
Vertigo
Teratogenicity |
|
|
Term
| Which part of protein synthesis process do aminoglycosides interfere with? |
|
Definition
| They bind to the 30s ribosomal subunits, interfering with the initiation of protein synthesis |
|
|
Term
| Which types of infections would one use aminoglycosides to treat? |
|
Definition
Tularemia (use Gentamicin)
Enterococci (usually a combo of an aminoglycoside and a b-lactam)
Pseudomonas Aeruginosa (tobramycin and sometimes a penicillin) |
|
|
Term
| Name some adverse effects of aminoglycosides |
|
Definition
Ototoxicity
Nephrotoxicity
Paralysis
Skin rash |
|
|
Term
| Which class of drugs includes tobramycin, gentamicin, neomycin, streptomycin and Amikacin |
|
Definition
|
|
Term
| Give 3 examples of macrolides/ketolides |
|
Definition
Azithromycin
Clarithromycin
Erythromycin
Telithromycin |
|
|
Term
| How do macrolides/ketolides affect protein synthesis? |
|
Definition
| They bind to the 50s ribosomal subunit, inhibiting the translocation of the protein. Thus they inhibit the 'exit' site of protein synthesis. |
|
|
Term
| What are some infections commonly treated with macrolides/ketolides? |
|
Definition
Corynebacterium Diphtheriae (erythromycin)
Chlamydia (as an alternative to tetracyclines)
Legionnaire's Disease (Azithromycin)
Syphilis (Erythromycin, if pt is allergic to Penicillin G)
Mycoplasmal Pneumonia (erythromycin, also may use tetracyclines) |
|
|
Term
| Describe adverse effects of macrolide antibiotics. |
|
Definition
Ototoxicity
Jaundice
GI disturbance
|
|
|
Term
| Which drug is used to treat infection by bacteria resistant to vancomycin? |
|
Definition
|
|
Term
What suffix is used to refer to Quinolones?
Name an exception |
|
Definition
'floxacin'
Nalidixic Acid is the exception
|
|
|
Term
| What is the mechanism of action of fluoroquinolones? |
|
Definition
| They inhibit topisomerase (DNA gyrase) and therefore they inhibit DNA replication |
|
|
Term
| How does the target spectrum change as we move from 1st generation to 4th generation fluoroquinolones? |
|
Definition
| The later generations maintain the same gram negative coverage as earlier generations but they are also effective against more gram positive organisms |
|
|
Term
Which 2 fluoroquinolones are known as the "respiratory quinolones"?
|
|
Definition
| Levofloxacin and Moxifloxacin |
|
|
Term
| Which types of infections are fluoroquinolones used to treat? |
|
Definition
Anthrax (specifically Ciprofloxacin)
Urinary Tract Infections (mostly cipro and levo)
Resistant REspiratory Infections (not cipro, mostly levo and moxi)
GI Infections (mostly cipro) |
|
|
Term
| What are some adverse effects of fluoroquinolones |
|
Definition
Diarrhea
Nausea
Headache
Dizziness
Nephrotoxicity |
|
|
Term
| Give examples of folate synthesis inhibitors |
|
Definition
Mafenide
Silver Sulfadiazine
Sulfasalazine
Sulfisoxazole
|
|
|
Term
| Give examples of folate reduction inhibitors |
|
Definition
Trimethoprim
Pyrimethamine |
|
|
Term
| How does the combination of Trimethoprim and Sulfamethoxazole affect bacterial growth? What is the name of this drug combo? |
|
Definition
These 2 drugs have a synergistic effect, thus the combo shows greater inhibition of bacterial growth than either one alone.
This drug is called Cotrimoxazole (Bactrim) |
|
|
Term
| Describe Stevens-Johnson syndrome |
|
Definition
| A potentially serious or even fatal type of skin/mucous membrane eruption that is associated with sulfonamide use. |
|
|
Term
What are the two urinary tract antiseptics discussed in the notes?
What are their mechanisms of action |
|
Definition
Methenamine-the low pH of urine causes this drug to decompose, forming formaldehyde which kills bacteria
Nitrofurantoin-inhibits bacterial DNA synthesis |
|
|
Term
| What are the 2 illnesses discussed in the notes caused by mycobacteria? |
|
Definition
|
|
Term
| What type of drug therapy is required in treatment of tuberculosis and why? |
|
Definition
| Multi-drug therapy, pts must take at least 2 types of drugs at once since the bacteria can develop resistance so quickly & easily. |
|
|
Term
| Which drug used to treat tuberculosis may cause optic neuritis and color vision problems? |
|
Definition
|
|
Term
| Name the 4 drugs most commonly used to treat tuberculosis |
|
Definition
Ethambutol
Isoniazid
Pyrazinamide
Rifampin |
|
|
Term
| Name the 3 drugs discussed used to treat leprosy |
|
Definition
Rifampin
Dapsone
Clofazimine |
|
|
Term
| Name the 4 drugs discussed in class used to treat subcutaneous and systemic mycoses (fungal infections) |
|
Definition
Amphotericin B-only for severe, life threatening situations, can be toxic
Ketoconazole
Flucytosine
Caspofungin |
|
|
Term
| Name 4 drugs used to treat cutaneous mycoses |
|
Definition
Miconazole (Monistat, yeast infections)
Grisefulvin (fungal infections in nails)
Nystatin (fungal keratitis)
Terbinafine (Lamisil)-athlete's foot |
|
|
Term
| What is the target of most antifungal drugs? |
|
Definition
|
|
Term
| Why does Griseofulvin need to be used for a long period of time when treating a fungal infection? |
|
Definition
| It only affects new cells, thus in order to entirely get rid of the infection one has to wait for all of the infected nails to grow and be clipped off while continuing to prevent infection of new cells. |
|
|
Term
Describe the mechanism of Amphotericin B and name adverse effects.
What is a way of reducing these side effects? |
|
Definition
Amphotericin B interacts with ergosterol and forms a pore in the membrane, causing cell death.
Adverse effects include fever, chills, kidney failure,hypotension and anemia
Can take benadryl/antihistamine to help with the fever/chills. |
|
|
Term
| Why might flucytosine and amphotericin have synergistic effects when used in combination? |
|
Definition
| Amphotericin works on the cell membrane while flucytosine affects DNA synthesis. Since they have different modes of action they will have even greater effect. |
|
|
Term
Describe mechanism of Ketoconazole
Which drug should ketoconazole NOT be taken with? |
|
Definition
Ketoconazole inhibits ergosterol synthesis (fungal form of cholesterol)
Should not be taken with Amphotericin B |
|
|
Term
| How could the disruption of steroid synthesis by Ketoconazole affect humans? |
|
Definition
| It will also affect adreno-steroid synthesis like cortisol, androgens and aldosterone. Thus it may interfere with endocrine functions (eg. reduced testosterone) |
|
|
Term
| How does Terbinafine affect fungal cells? |
|
Definition
It inhibits squalene epoxidase and thus it inhibits sterol synthesis, causing cell death.
|
|
|
Term
| Why does Griseofulvin only affect new cells? |
|
Definition
|
|
Term
| In what case would one use mefloquine in the treatment of malaria? |
|
Definition
| To treat a chloroquine resistant strain of malaria. |
|
|
Term
| How does Primaquine differ from most other antimalarials? |
|
Definition
| It targets the 'tissue' form of the parasite whereas most other antimalarials target the blood type. |
|
|
Term
| What types of patients should not take primaquine? |
|
Definition
| Those with glucose-6-phosphate dehydrogenase deficiency, it can cause hemolytic anemia in these patients. |
|
|
Term
| Describe the mechanism of action of chloroquine |
|
Definition
The parasite normally polymerizes heme to hemozoin (after it digest host hemoglobin). Heme is toxic to the parasite and hemozoin is not.
Chloroquine prevents the conversion of heme to hemozoin and the accumulation of heme in the parasite results in lysis of the parasite as well as the RBC it is living in. |
|
|
Term
| Which drug is used to treat Toxoplasmosis? |
|
Definition
Toxoplasmosis is a parasite that can be found in cat litter.
It can be treated with pyrimethamine |
|
|
Term
| Name some adverse effects commonly associated with chloroquine |
|
Definition
GI disturbance
SKin rash
Headache
Blurred Vision |
|
|
Term
| 5 drugs used to treat respiratory virus infections |
|
Definition
Amantidine
Oseltamivir
Ribavirin
Rimantadine
Zanamivir
|
|
|
Term
| Drugs commonly used to treat hepatic viral infections |
|
Definition
Adefovir
Entecavir
Interferon
Lamivudine
Tenofovir
Telbivudine |
|
|
Term
| Name 4 drug classes used as anticancer drugs |
|
Definition
Antimetabolites
Antibiotics
Alkylating Agents
Microtubule inhibitors |
|
|
Term
Describe mechanism of Oseltamivir (Tamiflu)
|
|
Definition
| It is a viral neuraminidase inhibitor, thus it inhibits the release of virus |
|
|
Term
| Which drug used to treat influenza A is also used to treat Parkinsons? |
|
Definition
| Amantidine, it inhibits viral uncoating. Treatment of the flu is an off-label use |
|
|
Term
| Which drug is used to treat Severe Respiratory Syncytial Virus ( RSV)? |
|
Definition
|
|
Term
|
Definition
| Inhibits DNA polymerase and HIV reverse transcriptase |
|
|
Term
| What cell machinery is targeted in treatment of HIV infection? |
|
Definition
| Nucleoside and Nucleotide reverse transcriptase |
|
|
Term
| Which phase of the cell cycle do antimetabolites affect? |
|
Definition
| The S phase, they interfere with purine and pyramidine synthesis |
|
|
Term
|
Definition
5-Fluorouracil
6-Mercaptopurine
Methotrexate |
|
|
