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Exam 2 Pharm 2
N/A
202
Pharmacology
Professional
02/19/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
Define chemotherapy
Definition
Use of natrually occuring, semisynthetic, or synthetic chemical that:  1)Treats cancer or 2) Kills or inhibits the growth of microorganisms at low concentrations
Term
Antimicrobial abuses (5)
Definition

1.  Tx of untreatable infections

2.  Therapy of fever unknown origin

3.  Improper dosage

4.  Inappropriate use of chemotherapy alone

5.  Poor drug selection, due to lack of bacteriological information

Term

Anti-infective agents:

 

1.  Primary use

 

2.  Potential bad thing?

Definition

1.  To kill or inhibit growth of organisms

 

2.  Too toxic to be used systemically

Term

Antimicrobial agents

 

1.  Desired outcome of use

Definition
1.  Selective killing of pathogens
Term
Characteristics of Ideal Antimicrobial Agents (5)
Definition

1.  Demonstrates selective toxicity

2.  No allergic reactions

3.  Is not destroyed, neutralized or excreted too rapidly by the host

4.  Therapeutic dose is established at site of infection

5.  Pathogens do not develop resistance to it

Term
Strict definition of antibiotics, although now it includes things humans make
Definition
Substances produced by microorganisms that suppress the growth or cause the death of other microorganisms
Term
Define:  post antibiotic effect (PAE)
Definition
Persistant suppression of bacterial growth that results from drug exposure after the drug has been completely removed
Term
Factors that determine whether antibiotic is static or cidal (3)
Definition

1.  Drugs MOA (most important)

 

2.  Microorganism's state of growth

 

3.  Concentration (MIC or minimum bacteriocidal concentration [MBC])

Term

Narrow-Spectrum Antibiotics

 

1.  Define

 

2.  Benefit as far as antimicrobial stewardship

 

3.  Examples (7)

Definition

1.  Mainly go after Gm+ or Gm-; may even be specific against one type of organism

 

2.  Lower risk for development of bacterial superinfections

 

3.  Bacitracin; Clindamycin; Macrolides; Metronidazole; Penicillins (Except Extended-spectrum); Polymyxins; Vancomycin

Term

Extended-Spectrum 

 

1.  Define

 

2.  Examples (6)

Definition

1.  Affects a variety of Gm+ and Gm-

 

2.  Aminoglycosides; Cephalosporins; Extended-spectrum penicillins; Fluoroquinolones; Carbapenems; Monobactams

Term

Broad-Spectrum

 

1.  Define

 

2.  Examples (3)

Definition

1.  Affects both Gm+ and Gm- bacteria and other organisms (Rickettsia)

 

2.  Sulfonamides; Tetracyclines; Trimethoprim

Term
Triad of Interaction has what 3 componenets?
Definition

1.  Host

 

2.  Drug

 

3.  Pathogen

Term
3 ways to get selective toxicity
Definition

1.  Drug blocks vital pathway unique to microorganism

 

2.  Drug blocks a reaction vital to microbe and host, but with greater blocking through microbe

 

3.  Drug blocks a pathway vital to both host and microbe, but only the microbe converts the drug to its active metabolite

Term
Targets of Antimicrobial Agents (4)
Definition

1.  Cell wall synthesizing enzymes

 

2.  Bacterial ribosomes

 

3.  Enzymes required for DNA synthesis and replication

 

4.  Viral replication machinery

Term
Genetic mechanisms of acquired resistance to antimicrobial agents (4)
Definition

1.  Mutation of bacterial gene

 

2.  Transduction:  bacteriophage

 

3.  Transformation:  uptake of naked extrabacterial DNA

 

4.  Conjugation:  sex pilus (only Gm-)

Term
4 ways to avoid antibiotic resistance
Definition

1.  Only use antibiotics with well-established need

 

2.  Select based on bacteriologic tests

 

3.  Give at sufficient dose and for sufficient time to kill the bacteria

 

4.  Multiple drug therapy only when indicated (TB, HIV)

Term
Combination antimicrobial therapy indications (4)
Definition

1.  Severe infection of unkonwn cause

 

2.  Polymicrobial infections (intestinal puncture or dog bite)

 

3.  Enhanced antibacterial activity specific infections

 

4.  Prevention of emergence of resistant microorganisms

Term
Potential results of combination antimicrobial therapy (3)
Definition

1.  Antagonism:  one drug interferes with the other

 

2.  Addition:  net result is a summation of the drugs effects

 

3.  Synergism:  inhibition of growth by combinations at concentrations <25% MIC for each drug alone (sum greater than the parts)

Term
Mechamisms of antimicrobial synergism (3)
Definition

1.  Each antibiotic affects different step in biochemical pathway

 

2.  One drug may enhance the uptake of a second

 

3.  One drug may prevent the degradation of the second

Term
Disadvantages of combo antimicrobial therapy (3)
Definition

1.  Expensive

 

2.  One agent may enhance toxicity of other

 

3.  Allows for simultaneous selection of multiple drug resistant organisms

Term
Function of bacterial cell wall
Definition
Maintain integrity under conditions of osmotic stress
Term
Peptidoglycan Synthesis Inhibiting Drugs/Classes (5)
Definition

1.  Fosfomycin

 

2.  Cycloserine

 

3.  Bacitracin

 

4.  Vancomycin

 

5.  B-lactams

Term
Subclasses of B-lactams (4)
Definition

1.  Penicillins

 

2.  Cephalosporins

 

3.  Carbapenems

 

4.  Monobactams

Term

Peptidoglycan

 

1.  2 units that repeat

 

2.  What mediates transpeptidation

Definition

1.  N-acetyl glucosamine (NAG) and N-acetyl muramic acid (NAM)

 

2.  Penicillin Binding Protein (PBP) which is a transpeptidase 

Term

B-lactam MOA

 

1.  Structural analog of what?

 

2.  Competitive or Non-competitive inhibitor?

 

3.  Result of use (cidal or static)?

 

4.  What do you NOT combine them with and why?

Definition

1.  D-ala D-ala on peptidoglycan strand

 

2.  Competitive inhibitor by binding PBP

 

3.  Cidal b/c they prevent intact bacterial cell wall from forming

 

4.  Bacteriostatic drugs b/c you need the cell wall to be synthesized in order for them to work

Term
MOA B-lactamases
Definition
Open the B-lactam ring and inactivate the B-lactam antibiotics
Term
S. aureus, Haemophilus sp., and E. coli B-lactamases are specific for?
Definition
Penicillins (narrow substrate specificity)
Term

P. aeruginosa and Enterobacter sp:

 

1.  Produce what kind of B-lactamase

 

2.  What drugs do the B-lactamases effect (2)?

Definition

1.  AmpC

 

2.  Penicillins and cephalosporins

Term
What do extended-spectrum beta-lactamases target (2)?
Definition
Both Penicillins and Cephalosporins
Term
Mechanisms of bacterial resistance to B-lactams (4)
Definition

1.  B-lactamases

 

2.  Alteration of PBPs

 

3.  Alteration of outer membrane (Gm-)

 

4.  Efflux pump (Gm-)

Term
Natural penicillins (2)
Definition

1.  Penicillin G (or benzylpenicillin)

 

2.  Penicillin V

Term
Antistaphylococcal (Penicillinase resistant) Penicillins (4)
Definition

1.  Methicillin (no longer on market)

 

2.  Nafcillin

 

3.  Oxacillin

 

4.  Dicloxacillin

Term
Extended Spectrum Penicillins Classes (3)
Definition

1.  Aminopenicillins

 

2.  Carboxypenicillins

 

3.  Ureidopenicillins

Term
Aminopenicillins (2)
Definition

1.  Ampicillin

 

2.  Amoxicillin

Term

1.  Name the one carboxypenicillin

 

2.  Special feature

Definition

1.  Ticarcillin

 

2.  Anti-pesudomonal

Term

1.  Name the 2 ureidopenicillins

 

2.  Special feature

Definition

1.  Peiperacillin and Azlocillin

 

2.  Anti-pseudomonal

Term

Natrual Penicillins Spectrum of Activity (sensitive or not)

 

1.  Gm+ aerobes (1 sensitive, 1 not)

 

2.  Gm+ anaerobes 

 

3.  Gm-

 

4.  Spirochetes

Definition

1.  Streptococci:  sensitive

Staphylococci:  Resistant

 

2.  Some bacilli:  sensitive

 

3.  Mostly resistant

 

4.  T. Pallidum (drug of choice)

Term

Natural Penicillins:  Pharmacokinetics

 

1.  Penicillin G (Procain and benzantine):  How is it administered?  

 

2.  Penicilin V:  How is it administered?

Definition

1.  Acid labile so parenterally

Also has a water insoluble depot for IM

 

2.  Acid stabile (oral)

Term

Natural Penicillins Pharmacokinetics:

 

1.  How excreted

 

2.  What is given with them to alter excretion

Definition

1.  10% glomerular filtration; 90% tubular excretion

 

2.  Probenacid which impairs tubular secretion

Term

Penicillin G

 

Drug of choice for:  (3)

Definition

1.  Sterptococci (pharyngitis)

 

2.  Meningococci (meningitis)

 

3.  T. Pallidum (syphilis)

Term
Penicillin V indicated for minor infections b/c: (3)
Definition

1.  Poor oral bioavailability

 

2.  QID dosing

 

3.  Less active than Pen G

Term
Mechanism of bacterial resistance to natrual penicillins
Definition
B-lactamases
Term

Antistaphylococcal (Penicillinase resistant) penicillins

 

Spectrum of activity against

 

1.  Staph aureus

 

2.  Compared to Pen G

 

3.  Gm -

Definition

1.  Effective against penicillinase producing Staphy aureus

 

2.  Much less active against some Gm+ than Pen G

 

3.  Inactive

 

*Used exclusively in the treatment of staphylococcal infections

Term

MRSA and Methicillin-resistant Staph epidermidis (MRSE)

 

1.  Mechanism of resistance 

 

2.  You treat MRSA and MRSE with what?

Definition

1.  PBP alterations

 

2.  Vanc

Term

Antistaphy Penicillins:  Pharmacokinetics

 

1.  Which are acid stable (2)

 

2.  Which is less acid stable and given IV (1)

 

3.  Which 2 are cleared renally?

 

4.  Which one is cleared primarily biliary?

 

 

Definition

1.  Dicloxacillin and oxacillin (also given IV for systemic Staph)

 

2.  Nafcillin

 

3.  Dicloxacillin and oxacillin

 

4.  Nafcillin (no need to adjust for renal failure)

Term
Mechanism of bacterial resistance to antistaphy penicillins
Definition
PBP alterations
Term

Extended Spectrum Penicillins

 

1.  What do they hit that the other penicillins don't

 

2.  Why?

Definition

1.  Gm- bacteria

 

2.  Enhanced ability to penetrate the Gm- outer membrane

Term

Extended Spectrum Penicillins Spectrum of Activity

 

1.  Many Gm+?

 

2.  Amoxicillin and ampicillin cover?

 

3.  Ticarcillin covers

 

4.  Piperacillin covers?

Definition

1.  Some Gm+ but not many

 

2.  Some Gm- (Haemophilus; Proteus; E.coli)

 

3.  Pseudomonas, Proteus, H. flu, E. coli

 

4.  Pseudomonas aeruginosa

Term

Major therapeutic uses Amoxicillin and Ampicillin

 

1.  Drug of choice for ___ infections

 

2.  Tx of ___ infections caused by Gm+ and Gm- organisms

 

3.  Tx of penicillin-resistant ____

Definition

1.  Enterococci

 

2.  Mixed

 

3.  Pneumococci

 

*Infectinos due to susceptible Gm- microbes

Term
Piperacillin Major Therapeutic Use is serious systemic infection caused by:
Definition

Gm-:

 

Nosocomial infections

Sepsis

Pneumonias

Infected burns

P. aeruginosa with aminoglycoside

Term

Extended Spectrum Penicillins Administration

 

1.  Aminopenicillins (which is given oral and/or IV)

 

2.  Carboxypenicillins given how

 

3.  Ureidopenicillins given how

Definition

1.  Amoxicillin and Ampicillin given orally (amoxicillin absorbed more completely)

Ampicillin also given IV

 

2.  IV (Ticarcillin)

 

3.  IV and IM (Piperacillin) 

Term

Penicillin dosing adjustments

 

1.  Which do you not need to give 1-2 h before or after a meal?

 

2.  Which do you not need to dose for renal failure?

Definition

1.  Amoxicillin

 

2.  Nafcillin

Term

Extended-Spectrum Penicillin / B-lactamase inhibitor combos

 

1.  What type of inhibitors are the B-lactamase?

 

2.  Examples of B-lactamase inhibitors (3)

 

3.  4 combinations currently on market

Definition

1.  Suicide

 

2.  Clavulanic acid

Sulbactam

Tazobactam

 

3.  Amoxicillin-Clavulanate; Ampicillin-Sulbactam; Piperacillin-Tazobactam; Ticarcillin-Clavulanate

Term

ADEs Penicillins

 

1.  Major Type and frequency

 

2.  What metabolite causes this

 

3.  Cross-sesitivity with

 

 

Definition

1.  Hypersensitivity in 1-10% of individuals

 

2.  Penicilloic acid

 

3.  B-lactam antibiotics

Term

3 Types of Allergic Reactions with Penicillins

 

Definition

1.  Acute:  occur within 30 mins of adminitration (life threatening anaphylaxis)

 

2.  Accelerated (30min to 48 hrs post-admin):  generally not lifethreatening

 

3.  Delayed (2+ days after admin):  generally mild, reversible rash (80-90% of all reactions due to penicillins)

*Can desnsitize by gradually increasing dose

Term
6 types of ADEs with penicillins and the drug that causes them if applicable
Definition

1.  Hypersensitivity

2.  N/V/D:  more common with extended spectrum b/c of GI flora disruption

3.  Nephritis:  acute

4.  Platelet dysfunction:  ticarcillin

5.  Cation toxicity:  sodium and potassium salts

6.  Neurotoxicity:  seizures when blood levels are high or intrathecal injections

Term
First Generation Cephalosporins and Route of Administration (3)
Definition

1.  Cefadroxil (PO)

2.  Cefazolin (IV)

3.  Cephalexin (PO)

Term

Second Generation Cephalosporins and Administration Route (5)

 

*Which 2 are cephamycins

Definition

1.  Cefaclor (PO)

2.  Cefprozil (PO)

3.  Cefuroxime (IV, IM)

4.  Cefoxitin (IV)

5.  Cefotetan (IV, IM)

 

*  Cefoxitin and Cefotetan

Term
Third Generation Cephalosporins and Administration Route (8)
Definition

1.  Cefixime (PO)

2.  Cefdinir (PO)

3.  Cefpodoxime (PO)

4.  Ceftibuten (PO)

5.  Cefotaxime (IV)

6.  Ceftazidime (IV/IM)

7.  Ceftizoxime (IV)

8.  Ceftriaxone (IV/IM)**Only one listed that isn't solely renal elimination

 

Term
Fourth Generation Cephalosproine and Administration Route (1)
Definition
Cefepime (IV/IM)
Term
Fifth Generation Cephalosporin and Administration Route (1)
Definition
Ceftaroline (IV)
Term

Genral Trends Cephalosporins as Generations Increase

 

1.  Gm+ vs Gm-

 

2.  Stability vs B-lactamases

 

3.  CNS penetration

Definition

1.  Gm- decreases while Gm+ increases

 

2.  Stability increases

 

3.  Penetration increses

Term

First Gen Cephalosporins

 

1.  Spectrum of activity

 

2.  Pharamcokinetics

 

3.  Major therapeutic use

Definition

1.  Broad spectrum Gm+; Many Gm- including E.coli, Kelbsiella, Proteus

 

2.  Not well distributed to CNS

 

3.  Community acquired infections (RTI and uncomplicated UTI); Surgical prophylaxis (Cefazolin)

DO NOT use in serious infecitons

 

 

Term

Second Generation Cephalosporins

 

1.  Spectrum of activity

 

2.  Major Therapeutic Use

Definition

1.  Less Gm + than first; Additionoal Gm- with B-lactamase producing H. flu and K. pneumonia

**Cephamycins = anaerobic activity

-No P. aeruginosa activity

 

2.  Oral members:  sinusitis and otitis

-Cefuroxime:  community acquired pneumonia

-Cephamycins:  Anaerobes, mixed aerobic/anaerobic infections of skin and soft tissue; intrabdominal and gyncecologic infections; surgical propylaxis

Term

Third Generation Cephalosporins

 

1.  Spectrum of activity

 

2.  Major therapeutic use

Definition

1.  Expanded Gm-

-Susceptible to enterobacter B-lactamase (AmpC) but resistant to others

-Ceftriaxone and cefotaxime:  anti-pneumococcal

-Ceftazidime:  P. aeruginosa

 

2.  Ceftriaxone and Cefotaxime enter CNS so meningitis

-Ceftriaxone and Cefotaxime used empirically for seroius infectiont hat may be caused by PCN resistant pneumococci

Term

Fourth Gen Cephalosporine

 

1.  Spectrum of activity

 

2.  Major therapeutic use

Definition

1.  Gm- with better Gm+ than 3rd

-Better resistance to Gm- B-lactamases (especially enterobacter and PCN resistant streptococci)

-Active against P.aeruginosa

 

2.  Simiarl to 3rd gen

-Enterobacter infections

-Severe infections (pneumonia, sepsis, meningitis)

Term

Fifth Gen Cephalosporin

 

1.  Spectrum of activity

 

2.  Major therapeutic use

Definition

1.  Gm- similar to 4th gen

Gm+ against MRSA

 

2.  Community-acquired pneumonia

-Comnplicated skin and skin structure infection

Term

ADEs Cephalosporins

 

1.  Major ADE

 

2.  Cephamycins (what are they and what do they do)

 

3.  Other ADEs

Definition

1.  Hypersensitivity:  1% cross reactivity with PCNs so do not give to pts with hx of PCN reaction

 

2.  Cefoxitin, Cefotetan:  contain MTT side chain with disulfiram reaction and hypoprothombinemia and bleeding b/c of anti-Vit K effects

 

3.  Pain after IM injection and thrombophlebitis IV

-Interstitial nephritis and tubular necrosis

Term
Carbapenems (4)
Definition

1.  Imipenem

 

2.  Meropenem

 

3.  Ertapenem

 

4.  Poripenem

Term

Carbapenem Spectrum of Activity

 

 

Definition

-Mmore efficient interactions with PBPs than PCNs and cephalosporins

 

-Great Gm- with broadest spectrum of activity of all B-lactams

 

-Resistant to most B-lactamases (susceptible to metallo-B-lactamase)

Term

Carbapenems Pharmacokinetics

 

1.  How administered?

 

2.  How excreted

 

3.  What inactiavtes imipenem and what prevents this?

Definition

1.  IV and IM (ertapenem with 1% lidocaine)

 

2.  Renal

 

3.  Dehydropeptidases so give with equal amount cilastain which inhibits dehydropeptidases

Term

Carbapenem Major Therapeutic Use

 

1.  Drug of choice for (2)?

 

2.  Plays role in ___ therapy

 

3.  Use w/ or w/o aminoglycoside for what type of infection

Definition

1.  ESBL infections; Enterobacter

 

2.  Empirical

 

3.  P. aeruginosa

Term

Adverse Effects Carbapenems (4)

 

*most common with imipenem

Definition

1.  H/S

 

2.  NVD

 

3.  Local Reactions

 

4.  Seizures

Term

Monobactams

 

1.  Drug (Route)

 

2.  Spectrum

Definition

1.  Aztreonam (IV)

 

2.  Resistant to B-lactamases

-**No cross reactivity with PCNs

-Narrow spectrum (Gm- including Pseudomonas)

*no activity against Gm+ or anaerobes

Term

Fosfomycin

 

1.  Route

2.  MOA

3.  Spectrum

4.  Excretion

5.  Major therapeutic use

Definition

1.  PO

2.  Inhibits step 1 in cell wall synthesis

-Structural analog of PEP

Inhibits enol pyruvate transferase:  blocking addtion of PEP to UDP-N-acetyl-glucosamine 

-PEP provides linker for glycan and peptide

3.  Broad

4.  Renal

5.  Uncomplicated lower UTI

Term

Bacitracin

 

1.  MOA

2.  Spectrum

3.  Major therapeutic use

Definition

1.  Inhibits step 3 in cell wall synthesis

-Blocks dephosphorylation of isoprentyl pyrophosphate, a lipid which arries the building blocks of peptidoglycan outside the plasma membrane

 

2.  Gram +:  Neisseria; T. pallidum

 

3.  Topical only

-Localized skin and eye infections

-Propylaxis for wounds

Term
Vancomycin Mechanism of Action
Definition
  • Bind with high affinity to D-ala D-ala terminus of pentapeptide
  • Block transglycosylase (elongation of peptidoglycan)
  • Block transpeptidation (cross-linking)
Term
Vancomycin Specrum of Activity
Definition
Active only against Gm+ bacteria...staphylococci
Term

Vancomycin Major Thearpeutic Use

 

1.  Cidal against?

 

2.  Static against when given alone?

 

3.  What combo kills #2?

 

4.  Active, but not first line for what infection?

Definition

1.  Streptococci and staphylococci including MRSA

2.  Enterococci

3.  Vanc + aminoglycoside (gent)

4.  C. diff

 

*Not active against VRSA or VRE

Term

Vancomycin Pharmacokinetics

 

Two ways administered?

Definition

1.  IV (slow infusion)

 

2.  Orally for pseudomembranous colitis caused by C. diff; however, Flagyl is initial therapy

Term
Vancomycin ADEs (4)
Definition

1.  Red Man Syndrome:  caused by vanc-induced histamine release due to rapid infusion

 

2.  Phlebitis at injection site

 

3.  Ototoxicity

 

4.  Nephrotoxicity

Term

Bacterial resistance to vanc

 

1.  MOA in VRE

 

2.  MOA in VRSA

Definition

1.  Synthesize pentapeptide with D-ala-D-lactate or D-ala-D-serine to reduce affinity for drug

 

2.  Overexpress D-ala-D-ala which competes to bind up the drug

Term

Short acting tetracycline (1)

 

1.  Drug

 

2.  Administration

 

3.  Elimination

Definition

1.  Tetracycline

 

2.  PO, IV, IM

 

3.  Renal

Term

Intermediate Acting Tetracycline

 

1.  Drug (1)

 

2.  Admin

 

3.  Elimination

Definition

1.  Demeclocycline

 

2.  PO

 

3.  Renal

Term

Long Acting Tetracyclines (3 drugs)

 

1.  Drug

 

2.  Admin

 

3.  Elimination

Definition

Doxycycline:  PO; Renal

 

Minocycline:  PO, IV; Hepatic

 

Tigecycline:  IV; Hepatic

 

 

Term

Tetracyclines

 

1.  MOA

 

2.  Static or Cidal?

 

 

Definition

1.  Reversible binding of 30S subunit of bacterial ribosome blocking aminoacyl tRNA from entering A site of ribosome

 

2.  Static

Term

Tetracyclines:  Spectrum of Activity

 

What is it active and not active against?

Definition

1.  Broad spectrum, but more Gm+ than Gm-

 

2.  MRSA

 

3.  Atypical bacterial:  rickettsia, chlamydia, mycoplasma pneumoniae, yersinia pestis, vibrio cholera, borrelia

 

4.  Inactive against:  Proteus and pseudomonas (efflux pumps)

Term
Tetracyclines are drugs of choice for (6)
Definition

1.  Atypical pneumonia (mycoplasma or chlamydia)

2.  Genital infection (chlamydia)

3.  Tick-borne disease (borrelia, reckettsia

4.  Acne (propionibacterium acnes)

5.  Peptic ulcer (H. pylori) in combo

6. Severe infections (MDR infections with GM-...tigecycline)

Term

Tetracycline Pharmacokinetics

 

1.  Absorption oral

 

2.  What alters oral absorption

 

3.  Distribution

Definition

1.  30-100% so highly variable

 

2.  Divalent and trivalent cations decrease; decreased with elevated gastric pH (PPIs etc)

 

3.  Wide:  accumulating in liver, spleen, bone marrow, and in newly formed bone, dentine, and enamel of unerupted teeth

-Good CNS penetration

-Crosses placenta

Term

1.  Tetracyclines Mechanism of Bacterial Resistance (3)

 

2.  What 3 tetracyclines do resistance not typically develop to?

Definition

1.  Increased efflux or decreased influx; Ribosomal protection; Enzymatic inactivation

 

2.  Doxycycline, minocycline, tigecycline (Long acting)

Term
Tetracycline ADEs (5)
Definition

1.  GI (NVD) and superinfections

-To avoid:  food, carboxymethylcellulose, dec dose, D/C

 

2.  Photosensitivity

3.  Hepatotoxicity

4.  Renal toxicity

5.  Permanent discoloration of teeth so avoid in pregnant women and kids under 8

Term
How are all aminoglycosides eliminated from the body?
Definition
Renal excretion
Term

Aminoglycosides 

 

1.  MOA

 

2.  Cidal or static?

 

3.  ____ dependeint killing

 

4.  Significant ____

Definition

1.  Irreversible 30S binding 

-Interferese with initiation complex, produces mRNA misreading, blocks translocation of ribosomes

 

2.  Cidal

3.  Concentration

4.  PAE

Term

 Aminoglycoside

 

1.  Spectrum

 

2.  Which one hits P. aeruginosa?

 

3.  No activity against?

Definition

1.  Aerobic Gm-

 

2.  Tobramycin

 

3.  Anaerobes

Term

Major Therapeutic Use Aminoglycosides

 

1.  Combo with what to treat what

2.  Gentamycin

3.  Tobramycin

4.  Amikacin

5.  Neomycin

Definition

1.  PCN or vanc to act synergistically on Staph and S. epidermidis

2.  IV:  Severe Gm- infections; topical:  infected burns

3.  Inhalation:  P. aeruginosa cystic fibrosis

4.  TB

5.  Preoperative bowel prepartion (PO) and skin infections (topical)

Term

Aminoglycoside Pharmacokinetics

 

1.  Absorption

 

2.  Distribution

 

3.  Excretion

Definition

1.  Highly polar so poor GI; IV/IM administration

 

2.  Not well to most cells, eye, or CNS

High concentration only in inner ear and renal cortex (toxicity here)

 

3.  Renal 

Term
Aminoglycosides ADEs (3) and, if applicable, what drugs cause them
Definition

1.  Ototoxicity (irreversible):  avoid in pregnancy

 

2.  Renal toxicity (reversible):  Gentamycin, tobramycin

 

3.  Neuromuscular blockate (reversible) when used in very high doses...curare like effect

Term
Aminoglycoside mechanism of bacteiral resistance (3)
Definition

1.  Enzymatic inactivation of the drug 

 

2.  Mutation of bacterial ribosome

 

3.  Impaired entry of drug into cell (decreased influx)

Term

Spectinomycin (Aminocyclitol not aminoglycoside)

 

1.  Route of admin

2.  MOA

3.  Spectrum

4.  Therapeutic use

5.  ADEs

6.  Static or cidal?

Definition

1.  IM

2.  Reverible binding to 30S

3.  Gm-

4.  Antibiotic resistant gonorrhea, or gonorrhea in PCN-alergic pts

5.  Nephrotoxicity, anemia (rare)

6.  Static

Term
Macrolides (3) with drug, administration, and elmination
Definition

1.  Erythromycin:  PO/IV (lactobionate); Hepatic

 

2.  Clarithromycin:  PO; Renal

 

3.  Azithromycin:  PO/IV; Hepatic

Term
Ketolide (1) Drug, administration, elimination
Definition
Telithromycin:  PO; hepatic
Term

Macrolide Antibiotics MOA

 

1.  MOA

2.  Static or Cidal?

3.  Site of action very close to what 2 other drugs?

Definition

1.  Binds reversibly to 50S blocking aminoacyl translocaiton

 

2.  Static

 

3.  Clindamycin; streptogramin type B

Term

Macrolide Spectrum of Activity

 

1. General

 

2.  Clarithromycin and azithromycin more effective than ___ against ___

 

3.  Azithromycin highly active against what bacteria

Definition

1.  Gm+ including PCN-resistant streptococci

 

2.  Erythromycin against anaerobes

 

3.  Chlamydia

Term

Macrolide Antibiotics 

 

1.  Distribution

 

2.  Major therapeutic use (general and then azithromycin)

Definition

1.  Poor CNS penetration

 

2.  Alternative to PCNs in case of allergy

-Azithromycin:  community acquired pneumonia, atypical infection; mycobacterium avium complex infection (MAC)

Term
Macrolide ADEs (6) including Telithromycin
Definition

1.  GI disturbance b/c of GI motility stimulation

2.  H/S

3.  Telithromycin:  hepatotox (BBW) and worsening myasthenia gravis (BBW)

4.  Local reaction at injection site (erythromycin lactobionate)

5.  QT prolongation

6.  Ototoxicity

Term

Macrolide Drug interactions and why

 

*Which one doesn't

Definition

1.  Inhibit CYP3A4:  Theophylline, Warfarin, Cyclosporine, Methylprednisolone

 

*Azithromycin

Term
Macrolide Mechanism of Bacterial Resistance (3)
Definition

1.  Efflux

 

2.  Modificaiton of bacteiral ribosome, rendering it unable to bind the antibiotic (MLSb resistance)

 

3.  Enzymatic inactivation of drug

 

*most resistant strains susceptible to telithromycin:  less efflux and higher ribosomal affinity

Term

Lincosamides-Clindamycin

 

1.  MOA

 

2.  Spectrum

Definition

1.  Reversible binding 50S

-Bacteriostatic blocking of aminoacyl translocation

 

2.  Most Gm+ and anaerobes (esp B. fragilis)

*NO activity against Gm-

Term

Clindamycin

 

1.  Administration

 

2.  Distribution

 

3.  Excretion

Definition

1.  PO/IV

 

2.  Widely distributed; low concentrations CNS; Penetrate well into abcess

 

3.  Hepatic

Term
Clincamycin:  Major therapeutic use
Definition

1.  Skin and soft tissue infection

 

2.  Anaerobic infections

 

3.  Prophylaxis of endocarditis in patients with valvular heart disease undergoing dental surgery

Term
Clindamycin ADEs (4)
Definition

1.  NVD, abdominal pain, psudomembranous colitis

 

2.  Local reactions at injection site

 

3.  Impaired hepatic function

 

4.  Neutropenia

Term

Clindamycin Mechanism of Bacterial Resistance (2)

 

Definition

1.  Modifications of bacterial ribosome rendering it unable to bind antibiotics (MLSb resistance)

 

2.  Enzymatic inactivation of drug

Term

Streptogramins

 

1.  Drug

 

2.  MoA

Definition

1.  Quinupristin/dalfopristin (30:70)

 

2.  Quinupristin binds 50S at same site as macrolites and dalfopristin binds nearby acting synergistially with quinupristin

Term

Quinupristin/dalfopristin

 

1.  Spectrum of activity

 

2.  Cidal or static?

 

3.  Administration

 

4.  Elimination

Definition

1.  Gm+ including VRSA and VRE

 

2.  Individually:  static; Combined:  cidal

 

3.  IV

 

4.  Hepatic

 

Term
Quinupristin/dalfopristin Major Therapeutic Use
Definition
1.  Antibiotic resistant Gm+ VRSA or VRE
Term

Quinupristin/dalfopristin

 

1.  ADE

 

2.  Drug interactions

Definition

1.  Pain and phlebitis at injection site

 

2.  Inhibits 3A4 (warfarin and cyclosporine)

Term
Quinupristin/dalfopristin bacterial resistance mechanism (3)
Definition

1.  Efflux

 

2.  Modification of bactierial ribosome (MLSb)

 

3.  Enzymatic inactivation of drug

Term

 Chloramphenicol:

 

1. MOA

2.  Static or cidal?

3.  Spectrum?

Definition

1.  Binds reversibly to 50S blocking transpeptidation

 

2.  Static

 

3.  Broad spectrum (Gm+ and Gm-; anaerobes; rickettsiae)

Term
Chloramphenicol major therapeutic use
Definition

1.  Serious infections for which other drugs are ineffective or contraindicated:

 

Severe rickettsial infection

B-lactam H/S with meningitis

Term
Chloramphenicol ADEs (3)
Definition

1.  GI (NVD)

 

2.  BBW:  Bone marros suppression/aplastic anemia

 

3.  Grey baby syndrome:  inadequate glucuronidation leading to sock and death of 40% of patients in 2 days

*Do not use in infants

Term

Oxazolidinones-Linezolid

 

1.  MOA

2.  Spectrum

3.  Major therapeutic use

4.  Static or cidal?

Definition

1.  Binds 50S of bacterial ribosomes preventing formation of initation complex

2.  Mostly Gm+ including VRSA and VRE

3.  Antibiotic resistant Gm+ VRSA and VRE

4.  Static

Term

Linezolid

 

1.  Admin

2.  Elimination

3.  ADEs (2)

4.  Reason for bacterial resistance

Definition

1.  PO/IV

2.  Hepatic

3.  Hematologic disturbances (thrombocytopenia, anemia, neutropenia)

--Serotonin syndrome when combined with serotonergic drugs

4.  Mutation of binding site

Term
MLSb resistance in what 3 agents?
Definition

1.  Macrolides

 

2.  Clindamycin

 

3.  Streptogramin type B (quinuprist)

 

*Mustation of 50S gives resistance to all these agents

Term

Concentration Dependent activity with Significant PAE

 

1.  Drugs (4)

 

2.  Goal of therapy

Definition

1.  Aminoglycosides; Daptomycin; Fluoroquinolones; Ketolides

 

2.  Maximize concentrations

Term

Time-dependent activity and minamal PAE

 

1.  Drugs (5)

 

2.  Goal of therapy

Definition

1.  Carbapenems; Cephalosporins; Erythromycin; Linezolid; Penicillins

 

2.  Maximize duration of exposure

Term

Time-dependent actvity and moderate to prolonged PAE

 

1.  Drugs (5)

 

2.  Goal of therapy

Definition

1.  Azithromycin; Clindamycin; Oxazolidinones (Linezolid); Tetracyclines; Vancomycin

 

2.  Maximize amount of drug

Term

Gram Staining

 

1.  Gm+ are what color?

 

2.  Gm- are what color?

Definition

1.  Blue/Vilet

 

2.  Pink/Red

Term
Bacterial cytoplasmic membrane has no ___ or other ___
Definition
Cholesterol or other sterols
Term

Gram Negative Bacteria

 

1.  No ___ acid

2.  Outer membrane anchored to cell wall by what?

3.  What component of LPS is toxic to humans and what does it cause?

4.  What does outer LPS-containing layer block?

Definition

1.  Teichoic acid

 

2.  Murein lipoprotein

 

3.  Lipid A (endotoxin) which is released upon lysis causing fever, diarrhea, septic shock (endotoxic)

 

4.  Blocks out antibiotics and lysozyme

Term

Gram Positive Bacteria

 

1.  Contains ___ acid not found in Gm-

 

2.  What does the inner surface of the cell wall touch?

 

3.  Reason they end up stained purple?

Definition

1.  Teichoic acid

 

2.  Outer surface of cytoplasmic membrane

 

3.  Meshed enough to allow crystal violet in, but traps it so it cannot be washed away by alcohol

Term
4 major bacterial shapes
Definition

1.  Cocci

 

2.  Bacilli

 

3.  Spiral forms

 

4.  Pleomorphic-lacking a specific shape

Term
6 main Gm+ organisms that cause disease and humans and their shape and spore forming ability
Definition

1.  Streptococcus sp:  chains of cocci

2.  Staphylococcus sp:  clumps of cocci

3.  Bacillus sp:  rods that form spores

4.  Clostridium sp:  rods (no spores)

5.  Corneybacterium sp:  rods (no spores)

6.  Listeria sp:  rods (no spores) only Gm+ organism that has endotoxin

Term
Gram negative bacteria shapes (3)
Definition

1.  Neisseria sp:  diplococci

 

2.  Spirochetes:  treponema pallidum-->too small to be seen with light microscopy

 

3.  The rest are rods

Term

Cell structure Bacteria

 

1.  Define nucleoid 

2.  Transcription and translation are ____ 

3.  Function of plasmids

4.  Function fo plasma membrane

5.  Gm+ or Gm- contains teichoic acid?

Definition

1.  Contains circular DNA (one chromosome) and no nuclear membrane 

2.  coupled:  can be done at same time unlike eukaryotic cells 

3.  Extra DNA usually with resistance genes

4.  Energy production, metabolite transport, synthesis of cell wall and capsule, support

5.  Gram +

Term

Mycobacterium Cell Wall

 

1.  What surrounds peptidoglycan-like layer and acts as a drug target?

 

2.  #1 also responsible for what?

 

3.  What other 2 species also produce #1

Definition

1.  Mycolic acid in lipid coat

 

2.  Virulence and antiphagocytic activity of mycobacteria

 

3.  Corneybacterium and nocardia spp.

Term

Bacterial component definitions

 

1.  Capsule and which 4 bacteria found in

 

2.  Pili (fimbrae)

 

3.  Flagella

Definition

1.  Polysaccharide capsule surrounding some bacteria which is poorly antigenic and also makes phagocytosis more difficult

-S. pneumoniae, Klebsiella pneumoniae, Neisseria meningitidis, and H. flu b

 

2.  Short appendages that promote adherence to host cells (sex pili)

3.  Long appendages for motility

Term

Bacterial Oxygen Requirements

 

1.  Obligate aerobes

 

2.  Anaerobes

 

3.  Aerotolerant anaerobes

 

4.  Facultative anaerobes

Definition

1.  Require O2

 

2.  Do not require O2

 

3.  Can survive with low O2, but thrive without it

 

4.  Can grow under both anaerobic and aerobic conditions

Term
Virulence factors:  EAT RICE
Definition

1.  Enzyme-mediated tissue damage

2.  Adherence:  pili

3.  Toxin-induced localized and systemic effects:  LPS

 

4.  Resistance to antibiotics

5. Invasion and growth in normally sterile sites (blood, lung, CNS)

6.  Circulation via the blood or other means spreading from primary infection site:  tissue damage

7.  Evasion of host immune response by capsule, catalase, intracellular growth, or other mechanims

Term

Staphylococcus aureus

 

1.  Most __ of staphylococcus spp

2.  2 toxin-mediated diseases

3.  Inflammatory diseases 

Definition

1.  Virulent

 

2.  food poisoning, toxic shock syndrome

 

3.  With pyrogenic and necrotic functions-range from mild skin lesions to life-threatening systemic disease and bacteremia 

Term

Staphyloccus epidermidis

 

-Most common site of infection

Definition
Prosthetic heart valves, stents, and prosthetic joints
Term

Staphyloccus saprophyticus

 

-Common type of disease caused

Definition
-Frequent cause of UTIs in sexually active young women
Term
Streptococcus pyrogenes and pneumonia cause what 3 dieseases
Definition

1.  Serious neonatal disease

 

2.  Endocarditis

 

3.  Dental caries

Term

Streptococcus pyogenes

 

1.  Group __ Strep

 

2.  Types of infections caused (5)

Definition

1.  A

 

2.  Strep throat

Skin infections

Postsurgical cellulitis

TSS, scarlet fever

Nonsuppurative autoimmune sequelae (glomerulonephritis and rheumatic fever)

Term

Enterococcus spp.

 

1.  Normal flora where?

 

2.  What is common in this species

 

3.  3 common diseases

Definition

1.  Large intestine and feces

 

2.  Antibiotic resitance is common

 

3.   UTIs (hospital pts); Endocarditis; Wound infections

Term

Bacillus spp.

 

1.  Cause what?

 

2.  Produce what that is highly toxic, causing localized edema and cell death

 

3.  What are the 2 forms

 

4.  Were to do spores live?

Definition

1.  Anthrax

 

2.  Exotoxin

 

3.  Cutaneous and pulmonary

 

4.  Spores can survive in soil, wool, hair, and animal hides for years

Term

Clostridium spp

 

1.  4 major types

 

2.  Gm+/-?

 

3.  Aerobic or anaerobic

 

4.  Form ___ and produce potent ___

Definition

1.  C. botulinum, difficile, perfringens, tetani

 

2.  Gm+

 

3.  Anaerobic

 

4.  spores and produce potent exotoxins

 

*gas gangrene, tetanus, botulism, necrotizing enterocolitis

Term

Corynebacterium diphtheriae

 

1.  Causes of what?

Definition
1.  Respiratory and cutaneous diphtheria
Term

Enterobacteriaceae

 

1.  Includes what (6)

Definition

1.  E. coli

2.  Klebsiella spp

3.  Salmonella spp

4.  Shigella spp

5.  Yersinia spp

6.  Proteus spp

Term
E. coli causes what infections (4)
Definition

1.  Gastroenteritis

 

2.  UTI

 

3.  Neonatal meningitis

 

4.  Septicemia

Term
Salmonella causes what types of inections (2)
Definition

1.  Enteritis

 

2.  Typhoid fever

Term
Shigella causes what disease (1)
Definition
1.  Dysentary
Term
Neisseria meningitidis causes what?
Definition
Meningitis, ususally in kids under 5 and college/military personnel
Term
Neisseria gonorrhoeae causes what infection
Definition
Acute gonorrhea, PID, infection of female reproductive organs
Term
H flu (b) causes what infections (4)
Definition

1.  Meningitis

 

2.  Epiglottis

 

3.  Arthritis

 

4.  Otitis

Term
Pseudomonas Aeroginosa causes what type of infections
Definition

Opportunistic:

 

UTI, burn/wound infections, ear infections, skin infections, pulomary infections (CF pts)

Term

Fungi

 

1.  Membranes contain what instead of cholesterol

Definition
1.  Ergosterol
Term
3 Forms of Fungi with definition of each
Definition

1.  Molds (filamentous fungi):  granching tubular filaments (hyphae) that elongate at the tipes; may be segmented or longa nd multinucleated

 

2.  Yeasts:  unicellular, round or slightly oblong; may develop pseudohyphae

 

3.  Dimorphic fungi:  exist as molds or yeasts depending on environment

Term

Fungi reproduction

 

1.  Molds

 

2.  Yeasts

Definition

1.  spores

 

2.  budding

Term

Define the following categories of fungal infections

1.  Superficial mycoses

2.  Cutaneous mycoses

3.  Subcutaneous mycoses

4.  Systemic mycoses

5.  Cadidiasis

Definition

1.  Surface of hair, nails, skin

2.  Epidermis and deeper layers of skin, hair, and nails

3.  Dermis and subcutaneous tissues and muscles-cause chronic nodules or ulcers in SC tissue

4.  Inhaled from the environment and produce lung infections that spread in immunocompromised host

5.  Cause by candida albicans-opportunistic pathogen

Term

Superficial mycoses

 

1.  Immune response?

 

2.  __ problem

 

3.  What do they alter in the body

 

4.  Use ___ tx

Definition

1.  No

 

2.  Cosmetic

 

3.  Change color of skin or infect hair

 

4.  Topical

Term

Cutaneous mycoses

 

1.  Caused by 30 different fungi called ___

2.  Includes what diseases

3.  Type of tx

Definition

1.  Dermatophytes

 

2.  Ringworm, jock itch, athlete's foot, scalp infection, nail infection, cutaneous candidiasis (oral thrush), vulvovaginitis

 

3.  Topical

Term

Subcutaneous mycoses

 

1.  Often caused by what that may contain melanin

 

2.  How do they enter the person?

 

3.  What one is associated with thorn pricks in gardeners

Definition

1.  Organisms in the soil

 

2.  Breaks in skin

 

3.  Sporothrix schenckii

Term

Systemic Mycoses:  Basics about the following

 

1.  Aspergillus spp

 

2.  Pneumocystic jiroveci

 

3.  Coccidiodes immitis

Definition

1.  Induces allergic rxns and becomes systemic in immunocompromised patients

 

2.  May be classified as protozoan; interstitial pneumonia in AIDS patients

 

3.  Endemic in desert areas of southwestern US; San Joaquin Valley fever which is an acute, self-limiting flu-like illness

Term

Systemic Mycoses:  Basics about the following

 

1.  Cryptococcus neoformans

 

2.  Histoplasma capsulatum

Definition

1.  Found in pigeon droppings; Can appear as a tumor on scans; Can spread to CSF in AIDS patients

 

2.  Endemic in Ohio and Mississippi river valley; Found in bird and bat droppings; pulmonary granulomas visible on X-ray

Term

Introduction to parasites

 

1.  2 Groups causing human dissease

 

2.  Pro or Eukaryotes?

 

3.  Replicaiton occurs in?

 

4.  How are human tissues damage?

Definition

1.  Protozoa and helminths

 

2.  Eukaryotes

 

3.  Specific cell types or organs; may be species specific

 

4.  Toxic substances produced by parasite; Mechanical damage from size or movement of parasite; Immune response

Term

Describe the following intestinal and urogenital protozoa

 

1.  Cryptosporidium spp

2.  Entamoeba histolytica

3.  Giardia lamblia

4.  Trichomonas vaginalis

Definition

1.  Self-limited watery diarrhea and flu-like sx (severe and prolonged diarrhea in AIDS pts)

2.  Watery diarrhea with blood and mucus in stools (amebic dysentary); liver abcesses

3.  Watery, foul-smelling diarrhea with malabsorption, flatulence, and cramps; often acquired from drinking contaminated creek water (hikers, campers)

4.  Vaginitis with frothy discharge (due to flagella motion); STD

Term

Describe the following blood and tissue protozoa

 

1.  Leishmania spp

 

2.  Plasmodium spp

 

Definition

1.  Endemic in tropical and subtropical regions

-Sandfly transmision

-Infects macrophages:  cutaneous, mucocutaneous, and visceral disease

 

2.  Endemic to tropical regions

-Transmitted by female Anopheles mosquito

-Causes malaria

-Life cycle takes place in mosquito, human liver, and human RBCs

Term

Describe these blood and tissue protozoa

 

1.  Toxoplasma gondii

 

2.  Trypanosoma cruzi

Definition

1.  Cat litter, ingestion of undercooked meat, in utero

-Mononucleosis-like syndrome in healthy people

-Potentially fatal encephalitis in immunocompromised pts

 

2.  Endemic to South America

-Transmitted by reduviid bug

-Causes Chagas' disease:  cardiomyopathy, megacolon, megaesophagus

Term

Describe the following blood and tissue parasite

 

1.  Trypanosoma brucei

Definition

1.  Endemic to West Africa

 

2.  Transmitted by tsetse fly

 

3.  Causes sleeping sickness (early enlargement of posterior cervical lymph nodes-later CNS involvement)

Term

Describe the following helminths:  

 

1.  Ascaris lumbricoides (roundworms)

 

2.  Enterobius vermicularis (pinworms)

Definition

1.  Ingestion of food or soil containing larvae

-May cause intestinal obstruction with growth

-Pneumonitis with eosinophila with larval migration

 

2.  Perianal pruritis and itching

-Fecal-oral transmission and self-reinfection from touching anus and then mouth

-Scotch tape test

Term

Describe the following helminths:

 

1.  Necator and Ancylostoma spp.:  hookworms

 

2.  Strongyloides stercoralis:  threadworm

Definition

1.  Located in soil, enter humans between toes

-Diarrhea, abdominal pain, weight loss

-Worm sucks blood from intestine:  anemia

-Larvae travel to lung:  pneumonitis

 

2.  Soil

-Dermatitis

-Larval migration causes pneumonitis

-Immunicompromised pts:  disseminated infection

Term

Describe the following helminth

 

1.  Trichinella spiralis

 

Definition

1.  Transmitted by undercooked meet...pork

 

-Encysted larvae in muscle:  extreme muscle pain

 

-Fever, diarrhea, eye edema, hemorrhages under nails

Term

Describe the following helminths:  flukes and flatworms

 

1.  Schistosoma spp:  blood an bladder flukes

 

2.  Taenia spp:  beef and pork tapeworms (up to 10m)

Definition

1.  Transmission:  skin penetration by motile larvae-snails are intermediate hosts

-Fibrosis of live rand ascites

-Bladder granulomas and hematuria

-Eggs are covered with spines-stool or urine

 

2.  Suckers and hooks on larvae

-Abdominal pain, diarrhea, weight loss

-Brain, eye, and muscle involvement (cysts and inflammation) due to ingestion of eggs rather than larvae...rare in US

Term

Describe the following helminths:  flukes and flatworms

 

1.  Diphyllobothrium latum:  fish tapeworm (45 m long)

 

2.  Echinococcus granulosus:  dog tapeworm

 

Definition

1.  Raw or undercooked freshwater fish

-Human, crustacean, fish involved in lifecycle

-Can absorb B12:  anemia

 

2.  Dogs and sheep invovled in lifecycle

-Humans ingest eggs, which hatch in intestine, bore through intestinal wall, and disseminate

-Larva forms a cyst which can grow 5-10 cm in liver, lung, or brain

-Humans allergic to cystic fluid:  cyst rupture can be fatal

-May be misdiagnosed as tumors

Term

1.  Define viral Virion

 

2.  Enveloped?

Definition

1.  Genome (DNA or RNA) packaged in a protein coat (capsid)

 

2.  May or may not be enveloped

Term
6 types of viral genomes
Definition

1.  ssDNA

2.  dsDNA

3.  +RNA=mRNA

4.  -RNA

5.  dsRNA

6.  Segmented genome in several small pieces 

Term

Viral Replication Basics

 

1.  DNA viruses

 

2.  RNA viruses

 

3.  Retroviruses

Definition

1.  DNA enters nucleus of host and is translated into mRNA/protein

 

2.  Already mRNA or converted to mRNA (-RNA virus) to make viral proteins

 

3.  Reverse transcriptase makes DNA from RNA and DNA inserts into host genome

Term
8 steps of viral replication
Definition

1.  Viral attachment

2.  Entry into host cell

3.  Uncoating of viral nucleic acid

4.  Synthesis of early regulatory proteins

5.  Synthesis of RNA or DNA

6.  Syntehsis of late structural proteins

7.  Assembly of viral particles

8.  Release from host cell

Term

Types of Viral Infections:  Define

 

1.  Cytolytic

 

2.  Chronic

 

3.  Latent

 

4.  Immortalizing 

Definition

1.  Viral replicaiton kills host cell

 

2.  Continual production of virions without host lysis or immune resolution

 

3.  Dormant virus until stress or immunosuppression activates it to cytolytic or chronic infection

 

4.  Persistant infection leads to cancer:  inhibits activation, acts as mitogen, inhibits tumor suppressor proteins

Term
7 mechanisms of viral pathology
Definition

1.  Inhibit cellular protein synthesis

2.  Inhibit cellular DNA synthesis or degrade DNA

3.  Alteration of cell membranes (glycoprotein insertion, syncytia formation, permeability changes)

4.  Disruption of cytoskeleton

5.  Formation of inclusion bodies

6.  Toxicity of virion components

7.  Immunosuppression

Term

Incubation period

 

1.  What determines?

Usual length of time

2.  Disease manifesting at site of entry

3.  Disease manifesting in tissues distant from site of entry

4.  Diseases resulting from immune system damage

Definition

1.  Site of disease and time needed for damage to occur 

 

2.  <1 week (exception is papillomavirus:  7-21 wks)

 

3.  1 wk to several months

 

4.  Several weeks to years

Term

Clinical course of viral disease:  Explain

 

1.  Acute infections

 

2.  Persistent infections

 

3.  Conventional slow infections

Definition

1.  Immune system can eliminate virus and infection resolves

 

2.  Immune system only partially eliminates virus

 

3.  All involve neuronal tissue and have a very slow increase in viral load

Term

Nonenveloped DNA virus

 

1.  Example given

2.  Mechanism of infection

3.  Production of proteins that do what?

4.  How transmitted

Definition

1.  Human papillomavirus

 

2.  Infects and replicates in cutaneous and mucosal epithelial tissue

 

3.  Inactive tumor suppressor proteins Rb and p53 leading to host cell hyperplasia

 

4.  Direct contact:  sex or child birth

Term

Herpesviridae

 

1.  Type of virus

 

2.  What distinuishes different families

 

3.  2 types of infections caused

 

4.  Unique feature of the example virus given

Definition

1.  Enveloped DNA

 

2.  Glycoprotein spikes on envelope

 

3.  Cytolytic or persistent infection

 

4.  Latent infection for life of host

Term

Herpesviridae

 

1.  Where does envelopment of virus occur

 

2.  What are the primary sites of HSV-1 and HSV-2, even though they can infect either

 

3.  Why doesn't immune system clear it?

Definition

1.  Nuclear membrane after capsid formed

 

2.  HSV-1:  oral

HSV-2:  genital

 

3.  No viral antigens expressed on nerves where it lies dormant

Term

Varicella zoster virus

 

1.  Type of virus in what family

 

2.  2 diseases caused

 

 

Definition

1.  Enveloped dsDNA virus in herpesviridae family

 

2.  Chickenpox:  bad in immunocompromised ppl

 

Shingles:  VZV reactivation

Term
Varicella zoster lifecycle
Definition

1.  Infection at respiratory tract, migration to lymphoid tissue

2.  After 14 days, goes out to skin and cause the formation of swollen, multiucleated cells creating lesions 

Term

Shingles

 

1.  What % of individuals get it with prior exposure to VZV

 

2.  What happens when it occurs

Definition

1.  20%

 

2.  Virus reactivates in ganglion and travels to sensory nerves in skin

-Restricted to area of skin innervated by infected nerve

-Associated with intense destructive inflammatory changes in ganglion

-Most reactivation occurs spontaneously, but stress and trauma can also cause

Term

Epstein-Barr Virus (EBV)

 

1.  Type of virus and family

 

2.  What type of cell is infected

 

3.  How transmitted

 

4.  Diseases associated with EBV

Definition

1.  Enveloped dsDNA virus of herpes family

 

2.  B-lymphocytes:  can be latent until activation with lytic infection

 

3.  Oral secretion

 

4.  Infectious mononucleosis, Burkitt's lymphoma, nasopharyngeal carcinoma, Hodgkin's disease, other lymphoid and epithelial tumors

Term

Pox viruses

 

1.  Type of virus

 

2.  What specific virus is usually asymptomatic in children and adults?

Definition

1.  Enveloped DNA viruses

 

2.  Cytomegalovirus

Term

Hepadnaviridae

 

1.  Type of virus

 

2.  Only human pathogen is?

Definition

1.  Enveloped DNA

 

2.  Hepatitis B

Term
Nonenveloped RNA viruses (6)
Definition

1.  Poliovirus

2.  Coxsackieviruses

3.  Hep A

4.  Rhinoviruses (common cold)

5.  Rotoviruses

6.  Norwalk virus

Term

Poliovirus

 

1.  Type of virus

 

2.  3 outcomes

 

3.  Infected cells

Definition

1.  Nonenveloped RNA

 

2.  Paralytic, nonparalytic, minor illness

 

3.  Receptors on muscle and nerve cells

Term

Coxsackievirus A

 

1.  AKA

 

2.  Type of virus

Definition

1.  Hand-foot-and-mouth

 

2.  Nonenveloped RNA

Term

Rotovirus

 

1.  Type of virus

 

2.  How transmitted

 

3.  Results of infection

 

4.  Can be deadly in what pt population

Definition

1.  Nonenveloped RNA

 

2.  Fecal-oral

 

3.  Diarrhea and vomiting

 

4.  Infants (dehydration)

Term
Large enveloped RNA viruses (5)
Definition

1.  Measles

2.  Mumps

3.  Influenza

4.  RSV

5.  SARS

Term
Small and midsized enveloped RNA viruses (6)
Definition

1.  Rabies

2.  Ebola

3.  Marburg

4.  Hantavirus

5.  Rubella

6.  Hep C

Term
Retroviruses (2)
Definition

1. HIV

 

2.  Human T-cell lymphotropic virus 1 (HTLV-1)

Term

Influenza

 

1.  Type of virus and family

 

2.  2 key glycoproteins

 

3.  How often dose large antigenic shift occur?

 

4.  Major site of infectivity (specific cells)

Definition

1.  ssRNA virus from Orthomyxoviridae family

 

2.  Hemagglutinin:  attachment

-Neuraminidase:  aid in release of virions from host

 

3.  10-40 years

 

4.  Ciliated columnar epithelial cells

*no explanation for many of symptoms:  myalgia

Term

RSV

 

1.  Type of virus

 

2.  Difference in infections betwen infants and older children/adults

 

3.  What age group gets the lower respiratory tract version of the infection

Definition

1.  Enveloped ss - RNA virus

 

2.  Infants:  pneumonia and brhonchiolitis

Children/Adults:  trachobronchitis and upper RTIs

 

3.  <3 yrs old

Term

RSV

 

1.  Transmission

 

2.  Best way to limit transmission

 

3.  What happens as disease progresses

Definition

1.  Contact with large particles of respiratory secrestion through eyes and nose

 

2.  Handwashing b/c it can live for awhile on hands

 

3.  Necrosis and sloughing of bronchiolar epithelia causing dead cells to plug up airways blocking airflow

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