Pharm 2 - Kumar's Review

drraythe's version from 2015-09-10 04:30

Dr. Kumar's Review

Question Answer
minocycline belongs to what group?tetras, semisynth
what are the tetracyclines?chlortetracycline, tetracycline, oxytetracycline (are the naturals) and minocycline and doxycycline (semisynths)
what are the topical sulfas?silver sulfadiazine, mafenide
what are the enteric sulfas?Sulfaguanidine, Sulfaquinoxaline, Sulfasalazine
opthalmic sulfa?sulfacetamide
group streptomycin is under?aminos
what kinda molecule are aminos?polar, polycationic
are tetras basic or acidic in nature?acidic
molecular properties of chloram highly lipid soluable and neutral, so widely distributed (can go into CNS)
tetra can txG+, G-, spiro, rickettsia, and intracellulars
what can aminos kill?aerobic G-
what can kill protozoans/gardia/coccidia?sulfas do coccidia, but POT. sulfas can do giardia too
what kills coccidia?sulfas
who's only parenteral?aminoglycosides
what cant be taken orally?penicillin G (rapid degradation)
what is an example of when metabolism is related to toxicity?sulfas-->acetylation-->causes the crystalluria b/c the acetylation makes the metabolite not soluble
how is chloramphenicol metabolized? any connection with possible tox situations?glucoronidation---> so cats, liver damaged, and young animals struggle with this one
which drugs chill out in the extracellular area?penicillin/cepha/amino
what is safe for kidney, and why?doxy, bc no excretion in the kidney
where is doxycycline excreted?FECES
toxes of sulfa?immuno- KCS and hepatic necrosis. nonimmuno-- crystalluria (and kidney damage leads to DEC blood cell count)
tox of aminoglycosides?nephrotox, ototox, and neuromuscular blockage
Tetra causes what bad thing?tooth mottling
fluoros cause what bad thing?arthropathy
bad thing chloram causes?bone marrow suppression (dose dependent reversible)
bad thing lincosamides cause?enterocolitis
dobermans are sensitive to...sulfas
if doxycycline is given through IV, what happens?HORSES! chelation--> cardiac arrythmias= fatal
what is the killing kinetic (or efficacy predictor) of aminoglycosides? what impact does this have?Its 1 (conc dependent) but INCLD PAE. Means you can give once a day and it'd be just as effective (owners love this)
what are the 3 type 3 killing kinetic drugs am I thinking of?Azithromycin, Tulathromycin, tetracycline (time dependent with post antibiotic effect)
efficacy predictor/killing kinetic of metronidazole?type 1 conc dependent
what inhibits mitochrondrial prot synth in mammals?chloramphenicol
which CAN be given to food animals?florfenicol, thiamphenicol
bacterial folic acid synth inhibitor?sulfas and diaminos
p-aminobenzoic acid (PABA) agonistsulfas
static or cidal for sulfa, diaminos, and potentiated sulfas?sulfa= static. diamino=static. potentiated=CIDAL (synergistic)
dihydrofolate reductace inhibitor?diaminopyrimidines
major metabolism of sulfas?acetylation (least soluable, so crystalize, and also dogs struggle with this)
who does coccidia?sulfas
adverse affects ducks and dogs with sulfas?hypoglycemia
what causes iatrogenic hypothyroidism in dogs?sulfas
efficacy predictor of sulfas?type 2
killing kinetics of sulfas?time dependent
diamino for protozoa?Pyrimethamine
ratio for potentiated sulfas? (trimeth and sulfa)1:5 formulation, 1:20 in plasma tho!
beta-lactam drugs are?penicillin, cephalosporin, carbapenams, monobactams
MOA for betalactams (what enzyme?)inhibit transpeptidase enzyme (prevents cell wall from being made)
what are natural penicillins, and their admin?Penicillin V (oral) penicillin G (parenteral)
what are the three groups of semisynth penicillins (and which drugs are in them)penicillinase-resistant (cloxacillin, oxacillin, dicloxacillin, methicillin, and nafcillin), broad spectrum penicillins (amoxicillin and ampiclillin), extended spectrum(antipseudomonal) (Ticarcillin Carbenicillin Piperacillin Mezlocillin Azlocillin)
what are the beta-lactamase inhibitors?clavulonic acid and sulbactam
which has a wider spectrum, of the broad spectrum penicillins? what does this mean for the other one?amoxicillin has broader spectrum, ampicillin thus needs to me adminstered as prodrugs (which is why there are a bunch of prodrugs)
what can defeat penicillinase producing staph. species?any of the penicillinase-resistant species (cloxacillin, oxacillin, dicloxacillin, methicillin, and nafcillin)
which penicillin should not be administered orally?penicillin G, and the extended spectrum/anti-pseudomonal penicillins (azlocillin, carbencillin, piperacillin, mezlocillin, ticarcillin)
what shouldnt you give IV (of the penicillins). what should you?procaine salt and potassium (K) salt. Recommended to give IV is sodium salt
sig. of benzathine (penicillin G)? admin?it is a repository! can extend half life of drug for like 7 days. ONLY DEEP IM ROUTE.
where do penicillins like to hang out? why?Extracellular space!! because it is an organic acid
tell me about probenicidinteracts competitively at the renal tubule so pencillin doesnt get out, which extends penicillin's half life
adverse effect of penicillins?ALLERGIC RXNs to PENICILLOIC acid
which penicillin produces ataxia and convulsions in dogs and cats? why?Sodium benzylpenicillin. bc it inhibits GABA
what two drugs inhibit GABA and thus cause seizures?sodium benzylpenicillin, and fluoroquinolones
which cephalosporin is preferred parenteral use in small animals?Cefazolin
what are the biphasic drugs?aminoglycosides and tetracyclines
which 2 cephalos are for mastitis (intramammary infusion)?Cephapirin, Cefalonium
which cephalosporin has a long (how long?) half life, and what is it used to treat?Cefovicin, 5-7 days, as a single SC injection for cats/dogs with pyoderma
what is the cephalosporin that is a pro-drug?Cefpodoxime Proxetil (ester form for oral admin)
what are the drugs in the cephamycin group? why do we care about this group?cefotetan, cefoxitin. This group has a Cephem nucleus; so they are amazing at fighting anaerobic infections
which cephalosporins are best at fighting anaerobes?the cephamycins ( cefotetan, cefoxitin)
which cepha has an active metabolite? name of the metabolite? what does this mean for it's action?Ceftiofur, metabolite is desfuroylceftiofur. if metabolite is also active, it means it will have long acting effects.
what is broad spectrum and resistant to cephalosporinases?Cefepime
distribution of cephalos?can get into CSF -- also to Extracellular space
bad side effects of cephalosporins?same as penicillins-- allergic reactions, some dec blood cell counts
how do you give sulbactam?IV route
how do you give clavulonic acid?oral and parenteral route
what are the two carbapenams? what are they good against? imipenem, Meropenems. good against G-'s and also pseudomonas
what is important to know abt imipenem? (explain why)must be administered with cilastatin (renal enzyme inhibitor), to prevent neprotox
what is the monobactam drug?aztreonam
what group of drugs does aztreonam belong to, and what is special about it?monobactam (beta-lactamase) it has super low immunogenecity, so can be given to ppl allergic to penicillins
penetration of aminoglycosides?highly polar and polycationic, so has a BIPHASIC penetration
what are aminoglycosides good against?ONLY AEROBICS (G-) (because they need O2 to finish their biphasic penetration)
aminos are cidal or static?CIDAL! **It is significant that most of the antimicrobials that interfere with ribosomal protein synthesis are bacteriostatic, while aminoglycosides are bactericidal.
broadest acting aminoglycoside?amikacin (double Ami, goes twice as far)
what are the aminoglycosides?Gentamicin (most renal toxic), Streptomycin, Neomycin (topical), Kanamycin, Amikacin (broadest spectrum), Tobramycin, and Paromomycin (G+, G-, and protozoans) (Ami Kan Genta-ly Strep the paro Neo and Tob-y naked)
what is the anti-protozoal aminoglycoside?Paromomycin
how do you administer aminoglycosides?parenteral!!
aminoglycosides shouldnt be given to what type of animals (condition)super thin animals, because distribution increases in lean and cachectic (wasting) animals (toxicity). because of decreased plasma protein production leading to extravasation of fluid and resultant edema. In such cases, dose should be adjusted to avoid the toxicity
toxicities of aminoglycosides? why do these happen?hepatic necrosis, ototoxicity(cochlear or vestibular), and neuromuscular blockade. (they are cationic so bind to anionic tissues of renal cortex and inner ear)
penetration/MOA of tetracyclines?biphasic penetration, interfere with the binding of aminoacyl-tRNA to the messenger RNA molecule/ ribosome complex (in the 30s ribosomal subunit)
are tetracyclines good for intra or extracellular organisms?good at fighting intracellular
if you are giving a tetracycline orally, what must you keep in mind?chelates with cations, so cant give with milk/antacids or it will be useless
which tetracycline do you want to give parenterally? oxytetracycline (IM route!!)
what are the two semisynth tetracyclines? what is special about this group?doxycycline, minocycline. they are MORE LIPID SOLUBLE, so, better distribution (LONGER LASTING EFFECT!!!))
toxicity of tetracyclines? (by route of admin)ORAL--> superinfections. IV--> anaphylaxis. (arrythmia in horses) IM--> MUST BE DEEP or there will be a tissue inflammatory rxn... also TOOTH MOTTLING, BECAUSE IT CHELATES THE Ca++ (also phototoxicity)
bad side effect of doxy?IV injection--> arrhythmia in horses
what two antimicrobials cause phototoxicity?tetracyclines and fluoroquinolones (FoTo)
how do tetracyclines affect cats?Hypersensitivity and drug fever in cats
how do tetracyclines affect horses?if doxy given iv, cause arrhythmia (fatal)
efficacy predictor of tetracyclines?type 3
MOA for chloramphenicols?inhibit the bacterial enzyme peptidyl transferase at the 50S ribosomal subunit
bad news about chloramphenicols?can penetrate mammalian mitochondrial membrane and mess with that protein synth, leading to bone marrow suppression (dose dependent reversible)
caution of chloramphenicols and ruminants?their flora will cause degradation (inactivation)
what drugs are preferred for treating meningitis?chloramphenicols
metabolism of chloramphenicols? what groups does this affect?glucoronidation (glucose and chlorine go together apparently, like koolaid and pool water) so cats, liver patients, and young animals struggle with this one\
adverse effects of chloramphenicol?bone marrow suppression!!--->aplastic anemia in HUMANS (bc some ppl sensitive)
which 50s protein inhibitors can be used in food animals?thiamphenicol and floramphenicol (NOT CHLORAMPHENICOL)
which drugs inhibitors of cytochrome enzymes?macrolides and chloamphenicols (McLiver)
which 50s is resistant to bacterial enzyme degradation?florfenicol, bc of its F group
MOA for macrolides?inhibit translocation of tRNA from the amino acid acceptor site, which disrupts addition of new peptide bond and thus prevents synthesis of new protein within the microbial cell.
which drugs fight MYCOPLASMA? Tiamulin > Tylosin > Tilmicosin (NOT ERYTHROMYCIN, thats for campylobacter)
what drug is effective against campylobacter?erythromycin
what are the type 3 macrolides?Azithromycin, Tulathromycin
what does the basic nature of macrolides mean for its administration?must have enteric coating to be given orally
which drugs do you want for a resp. tract infection? (broad and specific)macrolides (Erythromycin, tylosin and tilmicosin)
which drug causes cardiotoxicity if given IV?tilmicosin
which drug is FATAL TO HORSES?tylosin
side effects of macrolides?DIARRHEA in cows, inhibits cytochrome enzymes-->drug interaction implications (tylosin fatal to horses) (tilmycosin--> cardiotox if IV)
diff between lincomycin and clindamycin? implication?clindamycin has Cl substitution at 7th position of the molecule. VERY GOOD ORAL ABSORPTION for clinda, then
which lincosamide has good oral availability?clindamycin
which drug reaches good concentrations in the BRAIN?clindamycin
lincomycin is good against? clindamycin?linco-> G+ aerobic. Clinda-> G- anaerobic+TOXOPLASMA GONDII
which drug for toxoplasma gondii?clindamycin
lincomycin and clindamycin adverse effect?(lincosamides) fatal enterocolitis (horses, ponies, rabbits, small rumis)
enrofloxacin is in what group?fluoroquinolones (got the fl in it)
what drug is good against methicillin resistant strains of stapholococci and vancomycin-resistant strains of Enterococci?Premafloxacin (prema-donna because it can do these special strains)
which drug affects both type 2 and 4 topoisomerase enzyme, and what implication does this have?very BROAD spectrum, Pradofloxacin (if it's PRADA, i want 2 of that and 4 of that!)
MOA for fluoroquinolonesinhibit DNA gyrase enzyme--> stop DNA synth
special places fluoros attain high conc?prostate, skin, respiratory, and bone tissues
what is preferred drugs for prostate and respiratory infections?fluoros
which floros have active metabolites? what are the metabolites?Difloxacin (to sarafloxacin), Enrofloxacin(to ciprofloxacin), Pefloxacin(norfloxacin)
tox of fluoros?ARTHROPATHY! cats-->retinal degeneration. CNS excitation (IV route)
if you IV fluoros, what can happen?CNS excitation
which misc can cause IV anaphylaxis?vancomycin
which misc deals with cell membrane?polymyxin B
admin of bacitracin? effective on what?topical, G+ infections
what is zinc combined with, and why does it inc efficacy?bacitracin, it works as an astringent
which misc should you NOT GIVE TO FOOD ANIMALS?nitrofuran, metronidazole, vancomycin
which drug is a urinary antispetic? what is important for this to work?methenamine. need ACIDIC pH!!! to release formaldehyde
methenamine can't be used to treat what, and why?cant treat Proteus mirabilis, because this bact makes the urine alkaline
what should methenamine never be combined with?sulfas (due to the formation of insoluble formaldehyde-sulfonamide precipitates. AND inc crystalluria)
obligate anaerobic infection/protozoans are treated with who?metronidazole
MOA rifampin?inhibit RNA synthesis by inhibiting DNA dependent RNA polymerase
which drugs accumulate in phagocytic cells?rifampin and fluoroquinolones
which drug rapidly develops resistance, and how can you prevent that?rifampin, by combining with other antimicrobials
admin of Thiostrepton?TOPICAL
admin of nitrofuran?oral OR topical **not for food animals
MOA of virginamycin?inhibit prot synth, Translation is blocked at 23S ribosomal subunit
carbadox is usually used for what? what is its toxicity?feed additive in swine, and SUPPRESSES ALDOSTERONE PRODUCTION