Term
Which aspects of modern medicine are made practical by antimicrobials? |
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Definition
cancer chemotherapy, gut surgery |
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Term
Asian fish, shrimp, and shellfish test repeatedly positive for... |
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Definition
nitrofuran, malachite green, flouroquinolones |
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Term
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Definition
new delhi metallo-lactimase 1 found in E coli and klebsiella pneumonia; confers resistance to antibiotics |
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Term
Name the beta lactam drugs. |
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Definition
penicllins, cephalosporins, carbapenems |
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Term
Name the nonbeta lactam antibiotics that are inhibitors of cell wall synthesis? |
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Definition
cecloserine, vancomycin, bacitracin |
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Term
Which antimicrobials work by disrupting cell membranes? |
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Definition
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Term
What antibiotics are reversible inhibitors of protein synthesis (bacteristatic)? |
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Definition
chloramphenicol, tetracyclines, macrolides (erythromycin), clindamycin, linezolid |
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Term
What antibiotics are irreversible inhibitors or protein synthesis? |
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Definition
the bacteriocidal aminoglycosides |
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Term
____ concentrations are what determine susceptibility of resistance to drug. |
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Definition
achievable serum concentrations |
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Term
What are some pharmacokinetic considerations that must be taken into account when treating an infection? |
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Definition
location of infection (some antibiotics may or may not reach therapeutic concentrations in certain bodily fluids), and the degree to which antibiotic binds serum proteins (excessive binding can affect passive diffusion from serum to tissue) |
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Term
Sulfonamides are analogues of... |
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Definition
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Term
What is the MOA of sulfonamides? |
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Definition
competitive inhibitors of dihydropteroate synthase--needed for folic acid synthesis |
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Term
Are sulfonamides bactericidal? |
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Definition
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Term
What is the mech of resistance for sulfonamides? |
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Definition
altered affinity of enzyme for drug, decreased permeability or active efflux, new pathway of folic acid syntehsis |
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Term
Are sulfonamides easily absorbed from teh GI tract? |
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Definition
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Term
What is the distribution pattern of sulfonamides in the body? |
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Definition
binds variably to serum albumin, wide tissue distribution, including trans-placentally |
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Term
What is the metabolism and excretion of sulfonamides? |
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Definition
variably inactivated in liver by acetylation and then excreted in urine |
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Term
At what pH are sulfonamides at risk for precipitating out of the urine? |
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Definition
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Term
Name some rapidly abosrbed and eliminated sulfonamides. |
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Definition
sulfisoxazole, sulfamethoxazole, sulfadiazine |
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Term
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Definition
sulfamethoxazole combined with trimethoprim |
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Term
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Definition
sulfamethoxazole combined with trimethoprim |
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Term
What are the pharmacokinetics of rapidly absorbed and eliminated sulfonamides? |
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Definition
binds extensively to plasma proteins and are highly concentrated in the urine (cidal) |
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Term
Name a poorly absorbed sulfonamide. |
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Definition
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Term
What is sulfasalazine used for? |
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Definition
poorly absorbed in the GI tract so used to treat ulcerative colitis and irritable bowel syndrome |
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Term
How is sulfasalazine metabolized? |
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Definition
by gut flora into 2 compounds: 1 toxic, 1 therapeutic (5-aminosalicylate) |
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Term
Which sulfonamide has good penetration int he eye? |
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Definition
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Term
Which sulfonamide is used for prevention and treatment of burn wound infections? |
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Definition
silver sulfadiazine; mafenide is used for prevention of burn wound infections |
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Term
Name a long acting sulfonamide. |
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Definition
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Term
What is the half life of sulfadoxine? |
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Definition
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Term
What is the use of sulfadoxine? |
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Definition
combined with pyrimethamine to treat malaria |
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Term
What are the therapuetic uses of sulfonamides? |
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Definition
urinary tract infections, nocardiosis, toxoplasmosis (avoid using in pregnant women) |
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Term
How do you prevent sulfonamides from forming crystals? |
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Definition
alkalize urine or increae hydration |
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Term
What are the toxicities of sulfonamides? |
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Definition
acute hemolytic anemia due to glucose-6-phosphate dehydrogenase deficiency, agranulocytosis, aplastic anemia, hypersensitivity reactions, nausea, anorexia, vomiting, kernicterus |
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Term
What are the different types of hypersensitivity reactions associated with sulfonamides? |
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Definition
skin and mucous membrane manifestations, serum sickness, focal or diffuse necrosis of the liver |
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Term
What are the very common side effects of sulfonamides? |
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Definition
nausea, anorexia, vomiting |
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Term
In what patient populations are sulfa drugs contraindicated? |
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Definition
those with G-6PD deficiency or pregnant or lactating women |
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Term
Why should sulfa drugs enver be given to a pregnant or lactating woman? |
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Definition
causes displacemnt of bilirubin from plasma albumin to brain resulting in encphalopathy |
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Term
Sulfonamides cause potentiation of which drugs |
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Definition
oral coagulants, sulfonylureas, and hydrantoin anticonvulsants |
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Term
What compounds are all quinolones dervied from? |
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Definition
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Term
What is the MOA of quinolones? |
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Definition
targets DNA gyrase (G-) and topoisomerase IV (G+) |
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Term
What causes resistance against quinolones? |
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Definition
resistance due to efflux and mutations in targets |
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Term
What are the first generation flouroquinolones? |
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Definition
nalidixic acid, cinoxacin, oxolinic acid |
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Term
What arethe second generation flouroquinolones? |
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Definition
ciprofloxacin, enoxacin, lomefloxacin, ofloxacin |
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Term
What are the favorable pharmacological attributes of quinolones? |
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Definition
quickly absorbed from GI, even with a full stomach, excellent bioavailability in a wide range of tissues and body fluids (including inside cells) |
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Term
How are quinolones excreted? |
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Definition
mostly by the kidneys; exceptions are perfloxacin and moxifloxacin which are metabolized by the liver |
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Term
Which quinolones are excreted in breast milk? |
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Definition
ciprofloxacin, ofloxacin, perfloxaci |
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Term
What are the therapeutic uses of quinolones? |
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Definition
UTIs, prostatitis, STDs (chalmydia, chancroid), GI and abdominal (travelers diarrhea, shigellosis, typhoid fever), respiratory tract (all work well against atypicals, new agents for strep pneumo); bone/joint/soft tissue, ideal for osteomyelitis, good against polymicrobial infections like diabetic foot ulcers, cipro for anthrax and tularemia, in combo for mycobacterium |
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Term
Quinolones are good for chronic osteomyelitis but resistance is developing in.... |
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Definition
S. aureus, Paeuroginosa, and S. marcesens |
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Term
What are the GI side effects of quinolones? |
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Definition
nausea, vomiting, abdominal discomfort, diarrhea and antibiotic associated colitis |
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Term
What are the CNS side effects of quinolones? |
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Definition
mild headache and dizziness, hallucinations, delirium, and seizures |
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Term
What are the risks of giving quinolones to children? |
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Definition
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Term
T/F Quinolones can cause arrhythmias. |
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Definition
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Term
What toxic side effects do quinolones have on the blood? |
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Definition
leukopenia and eosinophilia |
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