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Pharmacology HHD 3/31
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Medical
Professional
03/31/2009

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Term
selective toxicity
Definition
inhibition of pathogenic cell growth at drug concentrationt hat minimally affect host cells
Term
selectivity can be achieved
Definition
unique to pathogenic cells and not present in host cells

similar but not identifcla in pahtologic cells (rna pol or ribosmomes in bacteria)

shared by both pathogenic and host cells but differ in importance
Term
target sfor anti bacterial drugs
Definition
cell wall synthesis
beta lactams
glycopeptides
isoniazid
pyramidizide
ethambutol (anti tb)

cell membrane integrity lipopeptide (daptomycin)

DNA syntheses- folate anoalogs
fluoroquinolones

mrna synthessi-rifamycins

protein synthesis-ribosome affectors
aminoglycosides
chloroamphenicol
lincosamides
macrolides
exazolidnone
streptogramiris
tetracyclines
Term
bacterial ibosomes are sufficiently _____
Definition
different
Term
some drugs kill
Definition
bateriocidal-lowest drug concentration at which 999.9 of microbes are killed after and 18-24 hour incubation
Term
some druges inhibit
Definition
Minimum inhibitory COncentraation \
inhibit microbial growht
static -inhibits growth.
Term
statis if
Definition
its MBC is much greater than MIC
Term
cidal if
Definition
its MBC is close to its MIC
Term
bacteriostatic drugs
Definition
inhibit bacterial growth they require host defense mechaism to eradicate infection
Term
bactericidal kill bacteria
Definition
they eradicate infection in who defense mechanisms are compormised
Term
in immunocompromised patients use:
Definition
bactericidal drugs.
Term
for a cidal to work
Definition
you need to have active bacterial growth
Term
penicillin is a ______ drug with little side effect
Definition
bacetericidal
Term
side effects are a consequence of
Definition
the targe
Term
sometimes you want ot use bactericidal and bacteristatic together what is the effect
Definition
it is bacteriastatic because the cells will not activley grow
Term
Bactericidal drugs
Definition
inhibtors of cell wall synthesis (b lactams, vancomycins)
RNA polymerase (rifampin)
topoisomerase 9fluoroquniolone0
folic acid suynthesis
protein synthess
cell membrane integritty (daptomycin)
Term
When is it important to use bactericidal drugs?
Definition
When you have an immunocompromised patient
Term
A few of the bactericidial drugs (aminoglycoside) you have _____ dependent killing
Definition
concentrating dependant killing
the higher the drug concentration the better the killing
Term
In concentration dependent drugs- maximizing peak drug levels enhances the _______ effect
Definition
killing-
Drugs inhibit a post antibiotic affect
Term
aminoglycosides
Definition
serious gram negative infection. can give one a daye rather thane very few hourse.
Term
post antibitoic effects
Definition
growth is suppressed even when the drug concentration drops belw the MIC
Term
time dependent come back and fill in
Definition
beta lactams
vancomcin
Term
innate resistance to antibacterial drugs
Definition
reflects absence or inaccessibility of the drug target

if the bug doesn;t have the target

or if it is inaccesible.
Term
isonizaid
Definition
kills TB because of a compnenet in the mycobacter cell wall.

most bacteria are resistant to this
Term
outer membrane of gram negative bacteria
Definition
outer lipid membrane with a PBP . To reach the raget in gram negative they have to go throught hte outer layer. They hgo through porins. Water soluable molecules only. You must add an amino group or make penicilling more polar.

Ampicillin
amoxicillin add amino to the penicillin
Term
resistance require exposure?
Definition
Acquired drug resistance doest not require prior exposure
Term
Anti micrbrobial druges
Definition
inhibit the growth of susceptible bacteria and select for the growth of pre-existing resistant bacteria
Term
Lederburg experiment
Definition
grow bugs without drug
improint colonies onto velvet
transfer colonies to plate with drug
grow bugs with drug
identify drug resistant colonies
analyze orginial colonies for drug resistance
Term
How do bugs acqurie drug resistance 2 mechanis,s
Definition
spontaneous mutation
tranfer of mutant genes among plasmids and bacteria.
Term
transposon
Definition
drug resistance gene on a plasmid. plasmid cna be carried to another bacteria by a bacterial phage and transduce this.
Term
conjugation
Definition
gram negative especially enteric bugs. transfer directly
Term
free dna pick up
Definition
tranformation pneumococcus.
Term
pneumococcus o
Definition
transformation.
Term
95 percent of drug resistance is
Definition
on plasmids, transposons, bacteriophages
Term
CHromosonal mutations separeate ________-
Definition
independently
1. MRSA
2 PRSP penicillin resistnat strep pneumoniae
drug resistant M tuberculosis
Term
RTF
Definition
ressitance traner factor
responsible for enxaymes of transfer of plasmid
Term
resistance compnenet
Definition
encodes for resistnace
Term
non pathogenic bacteria which get resistance plasmid
Definition
serve as a resovoir as long as there is a selective pressure
Term
pathogenic bacteria in the presence or rsistance
Definition
can get widespread resistance
Term
How can the administration of one antimicrobial drug elad to emeregence of bacteria resistance to multiple driugs?
Definition
if it is on the same plasmid, theat plasmid will be slected for and then you get the multiple resistnace.
Term
enzymatic inactivation of drugs
Definition
beta lactamases
modifying enzymes-aminoglycosies
Term
enzymatic inactivation of drugs
Definition
beta lactamases
modifying enzymes-aminoglycosies
Term
Co-evolution of antibiotic production and resistance
Definition
organizsims in soil compete fo rlimited nutrients and space-they developed antibitocs
-they developed protective mechansims-efflux pupls
antibiotic modifying enzymes or altered antibiotic ragets
Term
antibacterial drugs as growth factors in liestock feed
Definition
leads to development of resrovors of drug resistant bacteria in poultry and cattle and their transfer to human
Term
phar industry reduces efforts to deiscover new anti
Definition
infectives
Term
rates of resistance to drugs in use increases
Definition
MRSA
sTREP PNEUMO AND tb
Multidrug resistant gram negative esp. Ps aeuruginosa
Term
What can doctors do?
Definition
reduce sources of selection pressure
inappropriat euse
viral ifnections
use of narrow drugs
Term
Bacterial infection: three coplenents
Definition
three component probnlem
host
bug drug
Term
How do we know there is infection
Definition
fever
signs of inflmmation
rubor coalor
odor
dolor
Term
formulate a provisional micro diagnoses then obtain _____ then
______ need for drugs
then presecribe ____
Definition
labs to confrm or deny
assess need for drugs
prescirbe drug
Term
WHat host factors help make a micro diagnosis?
Definition
Host defenses? Are they solid or not?
Age
Location of the infection
What organisms are most likely to cause these particular things?
Term
What bug factors influnence the choice of antimicrobial
Definition
gram stain
type of bug
RESISTANCE! intrinsic and acquired
Term
What drug factors infleunce the choice of drug
Definition
cidal/static
therapeutic wondow/toxicity
drug interactions
antimicrobial spectrum
Term
What host factors infleunce the choice of antimicrobial drug
Definition
cidal or static?
location? brain?
insurance
renal hepati cfunction
age
allergy
pregnancy
Term
are there wsituations in which antibacterial therapy is started proor to establsihing a definitive micro diagnosess
Definition
TB
severity of disease if very bad or if very spreading of disease.
Term
propholactic preventative antibacterial therapy
Definition
prevent colonization by an infectious orgnaism
prevent disease after colonization has occurred
Term
20 yo male with abscess on the buttock
Definition
staph aureus or strep ppyogenes
Term
fpr infection control
Definition
wash your hand
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