Antimicrobial 3

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Antimicrobial 3
2012-02-16 01:14:29

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  1. Should the aminoglycosides (AMGS) be used for everyday infections, or be reserved for more serious infections? Why?
    more serious infections - AMGS are usually given parenterally, and they are neprotoxic and ototoxic
  2. Are AMGS cidal or static? How do they work?
    cidal. bind to nucleic acids in bacterial ribosomes, prevent protein synthesis
  3. Are AMGS most commonly given PO?
    no. usually parenteral administration
  4. Do AMGS work well on anaerobic bacteria?
  5. How are AMGS excreted?
    kidneys - glomerular filtration
  6. What parts of the body are AMGS toxic to?
    kidneys and inner ear
  7. What are the clinical signs of ototoxicity?
    hearing and vestibular problems - deaf, head tilt, circling, etc.
  8. How do you prevent nephrotoxicity when using aminoglycosides?
    blood concentration of the drug must fall below a certain level between doses to give the kidneys a break. if the patient is renally impared, extend the dosage interval. monitor protein and casts in urine sediment. monitor BUN, creatinine, USPG. may give IV fluids.
  9. Why is it important to clean off a draining skin lesion before applying a topical preparation including an aminoglycoside?
    puss and cellular debreis inactivate AMGS. extra nucleic acids available for AMGS to bind to.
  10. Which AMGS is usually given orally to work agaisnt bacteria in the gastrointestinal tract? Should it be given if the patient's GI tract is damaged?
    neomycin. no - neomycin could get into the systemic circulation - it is very nephrotoxic
  11. Which AMGS is often mixed with bacitracin and polymixin B in topical preparations?
  12. List 5 specific aminoglycosides.
    • gentamycin
    • neomycin
    • strptomycin
    • kanamycin
    • amikacin
  13. What is a common ending to the nonproprietary name of most quinolones?
  14. Are quinolones (fluoroquinolones) static or cidal?
  15. Are quinolones given orally or parenterally or both?
  16. Are quinolones indicated for prostatic infections?
  17. How are quinolones excreted?
    liver and kidneys
  18. What kind of problem can high doses of Baytril cause in cats?
    blindness due to retinal changes
  19. What kind of problem can quinolones cause in growing dogs and horses?
    defects in joint cartilage
  20. Why is it important to keep patients on quinolones well hydrated?
    prevent crystal formation in kidneys
  21. List 5 specific quinolones
    • enrofloxacin - Baytril
    • ciprofloxacin - Cipron
    • orbifloxacin - Orbax
    • marbofloxacin - Zeniquin
    • difloxacin - Dicural
  22. Name 2 older tetracyclines. Are they more hydrophilic or more lipophilic?
    • tetracycline
    • oxytetracycline
    • more hydrophilic
  23. Name 2 newer tetracycline. Are they more hydrophilic or more lipophilic?
    • doxycycline
    • minocycline
    • more lipophilic
  24. Are tetracyclines static or cidal?
    static. do not give tetracyclines with penicillins or cephalosporins, which require actively growing and dividing bacteria to work on
  25. Are tetracyclines broad spectrum or narrow spectrum?
    broad spectrum
  26. What foods should you avoid giving with the older tetracyclines? Why?
    dairy products, antacids, kaopectate - older tetracyclines bind to divalent ions - Ca, Mg, Fe, Cu
  27. How are tetracyclines excreted?
    mainly through the kidneys. enterohepatic circulation prevents major liver excretion
  28. Is enterohepatic circulation important in preventing major amounts of tetracyclines to actually leave the body by the liver?
  29. Why do you avoid giving tetracyclines, especially older tetracyclines to pregnant and young animals.
    causes enamel of teeth to be yellow, retards fetal bone growth
  30. Should you reduce the dose of tetracyclines given to patients in renal or liver failure?
  31. What happens chemically to expired tetracycline and oxytetracycline?
    they can decompose to a nephrotoxic compound
  32. What are common side effects from tetracycline in dogs? In cats?
    • dogs: GI signs - vomiting, diarrhea, anorexia
    • cats: fever, depression, abdominal pain
  33. Which tetracycline is newer, in more commone use, broader spectrum, less likely to cause teeth yellowing, is more lipid soluble, and is excreted mostly through the intestines?
  34. Which is safest to use in renal impaired patient - tetracycline or doxycycline?
  35. Can doxycycline get into the CNS, prostate, and eye?