Pharmacology

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hannahshort
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233874
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Pharmacology
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2013-09-16 22:18:59
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chapter 10
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week 2
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  1. antimicrobials
    drugs that kill or inhibit growth of microorganisms such as bacteria, protozoa, viruses, and fungi
  2. suffix 'cidal'
    kills microorganism
  3. suffix 'static'
    inhibits growth of microorganism

    (basically starving the microorganism to death)
  4. antibiotics
    antimicrobials produced by a microorganism
  5. antibacterials
    synthetic, toxic to bacteria
  6. primary goal of antimicrobial therapy
    kill microorganism without killing patient
  7. MIC
    • Minimum Inhibitory Concentration
    • lowest concentration at which growth of the bacterium is inhibited 


    (how susceptible is a bacterial strain?^)
  8. MIC low vs. high #
    • low #-strong antibiotic
    • high #-weak antibiotic

    (ex:MIC for Penicillin may be higher than MIC for Amoxicillin. the MIC changes as time goes on and the bacteria become more and more resistant to the antibiotic)
  9. iatrogenically induced bacterial resistant practices   
    • antibiotics in feed over long periods (ex: Strongid T)
    • failure to admin for appropriate period of time (never use antibiotics less than 5 days)
    • failure to consider pharmacokinetics of drug (ex: renal infections, drug have to be admin for extended periods of time)
  10. ways antimicrobials kill bacteria
    • cell wall- lyse wall&kill bacteria. effective only in growing bacteria
    • cell membrane permeability-penetrates cell wall and membrane by bringing about death inside the cell once entered (but does not destroy cell wall)
    • ribosomes-block protein synthesis by interfering with sequence of amino acids and thus protein development
    • critical enzymes- drug attach to enzymes needed in the conversion of food&growth products thus starving to death (ex:bacteriostatic)
  11. most recent method of killing bacteria
    • nucleic acids
    • these drugs damage the nucleic acid production of a bacteria, preventing it from normal division
    • these drugs usually take longer to work/kill
    • ex: antiprotozoan/antifungal products
  12. Penicillin synthetic derivatives
    • penVK
    • ampicillin
    • amoxicillin
    • hetacillin
    • cloxacillin
  13. how does Penicillin work?
    • cell wall lysis
    • effective against gram + bacteria (not beta-lactamase)
    • procaine&benzathine- vehicles
    • broad&narrow spectrum
    • belongs to group B-Lactam Drugs
  14. vehicle
    either intensify or lengthen effect of drug
  15. broad spectrum
    kills gram+ and -

    (narrow kills one or the other)
  16. B-Lactam drugs
    act by disrupting bacterial cell wall synthesis

    inclues penicillins, cephalosporins, etc.
  17. B-lactamase enzymes
    most common mechanism of bacterial resistance to B-lactams is production of B-lactamase enzymes which damages the B-lactam ring of these compounds and renders them ineffective.

    these organisms are classified as methicillin-resistant types and compromise a majority of nosocomial isolates from human&some animal hospitals
  18. nosocomial infection
    infections inside an otherwise sterile area

    (infection at hospital)
  19. increases bacteria's resistance by converting penicillin to inactive penicillic acid
    beta-lactamase (penicillinase)

    beta-lactamase-resistant/penicillinase resistant penicillins: some penicillins are more resistant to beta-lactamase-hydrolysis
  20. penicillins are usually very effective against
    gram-positive bacteria

    but gram-negative bacteria have an outer membrane around the cell wall that limits permeability (ex: methicillin, cloxacillin, dicloxacillin, oxacillin)
  21. narrow spectrum penicillins (common gram positives)
    • Penicillin G sodium
    • Penicillin G potassium
    • Penicillin G procaine
    • Penicillin G benzathine
  22. narrow spectrum acid-resistant penicillins
    Penicillin V
  23. beta-lactamase resistant penicillins
    • Methicillin
    • Cloxacillin
    • Dicloxacillin
    • Oxacillin
  24. broad spectrum penicillins
    • Ampicillin
    • Hetacillin
    • Amoxicillin
    • Carbenicillin
  25. potentiated penicillins
    Amoxicillin
  26. antagonists for narrow spectrum penicillins (Penicillin G sodium,potassium,procaine,benzathine)
    tetracyclines & chloramphenicol
  27. antagonists for penicillin V
    tetracylines & chloramphenicol
  28. antagonists for beta-lactamase resistant penicillins
    methicillin, cloxacillin, dicloxacillin- tetracyclines& chloramphenicol

    oxacillin- sulfonamides
  29. antagonist of ampicillin and hetacillin
    chloramphenicol, erythromycin, tetracyclines, cephalosporins
  30. antagonist of amoxicillin
    chloramphenicol, erythromycin, tetracyclines, cephalosporins
  31. antagonist of carbenicillin
    chloramphenicol, erythromycin, tetracyclines, cephalosporins
  32. most of absorption of penicillins takes place in stomach&upper small intestines, therefore, immediate allergic reactions can be treated with
    anti-emetics like apomorphine or syrup of ipeca
  33. primary organ for excretion
    kidney

    therefore, kidneys BUN and Creatinine must be checked in geriatric animals
  34. why must withdrawal times be computed when treating mastitis in dairy animals?
    Penicillins are excreted through the milk in small amounts
  35. more specific name for mastitis
    Staphlococcus agalactiae
  36. this should be ready to admin at all times for sensitivity reactions (hives, respiratory distress) to penicillin or procaine
    Epinephrine 1:10,000 IV

    comes 1,000 mg per mL--reconstitute to 1 mL of epi per 10 mL water (will kill by IV if not)
  37. is Penicillin G long or short acting?
    long acting (48-72 hrs)

    not normally approved for use in dairy animals
  38. dosage forms for penicillin
    • polyflex (ampicillin injection)
    • penicillin G procaine or benzithine injection
    • ambi-pen injection
    • amoxi-tabs&clavamox tabs for dogs&cats
  39. Cephalosporins
    • ceph/cef prefix
    • similar to penicillins
    • bacteriocidal
    • susceptible to beta-lactam
    • broad spectrum, more effective against gram+ bacteria
    • classified by generations

    higher the generation=more gram neg. effectiveness

    • major risk- allergy to penicillin also allergic
    • minor risk- nephrotoxic
  40. first generation cephalosporin
    Cephalexin (Keflex)
  41. second generation cephalosporin
    Cefaclor (Ceclor)
  42. third generation cephalosporin
    Cefixime (Suprax)
  43. antipseudomonal third generation cephalosporin
    Ceftazidime (Fortaz)
  44. fourth generation cephalosporin
    Cefepime (Maxipime)

    *IV only*
  45. only antagonist for cephalosporins
    any product containing gentamicin
  46. what should never be given with penicillin?
    tetracycline
  47. dosage forms for cephalosporin
    • cefa-drops
    • cefa-tabs
    • cefa-lak (mastitis treatment)
    • naxcel powder for injection
    • excenel injectable suspension

    adverse side effects: nausea, vomiting, diarrhea, lethargy
  48. name some gram-neg bacterias
    • proteus
    • pseudomonas (most resistant-use polymyxin B, Gentamicin)
    • pastuerella
    • klebsiella
  49. effective against the very resistant, gram negative bacteria, pseudomonas
    Polymyxin B
  50. Bacitracin
    • antimicrobial effective against gram+ bacteria
    • topical--dissolves well into dermis
    • often combined with other antibiotics for broad spectrum effect (ex: triple antibiotic ointment contains bacitracin, polymyxin B, neomycin)OTC

    bacteriostatic unlike penicillin&cephalosporin
  51. Aminoglycosides
    • developed from gram neg bacteria
    • broad spectrum
    • bacteriocidal
    • includes: gentamicin, amikacin, neomycin, streptomycin, dihydrostrep, apramycin, kanamycin, tobramycin
    • nephrotoxic&ototoxic in felines
    • to prevent nephrotoxicity in animals other than feline, IV fluids must be admin simultaneously
    • combine with ribosomes interfering with amino acid sequence
    • be careful with--very toxic!
  52. Oxacillin antagonist
    sulfonamides
  53. amoxicillin antagonist
    • erythromycin
    • tetracycline
    • cephalosporins
    • chloramphenicol
  54. why are aminoglycosides administered parenterally (except neomycin)?
    because they are not readily absorbed through GI tract

    neomycin administered orally bc it is not absorbed at all. thus, can be accurately administered by weight for infections of GI tract&be assured that 0% is lost in the tissues surrounding the tract (ex: Neo-pectalin--oral absorbant)
  55. Tetracyclines
    • bacteriostatic
    • one of oldest antibiotics
    • binds to ribosomes disturbing amino acid
    • first antibiotic broad spectrum (gram+&-, as well as mycoplasmas, spirochetes, chlamydia)
    • precautions: chelates with minerals of developing tooth enamel&bones imparting a yellow discoloration, use cautiously with impaired liver function
  56. adverse side effects of tetracyclines
    • permanent staining of teeth if received in utero or as juvenile
    • drug is also deposited in growing bones, slowing their development
  57. absorption of tetracyclines by GI tract is dramatically decreased by
    presence of food, milk products, antacids 
  58. list tetracyclines
    • Oxytetracycline
    • Chlortetracycline
    • Doxycycline
    • Minocycline
  59. antagonist of Oxytetracycline
    diuretics, antacids, milk, penicillins (DAMP)

    (shock&diarrhea can occur if given IV in horses)
  60. antagonist of Chloretetracycline
    diuretics, antacids, milk, penicillins (DAMP)
  61. antagonist of Doxycycline
    • diuretics, antacids, milk, penicillins (DAMP)
    • same as barbituates
  62. antagonist of Minocycline
    diuretics, antacids, milk, penicillins (DAMP)
  63. Chloramphenicol
    • bacteriostatic in low doses
    • bacteriocidal in high doses (unique)

    penetrates CNS (blood-brain barrier), prostate gland, globe of eye, etc due to the fact that in high doses it exceeds the MIC

    • precautions: anorexia in cats
    • banned in food animals
    • gray babies in humans
    • vehicle with barbituates
  64. adverse side effects of Chloramphenicol
    blood dyscrasias in cats after prolonged treatment
  65. antagonists of chloramphenicol
    • penicillin
    • streptomycin
    • cephalosporins
  66. the primary lincosamides
    • Lincomycin
    • Clindamycin
  67. synergistic with sulfur
    chloramphenicol
  68. what type of bacteria are lincosamides effective against?
    • gram-positive
    • anaerobic
  69. clindamycin is especially noted for use in
    dentals (ex: Antarobe)
  70. primary macrolides
    • Erythromycin
    • Tylosin (Tylan)
  71. how do macrolides work?
    • binds to ribosomes with no aa sequencing
    • will penetrate many tissues but not CNS
  72. drug of choice for prostate infections
    Erythromycin
  73. very first anti-infective drug used in both human and veterinary medicine
    sulfanomides 
  74. how do sulfonamides work
    interfere with formation of folic acid, so effective against bacteria that form their own folic acid
  75. sulfonamides effective against
    • gram-positive
    • gram-negative
    • coccidia
  76. do sulfonamides penetrate CNS?
    yes
  77. what must you make sure of if using sulfonamides?
    animal has ample amounts of water bc will precipitate out in kidneys and cause dryness of cornea and keratoconjunctivitis
  78. "BIG BOYS"
    Fluoroquinolones
  79. how do flouroquinolones kill bacteria(work/action of)?
    damage nucleic acid production of bacteria preventing bacterium from normal division
  80. most popular type of antibiotics in outpatient clinic
    Fluoroquinolones

    (especially in gram-positive rods in dogs,cats,fowl,cattle--not horse)
  81. examples of fluoroquinolones
    • Enrofloxacin (Baytril)
    • Orbifloxacin (Orabax)
    • Ciprofloxacin (Cipro)-for anthrax ppl only
  82. fluoroquinolones effective against
    • gram-positive
    • gram-negative
    • pseudomonias (gn)
    • aeromonas
    • beta-lactam bacteria

    (good broad spectrum)
  83. used for a lot for middle ear infections
    fluoroquinolones
  84. non-proprietary name for Baytril
    enrofloxacin
  85. fluoroquinolones commonly used today
    • ciprofloxacin
    • enrofloxacin
    • difloxacin hydrochloride
    • orbifloxacin
    • sarafloxacin
    • marbofloxacin
    • norfloxacin
    • pradofloxacin
  86. non-proprietary name for Cipro
    ciprofloxain
  87. non-proprietary name for Dicural
    difloxacin
  88. non-proprietary name for Zeniquin/Marbocyl
    Marbofloxacin
  89. non-proprietary name for Noroxin
    norfloxacin
  90. non-proprietary name for Veraflox
    pradofloxacin
  91. fluoroquinolone oral suspension for cats only
    Veraflox (pradofloxacin)
  92. adverse side effect of quinolones
    formation of lesions in joint articular cartilage during rapid growth phase of dogs
  93. #1 antibiotic prescribed for cats
    Metronidazole

    (commonly prescribed with corticosteroids for IBD and periodontal disease)
  94. "Flagyl" in human medicine
    Metronidazole
  95. Metronidazole is
    an antibacterial/antiprotozoal agent commonly used to treat protozoal infections and anaerobic bacterial infections. also has marked antiinflammatory effect on bowel.
  96. mycoses
    fungal infection
  97. two types of fungal infections
    • topical (superficial)- affecting skin and mm
    • systemic- affecting blood, lungs, or CNS
  98. non-proprietary name for Fungizone
    Amphotericin B
  99. Amphotericin B
    • antifungal drug
    • fungistatic or fungicidal
    • mixed with D5W to decrease nephrotoxicity
    • IV
    • breaks down membrane wall for early death
  100. Ketoconazole&Miconazole
    • used for yeast to systemic funguses
    • can effect testosterone production in male
  101. Miconazole Nitrate
    topical application to treat dermatophytes and yeast

    • low dose-fungistatic
    • high-cidal
  102. Sulconazole Nitrate
    • "Exelderm"
    • better than miconazole
    • effective topically against ringworm (Microsporum canis)
  103. Nystatin
    • oral&topical
    • most commonly used for Candidas albicans infections of the skin
  104. Griseofulvin
    • oral
    • antifungal effective against dermatophytes
    • easily absorbed in skin/nails especially with oils/fats in diet
    • should never be given to pregnant-monsters and cleft palates can result
  105. antiviral drugs
    more of "immuno stimulants"

    include: amantadine, ganciclovir, idoxuridine, azidothymidine

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