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92 Cards in this Set
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- Back
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Gram Positive COCCI |
*Staph Aureus -skin wounds, impetigo and pneumonias * Staph Epi- skin wounds * Strep Pyogenes-pharyngitis * Strep Pnuemo- Pnuemonia, meningitis, Ottis media, sinusitis, URI |
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Gram Positive Rods |
*Corynebacterium- psuedomembranous pharyngitis, myocarditis * Actinomyces Israelli- Ocular Pathogens |
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Gram Negative Cocci- |
Neisseria Gonorrhea- |
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normal ocular flora |
Mostly Staph Epi Staph Aur Strepto Veridans Hemo Strepto pnu Very little psuedomonas |
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Major Ocular Pathogens |
Staph epi Staph aur strepto corynobacterium strepopnuemo hemo |
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Chronic Blepharitis is caused form what |
Gram + staph OVERGROWTH OF STAPH (especially epi) |
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Strep Pnuemo |
Cold climates perforate in 7 days CELLULITIS |
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What bacterium casues Blepharitis and Cellulitis? |
Cellulitis= Strep Pnumo Bleph= Staph Epi/Aur |
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Gram (-) ocular pathogens |
Psuedomonas -ventilators, hot tubs #1 noso infection **DESTROYS CORNEA IN 48 HRS** |
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Haemophilus Influ |
most common in kids |
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Serratia |
Produces SPK in CL |
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Klebsiella |
URI/UTI- invades intact cornea |
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To treat peds conjunctivitis you must check what 1st? |
Ears, Throat, temp and HIstory |
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Neonatal conjunctivitis |
common because babies * low tear pro * lack IgA * decrease immune funciton * Absent lymphoid in conj tissue * Decrease lysozyme activity |
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Opthalmia Neonatorum= what |
Neonatal conjunctivitis |
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True or false, neonatal conjunctivitis is also called Ophthalmia neonatorum |
True |
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Ophthalmia neonatorium |
ALWAYS AN EMERGENCY |
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Neonatal conj types |
1st 24 hours- Chemical 24-48 hours- Bacterial 5 to 14 days- Chlamydia Trachomatis 6-14- herpes |
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Neonatal conj stages |
Chemical- Bacterial - (Chlamydial trach) or (herpes) |
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Oral Cephalosporins |
**** 1st line of defense for neonatal conjunctivitis**** |
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What is the 1st line of defense for Neonatal conj? |
Oral cephlosporins |
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Chlamydial conj |
* most common cause of chronic conj *onset is 1-2 weeks post partum *potential conj scarring TX=oral Erythromycin or azithromycin |
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s |
s |
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what is the treatment for Chlamydial conj? |
Oral Azithro or erythromycin |
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Cephlosporins are used to treat what? Oral Azithromycin and Erythromycin are used to treat what? |
Cephlosporins are for neonatal conjunctivits Oral Azithromycin Erythromcins are used to treat Chlamydial conjunctivitis |
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Drug selection factors |
*ID organism * Aintimicrobial susceptibility of org * Lab culture * Emnpirical treatment |
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Lab tests |
1. gram stain 2. Culture ID 3. Detect microbial agents 4. PCR 5. Detect antibody against pathogens |
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Gram stain |
(+)= thick cell wall (-)= peptidoglycan wall covered with outer membrane |
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Bacterial conjunctivitis |
Purulant discharge minimal itch no Periauricular lymph nodes |
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Viral conj |
Watery discharge minimal itch HAS PERIAURICULAR Lymphnode -monocytes and lymphocytes |
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Allergic conjunctivitis |
Stringy discharge heavy itch NO PERI lymph node Eosinophils |
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Antimicrobial Tx |
Bactericidal= kills cells Bacteriostatic= no growth of cells but existing cells are NOT killed |
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Spectrum antibiotics |
Narrow= acts on single to small amounts of microorgs Extended= drugs affective vs G+ and G- Broad Spectrum= effective against a variety of microbial species |
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Tx principles |
1. Diagnosis 2. destroy org with min AE 3. Alleciate sx 4. Pharm Agent eff is varies with type and location 5. Route, dosage and length of time |
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nature of inf |
__ pH can innact or act some drugs - p[urulant inf can inact some meds -ANTI micro agents can penetrate everywhere but CSF, Brain, eye and prostate |
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if the pt is immunosppressed |
require bactericidal agents |
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Which areas in the body can antimicrobes not enter>? |
Eye, brain CSF prostate gland |
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True or false, Antimicrobial agents can enter in every compartment in the body |
False, They cant enter Brain, Eye, Prostate gland or CSF |
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Drug selection factors |
Age genetics allergy renal function Hepatic function Pregnancy |
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Pregnancy issues |
-Tetracycline can casue fatal necrosis of liver -some antibiot can be teratogenic -drugs pass through breast milk -reduce effectiveness of oral contraceptives |
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TERATOGENIC SE |
*Aminoglycosides * Chloramphenicol- Gray baby syndrome Sulfonamides Tetracyclines- limb abnormalities, dental staining Fluoroquinolones- abnormal cartilage Vancomycin |
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Chloramphenicol causes what? |
gray baby syndrome |
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CATS VF= teratogenic SE |
C=chloramphenicol (gray baby) A=aminoglycosides T= tetracyclines (limb abnormalities) S=Sulfonamides V= Vancomycin F= Fluoroquinolones (cartilage abnormalities0 |
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What is the Teratogenic SE Acronym |
CATS VF |
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Combo therapy |
*indifferent/additive-combination equals efficacy of sum of sep entities *Synergistic- combines = greater than sum * Antagonism= combo is less than sum |
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Why would you want to use more than 1 |
synergism life threatening inf polymicrobial inf prevent resistane reduce toxicity |
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Mech of Drug resistance |
*pathogens pro enz that inact antibio * Altered micro target prevents antibio from binding * Bacteria alter metabolic pathway * reduce antibio accumulation (decrease passiv tran into cell or increase activ tran out of cell) |
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Metabolism inhibitors (metabo 3 sulfers) |
Sulfonamides (teratogenic) Trimethoprim |
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Cell wall inhibitors (BV DTF) |
B-Lactams Vancomycin Daptomycin Telavancin Fosfomycin |
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Protein syn inhibitors TAM CCL |
Tetracycline aminoglycoside macrolide clindamycin chloramphenicol linezolid |
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Nucleic acid inhibitors (flu Ri |
Fluroroquinolones rifampin |
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Cell membrane inhibitors (I Am Poly) |
isoniazid amphotericin B Polymixin |
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Protein Synthesis inhibitors MOA (TAM CCL) |
Tetracycline-30s subunit, stops trna from attaching to Mrna ribosome complex |
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Tetracycline (protein synthesis inhibitors) |
binds to 30s subunit Stops Trna from attaching to mrna ribo subunit *tetracycline *doxycycline *minocycline BROAD: Chlamydia, rickettsia mycoplasm, spirochetes |
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Aminoglycoside |
Binds to 30s subunits, causes inh of translation causing an incorrect reading of Mrna Tobramycin-Psuedomonas Gentamicin- francisella tularensis Tx (G- Rods) |
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Aminoglycosides |
Tobramyosin- Psudomonas Gentomicin= Francisell Tularensis (rabbits) AE= inhib release of Ach nephrotoxicity ototoxicity contact dermatitis |
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What are the Tetracyclines, what do they do? and MOA? |
Tetracyclines are protein synth inhib Tetracycline, doxycycline, minocycline bind to 30s sub and inhibit attachment of TRna Doxy= chlamydia, cholera, lyme disease Mino= MRSA, Meningitis |
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What are the aminoglycosides? what is the MOA and what do they treat? |
Aminoglycosides are protein synthesis inhibitors Tobramyosin, gentamysin Tobra=psuedomonas Genta= Francisella MOA= binds to 30s sub and inhibits translation of TRNA so it reads incorrectly |
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Chloramphenicol (PSI) |
binds to 50s sub unit, inhibits peptidyl transferase Tx: meningitis, hemophilus and Ricketsia IV admin: CAN CROSS BBB AE= can canuse Grey Bby syndrome, Optic Neuritis and peripheral edema ***can cause Aplastic anemia |
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Macrolidses (protein synthesis inhibitors) ACE |
Bind to 50s subunit and inhibits translocation Azithromycin- Haemophilius moraxella, mycoplasm Clarithromycin- good for H Pylori peptic ulcer Erythromycin- Good for penicillin allergies AE- GI disturbance, jaundice and Ototoxicity |
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Azithromycin (Macrolide) |
Good for tx for hemophilus, Moraxella and Mycoplasms -LONG Halflife making infrequent dosing possible AE- Ototoxicity, GI disturbances and ototoxicity |
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Erythromycin (Macrolide) |
Good for Pennicillin allergies Tablets must be coated for enteric path CONVERTED TO INACTIVATED FORM |
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Clindamycin (Protein synthesis inhibitors) |
Same MOA as Erythromycin For MRSA, Strepto and Anaerobes AE- Can CAUSE C DIFF, BAD TASTE SO KIDS DONT LIKE it |
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Streptograms (synerid) |
USED FOR VANC resistant Enterococcus AE- Myalgia Arthralgia , Hyperbillirubinism |
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What drug is used for Vanc resistant enterococci? and what are its AE? |
Synerid its AE are hyperbillirubinism and Myalgia and Arthralgia |
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Linezolid (Protein synth) |
Binds to 50s and stops interaction between 30s sub **used for meth,vanc resistant bacteria AE: thrombocytopenia (>10D" and peripheral optic neuropathy |
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Fluoroquinolones |
Inhibit Topoisomerase 2/4 |
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Cipro (2nd gen) |
Uses DOC- Anthrax * BEST fluoro for Aeruginosa UTI, Travelers diarhea, Thyroid fever |
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3/4th gen Fluoroquinolones |
RESPIRATORY FLUOROQUINOLONES |
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Which drug is the DOC for Anthrax? What is its generation and what should you not use it on? |
Cipro, 2nd gen and you dont use it for Strep Pneumo |
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3rd gen Fluoroquinolones (RESPIRATORY) |
Levofloaxin (G+) good for Strepto Pnumo (and nosocomial pnuemo) |
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4th generaion fluoroquinolones |
Moxifloaxin GREAT AGAINST STREP PNUMOE ** does not concetrate in the urine (BAD FOR UTI) Not good against Psuedomonas |
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Why would you not use moxifloxacin for UTIs? |
Because it doesn't accumulate in the urine |
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Cell wall Inhibitors |
B-Lactams Vanc Bacitracin Polymixin |
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Cell walls |
G+=Thick peptidoglycan layers NOO PHOSPHO LAYER G-=Thin peptido layer, HAS PHospho bilayer outside *has small pores |
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Penicillin binding proteins |
Site where B-Lactam rings bind to and activate cascade to degrade the cell wall |
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Bacterial cell wall |
Composed of NAM NAG repeats and are connected by peptides which hook on to Transpeptidase (TP) |
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B-Lactams inhibits TP |
This messes stuff up for bacteria cell walls |
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HOW BACITRACIN WORKS |
Bacitracin inhibit the Transporter protein in the bacterial cytoplasm. The lipid carrier transports the disaccharides across the membrane thus helping them extend |
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How Vanc works? |
Vancomyosin works by binding to the polysaccharides on the NAM NAG subunits and doesn't let TP bind |
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So What is the MOA of Each Cell wall inhibitor Category? |
B-Lactams- Inhibit TP Bacitracin- targets the lipid carrier in the cell wall Vancomyosin- targets the Polysaccharides attached to NAM NAG sub and stops them from binding top TP |
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Types of B-LActams (INHIB TP) |
Penicillin G/V Pen G=BAD FOR GUT PEN V= "oral" survives well in the gut ***Suseptible to B Lactamase so must be used with a Blactamase inhibitor |
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B- Lactamase inhibitors |
*Clavulanic Acid * Sulbactam * Tazobactam |
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Penicillins that are Blactamase OKAY (MO DNA) |
Methicillin Oxacillin Diclocillin Nafcillin Augmentin |
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Penicillin is DOC for what? |
Syphilus |
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Syphillis and Perfringes |
jjjj |
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Diclocillin |
* can be taken by itself |
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What is the best tx for Orbital cellulitis? |
Nafcillin and Cephlosporin |
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Ampicillin (AMINO PEN) |
DOC for Listeria -used with Sulbactam |
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Amoxicillin |
MOST COMMONLY PRESC ANTIBIOTIC -tx H Pylori, Preseptal cell, dacrocystitis |
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What is the most commonly prescribed antibiotic? and what does it treat? |
Amoxicillan it treats H Pylori |
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Augmentin |
(AMoxicillan+ Clavulanic Acid) -more expensive than other Pen Used to treat a broad spectrum. |
