Pharm Chapter 49-51 Flashcards
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Questions and Answers

What is the first step in the four-step process for DNA replication enzymes?

  • Migrate
  • Replicate
  • Unwind
  • Relax (correct)
  • Which of the following are ways for drugs to block bacterial DNA replication? (Select all that apply)

  • Inhibit the synthesis of nucleotides (correct)
  • Bind to enzymes of DNA replication (correct)
  • Prevent DNA transcription
  • Bind to bacterial DNA (correct)
  • Fluoroquinolones act on what two enzymes of bacterial DNA replication?

    DNA gyrase and topoisomerase IV

    What are fluoroquinolones?

    <p>Bactericidal antibiotics affecting bacterial DNA synthesis</p> Signup and view all the answers

    What infections are fluoroquinolones clinically used to treat? (Select all that apply)

    <p>Respiratory tract infections</p> Signup and view all the answers

    Moxifloxacin (Alelox) is effective against?

    <p>Anaerobes</p> Signup and view all the answers

    Ciprofloxacin (Cipro) is the drug of choice for which conditions?

    <p>Infections by Pseudomonas aeruginosa and postexposure prophylaxis for anthrax</p> Signup and view all the answers

    Fluoroquinolones exhibit postantibacterial effects.

    <p>True</p> Signup and view all the answers

    What are some adverse side effects related to fluoroquinolones' cartilage toxicity?

    <p>Severe tendon disorders</p> Signup and view all the answers

    Which gastrointestinal adverse effects are associated with fluoroquinolones? (Select all that apply)

    <p>Vomiting</p> Signup and view all the answers

    Fluoroquinolones have a risk for serious hypersensitivity reactions.

    <p>True</p> Signup and view all the answers

    What cardiac adverse effect can fluoroquinolones cause?

    <p>Dysrhythmias and prolonged QT interval</p> Signup and view all the answers

    What are nervous system toxicity side effects associated with fluoroquinolones? (Select all that apply)

    <p>Dizziness</p> Signup and view all the answers

    What liver toxicity is associated with fluoroquinolones?

    <p>Elevated hepatic enzymes</p> Signup and view all the answers

    What is the phototoxicity risk for fluoroquinolone patients?

    <p>Moderate to severe phototoxicity</p> Signup and view all the answers

    What types of resistance can develop against fluoroquinolones? (Select all that apply)

    <p>Reduced cell wall permeability</p> Signup and view all the answers

    Match the following fluoroquinolone generations to their specifics:

    <p>First generation = Nalidixic acid (NegGram), Oral, Enterobacteriaceae, Uncomplicated UTI Second generation = Ciprofloxacin (Cipro), Norfloxacin (Noroxin), Ofloxacin (Floxin), PO and IV, Enterobacteriaceae, Atypical pathogens, P. aeruginosa, Complicated UTI, Gastroenteritis with severe diarrhea, STIs</p> Signup and view all the answers

    Study Notes

    DNA Replication Process

    • Four steps involved: relax, unwind, replicate, and migrate.
    • Relaxation of supercoil by DNA gyrase.
    • DNA helicase unwinds the DNA strands post-relaxation.
    • DNA polymerase adds precursor bases to form new DNA strands.
    • Topoisomerase IV frees interlocked strands to allow migration and segregation into daughter cells.

    Mechanisms of Action Against Bacterial DNA Replication

    • Drugs can inhibit synthesis or availability of nucleotides.
    • Some bind directly to bacterial DNA, disrupting uncoiling processes.
    • Others target enzymes involved in DNA replication, stopping new DNA formation.

    Fluoroquinolones

    • Primarily target enzymes DNA gyrase and topoisomerase IV.
    • Known for their bactericidal properties and inhibiting bacterial DNA synthesis.
    • Classified into four generations with varying scopes of activity.

    Clinical Applications of Fluoroquinolones

    • Effective for treating infections in respiratory, gastrointestinal, genitourinary tracts, and skin/soft tissue.

    Specific Fluoroquinolones

    • Moxifloxacin (Alelox) is effective against anaerobic bacteria.
    • Ciprofloxacin (Cipro) is preferred for Pseudomonas aeruginosa and postexposure prophylaxis for anthrax and other bioterrorism-related infections.

    Postantibacterial Effects

    • Bactericidal effects can persist post-administration, continuing after serum levels drop below minimum inhibitory concentrations.

    Adverse Effects of Fluoroquinolones: Cartilage Toxicity

    • Potential tendon toxicity in children due to cartilage matrix effects.
    • Increased risk of tendinitis and tendon ruptures in patients over 65.

    Adverse Effects of Fluoroquinolones: GI Toxicity

    • Common side effects include nausea, diarrhea, and vomiting.
    • Absorption can be delayed by multivitamins/minerals containing calcium, zinc, iron, aluminum, or magnesium.
    • Associated with risk of Clostridium difficile-associated diarrhea (CDAD).

    Adverse Effects of Fluoroquinolones: Hypersensitivity Reactions

    • Risk of serious and potentially fatal reactions after multiple doses, necessitating an FDA warning.

    Adverse Effects of Fluoroquinolones: Cardiotoxicity

    • Moxifloxacin linked to dysrhythmias and prolonged QT interval.

    Adverse Effects of Fluoroquinolones: Nervous System Toxicity

    • Symptoms include dizziness, headache, sleep disturbances, seizures, and potential peripheral neuropathy.

    Adverse Effects of Fluoroquinolones: Hepatotoxicity

    • May elevate hepatic enzyme levels, suggesting potential liver toxicity.

    Adverse Effects of Fluoroquinolones: Phototoxicity

    • Patients can exhibit moderate to severe reactions when exposed to sunlight.

    Fluoroquinolones Resistance Mechanisms

    • DNA gyrase alteration can reduce fluoroquinolone binding.
    • Some bacteria develop efflux pumps to remove these drugs.
    • Changes to the cell wall can decrease permeability to fluoroquinolones.

    Fluoroquinolones: First Generation

    • Example: Nalidixic acid (NegGram).
    • Administered orally; effective against Enterobacteriaceae.
    • Used primarily for uncomplicated urinary tract infections.

    Fluoroquinolones: Second Generation

    • Common examples include ciprofloxacin (Cipro), norfloxacin (Noroxin), and ofloxacin (Floxin).
    • Administered either orally or intravenously and active against Enterobacteriaceae and atypical pathogens.
    • Indicated for complicated UTIs, gastroenteritis with severe diarrhea, and STIs.

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    Description

    Dive into the four-step process of DNA replication with these flashcards covering key enzymes. Each step—Relax, Unwind, Replicate, and Migrate—is explained in detail, making it easy to understand the roles of different enzymes in the process. Perfect for reviewing essential concepts in pharmacology and molecular biology.

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