Pharmacology of Hydrophilic Antibiotics (BMS161)
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Questions and Answers

What is the primary indication for using Streptomycin?

  • Hepatic coma
  • Tuberculosis (correct)
  • Pseudomembranous colitis
  • MRSA infections
  • Which of the following adverse effects is associated with the release of histamine?

  • Nephrotoxicity
  • Neuromuscular paralysis
  • Ototoxicity
  • Red Man Syndrome (correct)
  • What is the mechanism of action of Daptomycin?

  • Disruption of cell membrane (correct)
  • Inhibition of 50S subunit
  • Inhibition of DNA replication
  • Inhibition of protein synthesis
  • What is a common side effect of using Linezolid for more than 10 days?

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

    Why is Daptomycin not used to treat pneumonia?

    <p>It is inactivated by pulmonary surfactant</p> Signup and view all the answers

    What is the primary indication for using Vancomycin?

    <p>Gram-positive infections</p> Signup and view all the answers

    What is the mechanism of action of Streptogramins?

    <p>Inhibition of 50S subunit</p> Signup and view all the answers

    What is a common side effect of using Neomycin?

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

    What is the primary mechanism of action of aminoglycosides?

    <p>Protein synthesis inhibition</p> Signup and view all the answers

    Why are aminoglycosides not used against anaerobes?

    <p>They are not effective against anaerobic bacteria</p> Signup and view all the answers

    What is the primary route of administration for aminoglycosides?

    <p>Parenteral administration</p> Signup and view all the answers

    Why are aminoglycosides given as once-daily dosing?

    <p>Because they have a concentration-dependent effect with a post-antibiotic effect (PAE)</p> Signup and view all the answers

    What is the primary mechanism of elimination for aminoglycosides?

    <p>Renal elimination</p> Signup and view all the answers

    Why is vancomycin given as an intravenous infusion over 60-90 minutes?

    <p>Because it has a time-dependent effect</p> Signup and view all the answers

    What is the primary mechanism of action of vancomycin?

    <p>Cell wall inhibition</p> Signup and view all the answers

    What is the primary indication for streptomycin?

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

    What is a crucial factor to consider when selecting an antibiotic for a pregnant woman?

    <p>The risk of kernicterus</p> Signup and view all the answers

    Which of the following antibiotics is associated with arthropathy?

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

    What is the primary consideration when initially selecting an antibiotic for a patient?

    <p>The broadest spectrum of activity</p> Signup and view all the answers

    What is a significant concern when using aminoglycosides in neonates?

    <p>The risk of ototoxicity</p> Signup and view all the answers

    In what population is the use of quinolones currently justified?

    <p>Children with cystic fibrosis</p> Signup and view all the answers

    What is the primary goal of subsequent questions to consider once a specific cause is identified?

    <p>To narrow the spectrum of the initial empiric drug</p> Signup and view all the answers

    Study Notes

    Hydrophilic Antibiotics

    • Aminoglycosides are used parenterally in serious gram-negative infections, but not against anaerobes.
    • Hydrophilic antibiotics are given orally due to poor absorption.
    • Adverse effects of hydrophilic antibiotics include ototoxicity, nephrotoxicity, and neuromuscular paralysis.

    Aminoglycosides

    • Mechanism of action: Protein synthesis inhibition.
    • Characteristics: Concentration-dependent with PAE (Post-Antibiotic Effect).
    • Administration: Given as once-daily dosing intravenously.
    • Members: Streptomycin, Gentamicin, Amikacin, Tobramycin, and Neomycin (oral or topical only).
    • Pharmacokinetics: Renally eliminated, not absorbed orally, and not cross BBB (except in inflammation).
    • Accumulated in the renal cortex and inner ear, and cross the placental barrier.
    • Spectrum: Active against aerobic Gram-negative bacteria.
    • Uses: Gram-negative infections, peritonitis, septicemia, pneumonia, endocarditis, UTI, and TB.

    Vancomycin

    • Mechanism of action: Cell wall inhibition.
    • Characteristics: Time-dependent.
    • Administration: Intravenous infusion over 60-90 minutes.
    • Spectrum: Active against anaerobic Gram-positive bacteria.
    • Uses: MRSA (ORSA), severe staph in B-lactam allergy, and oral in pseudomembranous colitis.
    • Adverse effects: Red Man Syndrome, fever, chills, and rigors.

    Alternative Antibiotics in Vancomycin Resistant Strains

    • Daptomycin: Cell membrane inhibition, administered IV/IM, and has side effects like myopathy and elevated liver enzymes.
    • Streptogramins: 50 S subunit inhibition, administered orally/IV, and has side effects like arthralgia, myalgia, and thrombocytopenia.
    • Linezolid: 50 S subunit inhibition, administered IV, and has side effects like GIT disturbance, thrombocytopenia, and MAOI property.

    General Principles of Anti-microbial Therapy

    • Indication of antimicrobial agent based on clinical findings.
    • Obtain appropriate clinical specimens for microbiologic diagnosis.
    • Identify likely etiologic agents for the patient's illness.
    • Consider patient factors (age, gender, pregnancy, lactation, neonates, children) for antibiotic selection.
    • Consider rational antibiotic prescription, including the dose, route, and duration of therapy.
    • Consider drug interaction with antibiotics.

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    Description

    This quiz covers the lecture on chemotherapy pharmacology, focusing on hydrophilic antibiotics and their pharmacokinetics, particularly aminoglycosides.

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