101

Question 1

Gram Positives - Give examples and disease
Bacillus
Clostridium
Cortynebacterium
Mycobacterium
Staphylococcus
Streptococcus

Answer 1

Bacillus Anthrax
Clostridium Tetani/Difficile
Cortynebacterium Diptheriae
Mycobacterium tuberculosis/Leprae
Staphylococcus Aureus - wound infections, septicaemia
Streptococcus pneumoniae/pyrogenes -pneumonia, meningities,cellulitis

Question 2

Gram Negative - Give examples and disease
Bordatella
Brucella
Campylobactor
Escherichia
Haemophilus
Helicobactor
Klebsiella
Legionella

Answer 2

Bordatella Pertussis - Whooping cough
Brucella abortus - Brucellosis
Campylobactor jejuni- Food poisoning
Escherichia coli - UTI, Sept,wound infections
Haemophilus influenzae - RTI, Meningitis
Helicobactor pylori - Peptic ulcers, gastric cancer
Klebsiella pneumoniae- pneu, septicaemia
Legionella pneumophilla - Legionnaire’s disease

Question 3

Tests for Bacteria ID

Answer 3

Gram stains
Coagulase test -conv of fibrinogen to fibrin. diff of staphylococcus sp
Haemolysis test - further class of Staph.
Lactose fermentation - diff og grame -ve rods

Question 4

Benefits of normal flora

Answer 4

Compete with invading bacteria to prevent infections
Metabolising non-digestible carbohydrates
Prov nutrients - vit K, B

Question 5

General sites of infections

Gram + cocci
Grame -ve rods
Anaerobes
Atypical

Answer 5

Gram + cocci : Skin,soft tissue,heart,lungs, hardware
Grame -ve rods ; Lung (all types of pneu), any intra-abd organ, GU
Anaerobes; Lung(abscess), oral cavity, intra abd
Atypical - Lung(CAP)

Question 6

Classification of antibiotics

Answer 6

Bactericidal or Bacteriostatic
Action - types of bacteria targeted, MOA)
Chenical Structure
Clinical use

Question 7

Bactericidal Antibiotic and conditions

Answer 7

Penicillins
Cephalosporins
Glycopeptides

Endocarditis, Meningitis, Osteomylitis, Neutropenia

Question 8

Mechanisms of Action

Answer 8

Cell wall synthesis
Nucleic Acid Synthesis
Protein Synthesis

Question 9

Narrow Spectrum Penicillin

Answer 9

Benzylpenicillin(Pen G) -given parenterally
Phenoxymethylpenicillin (Pen V)
Flucloxacillin

Question 10

Broad Spectrum Penicillin

Answer 10

Amoxicillin
Ampicillin
Pipercillin with Tazobactam (Tazocin)

Question 11

B-lactams/penicillin Pharmacokinetics

Answer 11

Abs - 30-60 mins bfr meals. decr by food in stomach
Distribution - will only penetrate CNS if meninges inflamed
Metabolism - Liver
Eliminations- kidneys ; unchanged in Urine
Side effects - Hypersensitivty - mild rash, anaphylaxis
Cross-reactivity
Nausea, Vomiting , diarrhoea
rare - c.difficile and thrush

Question 12

Chemicals to inhibit resistance to B-lactams ( Beta -lactamase)

Answer 12

Clavulanic acid
Tazobactam

Amoxicillin + C.Acid= Augmentin
Piperacilin+Tazobactam = Tazocin
Ticarcillin + C.Acid = Timentin

Other resistant penicillins
Carbapenems -v.broad spectrum ; meropenem
Monobactam; aztreonam

Question 13

Cephalosporins and admin

Answer 13

PO,IM, IV
Related in structure and function to penicillin
Classed by generation the higher the broader the spectrum

Pharmacokinetics similar to penicillin
except - Cefotaxime (will appear in bile) and ceftriaxone are used for menengitis - penetrate CNS

SE- alter flora and permit overgrowth of C.difficile

Question 14

Glycopeptides uses and admin

Answer 14

Treatment of MRSA and C.difficile
IV
only PO if local GI effect needed e.g colitis

SE - ototoxicity, nephrotoxicity,
red man syndrome
anaphylaxis

Question 15

Aminoglycosides

-ve

Answer 15

IV,IM
Gentamycin drug of choice in UK for serious infections
can be toxic

Abs - poor in GI tract
Dist- No CNS penetration
Metab- Liver
Elim- Kidneys - unchanges on urine
AE- Nephrotoxicity
Ototoxicity
Neuromuscular paralysis
Avoid in R.Factors - Dehydration, renal toxic drugs

Question 16

Macrolides

+ve

Answer 16

Low toxicity

Abs - PO
IV use - ris of thrombophlebitis
Meta - Liver
Elim - Bile(E &A), Urine (C)

SE - GI, jaundice,ototoxicity

Question 17

Tetracyclines

+ve, -ve

Answer 17

Abs -adequate but incomplete oral absorption, hindered by calcium(milk) and mg,al sals (antacids)
Dist- liver, skin, kidneys
Metabolism - Liver
Eliminations - Bile and urine

Lyme disease, cholera, Brucellosis

A.E - Oaesephageal ulcerations
Photocensitivity
Incorporate into foetal and children bone and teeth

Question 18

Quinolones

-ve,+ve

Answer 18

Limited therapeutic utility
Rapid dev of resistance
abs -Parenterally, PO
Not with Fe, Ca and most antacids
Dist - poor CNS penetraction
Met - Liver
Elim - Bile, Urine
SE - Diarrhoea, Nausea, toxicity with Theophylline, convlsions

Question 19

Rifampicin

Answer 19

TB and treatment of Gram + infections with penicillinase activity

Question 20

Sulfonamides

Answer 20

UTI and RTI

Question 21

Trimethoprim

Answer 21

UTI