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Pharm part 2 > 15. General Principles of Antibiotics > Flashcards

15. General Principles of Antibiotics Flashcards

1
Q

Paul Ehrlich 1901

A

Magic bullet

Salvarsan for syphilis

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2
Q

Alexander Fleming 1928

A

penicillin

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3
Q

Howard Walter Florey and Ernst Boris Chain 1940

A

penicillin purification

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4
Q

Gerhard Domagk 1939

A

sulfamides

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5
Q

Antibiotic: (2)

A
  • (old) Anti-infective compound produced by a microorganism.
  • Also used to name synthesized chemical drugs
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6
Q

Define Spectrum: (2)

A

-range of pathogens that are affected by the antibiotic

Activity of a drug is defined by their spectrum: antibacterial, antiviral or antifungal

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7
Q

What germ do antibiotics affect? (3)

A

Bacteria Mycobacteria Rickettsia, etc

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8
Q

What germ do antivirals affect?

A

virus

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9
Q

What germ do antifungals affect?

A

fungi

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10
Q

What germ do antiparasitics affect?

A

parasites

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11
Q

BACTERICIDES:

A

are able to produce the destruction of the bacteria

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12
Q

BACTERIOSTATIC: (3)

A

inhibit bacterial replication (stop bacteria from growing), without eradicating the bacteria

  • It is essential the action of the host defense mechanisms
  • After discontinuing the antibiotic the microorganism can multiply again.
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13
Q

Common property to all antibiotics is the

A

selective toxicity

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14
Q

What is selective toxicity? (2)

A
  • common property to all antibiotics

- the toxicity towards invading organisms is greater than the toxicity towards humans (host tissue)

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15
Q

Antimicrobial agents behave as ________ when they produce the death of the organisms responsible for infectious process
Eg: (3)

A
  • BACTERICIDAL

- ex. B-lactams, quinolones, aminoglycosides

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16
Q

Antimicrobial agents behave as _______ when they inhibit bacterial growth and replication although the microorganism remains viable.

eg: (3)

A

Bacteriostatic

-ex. tetracyclins, macrolides, sulfonamides

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17
Q

How do bacteriostatic drugs work? (2)

A

inhibit bacterial growth and replication and then the host immune system eliminates the bacteria.

IF you discontinue the antibiotic the microorganism can recover and multiply again

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18
Q

To classify an antimicrobial as bactericide or bacteriostatic depends on: (4)

A
  • Its mechanism of action
  • the concentration achieved at its site of action
  • inoculum size
  • type of microorganism, etc
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19
Q

What are the two types if antibiotic treatment?

A
  • empirical: without knowing the specific germ

- specific: chosen after identifying the germ and knowing the antibiogram

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20
Q

Bacterial strains can be… (3)

A
  • susceptible
  • intermediate
  • resistant
21
Q

Types of antibiogram techniques (2)

A
  • diffusion

- dilution

22
Q

Define MIC (2)

A

minimum inhibitory concentration.

lowest concentration of antibiotic capable of inhibiting the growth of 10 (5) bacteria in 1 ml of growth medium after 18- 24h of incubation.

23
Q

Define MBC

A

minimum bactericidal concentration

lowest concentration that can destroy or kill 10 (5) bacteria in 1 ml of growth medium after 18-24 h of incubation.

24
Q

The purpose of anti-infective therapeutics will be to achieve …

A

an antibiotic tissue concentration exceeding the MIC

25
Q

Information obtained about the MIC of the germ, we will know whether a…

A

-bacterial strain is sensitive to one or more antibiotics and if it can be treated with standard doses of these antibiotics

26
Q

If you find a resistant strain on an antibiogram it means…

A

unlikely a good therapeutic result even with the administration of higher doses

27
Q

What is the pharmacokinetics / pharmacodynamics relation?

A

relationship between antibacterial activity and the concentration achieved at the site of action

28
Q

According to the PK/PD there are 2 antibacterial drug categories:

A
  • Concentration-dependent action antibiotic

- Time-dependent action antibiotic:

29
Q

What is a Time-dependent action antibiotic?

A

concentration of the drugs in this group at the site of action has to exceed the MIC for at least half of the dosing interval

30
Q

What is a Concentration-dependent action antibiotic?

A

The greatest bactericidal activity is obtained when reaching concentrations above the MIC at the site of action. The higher the concentration, the greater the bactericidal effect

31
Q

What are the mechanisms of action for antibiotics? (5)

A
  • Increased permeability of the cell membrane.
  • Inhibition of cell wall synthesis.
  • Altered DNA and RNA synthesis.
  • Inhibition of protein synthesis (ribosome: 50S / 30S)
  • Antimetabolites
32
Q

What are the fundamental rules of antibiotics treatment?

A
  1. Treatment indications
  2. Choice of antibiotic
  3. Route of administration
  4. Duration of treatment
33
Q

What are treatment indications for antibiotics? (2)

A
  • FEVER (bacterial origin): do bacteriological study (isolate)
  • Pathogen most likely involved by LOCATION
34
Q

What are contraindications for antibiotic treatments? (3)

A
  • Non-infectious fever
  • Fever caused by no susceptible organisms
  • Tend to recover spontaneously (viral infections)
35
Q

When do you give antibiotics in dentistry? (3)

A
  • Important local extension
  • Systemic involvement
  • High risk
36
Q

What type of antibiotic treatment is used in dentistry?

A

empirical

37
Q

When do you do empirical antibiotic treatment? (3)

A
  • In seriously ill patients
  • Impossibility to collect a culture
  • Negative cultures in severe infection
38
Q

Choice of antibiotic depends on.. (4)

A

Gram Stain
Serology
Culture
Antibiogram

39
Q

IF a patient has an immune system deficiency what antibiotic do you use?

A

bactericidal

40
Q

What are the routes of administration for antibiotics? (7)

A
  • ORAL
  • RECTAL
  • INTRAVENOUS
  • CONTINUOUS INFUSION
  • INTRAMUSCULAR
  • INTRATHECAL
  • INHALED
41
Q

Antiobiotic treatment duration is usually around…

A

7-10 days

42
Q

Why do we use a combination of antibiotics? (3)

A
  • Preventing resistance
  • Synergistic effect
  • Enlarge spectrum of action
43
Q

Why does bacterial resistance occur with antibiotics prescribed? (4)

A
  • Misuse of antibiotics
  • Inadequate doses
  • Duration of therapy (short or long)
  • Use of broad spectrum antibiotics
44
Q

Whats the mechanism of action for bacterial resistance? (3)

A
  • Inactivation of the antibiotic
  • Decreasing antibiotic permeability
  • Modification of the target structure
45
Q

Antibiotic prophylaxis in dentistry should occur in pateints with these conditions (6):

A
  • Prior Endocarditis
  • Prosthetic valve
  • Congenital heart disease (Not repaired)
  • Heart transplant
  • Valve Disease (stenosis or regurgitation)
  • Hypertrophic Cardiomyopathy
46
Q

What procedures in dentistry need antibiotic prophylaxis? (7)

A

Bleeding procedures:

  • gingival manipulation
  • periapical manipulation
  • alteration or oral mucosa
  • extractions
  • perio surgery
  • implants
  • endodontics
47
Q

This bacteria is the most frequent cause of infective endocarditis after dental procedures:

A

streptococcus viridans

48
Q

What drugs are given for dental prophylaxis if the patient is not allergic to penicillin? dosing? (2)

A
  • Amoxicillin: 2 g oral, 1 hour before intervention.

- Ampicillin: 2 g i.m. or i.v 30 minutes before.

49
Q

What drugs are given for dental prophylaxis if the patient is allergic to penicillin? dosing? (2)

A
  • Clindamycin: 600mg oral 1hour before intervention.

- Macrolides: (clarithromycin 500mg o., azithromycin 500mg o….)

Pharm part 2 (7 decks)

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