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Y2 INFLAMMATION > 2. antimicrobial therapy > Flashcards

2. antimicrobial therapy Flashcards

1
Q

what are the classes of beta lactams

A

penicilin
cephalosporins
carbapenems

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2
Q

what is the mechanism of action of beta lactams

A

(enzymatic) act on bacterial cell walls by binding to penicillin binding proteins (PBP) in the cell membrane which interferes with peptidoglycan synthesis

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3
Q

what are macrolides used for

A
  • penicillin allergy against gram positive staph and strep, e.g. skin and thread infections.
  • atypical pneumonia
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4
Q

examples of macrolides

A

erythromycin IV&PO
clarithromycin IV&PO (newer)
azithromycin PO (newer)

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5
Q

what is the mechanism of action for erythromycin

A

bacteriostatic.

interferes with protein synthesis by ribosomal binding

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6
Q

what are tetracyclines used for

A
  • broad spectrum
  • resp tract and soft tissue infections
  • in penicillin allergy with side effects to macrolides
  • atypical respiratory pathogens
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7
Q

examples of tetracyclines

A

oxytetracycline
doxacycline
tigecycline

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8
Q

what is tigecyline

A

recent tetracycline.
potent broad spectrum
works against gram positives, negatives and anaerobes

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9
Q

mechanism of action of oxytetracycline + doxycycline

A

bacteriostatic.
inhibit tRNA binding to ribosome

doxy: PO, give once daily

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10
Q

what is the mechanism of action of trimethoprim + co-trimoxazole

A

block bacterial nucleotide synthesis in the pathway of folic acid/nucleotide synthesis

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11
Q

what do trimethoprim + co-trimoxazole work against

A

active against gram positive and negative bacteria

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12
Q

what is a use of trimethoprim

A

commonly used against UTIs

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13
Q

what is a use of co-trimexazole

A

(trimethoprim + sulfamethoxazole)

  • treatment and prophylaxis of pneumocystis jirovecii pneumonia
  • stenotrophomonas maltophilia infection
  • nocardiosis
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14
Q

examples of quinolones

A

ciprofloxacin
levofloxacin
moxifloxacin

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15
Q

what is the mechanism and use of ciprofloxacin

A
  • inhibit DNA gyrase (enzyme that supercoils bacterial DNA) = disrupt organism
  • better action for gram positive
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16
Q

what is the function of levo and moxifloxacin

A

new, have better gram positive cover

‘respiratory quinilones’

17
Q

what is the mechanism of aminoglycosides

A

interfere with ribosomal reading of mRNA

18
Q

what’s the function of aminoglycosides

A

gram positive mainly

  • synergy with penicillin against strep
  • mainly used IN SERIOUS SEPSIS
  • potential for nerve 8 and renal toxicity: measure levels
19
Q

examples of aminoglycosides

A

gentamicin
amikacin
netilmicin
tobramycin

20
Q

what is the mechanism for glycopeptides

A

act on bacterial cell walls

21
Q

use of glycopeptides

A

against gram positive
treatment of MRSA
treatment of coagulase negative staph infection
occasionally when penicillin allergic

22
Q

examples of glycopeptides

A

vancomycin: potentially nephrotoxic

teicoplanin

23
Q

what is teicoplanin used for

A

outpatients with long lasting infections e.g. osteomyelitis

24
Q

metronidazole

A

breaks DNA strands.

active against all anaerobes, amoebae and trichomonad vaginalis

25
Q

linezolid

A

active against gram positive, including MRSA and glycopeptide-resistant enterococci

26
Q

chloramphenicol

A

occasional therapy of meningitis and topical treatment f eye infections.
bone marrow toxicity

27
Q

fosfomycin

A

multi-resistant gram negative bacterial infections

28
Q

fidaxomycin

A

severe or recurrent c.difficile infections

29
Q

colistin

A

disrupts bacterial membrane.

reserved for multi- or pan-resistant gram negative infections

30
Q

daptomycin

A

a lipopeptide, similar activity to glycopeptide

against gram positive

31
Q

fusidic acid

A

staphylococcal infections only
topical
if systemic: use with second anti-staph agent

32
Q

rifampicin

A

v active against gram positive
prosthetic valve endocarditis and other prosthetic infections.
part of first line TB regimen

33
Q

what is the issue in terms of resistance about staphylococcus aureus

A

meticillin-resistant S. aureus (MRSA)

34
Q

what is the issue in terms of resistance about streptococcus pneumoniae

A

penicillin and multiply resistant

35
Q

what is the issue in terms of resistance about enterococcus faecium

A

glycopeptide and linezoid resistant

36
Q

what is the issue in terms of resistance about mycobactum tuberculosis

A 
resistant to one or more anti-TB drugs: 
rifampicin
isoniazid
pyrazinamide
ethambutol
37
Q

what is the issue in terms of resistance about salmonella typhi

A

multi-resistant in some parts of the world

Y2 INFLAMMATION (8 decks)

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