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AANIYA PATH > Aani Micro: Drugs- Antivirals and Antimicrobials > Flashcards

Aani Micro: Drugs- Antivirals and Antimicrobials Flashcards

1
Q

How does acyclovir work?

A

Guanosine analogue - blocks viral thymidine kinase

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2
Q

How to treat CMV?

A
  1. ganciclovir (nucleoside analogue)
  2. foscarnet
  3. cidofovir
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3
Q

Why does acyclovir not work for CMV?

A

It doesnt have thymidine kinase enzyme

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4
Q

How to treat HSV?

A

Act Very Fast
Acyclovir
Valacyclovir
Famcyclovir

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5
Q

Sideeffect of Ganciclovir?

A

Bone marrow toxicity

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6
Q

How high should HBV levels be before you treat the patient?

A

> 2000 HBV DNA serum levels

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7
Q

What is Palivizumab used for?

A

RSV

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8
Q

What can treat RSV?

A

Palivizumab
OR
Ribavirin (guanosine analogue)

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9
Q

How to treat Hep C?

A

Peg IFN Alpha
Or
Ribavarin

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10
Q

Which types of Hep C are most successfully treated?

A

Genotypes 2 and 3

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11
Q

Which types of Hep C are least successfully treated?

A

Genotypes 1 ,4,5 and 6

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12
Q

Sideeffect of Ribavarin?

A

Haemolytic Anaemia

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13
Q

Name some influenza neuraminidase inhibitors

A

Oseltamivir, Zanamivir and Sialic Acid

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14
Q

Name an influenza drug that isnt a neuraminidase inhibitor- what does it do?

A

Amantidine - blocks M2 ion channel

MAN
M2

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15
Q

Why is the risk of getting CMV higher in BM transplant if the pt already has CMV (seropositive)?

A

So basically the recipient is seropositive so already has CMV.
The recipient can control it but is getting BM transplant so losing their protective Abs. Because the donor is seronegative they don’t have protective Abs against CMV so the recipient doesnt get new ones and so they contract CMV.
If the donor was seropositive they’d likely be also donating protective Abs!

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16
Q

Name the types of antimicrobials

A
  • Cell wall synthesis inhibitors
  • Protein synthesis inhibitors
  • DNA synthesis inhibitors
  • RNA synthesis inhibitors
  • Cell membrane toxins
  • Folate inhibitors
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17
Q

What are the cell wall synthesis inhibitor groups and how do they work?

A

B lactams and Glycopeptides
B lactams inactivate transpeptidase enzymes that are needed for peptide cross links in the cell wall.
Glycopeptides inhibit transglycosidase enzymes

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18
Q

Name the B lactams

A 
PEN CAR SEF MON
Penicillins
Carbapenems
Cephalosporins
Monobactams
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19
Q

What are the penicillins and talk about each key feature

A

In general the penicillins have good aerobic and anaerobic cover.

Penicillin - gram +. broken down by B lactamases

Amoxicillin - broad spec gram + and -. Also broken down by B lactamases.

Clavulanic acid - add to amoxicilin to protect against B lactamased = augmentin.

Flucloxacilin - Less active but resistant to B lactamases.

Piperacilin - Same as amoxicilin but with pseudomonas cover too

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20
Q

What are the Carbapenems?

A

Meropenem and ertapenem

Stable to extended spectrum B lactamases but worried about carbapenemase enzymes building resistance.

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21
Q

What are the Cephalosporins?

A 
In general they are good for Gram -
 and cover pseudomomas.
Cephtriaxone - for meningitis
Cefuroxime
Ceftazidime 
BUT B lactamases are resistant to these AND you need to add metronidazole for anaerobic cover
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22
Q

What are the positives and negatives about B lactam antibiotics?

A

+ Not v toxic
+ Can cross inflamed meninges

  • Renally excreted
  • Cross allergenic - anaphylaxis
  • Short half life
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23
Q

What are the glycopeptides?

A

Vancomycin and Teicoplanin

what the glycoPLANIN on TV

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24
Q

Benefits of glycopeptides?

A

Gram + cover

Good for MRSA as resistant to B lactamases

25
Q

Negatives of glycopeptides?

A
  • Only work against gram + cos too big to get through outer cell wall of gram -
  • Nephrotoxic
  • Slow
26
Q

What are the Protein Synthesis inhibitor antimicrobial drugs?

A 
ATM CO
Aminoglycosides
Tetracyclins
Macrolides
Chloramphenicol
Oxazolidinones
27
Q

Which ribosomal subunit to the Protein synthesis inhibitors each bind to?

A 
Aminoglycosides - 30s
Tetracyclines - 30s
Macrolides - 50s
Chloramphenicol - 50s
Oxazolidinones -23s of 50s to prevent 70s
28
Q

Side effect of chloramphenicoles?

A

Grey baby syndrome and risk of aplastic anaemia

29
Q

What is chloramphenicole used for?

A

Eye drops

30
Q

What are the macrolides?

A

Erythromyciin/Clarithro/azithromycin

31
Q

What are the macrolides used for?

A

Intracellular organisms such as campylobacter and legionella

32
Q

What is a common tetracycline?

A

Doxycyclin

33
Q

What is doxycyclin used for?

A

Broad spec against intracellular pathogens e.g. Chlamydia and mycoplasma and Rikettsia

34
Q

What are the inhibitors of DNA synthesis antimicrobials?

A

Nitroimidazoles e.g. metronidazole

And Quinolones e.g. Ciproflox - all the FLOX.

35
Q

What are the Nitroimidazoles used for?

A

Good anearobic cover and against protozoa e.g. giarda

36
Q

What are the RNA synthesis inhibitor antimicrobials?

A

Rifamycins e.g. Rifampicin and Rifabutin

37
Q

How do RNA inhibitors work?

A

Bind to the DNA dependent RNA polymerase

38
Q

How do we use the RNA synthesis inhibitors?

A

NEVER alone as they develop resistance quickly. used for mycobacteria

39
Q

S/E of RNA synthesis inhibitors?

A

Orange secretions

40
Q

What are the cell membrane toxin antimicrobials?

A

Daptomycin and Colistin

Dapto for gram + and colistin for gram -

41
Q

When can you not used daptomycin?

A

Pneumonia- it is broken down by lung surfactant

42
Q

What are the inhibitors of folate metabolism? Give an example each and how they’re used.

A

Sulphonamides e.g. sulfamethoxazole and Diaminopyrimidines e.g. trimethoprim.
They are both combined to treat PCP

43
Q

How do you treat community vs hospital acquired UTIs?

A

Community- trimethoprim x 3

Hospital - Co-amoxiclav (augmentin)

44
Q

How to treat mild community acquired pneumonia?

A

Amoxicililin (Penicillin B lactam)

45
Q

How to treat severe community acquired pneumonia?

A

Cefuroxime (cephalosporin B lactam) AND clarithromycin (Macrolide- protein synthesis inhibitor)

46
Q

How to treat hospital acquired pneumonia?

A

Cefuroxime (cehalosporin B lactam)

47
Q

Which skin pathogen is most common?

A

Staph Aureus

48
Q

How to treat Staph A skin infections?

A

Flucloxacillin (a norrow spec penicillin B lactam)

49
Q

Which organism causes Bacterial meningitis?

A

Meningiococcus/streptococcus

50
Q

How to treat bacterial meningitis in adults?

A

cafriaxone - think you want to shop the treee down if you have meningitis TREE-AXE.

Ceftriaxone IV 2g bd
Give amoxicillin instead if immunocompromised

51
Q

How to treat someone who has meningitis with encephalitis?

A

Cetfriaxone 2g bd AND acyclovir 10mg/kg tds

52
Q

How to treat C.Diff?

A

Metronidazole (stop offending Abx e.g. ceph)

53
Q

How to treat severe sepsis?

A

Cefuroxime, metronidazole and gentamicin

54
Q

How to treat neutropaenic sepsis?

A

Tazocin and gentamycin

55
Q

How to treat B haemolytic strep?

A

Benzylpenicillin

56
Q

Which organisms cause early onset sepsis in babies?

A

Group B strep
E.Coli
Listeria

57
Q

How to treat meningitis in kids?

A

<3 months : Cefotaxime AND amoxicillin - babies a taxing amo
3 months - 5 years: Caftriaxone
6 years +: Cefrtriaxone + Clarithromycin

58
Q

Which organisms cause meningitis in kids?

A

N.meningitidis all ages
Strep Pneumonia all ages esp < 2 years
HIB <3 months

AANIYA PATH (35 decks)

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