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Abx Flashcards

1
Q

What types of organism aminoglycoside cover?

A

Gram -ve
Adavantage
Rapidly bactericidal
Lowresistance

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2
Q

How Kanamycin is different to Genta?

A

Usefull for resistant mycobacterial infections but inf to other aminoglycoside for gm -ve cover

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3
Q

What are contraindications of aminoglycoside?

A

1) Hypersensivity

2) ototoxicity3)M Gravis

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4
Q

Advantages of Aminoglycosides?

A
  • Post antibiotic effect allowing once daily dosing
  • synergistic with cell wall active drug against streptococcal and enterococcal••
  • rare c diff colitis
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5
Q

What do you about Aminoglycoside related vestibular and auditory toxicity?

A
  • Occur when longer than 5-7 days course
  • Preexisting kidney dysfunction
  • reversible

Toxicity not predicted by plasma level.

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6
Q

What are the causes of cavitatory lung infiltrates

A

1) Tuberculous and non tuberculous lung infiltrates
2) MRSA
3) fungus
4) oral anaerobes

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7
Q

What are common organism of pneumonia in COPD?

1)

A

1) HIb
2) M catarrhalis
3) pseudomonas
4) atypical org

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8
Q

what are different classes of cephalosporin cover

A

Gen 1 proteus , Klebsella , E coli and skin surgical prophylaxis
Gen 2 Nisseria, hemophilus ecoli serrtia,anerobes
Gen 3 pseudomonas , Gonorrhea and meningitis
Gen 4 cefpime
Gen 5
ceftaroline –>not cross BBB but effective against mrsa
Ceftolozane

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9
Q

what are Cephalosporin SE

A

Disulfarim like reaction

Cross reactivity with penicillins

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10
Q

what are cell wall inhibitor abx

A

1) pencillins
2) Cephalosporin
3) Carbepenams
4) Monobactams
5) Glyco peptide inhibitors
6) Bactroprenol inhibitors(Bacitracin )
7) Lipopeptides

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11
Q

S/E OF Carbepenums ?

A

CNS toxicity

Nephrotoxicity

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12
Q

spectram of Aztreonam (Monobactam )

A

Mainly Gram -ve
Pseudomonas
Proteus
E coli

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13
Q

what are glycopeptides Abx ?

A

1) Vancomycin
2) Teicoplanin
3) Telavancin

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14
Q

How glycopeptides abx works?

A

They latch on Tetra peptide side chain it self By passing PBP enzymes

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15
Q

What are VRSA ?

A

Some staph has D lactate at tip of tetra peptide chain making them resistant to Glyco peptide abx

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16
Q

What are Protein synthesis inhibitor Abx?

A

1) Aminoglycosides
2) Tetracycline
3) Lincosamide
4) Macrolides
5) Oxazolenones
6) Chloramphenicol
7) Streptogramins

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17
Q

what is MOA of aminoglycosides?

A

1) Inhibiting 30s of ribosome(Bacteriostatic)

2) Disrupting proof reading and and translocation(Bactricidal)

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18
Q

WHAT s MOA for Tetracylines ?

A

Bind to Amino acyle group on 30

Inhibits binding of t RNA to mRNA

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19
Q

what is Tigacycline?

A

Modified to add DGMA side change to counter act defence mechanism of bacteria by which they extrude drug out of bacteria

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20
Q

what are SE of Tigacyclines ?

A

can interfere with absorption of Iron , Megnesium and Aluminum

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21
Q

what org does tetracycline cover

A

wide vriety of Gram +ve and -ve

concentrate in the cell hence useful for intracellular pathogens

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22
Q

Name tetracycline that cover MRSA

A

Both Doxy and tigacycline cover MRSA

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23
Q

What are SE of tetracycline?

A

1) ototoxicty and tinnitus
2) Nephrotoxcity Fanconi syndrome
3) Discoluration of teeh in children under 8
4) bon deformities in children

24
Q

how do divide protein synthesis inhibitor?

A

30 S inhib( Amino glycoside
+tetracycline)
50 S inhib (Macrolide, Chloramphenicol, lincosamide, oxazolidinones,streptogramins)

25
what MOA of Macrolides(Azithro, erythro, clarithro)
``` work by bocking 50 s of bacteria hen blocking movement of nucleotide on Ribosome Bacteriostatic both Gram +ve and _ve cover Bartonella Atypical Cap H Pylori with amoxi ```
26
What iS lincosamide ABX
Clindamycin | Used for anerobes above the diaphregm
27
what are oxazolidinones?
Linzolid Work by binding to 50 S and would not let 50 S joint by 30 S hence stoping protein synthesis before it begins Cover Gram +ve MRSA ,VRE
28
What are SE of LinazoLid
1)one marrow supression, Thrombocytopenia 2)Neurotoxicity, 3)OPtic neuropathy 4) Serotonin syn if simultaneously used with antidepressent (Weak MAO inhibitors )
29
what are ESCAPPM organisms
``` A subgroup of ESBLs bacteria that initially respond to Cephalosporins but later inducible Beta lactam acitvity and treatment failure . This is mediated thourgh Ambler Class C . E -enterobacter S-SERRTIA C-citrobacter H-hafnia A-aeromonas P-proteus P- providencia M-Moregnella ```
30
What is MO resistence in different Abx
1)Eflux Linzolids 2)decrease permeability Vanc TMZ-SMZ 3)Porin channels B lactams , Aminoglycosides, chloramphenicol 4)altered target sites , FOR EXAMPLE PBP,DN gyras flouroquinilones
31
what are DNA synthesis inhibitors
TMp-SMx Metronidazole Fluoroquinilones
32
What types of infection TMP-SMX can treat?
``` UTI Travellers Diorrhea Sinus Pneumonia PJP MRSA ```
33
What types of infection TMP-SMX can not treat?
Pseudomonas | Mycoplasma
34
how does metronidazole works?
By stopping synthesis of nucleic acid | get a electron from Ferridoxin from bacteria for activation and this causes damage to protein
35
what is most common organism in VRE
E faecum
36
what is commonest RF for VRE?
previous ABX use esp vanc and Cephalosporin Than Hospitalization more than 72 Hours Patient characteristics and NH residence
37
what is best test to DX MERSCOV
LRTI sample i--e tracheal aspirates , BAL and sputum
38
What is streptogramin?
protein synthesis inhibitor class of abx - act on 50 S andare Bacteriocidal example is Quinapristin-Dalfoprestin
39
For which infection TMP-SMZ is inferior to Vanc
for endovasc infection | TMP-SMZ best for soft tisue and bone infection-Bacteriostatic
40
what is the mechanism of VISA?
Cell wall thickening MIC 4-8 ug /ml
41
HOw VRSA has formed ?
By accuisiation of a plasmid containing Van A gene on a transposon from VRE. What is does ?Alters D Ala -Dala to DAla -Dlac and change of structure of cell wall.
42
What Is Hvisa?
heterogenous VISA -could have susceptible MIC for Vanc but a sub poulation has VISA and Tieoplanin should be avoided
43
what is the treatment for VRSA?
Daptomycin with another agent(Linzolid, TMP-SMX, gentamycin and Rifampicin
44
What Abx VRE is resistant to
``` Cephalosporins Tetracyclines Macrolides Flouroqunilones Glycopeptides E faecum more resistant Vx Faecalis ```
45
how Many Groups of Vanc resistance?
5 group Van A to E | Van A and B seen in E faecum and faecalis
46
what are Rx options for VRE?
LInzolid, Daptomycin,STreptogranins and Tigecyclins
47
Having Van A gene causes Resistance to which Glycopeptides?
Both Vanc and Teicoplanin
48
How ESBL develops
By plasmid mediated Beta Lactamases
49
How do we Classify ESBLs
``` Amber classification 4 Gp Majority ESBL in class A(ctx,m SHV, TEM) ```
50
What are Treatment OPtions for ESBLs
Cetaroline-Tazobactam Carbepenams Ceftazidime-Avibactam Non-betalactam
51
which bacteria is not covered by Ertapenam?
Acinobacter
52
what are Draw back of Dapatomycin
Poor CNS penetration and Inactivated by Lung surfactant
53
what are treatment options for MRSa?
Ceftaroline,Teicoplanin, Daptomycin | Streptogramins , Oxazolidines, Bactrim and Clinda
54
what are streptogramins?
work by Inhibiting 50s Ribosome-Bactricidal | Quinapristin- Dalfopristin
55
what are Treatment fro VRSA?
Daptomycin plus Linazolif /Bactrim /Rifampicin
56
what are new classes of abx?
streptogramins -Qinapristn -Dalfopristn Lipopepides-Dapatomycin cover Gram +ve

infecteous disease (8 decks)

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