Action Mechanisms of Antimicrobials Flashcards

(33 cards)

1
Q

What are three ways an antimicrobial can act?

A

Inhibition of cell wall synthesis
Inhibition of protein synthesis
Inhibition of nucleic acid synthesis

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2
Q

What are two classes of antimicrobials that inhibit cell wall synthesis?

A

Penicillins and cephalosporins (beta-lactams)

Glycopeptides

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3
Q

How do penicillins and cephalosporins work?

A

Disrupt peptidoglycan synthesis by inhibiting the enzymes (PBS) that cross-link the carbohydrate chains

Allows organism destruction by autolytic enzymes

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4
Q

What is resistant to benzyl-penicillin and why?

A

Gram negative bacteria as the cell wall is made impermeable by the lipopolysaccharide

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5
Q

Give two examples of glycopeptides

A

Vancomycin and teicoplanin

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6
Q

How do glycopeptides work?

A

Inhibit the assembly of a peptidoglycan precursor, therefore work prior to beta-lactams

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7
Q

Glycopeptides are suitable for use on what type of bacteria?

A

Gram positive, as they cannot penetrate the cell wall of Gram negative bacteria

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8
Q

How are glycopeptides administered?

A

They are not absorbed from the GI tract, only given parenterally

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9
Q

Describe a contraindication and precaution of vancomycin administration?

A

Toxicity;
IV should be over a few hours
Pre-dose levels should be monitored

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10
Q

Describe the advantages of using teicoplanin over vancomycin

A

Less toxic
Single daily dose
Same spectrum

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11
Q

What are four classes of antimicrobial that inhibit protein synthesis?

A

Aminoglycosides
Macrolides and tetracyclines
Oxazolidinones
Cyclic lipopetide

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12
Q

Name an example of an aminoglycoside

A

Gentamycin

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13
Q

What type of bacteria are sensitive to aminoglycosides?

A

Staphylococci and Gram negative bacteria

Streptococci are resistant

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14
Q

Describe the administration of aminoglycosides

A

Can be injected

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15
Q

Describe a contraindication and precaution of aminoglycoside administration

A

Renal and hearing toxicity

Careful dosing regime required

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16
Q

How are macrolides used and why?

A

As an alternative to penicillin for use against Gram positive bacteria
(penicillin allergy requires an alternative)

17
Q

What types of bacteria are resistant to macrolides/tetracyclines?

A

Many staphylococcus aureus and streptococci species

18
Q

Describe the improved action of newer macrolides?

A

Better tissue penetration, therefore lower MIC and better cover for flu strains

19
Q

What is the only oxazolidinone in common use?

20
Q

How is linezolid used?

A

Usually held in reserve for serious infection

Given orally against MRSA

21
Q

Name an example of a cyclic lipopetide

22
Q

How is daptomycin used?

A

Usually held in reserve for serious infection

Used against MRSA and Gram positive bacteria

23
Q

What are two classes of antimicrobials that inhibit nucleic acid synthesis?

A

Trimethoprim and sulphamethoxazole

Fluoroquinolones

24
Q

How do trimethoprim and sulphamethoxazole work?

A

Inhibit different steps in purine synthesis

25
What is the combined form of trimethoprim and sulphamethoxazole and how is it used?
Co-trimoxazole | Used in treatment of chest infections
26
Why is co-trimoxazole better for use in chest infection treatment than, for example, cephalosporins?
Less likely to cause clostridium difficile infections as a result of their use
27
Name an example of a fluoroquinolone
Ciprofloxacin
28
How does ciprofloxacin work?
Inhibits DNA synthesis more directly
29
How are fluoroquinolones administered?
Orally and parenterally
30
How are fluoroquinolones used?
Against Gram negative bacteria, including pseudomonas
31
Describe a contraindication of ciprofloxacin use
Can't be used in children as it interferes with cartilage growth
32
Name a newer fluoroquinolone and describe its improved action
Levofloxacin Has more activity against Gram positive bacteria Sometimes used in chest infection treatment
33
How is trimethoprim used on its own?
UTI treatment