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z) Pharmacology > Anti-Bacterials > Flashcards

Anti-Bacterials Flashcards

1
Q

Bactericidal vs Bacteriostatic

A

Bactericidal kills bacteria

Bacteriostatic slows bacterial proliferation, less effective in immunocompromised

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2
Q

Gram + bacteria susceptibility

A

cell wall synthesis interfered with well by beta-lactams

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3
Q

Gram - susceptibility

A

Cell wall impermeant and beta-lactamase enzymes prevent cell wall interference

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4
Q

Mycobacteria beta lactam susceptibility

A

Different cell wall composition so beta-lactams don’t work

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5
Q

Drug classes affecting cell wall

A

Beta-lactams (penicillins/cephalosporins)
Vancomycin
Polymyxins
Anti-mycobacterials

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6
Q

beta-lactam MOA

A

Prevents transpeptidation and decarboxylation in formation of proteoglycan cell wall

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7
Q

penicillins used in what situations

A

benzylpenicillin (IV), phenoxymethylpenicillin (oral) for narrow spectrum non-resistance gram + infection

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8
Q

beta-lactamase resistant drugs

A

Methicillin (IV), flucloxacillin (oral) for beta-lactamase producing organisms

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9
Q

Broad-spec penicillins

A

Amoxicillin/ampicillin (oral) more hydrophilic so can enter some gram - bacteria, beta-lactamase producing bacteria resistant to these so given with clavulinic acid which inhibits the enzyme

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10
Q

Pseudomonas drugs

A

Ticarcillin/piperacillin (IV)

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11
Q

Penicillin SE

A

Hypersensitivity when metabolised

GI disturbance/infection due to destruction of gut flora

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12
Q

Vancomycin MOA

A

Prevents transglycosylation in cell wall synthesis by binding to precursors

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13
Q

Vancomycin uses (all IV)

A

beta-lactam sensitive people
MRSA
C. difficile bowel superinfection

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14
Q

Polymyxin uses

A

Topical application to ear/eye/skin or for gut sterilisation pre-surgery, not used much as very toxic

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15
Q

Anti-mycobacterials

A

Isoniazid (bacteriostatic unless rapidly dividing mycobacterium)
Ethambutol

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16
Q

Isoniazid MOA

A

Inhibits mycolic acid synth

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17
Q

Ethambutol MOA

A

Inhibits mycolic acid incorporation in cell wall

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18
Q

Ethambutol uses

A

Combination with isoniazid, useful for isoniazid resistant

19
Q

Cephalosporin 3 generations of drugs and uses

A

1st - cephardroxil (oral, for resistant UTIs)
2nd - cefuroxime (IV/oral, when other antibios ineffective)
3rd - Ceftazidime (Oral for gram - (2nd gen for +), ceftriaxone has longer half life)

20
Q

Sulphonamides MOA

A

sulfamethoxazole inhibit folate synthesis step in DNA synth, bacteriostatic

21
Q

Trimethoprim MOA

A

Inhibits tetrahydrofolate from dirhydrofolate in DNA synth, bacteriostatic

22
Q

Folic acid synth inhibitor uses

A

Co-trimoxazole (sulfamethoxazole + trimethoprim mix) used mainly to treat P. jiroveci pneumonia and toxoplasmosis, lots of resistance though
Don’t affect humans as all of our folate is dietary not synthesised

23
Q

Sulphonamide SE

A

Allergic reactions

Aplastic/haemolytic anaemia in rare cases

24
Q

Sulphones use

A

Dapsone similar to sulphonamides but also affect mycobacteria and used in leprosy

25
Q

Quinolone MOA

A

Ciprofloxacin inhibits DNA gyrase to prevent bacterial DNA supercoiling

26
Q

Quinolone uses

A

Broad spec and bactericidal so used against gram - and resistant strains (but resistance developing due to use in farming

27
Q

Quinolone SE

A

Nausea vomiting etc

Rarely convulsions as it’s a GABA antagonist

28
Q

Rifampicin MOA

A

Prokaryotic RNA polymerase inhibitor, bacteriostatic

29
Q

Rifampicin use

A

In combination TB therapy, broad spec

30
Q

Rifampicin SE

A

Orange secretions

31
Q

5-nitroimidazole MOA

A

Metronidazole produces metabolites that interfere with DNA and it’s synth

32
Q

5-nitroimidazole SE

A

GI disturbance

33
Q

5-nitroimidazole use

A

Used against certain protozoa and selective for anaerobes (e.g. H. pylori)

34
Q

Bacterial protein synth inhibitor classes

A

Tetracyclines
Aminoglycosides
Chloramphenicol
Macrolides

35
Q

Tetracycline MOA

A

Doxycycline, tetracycline, tigecycline prevent aa binding to tRNA at A site, bacteriostatic

36
Q

Tetracycline SE

A

Reduced effectiveness with metal ions e.g. milk Ca++
Avoided in kids/pregnant women as binds to Ca++
Diarrhoa/nausea

37
Q

Aminoglycoside MOA

A

Streptomycin/gentamycin prevents codon/anti-codon recognition when given IV

38
Q

Aminoglycoside use

A

Not used much as very hydrophilic and toxic to host at active conc
Sometimes with beta-lactam
Last resort if lots of resistance

39
Q

Chloramphenicol MOA

A

Prevents transpeptidation during translation, bacteriostatic

40
Q

Chloramphenicol use

A

Well absorbed in CNS so used in meningitis

Broad spec, used in life threatening infections where there’s resistance

41
Q

Macrolides MOA

A

Erythromycin, clarithromycin block translocation in bacterial protein synth

42
Q

Macrolides use

A

Treat gram + bacteria in penicillin resistant patients

Used in mycoplasmas and legionella

43
Q

Macrolides SE

A

Inhibits P450 so not to be taken with warfarin, can causes cholestatic hepatitis

z) Pharmacology (24 decks)

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