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Optometry Class OP2503 > anti-infectives > Flashcards

anti-infectives Flashcards

1
Q

what are the three antinfectives?

A

-antibacterials
-antivirals
antifungals

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2
Q

what makes up the basic structure of a bacterial cell?

A

-DNA in the form of plasmid
-Cell wall
-ribosomes
-cytoplasm
-granule
-plasma membrane

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3
Q

name 2 types of bacteria that produce bacterial spores

A

-bacillus
-clostridium

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4
Q

why are bacterial spores dangerous

A

they are able to withstand extreme environments for a length of time mainly due to the thick cell wall.

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5
Q

when do bacterial spores get released?

A

when a bacterial cell bursts

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6
Q

what are the three mechanisms of micro-organism resistance to anti-infective drug?

A

-Spontaneous mutation of micro-organism
– Deactivation of drug by bacterial enzymes
– Decreased affinity between drug and binding site on bacteria

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7
Q

give a difference in the infections caused by gram negative and gram positive bactera

A

gram negative cause more nasty infection because they are more resistant to antibiotics due to them usually having an extra outer membrane

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8
Q

how do you identify type of bacterial infection?

A

-signs and symptoms
-do a microscopic examination
-gram staining
-test sensitivity to antibiotics

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9
Q

what colour do gram positive bacteria look?

A

purple as they retain gram stain

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10
Q

what colour do gram negative bacteria look?

A

colour of gram stain (usually pink) because it looses the gram stain following decolourisation and counterstaining

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11
Q

name 8 typical bacterial infections seen in practise

A
  • Stye, “hordeolum”
  • Blepharitis
  • Chalazion
  • Dacryocystitis
  • Conjunctivitis
  • Corneal Ulcer
  • Keratitis
  • (Orbital Cellulitis)
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12
Q

name two common bacteria seen in bacterial infections in practise

A

-staphylococcus aureus
-streptococcus

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13
Q

what kind of bacteria is staphylococcus aureus and what infections does it cause

A

-gram positive
– Blepharitis, mucopurulent conjunctivitis, dacryocystitis,
hordeola, central & marginal corneal ulcers, orbital cellulitis

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14
Q

what kind of bacteria is streptococcus and what infection does it?

A

-gram positive
-Mucopurulent conjunctivitis, dacryocystitis, central
corneal ulcers, orbital cellulitis

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15
Q

for psedomonas aeruginosa,
what kind of bacteria is it and what infecion does it cause?

A

– Gram negative
– Central corneal ulcers, endophthalmitis

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16
Q

for Escherichia coli, Neisseria, Salmonella,
Haemophilus influenzae, etc.
what kind of bacteria is it and what infecion does it cause?

A

– Gram negative
– Conjunctivitis, central corneal ulcers

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17
Q

for moraxella lacunata,
what kind of bacteria is it and what infecion does it cause?

A

– Gram negative
– Conjunctivitis, central & peripheral corneal ulcers

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18
Q

what 4 bacteria cause bacterial conjunctivitis in order from most common to least common

A

– Staphylococcus
– Streptococcus
– Haemophilus influenza
– Moraxella

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19
Q

What is the treatment process when using antibacterial drugs?

A

1.Establish clinical & laboratory diagnosis
2.Select antibacterial to which microorganism is
sensitive
3. Maintain effective dose at site of infection for
sufficient length of time
4. Augment drug therapy with physical treatment

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20
Q

give 4 mechanisms by which antibacterial drugs work

A

– Inhibition of protein synthesis within bacterial cell
– Inhibition of nucleic acid synthesis within bacterial cell
– Inhibition of bacterial cell wall synthesis
– Disruption of bacterial cell plasma membrane

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21
Q

how do antibacterial drugs inhibit protein synthesis?

A
  1. bacterial protein synthesis involves the building of peptide chains from amino acids
  2. Antibacterial drugs show selective toxicity for 30S and 50S ribosomal sub-units
  3. Prevents assembly of new proteins that are essential for bacterial cell growth and replication
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22
Q

what is dacryocystitis?

A

infection of the lacrimal sac

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23
Q

what are bacteriostatic drugs?

A

drugs that slow down or stop the replication of bacteria

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24
Q

what are bactericidal drugs?

A

drugs that kill bacteria

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25
Q

what’s the difference between a prophylactic drug and a therapeutic drug?

A

a prophylactic drug is a drug used to prevent an infection in a situation where infection is a risk whereas a therapeutic drug is a drug used for treatment of an existing infection

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26
Q

where does chloramphenicol need to be stored?

A

in the fridge

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27
Q

what is the first drug to give when treating an eye infection?

A

chloramphenicol due to its broad spectrum of activity

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28
Q

what are the three categories of anti infective drugs

A

– Antibacterials
– Antivirals
– Antifungals

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29
Q

Name 4 drugs that inhibit protein synthesis

A
  • Chloramphenicol
  • Fusidic acid
  • Propamidine isetionate
  • Aminoglycosides
  • Tetracyclines
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30
Q

give 3 examples of aminoglycosides

A

-framycetin
-gentamicin
-neomycin

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31
Q

what action does chloramphenicol work by and how des it work?

A

– Bacteriostatic action
– Binds to 50S ribosomal sub-unit which Inhibits protein synthesis

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32
Q

what microorganisms is chloramphenicol effective against?

A

-gram + and gram - bacteria
-some fungi

33
Q

when can chloramphenicol be obtained by a patient?

A

-when it’s used in practise
-supplied in an emergency
-when they have a written prescription for the pharmacy

34
Q

what forms is chloramphenicol available as?

A

– 0.5% eye drops (various brands)
– 1% ointment (various brands)
– Minims Chloramphenicol 0.5%

35
Q

what are the risks of chlormaphenicol?

A

-aplastic anaemia (rare)
-grey baby syndrome so babies need serum to be kept at low levels of 15-25 mg/litre

36
Q

how does fusidic acid work?

A

inhibits protein synthesis via bacteriostatic action but can be bactericidal at higher concs

37
Q

what type of bacteria is fusidic acid effective against?

A

gram + cocci especially staphyloccoci

38
Q

what is the spectrum of activity like for fusidic acid?

A

narrow spectrum of activity

39
Q

what form of drug is fusidic acid available under?

A

fusidic acid 1% Modified-Release Eye Drops: ophthalmic gel
this gel liquifies on contact with the eye

40
Q

do you need a prescription to get fusidic acid drops?

A

yes

41
Q

how does Propamidine isetionate work?

A

inhibits protein synthesis via bacteriostatic action

42
Q

what bacteria is Propamidine isetionate
/Dibrompropamidine isetionate active against?

A

– Specific for the treatment of Acanthamoeba keratitis
– active against Staphylococcus aureus & Streptococcus pyogenes
– Pseudomonas aeruginosa is resistant

43
Q

what ways are propamidine isetionate/ dibrompropamidine isetionate avaliable as to patients?

A

– Brolene eye drops 0.1%
* Propamidine isetionate
– Golden Eye drops 0.1%
* Propamidine isetionate
– Golden Eye Ointment 0.15%
* dibrompropamidine isetionate
Drugs that inhibit protein synthesis

44
Q

who can use gentamicin?

A

ophthalmologists and IP optoms only

45
Q

what kind of chemical is gentamicin?

A

an aminoglycoside antibiotic

46
Q

Explain how gentamicin works and by what action?

A

inhibits protein synthesis by binding to the 30S subunit of the bacterial ribosome via bacteriostatic action

47
Q

what kind of bacteria is gentamicin active against and name a specific bacteria its effective against

A

-wide range of gram + and gram -
-effective against Pseudomonas Aeruginosa

48
Q

what is gentamicin avaliable as to the patient?

A

0.3% eye drops

49
Q

how should gentamicin drops be administered?

A

1 drop every 2 hours, then reduce frequency, continue for 48 hours after healing due to poor cornea and systemic absorption

50
Q

name 2 aminoglycosides used in eye treatment

A

framycetin and gentamicin

51
Q

what is framycetin available as to the patient?

A

in eye drops as “Sofradex”, a combined drug with dexamethasone and
gramicidin

52
Q

name 3 drugs that inhibit nucleic acid synthesis

A

Fluoroquinolones
Sulphonamides
Trimethoprim

53
Q

how can ciprofloxacin be given to patients and what is it used to treat?

A

-Ciloxan 0.3% eye drops and ointment
– Superficial bacterial infections and corneal ulcers

54
Q

how can ofloxacin be given to patients and what is it used to treat?

A

– Exocin 0.3% eye drops
– Superficial bacterial infections and corneal ulcers

55
Q

how does polymyxin B work?

A

acts on cell plasma membrane via bactericidal action

56
Q

what kind of bacteria is polymyxin B active against?

A

gram -ve bacteria

57
Q

what is polymyxin B used for

A

superficial bacterial infections like conjunctivitis, keratitis, corneal ulceration and blepharitis

58
Q

what is polymyxin B available as?

A

Maxitrol in combination with dexamethasone and
neomycin as eye drops or ointment

59
Q

name 3 drugs that act on the bacterial cell wall used to treat bacterial ocular infections

A

-polymyxin B
-penicillins (not as common use)
-vancomycin (not very common again)

60
Q

what are the two types of fungi?

A

-moulds which have hyphae and produce spores
-yeasts which are unicellular an reproduce by budding

61
Q

what microbe is the most common cause of mucopurulent conjunctivitis?

A

staphylococcus bacteria

62
Q

what is fusarium solani and what can it cause?

A

a type of fungi that can cause keratitis and endophthalmitis

63
Q

what are the risk factors of contracting a fungal eye disease

A

– Exposure to pathogen like vegetable matter
– Immunocompromise
– Hot and humid climate
– Increased age

64
Q

name 3 examples of fungi that can cause ocular infections

A

– Candida albicans
– Aspergillus
– Fusarium solani

65
Q

what are the risks of having specifically an ocular yeast infection?

A

*Chronic ocular surface diseases
*Chronic mucocutaneous candidiasis
*Immunosuppression, including AIDS
*Corneal anesthetic abuse

66
Q

what are the clinical features of eye disease caused by moulds

A

*Stromal infiltrates have minimal
cellular reaction and rough texture.
*The epithelial surface looks dry, grey
and may be either above the level of
the corneal surface or ulcerated.
*Feathery infiltrates. Sometimes
pigmented fungal elements can be
recognized
*Satellite lesions or multifocal
microabscesses are also seen

67
Q

what are the clinical features of eye disease caused by yeasts

A

Small, oval, sharply demarcated
ulcerations with a “colour button”
configuration
*Extensive stromal inflammation and
edema
*May be indistinguishable from
Gram-positive bacterial keratitis

68
Q

name 3 antifungals and how they work

A
  • Nystatin
    – Affects fungal cell membranes causing loss of potassium and magnesium ions and consequently affects metabolism
  • Amphotericin
    – Increases permeability of fungal cell membrane so has effect more potent in fungal cells compared to host cells
  • Flucytosine
    – Narrow spectrum of activity against yeasts and only works by inhibiting RNA function and DNA synthesis
69
Q

how do chlamydiae cause disease

A

by attacking mucous membranes

70
Q

what species of chlamydia affects humans?

A

C. trachomatis

71
Q

name an anti chlamydial drug and how it works

A

tetracyclines work by preventing protein synthesis by binding to the 30S subunit of ribosomes

72
Q

you have a 12 year old child who seems to have an infection caused by chlamydia, what should you not give them and why

A

any tetracycline as it binds to calcium which gets deposited in teeth and bone leading to discoloration and slowed growth

73
Q

name 6 viruses and diseases they cause

A

-herpes simplex virus type 1: dendritic ulcers, keratoconjunctivitis and herpes simplex keratitis
-herpes zoster (varicella): causes chicken pox and shingles
-cytomegalovirus (CMV): retinitis
-Adenovirus: Epidemic keratoconjunctivitis (EKC). Highly contagious!
-Human Immunodeficiencey Virus (HIV) :AIDS and is associated with CMV infection
-Rubella (a “Toga virus”): Congenital microphthalmos, congenital cataracts

74
Q

name 2 antiviral drugs

A

aciclovir and ganciclovir

75
Q

what can aciclovir be used to treat

A

-herpes simplex and herpes zoster

76
Q

how does aciclovir work?

A

1.Viral thymidine kinase activates the drug
2. aciclovir to aciclovir
triphosphate
3. this prevents replication of viral DNA

77
Q

what is aciclovir avaliable as?

A

– Aciclovir 3% eye ointment
– Aciclovir tablets for systemic treatment of herpes simplex
and varicella zoster
Antiviral drugs

78
Q

what is ganciclovir used to treat?

A

acute herpetic keratitis, and for the treatment of cytomegalovirus retinitis (CMV) in AIDS patients

79
Q

what is ganciclovir available as?

A

Virgan, 0.15% ganciclovir gel, with benzalkonium chloride

Optometry Class OP2503 (9 decks)

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