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Microbiologie > Anti microbial agents 1 and 2 > Flashcards

Anti microbial agents 1 and 2 Flashcards

1
Q

What are the 3 targets of abx?

A

Cell wall synthesis

Bacterial protein synthesis

DNA gyrase and other prokaryote specific enzymes

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2
Q

Which abx target cell wall synthesis (peptidoglycan layer)

A

B lactam

Glycopeptides

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3
Q

What subtypes of beta lactams are there?

A

Penicillin
Cephalosporin
Carbapenems

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4
Q

What subtypes of glycopeptides are there?

A

Vancomycin and teicoplanin

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5
Q

What are beta lactams method of action?

A

Effective against rapidly dividing bacteria

Effective against bacteria that have peptiodoglycan cell walls

Bactiricidal

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6
Q

What are some examples of bacteria that do not have a peptidoglycan cell wall?

A

Mycoplasma and chlamydia

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7
Q

Which beta lactam can be used against gram positive like strep and clostridia?

A

Penicillin

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8
Q

What is amoxicillin?

A

Broad spectrum penicillin that extends cover to enterococci and gram negative organisms

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9
Q

Which abx are stable to beta lactamase produced by bacteria?

A

Flucloxacillin (Penicillin-like)

Penicillins and amoxacillin are broken down by beta lactamase

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10
Q

What beta lactam covers Pseudomonas and other gram negative organisms?

A

Piperacillin

But is broken down by beta lactamase

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11
Q

What are some beta lactamase inhibitors

A

Clavulanic acid

Tazobactam

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12
Q

What is co amoxiclav

A

Amoxicillin and clavulanic acid

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13
Q

Are cephalosporins stable to beta lactamases?

A

Yes

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14
Q

What are some first gen cephalosporins

A

Cephalexin

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15
Q

What are some second gen cephalosporins

A

Cefuroxime

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16
Q

Cefuroxime vs co amoxiclav, whats the difference?

A

Both are resistant to beta lactamasesm but cefuroxime is less active against anaerobes and need to add metronidazole

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17
Q

What can the 3rd gen cephalosporin ceftriaxone be used for?

A

Sepsis

Meningococcal

Pneuomococcal

But gives rise to C.difficile

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18
Q

What can the 3rd gen cephalosporin ceftazidime be used for?

A

Pseudomonas

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19
Q

What organisms are resistant to all cephalosporins

A

ESBL producing organisms

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20
Q

Which type of Beta lactams are resistant to ESBL?

A

Carbapenems

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21
Q

What are some examples of Carbapenems

A

Meropenem
Imipenem
Ertapenem

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22
Q

How are beta lactams excreted

A

Renally

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23
Q

Will beta lactams cross the BBB?

A

No, but can be used in meningitis

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24
Q

Are beta lactams cross reactive

A

Penicillins have about 10 % cross reactivity with cephalosporins and carbapenems

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25
Q

What are glycopeptides effective against?

A

Gram positive ONLY as they weaken the peptidoglycan cell wall

26
Q

Which infections are glycopeptides primarily used for?

A

MRSA (iv only)

27
Q

Which glycopeptides can be used for c difficile

A

Vancomycin

28
Q

What do you need to note about glycopeptides?

A

Nephrotoxic

29
Q

Which abx inhibit protein synthesis in bacteria?

A

Amnioglycasides

Tetracyclines

Macrolides

Chloramphenicol

Oxazolidinones

30
Q

What organisms are aminogylcasides used against?

A

Gentamicin and tobramycin are used against Pseudomonas aeruginosa

Primarily used against gram negatives

31
Q

What can aminoglycasides and beta lactams be used synergistically for?

A

Endocarditis

32
Q

What can tetracyclines be used for?

A

Intracellular pathogens such as chalmydia, legionella, rickettsiae, mycoplasma

MRSA

Atypical pneumonia

Soft tissue infections

33
Q

What to keep in mind for tetracyclines

A

Not used in preggo women or children

Light sensitive rash

34
Q

What can macrolides be used in

A

Mild stpah or strep infections in those who have penicillin allergy

Camplylobacter sp and legionella pneumophilia

Atypical pneumonia

35
Q

Name a macrolide used against salmonella

A

Erythromycin

36
Q

Name some new macrolides

A

Clarithromycin and azithromycin which have higher half life so can be used in paeds and preggo women

37
Q

When is chloramphenicol used?

A

Meningococcal and penuomococcal in penicillin allergy people

Eye preparations

38
Q

What are the down sided of chloramphenicol

A

Grey bebe syndrome

Aplastic anaemia

39
Q

What can oxazolidinones be used for and give an example of this abx

A

Gram +ve organisms like MRSA and VRE

Linezolid

40
Q

What are some downsides of oxazolidinones?

A

Can cause thrombocytopaenia and optic neuritis

41
Q

What abx inhibit bacterial DNA synthesis?

A

Quinolones

Nitroimidazoles

42
Q

What can floroquinalones be used against?

A

Gram -ve organisms

Pseudomonas aeruginosa

UTI

Pneumonia and atypical pneumonia

Bacterial gastroenteritis

43
Q

What do you need to watch out for in floroquinalones

A

Can cause tendonitis and seizures (especially in those using steroids)

44
Q

What can nitroimidazoles be used for?

A

Exclusively against anaerobes and protozoa

45
Q

Which abx closely related to nitroimidazoles can be used for simple UTIs

A

Nitrofurans like nitrofurantoin can be used as they are excreted via urine and can be used against e coli and staph and enterococci

46
Q

Which abx inhibit RNA synthesis

A

Rifamycins such as rifampicin and rifabutin

47
Q

What can rifampicin be used against?

A

Mycobacteria (TB) and chlamydia

48
Q

What needs to be noted when using rifampicin

A

Interaction with oral contraceptives and warfarin

Monitor LFTs

Can turn urine orange

49
Q

Why should rifampicin never be used for short term prophylaxis and what is the exception

A

Develop resistance really quickly due to chromosomal mutation

Can be used for meningococcal infection

50
Q

What can daptomycin be used for

A

Gram +ve

Treat MRSA and VRE infections

51
Q

What can colistin be used for?

A

Gram -ve - Pseudomonas, acinetobacter and klebsiella

Nephrotoxic

Not absorbed orally

52
Q

What is cotrimoxazole and what is it sued for?

A

Sulfonamide and diaminopyrimidine (trimethoprim)

Used in HAP, soft tissue infections and pneuomocystic pmeumonia in HIV

53
Q

What are some methods of abx resistance

A

Inactivation of abx

Modification or replacement of target

Reduced abx accumulation

Bypass abx sensitive step

54
Q

Which organisms have the biggest beta lactamase method of inactivating abx

A

Staph auereus

Gram -ve bacilli

55
Q

What is the method of resistance of penicillin in pneuomococci and MRSA

A

Altered penicillin binding protein

56
Q

Can penicillin be used for strep penumonia

A

The resistance is not due to beta lactamase. So co amoxiclov will not be useful

Resistance can be overcome by giving high dosage of amoxicillin

57
Q

Why can’t macrolides be used against UTIs

A

Metabolised by liver and not excreted via the bladder

58
Q

What abx would you use for pharyngitis due to Group A Strep

A

Narrow spectrum penicillin

59
Q

What side effects can aminoglycasides cause?

A

Ototoxicity

60
Q

What is the minimum inhibitory concentration

A

The lowest concentration of an antibiotic that prevents the visible growth of bacteria

It should be below the breakpoint

61
Q

How would you treat sepsis or hospital acquired pneumonia

A

Broad spectrum abx

62
Q

What would you use for E coli UTI?

A

Amoxicillin

Microbiologie (11 decks)

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