Anti-microbial Therapy Flashcards
1935: discovered by Gerhard Domagk
Sulfonamides
Initially used in the antibiotic therapy of certain sexually transmitted diseases such as gonorrhea and certain bacterial diseases like Staphylococcus Aureus
Sulfonamide
1940: Alexander Fleming discovered
Penicillin
Administer a drug to an infected person, which destroys the infective agent without harming the host’s cells
Selective toxicity
Antimicrobial treatment is not toxic to mammalian cells because of the absence of the characteristic ________ that you see in bcteria
Peptidoglycan layer
Ideal antimicrobial drug: microbicidal or microbiostatic
Microbicidal
Functions even when highly diluted in body fluids
Relatively soluble
Antimicrobial drugs should have high binding capacity to target the essential protein of the bacteria to be able to control the synthesis of their cell walls and the multiplication of the bacteria
Relatively soluble
T or F: Antimicrobial drug should remain potent long enough to act
T
The greatest number of current antibiotics are derived from bacteria in the genera. Give examples
Natural
Stretomyces and bacillus
From molds, penicillum and cephalosporium
Create new drugs by altering the structure of naturally occuring antibiotics
Semisynthetic drugs
Drugs that are chemically modified in the laboratory after being isolated from natural sources
Semisynthetic drug
Drugs produce entirely by chemical reactions within the laboratory setting
Synthetic drugs
Bioengineering techniques, drugs are produced by manipulating the genes of natural antibiotic producers
Synthetic drugs
In starting treatment, what are the things to consider (3)
Identify the microorganism causing infection
Identify the microorganism’s susceptibility
Identify the patient’s overall medical condition
Profile of antimicrobial sensitivity
Antibiogram
The surface of the plate of special medium is spread with the test bacterium and small discs containing a premeasured amount of antimicrobial are dispensed on the bacterial lawn
Agar diffusion test
Smallest concentration of drug that visibly inhibits the growth
Minimum inhibitory concentration MIC
Smallest concentration of drug that kills the bacteria
Minimum bactericidal concentration MBC
Graded amounts of antimicrobial substances are incorporated into the liquid or solid bacteriological media
Tube dilution test
Ratio of the dose that is toxic to humans to its minimum effectiveness therapeutic dose
Therapeutic index
T or F. The highest therapeutic index usually has the widest margin of safety
True
Period wherein clinician can initiate the effective antibiotics
Window of opportunity
Mechanism of action of antimicrobial (5)
Inhibit cell wall synthesis
Nucleic acid structure and fxn
Protein synthesis
Cell membrane structure and fxn
Folic acid synthesis
Acts on both 30S and 50S rRNA. Give example
Protein synthesis inhibitors
Linezolid
Folic acid synthesis in the cytoplasm example (3)
Sulfonamide
Trimethoprim
Bactrim and Co-trimoxazole
Cell wall inhibitors (7)
Penicillin
Cephalosporin
Carbapenem
Vancomyci
Bacitracin
Fosfomycin
Isoniazid
Cell membrane: cause the loss of selective permeability as demonstrated by the use of (2)
Polymyxins
Daptomycin
The unwinding enzyme
Gyrase
Inhibits gyrase
Quinolones (ciprofloxacin)
Inhibits rna polymerase
Rifampin
Drug that cover both tuberculosis and gram negative bacteria such as salmonellosis, plague, and gonorrhea
Streptomycin
Very effective against gram negative bacteria and some gram positive bacteria.
Last resort when dealing with gram negative bacteria
Carbapenems
Most widely used natural penicillin
Penicillin G
Relatively resistant to penicillin G
Streptoccocus pneumoniae
First gen cephalosporin
Cephalothin
Cefazolin
Cephalexin
Cefadroil
Cephradine
2nd gen cephalosporin
Cefaclor
Cefonicid
Cefoxitin
Cefotetan
3rd gen cephalosporin
Ceftazidime
Cefoperazone
4th gen cephalosporin
Cefepime
Cefpirome
5th gen cephalosporin
Ceftobiprole
Ceftaroline
Ceftolozane