Anti-microbials Flashcards

1
Q

How do we classify antimicrobials?

A

By pathogen eg antibacterial, antifungal, antiviral or antiprotzoal

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2
Q

What are the types of resistance

A

Intrinsic- No target or access for the drug which is generally permanent.
Acquired- New mutations or genetic material acquired which is then permanent.
Adaptive- Organism adapts to stress and this is reversible.

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3
Q

What are the genetics of resistance

A

Chromosomal gene mutation

Horizontal gene transfer

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4
Q

How do we classify antibacterials?

A
Bacteriocidal or bacterio static 
Spectrum broad or narrow
Target site (mechanism of action)
Chemical structure
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5
Q

What makes an ideal antimicrobial?

A
Selective toxicity 
Few adverse effects 
Reaches the site of infection
Oral and IV available
Long Half life (better compliance)
No interference with other meds
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6
Q

List different antibiotic mechanisms:

A

Cell wall synthesis
Cell membrane function
Protein synthesis
Nucleic acid synthesis

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7
Q

Name tow sub categories of cell wall synthesis targeting antibiotics.

A

Beta Lactams

Glycopeptides

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8
Q

What type of antibiotic are tetracycline?

A

protein synthesis targeting.

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9
Q

Give an example of nucleic acid synthesis targeting antibiotic.

A

Trimethoprim

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10
Q

How do penicillin and vancomycin differ?

A

They both effect cell wall synthesis.
Penecillin binds penecillin binding protein that normally crosslinks peptidoglycan chains.
Vancomycin blocks the penicillin binding proteins from binding.

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11
Q

How do fluoroquinolone work?

A

Bind enzymes and block DNA replication.

EG ciprofloxacin and trimethoprim.

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12
Q

Outline mechanisms of resistance:

A
Drug inactivating enzymes (Beta lactamases, amino glycoside enzymes)
Altered Target (lowering the affinity of the target enzyme)
Altered uptake (decreased permeability or increased flux)
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13
Q

How do fluoroquinolone work?

A

Bind enzymes, inhibit DNA gyrase and block DNA replication. Active giants Gram -ve, but risk C diff
EG ciprofloxacin and trimethoprim.

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14
Q

Describe disc sensitivity testing.

A

Culture a bacteria and apply filter paper discs that are impregnated with antimicrobials. Look at radial illimination to ascertain which one its most sensitive to.

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15
Q

What is minimum inhibitory concentration?

A

Used to get a quantitive value of dose needed for adequate response. Solution of bacteria spread into different test tubes with different concentrations of antibiotic- check what the west dose to eliminate the bacteria is.

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16
Q

What Beta Lactams must we know about?

A

Penecillin, amoxicillin, flucoxacillin, co-amoxiclav

Cephalasporins- ceftriaxone

17
Q

What do we use penicillin, amoxicillin and flucloxacillin for?
Why would we go to Coamoxiclav?

A

Penecillin- Strep
Amoxicillin- Gram Neg
Flucloxacillin- Staph and Strep
Co-amoxiclav- Anaerobes and all above

18
Q

What broad spectrum antibiotic is active in the CSF?

A

Ceftriaxone.

19
Q

Meropenan is a carbapenem and is broad spectrum, in what situation is it used?

A

Last ditch in highly resistant strains.

20
Q

What type of antibiotic is vancomycin?

A

Glycopetide.

Acts against gram +ve, not absorded so good for C diff. Needs therapeutic drug monitoring.

21
Q

What antibiotic is effective against chlamydia, some protazoa and atypical pneumonias?

A

tetracycline and doxycycline

Also great for penecillin allergy

22
Q

Which antibiotic types affect cell wall synthesis?

A

glycopeptdes and beta lactams

23
Q

Which types of antibiotics effect protein synthesis?

A

Tetracylcines, aminoglycosides and macrolides

24
Q

What antimicrobial type is gentamycin and why is it used?

A

Aminoglycoside antibiotic- good in gram negative sepsis.

25
Q

Why must we monitor patients on gentamycin?

A

Pettily nephro and oto- toxic.

26
Q

Name a macrolide and times to use it.

A

Erythromycin- atypical resp infection and alternative to penicillin in gram pos infection

27
Q

Why don’t we combine sulphonamides and trimethoprim now?

A

Rare but severe side effects

28
Q

Name some anti-fungals and outline how they work.

A

Azoles like flucanazole inhibit cell membrane synthesis- useful in candida infections
Polyenes like nystatin inhibit the function od the cell membrane and make topical candida ointments or can be used IV for systemic aspergillus

29
Q

Name some antivirals and outline how they work.

A

Aciclovir- gets phosphorylated and inhibits viral DNA polymerase- good for herpes.
Oseltamivir or tamiflu inhibits neuramidases but debatable how effective it is
Many specialist agents

30
Q

What is metranidozole?

A

Antibiotic that is antiprotazoal as well. It works on anaerobic bacteria, trichomonas and amoebae