antibacterial agents overview ppt

Question 1

Antibiotics eliminated by non renal functions (D-CRIMES)

Answer 1

Doxycycline
Clindamycin
Rifampin- inducer of P450 hepatotoxicity
isoniazid- genetic polymorphism hepatotoxicity
Metronidazole- drug to drug interaction with alcohol due to inhibition of aldehyde metabolism
Erythromycin- inhibition of P450
Sulfonamides- risk of renal crystalluria

Question 2

Mechanisms of antibacterial drugs

Answer 2

1. Cell wall synthesis
2. DNA
3. DNA gyrase
4. Folic acid metabolism
5. Protein synthesis inhibitors 50s and 30s
6. Protein synthesis
7. Cell membrane
8. DNA-directed RNA polymerase

Question 3

Cell membrane attacking antibacterial drugs

Answer 3

Polymyxins

Daptomycin

Question 4

Folic acid metabolism mechanism drugs

Answer 4

Trimethoprim

sulfonamides

Question 5

cell wall synthesis mechanism drugs

Answer 5

vanco
penicillins V and G, amoxicillin, ampicillin, pipercillin tazo
cephalosporins (cephalexin, cefazolin 1st gen), Cefuroxime 2nd gen, ceftriaxone 3rd)

Question 6

DNA mechanism drugs

Answer 6

metronidazole
nitrofurantoin
Fluoroquinolones (cipro, levo, moxiflo)

Question 7

DNA gyrase mechanism

Answer 7

quinolones

Question 8

DNA-directed RNA polymerase mechanism drugs

Answer 8

rifampin

Question 9

protein synthesis 50s inhibitors

Answer 9

Macrolides (eryhtromycin), azithromycin

clindamycin

Question 10

protein synthesis 30s inhibitors

Answer 10

tetracycline (doxy and tetracycline)
streptomycin
tobramycin (aminoglycosides)
amikacin

Question 11

Mechanisms of resistance

Answer 11

1. decreased entry
2. efflux pump
3. bypass pathway
4. enzymatic degradation
5. altered target site

Question 12

MRSA, S. pneumoniae and enterococci use Antibiotic target site alteration resistance mechanisms to which antibiotics?

Answer 12

B-lactam antibiotics (penicillins, cephalosporins, carbapenems)

Question 13

S. aureus, Pseudomonas species use Antibiotic target site alteration resistance mechanisms to which antibiotics?

Answer 13

Fluoroquinolones

Question 14

Enterococci, staphylococci use Antibiotic target site alteration resistance mechanisms to which antibiotics?

Answer 14

Vancomycin

Question 15

Streptococci, staphylococci and enterococci use Antibiotic target site alteration resistance mechanisms to which antibiotics?

Answer 15

erythromycin, clindamycin

Question 16

S. aureus, P aeruginosa, bacteroides and enterococci use antibiotic modification or inactivation resistant mechanisms against which antibiotics?

Answer 16

B-lactams ( penicillins and cephalosporins)

Question 17

Enterococci alone uses acetyl-phospho-adenylyl transferases modification or inactivation against which antibiotic?

Answer 17

aminoglycosides

Question 18

Pseudomonas aeruginosa uses decreased entry (natural resistance to which antibiotic?

Answer 18

B-lactam antibiotics

Question 19

Pseudomonas species in general use decreased entry (natural resistance to which antibiotic?

Answer 19

Fluoroquinolones

Question 20

E.coli, pseudomonas decreased entry (natural resistance to which antibiotic?

Answer 20

Aminoglycosides

Question 21

Streptococci, staphylococci and enterococci use increased efflux resistance to which antibiotics?

Answer 21

Tetracyclines, Macrolides (was a question on his powerpoint)

Question 22

Pseudomonas species use use increased efflux resistance to which antibiotics?

Answer 22

Fluoroquinolones

Question 23

Mechanisms of bactericidal drugs

Answer 23

1. inhibition of cell wall synthesis
2. Disruption of cell membrane function
3. interference with DNA function or synthesis

Question 24

mechanisms of bacteriostatic drugs

Answer 24

1. inhibition of protein synthesis

2. Inhibition of intermediary metabolic pathways

Question 25

What are the gram positive cocci

Answer 25

Streptococci (pneumonia, pyogenes)
Staphylococci (aureus: MSSA-MRSA)
Enterococci

Question 26

What are the gram negative cocci

Answer 26

Neisseria (meningitidis, gonorrhoeae), M. Catarrhalis

Question 27

Rods: gram (-) and (+)

Answer 27

Gram (-): E. coli, pseudomonas aeruginosa, H. Influ)

Gram (+): Listeria

Question 28

Anaerobes gram (-) and (+)

Answer 28

Gram (+): Clostridium difficile, H. Pylori

Gram (-): Bacteroides fragilis

Question 29

Atypical organisms?

Answer 29

Chlamydia
Mycoplasma
Rickettsia

Question 30

describe narrow spectrum I.E what are they effective against

Answer 30

either gram negative or gram positive

Question 31

describe extended spectrum?

Answer 31

effective against gram positive and negative organisms

Question 32

describe broad spectrum agents?

Answer 32

effective against gram positive and negative and atypical

Question 33

What is concentration dependent killing?

Answer 33

Some antibiotics kill bacteria faster in doses that result in high initial Cp levels-can be dosed less frequently

Question 34

What is time dependent killing?

Answer 34

Kill best when Cp is above MIC for longer durations

Beta-lactams
Vancomycin
Macrolides

Question 35

What is post antibiotic effect and which antibiotics do this?

Answer 35

Persistent supression of bacterial growth after a brief exposure (1 to 2 hours) of bacteria to an antibiotic

Aminoglycosides, Fluoroquinilones, macrolides, beta-lactams

Question 36

What are the narrow spectrum antibiotics

Answer 36

Aminoglycosides 
Penicillins-resistant penicillins 
Clindamycin 
Vancomycin 
Metronidazole 
Penicillin G, V

Question 37

What are extended spectrum antibiotics?

Answer 37

Extended spectrum penicillins
Cephalosporins
Fluoroquinolones
Carbapenems

Question 38

What are broad spectrum antibiotics

Answer 38

Macrolides 
Chloramphenicol 
Fluoroquinolones (moxi, Gemi)
Sulfonamides 
tetracyclines 
Trimethoprim

Question 39

Out of narrow, broad and extended which are most effective?

Answer 39

Narrow spectrum