Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IDMM > Antibacterial therapy > Flashcards

Antibacterial therapy Flashcards

1
Q

When drugs are greater than 80% bioavailable, how should you administer them?

A

Orally….pretty same serum concentration is achieved as IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When might Vd be increased

A

When ECFV is increased, as in heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Antimicrobials that do NOT require renal adjustment

A 
Azithromycin
Ceftriaxone
Clindamycin
Cloxacillin
Doxycline
Linezolid
Metronidazole
Moxifloxacin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

MIC and MBC

A 
MIC= mininum inhibitory concentration is the lowest antimicrobial concentration that inhibits visible growth
MBC= minimum bactericidal concentration is the minimum concentration of antimicrobial needed to have bactericidal action

Both are determined with broth dilution. MIC can be determined with Epsilometer testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of antimicrobial susceptibility testing

A 
Disk diffusion (yes/no)
Broth dilution (MIC and MBC)
E- test (MIC)
Synergy testing (synergistic vs. antagonistic effects)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bacteriostatic drugs are usually…

Bactericidal drugs are usually…

A

Protein synthesis inhibitors

Cell wall or DNA synthesis inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When would you use a bactericidal drug

When would you avoid bactericidal drugs

A

Deep seated infections
vs.
inflammation from bacterial lysis is a danger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Examples of bactericidal drug classes

A 
Beta lactams
Carbapenems
Fluoroquinilones
Aminoglycosides
Metroidazole
Glycopeptides
Lipopeptides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Examples of bacteriostatic drug classes

A 
Macrolides
Clindamycin (Lincosamides)
Linezolid (Oxazolidinones)
Tetracyclines
Glycylcyclines
Anti-folates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Post antibiotic effect

A

Continued inhibition of bacterial growth after the antimicrobial is discontinued

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Factors in choosing an antimicrobial

A

Efficacy: susceptibility of organism, infection site

Toxicity: interactions

Patient Factors: renal/hepatic function, weight, allergies, age, pregnancy, immune status

Ease of administration: PO vs. IV, once a day is easier than QID

Cost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Drug classes within beta-lactams

A

Penicillins
Cephalosporins
Carbapenems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Mechanism of action of beta-lactams and imitations of beta-lactams

A
  • Inhibit cell wall synthesis

- therefore, not active against mycoplasma (they lack a cell wall) and not active vs. intracellular pathogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mechanisms of resistance to beta-lactams

A
  • altered penicillin binding protein
  • alteration in channel in outer membrane needed to access cell wall (and PBP)
  • production of beta-lactamase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

PK/PD properties of beta-lactams

A
  • Relatively poor bioavailability (need IV for serious infections)
  • Bactericidal
  • Wide distribution (incl. bone, and some CNS) with IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Spectrum of cephalosporins

A

NO activity vs. enterococci

NO activity vs. MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Carbapenems are usually reserved for…

A

multi-drug resistance (but not effective vs. MRSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Glycopeptides MOA

A

Inhibit cell wall synthesis earlier than beta-lactams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Lipopeptides MOA

A

cell wall membrane disruption (unique MOA means less chance of resistance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Glycopeptide/Lipopeptide spectrum

A

G+ (including MRSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Glycopeptide/Lipopeptide PK/PD

A

Bactericidal

Poor CSF penetration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Aminoglycoside MOA

A

Binds to 30S, inhibits protein synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Aminoglycoside PK-PD

A

Bactericidal
Only IV/IM
Poor CNS and bone penetration
Renal elimination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Macrolides MOA

A

Protein synthesis inhibtiion (50S)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Macrolides PK/PD

A

Bacteriostatic
Works agains intracellular organisms
Poor bioavailability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Lincosamides MOA

A

Protein synthesis inhibition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Lincosamines PK/PD

A

Bacteriostatic
Excellent bioavailability
Penetrates bone, but not CSF or urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Tetracyclines and glycylcyclines MOA

A

Protein synthesis inhibition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Tetracyclines and glycylcyclines PK/PD

A

Bacteriostatic
Excellent bioavailability
Active vs. intracellular pathogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Fluoroquinolones MOA

A

Inhibition of DNA gyrase and topoisomerase

31
Q

Fluroquinolones PK/PD

A

Bactericidal

Excellent bioavailability

32
Q

Anti-folates MOA

A

Inhibit purine synthesis

33
Q

Anti-folates PK/PD

A

Bacteriostatic

Excellent bioavailability

34
Q

Nitroimidazoles MOA

A

Inhibits DNA synthesis

35
Q

Nitroimidazole PK/PD

A

Excellent bioavailability

Excellent CNS penetration

36
Q

Oxazolidinones MOA

A

Protein synthesis inhibition

37
Q

Oxazolidinones PK/PD

A

Bacteriostatic
Excellent bioavailability
Excellent lung and CNS penetration

38
Q

Anti-tuberculous MOA

A

Rifampin: inhibits mRNA synthesis
Isoniazid: inhibits mycolic acid synthesis
Pyrazinamide: inhibits mycolic acid synthesis
Ethambutol: inhibits cell wall synthesis

39
Q

How many people who report penicillin allergy have a true IgE mediated reaction?

A

10%

40
Q

Is IgE-mediated penicillin allergy genetic?

A

No

41
Q

Is IgE-mediated penicillin allergy permanent?

A

Not usually (80% lose sensitivity after 10 years)

42
Q

Graded challenge vs. desensitization

A

A graded challenge is good for distant reactions. Give 1/10th or less of the dose and observe.

Desensitization starts at a fraction of the therapeutic dose (1/100) and works up to therapeutic dose (AKA induction of drug tolerance)

43
Q

Penicillin allergy cross-reactivity

  • chance with cephalosporins
  • chance with carbapenems
A
  • 2.5% risk with cephalosporins with confirmed penicillin allergy. Better with later generations
  • 1% risk with carbapenems
44
Q

Example of non-IgE mediated lief-threating allergy

A

Stevens-Johnson Syndrome (Type IV hypersensitivity)

45
Q

Highest risk for subsequent C. diff infection

A

Cephalosporins
Fluoroquinolones
Clindamycin

46
Q

Highest risk of increasing INR due to inhibition of Vit K producing bacteria

A

Septra
Ciprofloxacin
Metronidazole

47
Q

Only useful for lower UTI

A

Nitrofurantoin

48
Q

Concentration dependent killing, so can give high dose less often….

A

Fluoroquinolones

Aminoglycosides

49
Q

CYP34A inhibitors

A

Clarithromycin

Anole antifungals

50
Q

CYP34A inducers

A

Rifampin

51
Q

Polyenes MOA

A

Bind to ergosterol

52
Q

Polyenes PK/PD

A

Fungicidal, not renally eliminated

53
Q

Azole MOA

A

inhibit ergosterol synthesis

54
Q

Azole PK/PD

A

fungistatic vs. candida and fungicidal vs. aspergillus

Potent CYP 3A4 inhibitors

55
Q

Echinocandins MOA

A

inhibit glucan synthesis

56
Q

Echinocandins PK/PD

A

fungicidal vs. candida, fungistatic vs. aspergillus

Not renally eliminated

57
Q

Allylamines MOA

A

inhibits squalene epoxidase (ergosterol synthesis)

58
Q

Allylamines PK/PD

A

Dsitributes mainly to sebum and skin

59
Q

Clotrimazole MOA

A

inhibit ergosterol synthesis

60
Q

Ciclopirox MOA

A

inhibit cell uptake of substrates

61
Q

Tolnaftate

A

inhibits squalene epoxidase (ergosterol synthesis)

62
Q

Chloroquine MOA

A

inhibits HgB utilization by plasmodium

63
Q

Mefloquine MOA

A

inhibts HgB utilization by plasmodium

64
Q

Atovaquone/proguanil MOA

A

inhibit ETC in plasmodium

65
Q

Artesunate MOA

A

free radicals

66
Q

Qunine MOA

A

intercalates plasmodium DNA

67
Q

Primaquine MOA

A

binds plasmodium DNA

68
Q

Albendazole MOA

A

inhibits microtubule formation in helminths

69
Q

Ivermectin MOA

A

activates chloride channels in helminths

70
Q

Pyrantel pamoate MOA

A

cholinesterase inhbitor (in helminths only?)

71
Q

Praziquantel MOA

A

increase schistome permeability to calcium

72
Q

Iodoquinol MOA

A

unknown, antiprotozoal

73
Q

Parmomycin MOA

A

bind 30S

74
Q

Permethrin MOA

A

alters sodium channels, paralyses parasite

IDMM (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions