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Core Conditions > Antibacterials > Flashcards

Antibacterials Flashcards

1
Q

Mechanism of action of amoxicillin ?

A

Inhibits cell wall synthesis by preventing cross linking between peptidoglycan chains, leads to cell lysis (bactericidal)

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2
Q

Indications for amoxicillin

A
  • Gram +ve: streptococci e.g. Pneumoniae
  • Gram -ve: H. Influenzae, N Gonorrhoeae
  • H pylori eradication
  • infective endocarditis prophylaxis before dental surgery
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3
Q

Contraindications for amoxicillin ?

A
  • hypersensitivity to penicillins or cephalosporin

- suspected/confirmed Infectious mononucleosis (develop generalised itchy rash)

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4
Q

Common side effects of amoxicillin ?

A
  • nausea, vomiting, diarrhoea
  • skin rash
  • vaginal thrush
  • hypersensitivity (rare)
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5
Q

Elimination of amoxicillin ?

A

Kidneys

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6
Q

What type of antibiotic is trimethoprim ?

A

Anti folate

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7
Q

Mechanism of action if trimethoprim ?

A

Decreases bacterial folate production by inhibiting dihydrofolate reductase which inhibits sequential enzymes in purine synthesis thus inhibiting DNA synthesis (bacteriostatic)

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8
Q

Indications for trimethoprim ?

A
  • UTI (e. Coli, p. Mirabilis)
  • acute or chronic bronchitis
  • pneumocystic pneumonia
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9
Q

Contraindications of trimethoprim ?

A
  • blood dyscrasias
  • pregnancy (1st trimester)
  • caution in severe renal impairment
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10
Q

Side effects of trimethoprim

A
  • nausea, vomiting, diarrhoea
  • blood dyscrasias
  • rash (e.g. TEN)
  • hypersensitivity
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11
Q

Interactions of trimethoprim

A
  • cyclosporins - increase risk of nephrotoxicity

- pyrimethamine - increase anti folate effects

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12
Q

What drug class is doxycycline ?

A

Tetracycline antibiotic

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13
Q

Mechanism of action if doxycycline ?

A

Inhibits ribosome (30s) and thus protein synthesis - bacteriostatic

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14
Q

Indications of doxycycline ?

A
  • malaria prophylaxis
  • pneumonia
  • resp infections caused by: staph, strep, H influenzae (inc sinusitis)
  • skin & soft tissue: acne, rosacea, cellulitis, abscess
  • syphilis, chlamydia
  • chronic protatitis
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15
Q

Contraindications of doxycycline

A
  • children
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16
Q

Elimination of doxycycline

A

Kidneys

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17
Q

Side effects of doxycycline ?

A
  • nausea, vomiting, diarrhoea
  • oesophagitis
  • photosensitivity
  • rash
  • hypersensitivity
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18
Q

Interactions of doxycycline

A
  • carbamazepine/phenytoin - increased doxycycline metabolism

- methotrexate- increased risk of methotrexate toxicity

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19
Q

What drug class is cephalexin?

A

Cephalosporin - broad spectrum

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20
Q

Mechanism of action if cephalexin “

A

Inhibits cell wall synthesis, leads to cell lysis (bacteriocidal)

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21
Q

Side effects of cephalexin ?

A
  • diarrhoea, nausea, vomiting
  • dyspepsia
  • hypersensitivity
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22
Q

How are cephalosporins excreted ?

A

Mostly renal

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23
Q

Contraindications of cefalexin ?

A
  • cephalosporin hypersensitivity

- immediate hypersensitivity to penicillins

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24
Q

Side effects of cephalosporins ?

A
  • diarrhoea, nausea, vomiting
  • rash
  • rarely: antibiotic associated colitis
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25
Q

Indication for cephalosporins ?.

A
  • septicaemia
  • pneumonia
  • meningitis
  • biliary tract infections
  • UTI
  • peritonitis

Susceptible gram positive and negative

26
Q

What drug class is meropenem ?

A

Carbapenem - beta lactam antibacterial, broad spectrum activity

27
Q

Are carbapenems active against MRSA ?

A

No

28
Q

Indications for meropenem ?

A

Aerobic and anaerobic gram positive and negative infections

29
Q

What are aminoglycosides ? What do they work against ?

A

Bactericidal antibiotics active against mainly gram negative bacteria e.g. Pseudomonas aeruginosa

30
Q

Why must aminoglycosides be injected for systemic infections ?

A

As are not absorbed through the gut

31
Q

Side effects of aminoglycosides

A
  • ototoxicity
  • nephrotoxicity
  • most commonly in elderly and renal failure *
32
Q

Where are aminoglycosides excreted ?

A

Kidney

33
Q

Which drug class is gentamicin ?

A

Aminoglycoside

34
Q

What is gentamicin inactive against ?

A
  • Anaerobes

- poor activity against haemolytic streptococci and pneumococci

35
Q

What is the blind therapy for serious illness ?

A

Gentamicin + penicillin or metronidazole

  • serious unidentifiable infection
36
Q

Indications for gentamicin ?

A
  • septicaemia
  • CNS infections
  • acute pyelonephritis
37
Q

Contraindications in gentamicin ?

A
  • myasthenia gravis

- pregnancy

38
Q

Side effects of gentamicin ?

A
  • vestibular and auditory damage

- nephrotoxicity

39
Q

Interactions of gentamicin

A
  • Cyclosporins: potentiate nephrotoxic effect

- loop diuretics (furosemide): potentiate ototoxicity

40
Q

Why is erythromycin usually used as an alternative for penicillin allergic patients ?

A

Has a similar but not identical spectrum

41
Q

What drug class is erythromycin ?

A

Macrolide

42
Q

Indications for erythromycin

A
  • resp infections e.g. Pharyngitis, tonsillitis (caused by strep)
  • whooping cough
  • legionnaires disease
  • campylobacter enteritis
  • penicillin resistant staphylococci
  • CAP
43
Q

What class of drug is amoxicillin ?

A

Broad spectrum penicillin, b-lactam

44
Q

Contraindications of erythromycin ?

A

Macrolide hypersensitivity

45
Q

Side effects of erythromycin ?

A

Common: GI disturbance, rash
Uncommon: reversible ototoxicity, cholestatic jaundice

46
Q

Elimination of erythromycin ?

A

Biliary ?

- hepatic ?

47
Q

What drug class is ciprofloxacin ?

A

Quinolone - broad spec antibiotic

48
Q

Mechanism of action of erythromycin ?

A

Binds to 5s subunit of bacterial ribosomes, inhibiting bacterial protein synthesis

49
Q

Mechanism of action of ciprofloxacin

A

Quinolone:

  • inhibits bacterial enzyme DNA gyrase, an enzyme that cuts and reseals DNA, allowing it to be unwound and read
  • quinolones inhibit the resealing, leading to fragmentation of DNA -> cell death
50
Q

Side effects of ciprofloxacin

A
  • diarrhoea
  • CNS effects: dizziness, confusion, tremor
  • seizures
  • QT prolongation
  • tendonitis
51
Q

Indications for ciprofloxacin ?

A
  • acute exacerbation of chronic bronchitis - H influenzae, M catarrhalis
  • acute pneumonia - enterbacter, H influenzae, E Coli etc
  • sinusitis
  • upper and lower UTI
  • skin and soft tissue infections - staph A + E and strep p
  • typhoid
  • N Gonorrhoeae
52
Q

Contraindications of ciprofloxacin

A
  • hypersensitivity to any quinolones

- concurrent treatment with tizanidine (muscle relaxant)

53
Q

Elimination of quinolones ?

A

Renal

54
Q

What class of antibiotic is metronidazole ?

A

Nitroimidazole

55
Q

Indications for metronidazole

A

Anaerobic organisms e.g.

  • intra abdo infections: c diff, h pylori
  • bacterial vaginosis
  • protozoal infections
56
Q

Mechanism of action of metronidazole

A

Broken down within anaerobic organism into toxic metabolites -> kills microbes by interfering with nucleic acid function and synthesis

57
Q

Side effects of metronidazole ?

A
  • GI disturbance
  • elevation in liver enzymes
  • CNS effects: dizziness, confusion, tremor
58
Q

Contraindications for metronidazole

A
  • hypersensitivity

- caution: pregnancy and hepatic impairment

59
Q

Interactions with metronidazole

A
  • alcohol: flushing, abdo pain, hypotension (disulfiram-like reaction)
  • phenytoin: increased plasma conc of phenytoin
  • warfarin: increased plasma conc of warfarin
60
Q

Main route of elimination for metronidazole

A

Kidney

Core Conditions (15 decks)

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