Antibaterials Flashcards

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1
Q

What is the unique proptery of antimicrobials

A

Antimicrobials target microbial biochemistry

The ideal antimicrobial would have no direct impact on patient biochemistry or physiology

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2
Q

How do antibiotics work?

A

Antibiotics work by sticking to specific bacterial molecules, interfering with their shape and consequently their function

  • For example, penicillin binds to DD- transpeptidase, a bacterial protein that is vital for making the outer cell wall of bacteria.
  • As a result of penicillin’s action, the cell wall is weakened and the bacteria burst
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3
Q

Which antibiotics act on dna synthesis

A

Quinolones ciprofloxacin
Folic acid
antagonists trimethoprim
sulphonamides

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4
Q

Which antibiotics act on protein synthesis

A

Ere witht ribosome and hence rotein synthesis.- downstream affects metabolic pathwaysInternet

Aminoglycosides gentamicin
Macrolides erythromicin
Tetracyclines

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5
Q

Which antibiotics act on cell wall synthesis

A

Beta-lactams
penicillins cephalosporins carbapenems

Glycopeptides vancomycin

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6
Q

What a re the. Reasons for antibiotics

A

Prevention of infections, therapy of significant bacterial infections

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7
Q

Who is at risk of nection

A
People at increased risk of infection
• Peri-operative
– Prevention of surgical site infections
Dont need repeat coursed for prophylaxis in surgical site. Except cardiac. But vast majority - usually single dose. Don’t need more once wound closed up. OR if very prolonged srgery also may need repeat courses 
• Short term
– Meningitis contacts
• Long term – Asplenia
– Immunodeficiency
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8
Q

Describe therapy o significant bacterial infections

A
  • Empirical treatment of suspected infection

* Treatment of culture proven infection

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9
Q

How can antibiotics be used empirically

A

1) follow the local guidelines
2) what is the cause? Which antibiotics are likely to be effective?
Which is the best choice?

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10
Q

What does the likely cause depend on?

A

Duration of illness, pmh, occupational history, travel history, time of year, age, personal big, anatomical site

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11
Q

What does the antibiotic that is likely o be effective depend on

A

Community or hathcare onset? Severity of infection? Baseline rate of resistance? Immune status of patient

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12
Q

What are factors whicheffect which antibiotic is the bets choice

A

Cost, efficacy, age, toxicity, ddis, allergies, pregnancy, breast feedin, organ function, administration route

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13
Q

How is susceptiby of bacteria tested

A

Disc testing

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14
Q

What is mic

A

MIC measurements are for a specific organism and antibacterial combination
e.g.
MIC of Streptococcus sanguinis to benzylpen

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15
Q

What is judicious antibiotic therapy

A

S

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16
Q

What is i time dependent killing

A

– Succesful treatment requires prolonged antibiotic presence at site of infection
– But not high concentration
– fT>MIC fraction of time concentration of unbound drug is greater than MIc

17
Q

What is pharmacodynamics

A

Concentration dependent killing
– Succesful treatment requires high antibiotic concentration at site of infection
– But not for long
– [Cmax]/MIC ratio of maximum unbound drug concentration to MIC

18
Q

What is therapeutic drug monitoring

A

• To ensure
– Adequate dose – Non-toxic dose
• Aminoglycosides • Vancomycin

19
Q

What is innate vs acquired resistance

A

RESISTANCE
• Antibiotics can only work if the antibiotic can bind to the bacterial target molecule.
• The bacterial molecule must be present, accessible and a fit for the antibiotic
INNATE RESISTANCE
• When this has never been the case for a specific bacteria- antibiotic combination, then the bacteria is innately resistant
ACQUIRED RESISTANCE
• If a bacteria was previously sensitive to an antibiotic but is now resistant, then the bacteria has acquired resistance

20
Q

What are the 2 main ways in which bacteria become reisisnct

A

Bacteria develop resistance to antibiotics in two main ways:
• mutation of their DNA
• acquisition of pre-formed resistance genes

21
Q

-

A

-

22
Q

Wat are the diverse effects of antibiotics

A
  • Organ toxicity
  • Allergicreactions
  • Idiosyncratic reactions