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Medicine - Respi > Antibiotic for Respiratory Infections > Flashcards

Antibiotic for Respiratory Infections Flashcards

1
Q

URTI examples

A
  • Common cold
  • Sinusitis
  • Pharyngitis
  • Epiglottitis
  • Laryngotracheitis
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2
Q

URTI etiology

A
  • Mostly viral
  • Epiglottitis and laryngotracheitis: Haemophilus influenza type B
  • Bacterial pharyngitis: streptococcus pyogenes
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3
Q

URTI clinical manifestations

A
  • Cold: runny nose, sneezing, no fever
  • Epiglottitis: difficulty in breathing, muffled speech, drooling, stridor
  • Larynogetracheitis: tachypnea, stridor, cyanosis
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4
Q

LRTI examples

A
  • Pneumonia
  • Bronchitis
  • Bronchiolitis
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5
Q

LRTI aetiology

A
  • Viral or bacterial
  • Bronchitis & Bronchiolitis: mostly viral
  • CAP: streptococcus pneumoniae
  • Atypical pneumonia: mycoplasma pneumoniae, chlamydia spp, legionella, coxiella burnetti, viruses
  • HAP: gram-negative organisms (staphylococci as predominant organisms)
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6
Q

LRTI clinical manifestations

A
  • Cough, fever, chest pain, tachypnea, sputum production

* Confusion, headache, myalgia

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7
Q

Antibacterials types

A
  • Beta-lactam antibiotics
  • Macrolides
  • Protein synthesis inhibitors
  • Others (vancomycin, quinolone)
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8
Q

Beta lactam antibiotics examples

A
  • Pencillins
  • Cephalosporins
  • Carbapenems
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9
Q

Protein synthesis inhibitors types

A
  • Tetracycline

* Doxycycline

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10
Q

Macrolides example

A

Erythromycin

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11
Q

Beta lactam antibiotics MOA

A

Inhibit cell wall synthesis (inhibit transpeptidase)

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12
Q

Penicillin clinical uses

A
  • Pneumococcal pneumonia/meningitis
  • Pharyngitis/recurrent rheumatic fever
  • Bronchiolitis
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13
Q

Penicillin ADR

A
  • Generally well-tolerated, except hypersensitivity reaction
  • Anaphylactic shock
  • Serum sickness (urticaria, fever, joint swelling)
  • Skin rash (ampicillin)
  • Interstitial nephritis
  • Diarrhoea & superinfections (ampicillin, amoxicillin)
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14
Q

1st generation cephalosporins examples

A

Parenteral: Cephalothin, cefazolin
Oral: Cephalexin, cefadroxil

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15
Q

1st generation cephalosporins clinical use

A
  • Against G+ve bacteria, Proteus, E. coli, Klebsiella (PEcK)
  • Cephalexin, cefadroxil: CAP
  • Cefazolin: used prior to surgical procedures
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16
Q

2nd generation cephalosporins examples

A
  • Parenteral: Cefuroxime

* Oral: Cefaclor

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17
Q

2nd generation cephalosporins clinical use

A
  • HENPEcK: H. influenza, Enterobacter aerogenes, Neisseria
  • More G-ve coverage
  • Esp beta lactamase producing H. influenza
  • Less active against G+
18
Q

3rd generation cephalosporins examples

A

Parenteral: Cefotaxime, ceftriaxone
Oral: Cefixime

19
Q

3rd generation cephalosporins clinical use

A
  • Enhanced activity against Enterobacter spp, serratia

* Cefotaxime, ceftriaxone: CAP

20
Q

4th and 5th generation cephalosporins

A 
4th generation (Parenteral): cefepime, cefpirome 
5th generation: ceftaroline
21
Q

4th and 5th generation cephalosporins clinical use

A
  • More resistant to betalactamases

* For serious G-ve infections: enterobacter, citrobacter, serratia

22
Q

Cephalosporins ADR

A
  • Hypersensitivity reaction: anaphylaxis, fever, skin rashes, nephritis, hemolytic anemia
  • Ceftriaxone: biliary sludging syndrome, cholelithiasis
23
Q

Cephalosporins contraindications

A

Allergy (cross reactivity with penicillins

24
Q

Carbapenems examples

A
  • Imipenem

* Newer agents: Meropenem, Ertapenem

25
Q

Carbapenems properties

A
  • Gram +ve, -ve aerobes, anaerobes
  • Given by Parenteral route
  • Rapidly hydrolysed by renal dehydropeptidase - I
  • Cilastatin - reversible inhibitor of this enzyme
26
Q

Carbapenems clinical use

A

• Severe hospital acquired infections, LRTI

27
Q

Carbapenems ADR

A

• Induce seizures at higher doses

28
Q

Protein synthesis inhibitors MOA

A

Bind to 30S subunit and inhibit tRNA binding to acceptor site

29
Q

Doxycycline indication

A
  • CAP due to S. pneumoniae, H influenza

* mycoplasma, chlamydia

30
Q

Doxycycline adverse effects

A
  • GI: Epigastric burning
  • Hepatotoxicity, renal toxicity
  • Fanconi’s syndrome with outdated tetracyclines
31
Q

Doxycycline contraindication

A

Children: discolouration of teeth

32
Q

Macrolides MOA

A
  • Binds to 50S ribosomal subunit

* Inhibits translocation of peptidyl-tRNA

33
Q

Macrolides indication

A
  • Respiratory tract infections due to Streptococcus pneumoniae, Haemophilus influenzae, and atypical pathogens (mycoplasma, chlamydia, legionella)
  • Acute exacerbations of chronic bronchitis, acute otitis media, acute streptococcal pharyngitis, and acute bacterial sinusitis
34
Q

Macrolides ADR

A
  • Cholestatic jaundice
  • GI disturbances: nausea, vomiting, diarrhoea
  • CVS: QT prolongation, vent arrythmia
  • Microsomal enzyme inhibition: enhances effect of warfarin, theophylline, digoxin, CCBs
35
Q

Vancomycin MOA

A

• Inhibit cell wall synthesis by binding with D-alanyl-D-alanine terminus of cell wall precursor units

36
Q

Vancomycin indication

A
  • Pneumonia when MRSA is suspected

* HAP/CAP with risk factors for staphylococcal infection

37
Q

Vancomycin ADR

A
  • Allergy: anaphylaxis, skin rash, urticaria
  • Skin flushing: red man syndrome
  • Ototoxicity: hearing impairment
  • Nephrotoxicity: more with high dose (esp w aminoglycosides)
38
Q

Quinolones MOA

A

Inhibit formation of negative DNA supercoils by DNA gyrase

39
Q

Quinolones indication

A
  • Respiratory tract infections: Ciprofloxacin
  • CAP: moxifloxacin
  • Legionella pneumophila: levofloxacin
40
Q

Quinolones ADR

A
  • GI: mild n/v and abdominal discomfort
  • tendinitis
  • Pseudomembranous colitis (Ciprofloxacin)
41
Q

Quinolones CI

A

• Children: may damage growing cartilage and cause arthropathy

42
Q

Drugs for influenza

A
  • Zanamivir (SE: bronchospasm)

* Oseltamivir (SE: nausea, vomiting)

Medicine - Respi (5 decks)

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