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Year II Pharmacology Term 5 > Antibiotic resistance > Flashcards

Antibiotic resistance Flashcards

1
Q

Types of resistance

A

Intrinsic or acquires

Constitutive or inducible

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2
Q

Intrinsic resistance

A

Lack of drug target or access to drug

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3
Q

Acquired resistance

A

Genetic variability

Real time clinical decision making

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4
Q

Constitutive resistance

A

Always present - pseudomonas

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5
Q

Inducible resistance

A

Stimuli triggers gene expression

Expanded-spectrum beta-lactamases in E. coli

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6
Q

Resistance from single nucleotide base pair mutations

A

Quinolone resistance

Evolution of beta lactamases in gram -

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7
Q

Mechanism for resistance

A

Altered drug permeability

Altered drug targets

Inactivation of drug

Active efflux

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8
Q

MIC

A

in microbiology, the lowest concentration of an antimicrobial that will inhibit growth of a microorganism in liquid culture

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9
Q

MBC

A

s the lowest concentration of an antibacterial agent required to kill a particular bacterium on solid medium

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10
Q

Sensitive

A

Serum concentration at least 4X MIC

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11
Q

Kirby-Bauer plate

A

AB discs placed on agar

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12
Q

Bacterium that develops resistance by altered penicillin binding proteins

A

Streptococcus pneumoniae

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13
Q

Bacteria that uses modified cell wall targets for resistane

A

Vancomycin resistant enterococus (VRE)

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14
Q

Altered RNA polymerase binding

A

MTB to rifampin

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15
Q

Ribosomal RNA methylation

A

Group A streptococcus - erythrpmycin or clindamycin

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16
Q

Efflux pump

A

Salmonella & coagulase negetive stahylococci to doxycycline in gentamicin

17
Q

Drug insensitive dihydrofolate reductase

A

E coli to TMP-SMX

18
Q

Drug for resistant coagulase-negetive staphylococci & enterococcus

A

Vancomycib

19
Q

Drug for resistant p. aeruginosa

A

Antipseudomonal penicillin or cephalosporin (i.e. piperacillin or ceftazidime) or carbapenem + aminoglycoside or quinolone

20
Q

Drug for resistant enteric gram 0

A

Extended-spectrum cephalosporin or carbapenem + aminoglycoside or quinolone

21
Q

Drug for resistant anerobes

A

Metronidazole> meropenem >beta-lactam + beta-lactamase inhibitors> cefotetan>clindamycin

22
Q

Resistant s. aureus

A

vancomycin

23
Q

Resistant s. pneumoniae

A

Meningitis or Sepsis: Vancomycin/Ceftriaxone

Pneumonia: Ceftriaxone

24
Q

Resistant group A streptoccus

A

Penicillin or cefazolin

25
Q

Resistant Neisseria meningitidis

A

Ceftriaxone

26
Q

Resistant H. influenza

A

Ceftriaxone or beta-lactam + beta-lactamase inhibitor combinations

27
Q

Management of MRSA infection

A

Cutaneous abcess:
- Incision and drainage

Hospitalized patients with complicated skin and soft tissue infections:
- Incision and drainage

Adjunctive measures

  • Use of cultures
  • Foreign body or device removal (if in place >30 d)
28
Q

GNR resistant to beta lactams

A

Often inducible

Penicillinase and Cephalosporinases
Extended spectrum beta-lactamases” (ESBL): Historically a specific reference to genetically related families of beta-lactamases that conferred resistance against the majority of penicillins and cephalosporins
Carbapenemases

29
Q

GNR with Pan resitant

A

Resistance to antipseudomonal cephalosporins, antipseudomonal carbapenems, piperacillin/tazobactam, ciprofloxacin and levofloxacin

30
Q

GNR with XDR or extreme drug resistance

A

Resistance to antipseudomonal cephalosporins, antipseudomonal carbapenems, piperacillin/tazobactam, ciprofloxacin and levofloxacin
AND
Resistance to aminoglycosides (including amikacin), tigecycline, polymixins (colistin)

31
Q

Multidrug-resistant Acinetobacter

A

Health-cares associated infections:
- Mostly VAP and bloodstream infections

  • Common source outbreaks related to respiratory and ventilator equipment

Military personnel
Disasters
Community outbreaks (rare0

Year II Pharmacology Term 5 (9 decks)

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