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Principles - Microbiology > Antibiotic Therapy > Flashcards

Antibiotic Therapy Flashcards

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1
Q

What is an antibiotic?

A

A drug used to treat or prevent infection caused by microorganisms

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2
Q

What is a bacteriostatic antibiotic?

A

One that inhibits the growth of bacteria

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3
Q

What is a bacteriocidal antibiotic?

A

One that kills bacteria

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4
Q

What does it mean for an antibiotic to have a narrow or broad spectrum?

A

It’s the range of microorganisms antibiotics affect

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5
Q

What is selective toxicity?

A

Where an antibiotic doesn’t kill human cells, just bacteria

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6
Q

What is the ideal antibiotic?

A 
Selectively toxic
Bacteriocidal
Long half life
Appropriate tissue distribution
No adverse drug interactions or side effects 
Oral and parental preparations
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7
Q

What does the half-life of an antibiotic affect?

A

How often dosages are taken

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8
Q

Where are antibiotics that are absorbed excreted?

A

In the urine

Via the liver, biliary tract, and into the faeces

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9
Q

What are the three methods of administering antibiotics?

A

Orally
Intravenously
Intramuscularly

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10
Q

What is the disadvantage of taking antibiotics orally?

A

Much of the antibiotic is not absorbed and is excreted unchanged in the faeces

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11
Q

What are common examples of antibiotic targets?

A 
Cell wall
Ribosomes
DNA replication 
DNA gyrases
Metabolic pathways
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12
Q

What are three types of commonly prescribed cell wall antimicrobials?

A

Penicilins
Cephalosporins
Glycopeptides

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13
Q

What are examples of penicillins?

A 
Penicillin
Amoxicillin
Flucloxacillin
Temocillin
Co-amoxiclav
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14
Q

What is an example of a cephalosporin?

A

Ceftriaxone

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15
Q

Are penillilins, cephalosporins and glycopeptides beta-lactam antibiotics?

A

Penicillins and cephalosporins are beta-lactam antibiotics

Glycopeptides are not beta-lactam antibiotics

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16
Q

What are the targets of beta-lactams?

A

Penicillin Binding Proteins (PBPs)

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17
Q

What is a beta-lactam antibiotic?

A

One with a beta-lactam ring in its molecular structure

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18
Q

How do beta-lactams compromise the cell wall?

A

Act as a suicide substrate and halt cell wall synthesis

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19
Q

What are the advantages of the penicillins?

A 
Safe with few side effects
They have variety due to being very flexible with side groups and chains able to alter multiple features
Range from narrow to broad spectrum
Excreted via kidneys
Safe in pregnancy
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20
Q

What are the limitations of the penicillins?

A

Patients can be allergic
Rapid excretion via kidneys requires frequent dosage
Resistance common

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21
Q

What are examples of beta-lactams?

A

Penicillins
Cephalosporins
Carbapenems

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22
Q

What is a gram positive penicillin?

A

Flucloxacillin

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23
Q

What are gram positive and negative penicillins?

A

Amoxicillin

Co-amoxiclav

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24
Q

What is a gram negative penicillin?

A

Temocillin

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25
Q

What are the three principle compounds of penicillin?

A

Benzylpenicillin
Phenoxymethyl penicillin
Benzathine penicillin

26
Q

What are the advantages of amoxicillin?

A

Safe and well tolerated
Well-absorbed when taken orally
Low binding to plasma proteins and good tissue distribution

27
Q

What are the disadvantages of amoxicillin?

A

Effectiveness challenged by the spread of beta-lactamases

28
Q

What are beta-lactamases?

A

Enzymes that destroy the beta-lactam ring

29
Q

What is co-amoxiclav a combination of?

A

Amoxicillin and clavulanic acid

30
Q

What is clavulanic acid?

A

An inhibitor of beta-lactamase

31
Q

What spectrum does flucloxacillin have?

A

Narrow

32
Q

What is the advantage of temocillin?

A

It is beta-lactamase resistant

It is active against ESBL-producing organisms

33
Q

What is an ESBL-producing organism?

A

Extended spectrum beta-lactamase producing organism

34
Q

What are the advantages of cephalosporins?

A 
Longer half life in plasma
Excreted via kidneys and urine
Few side effects, reduced allergy
Safe in pregnancy
More resistant to beta-lactamases
35
Q

What are the disadvantages of cephalosporins?

A

Broad spectrum so significantly affect normal bowel flora
This allows the overgrowth of C. difficile
Rarely used because of this

36
Q

What are the advantages of glycopeptides?

A

Bactericidal

37
Q

What are the disadvantages of glycopeptides?

A

Excreted via kidneys and urine

Only active against bacteria with gram positive cell wall, no activity against any gram negative organisms

38
Q

How do antibiotics that inhibit protein synthesis do so?

A

Attaching to bacterial ribosomes

39
Q

Are most antibiotics that inhibit protein synthesis bactericidal or bacteriostatic and why?

A

Bacteriostatic

usually protein synthesis can resume once antibiotic removed

40
Q

What is different about ahminoglycosides?

A

The binding of these to ribosomes in order to affect protein synthesis is lethal - bactericidal - instead of bacteriostatic

41
Q

What are examples of antibiotics targeting protein synthesis?

A

Aminoglycosides
Tetracyclines
Macrolides

42
Q

What is an example of an aminoclycoside?

A

Gentamicin

43
Q

What is an example of a tetracycline?

A

Doxycycline/minocycline

44
Q

What is an example of a macrolide?

A

Erythromycin

45
Q

How must gentamicin be given?

A

Intravenously

46
Q

What are the advantages of gentamicin?

A

Bactericidal
Active against gram negative aerobic organisms
Excreted in urine

47
Q

What is the disadvantage of gentamicin?

A

causes damage to kidneys and 8th cranial nerve

48
Q

What is the mode of action of tetracyclines?

A

Actively transported into cell and binds to 30S subunit

49
Q

What are the advantages of tetracyclines?

A

Broad spectrum so useful against intracellular bacteria and atypical bacteria

50
Q

What are the disadvantages of tetracyclines?

A

Resistance is increasing

Destruction of normal flora due to bored spectrum results in increased secondary infections

51
Q

What are examples of the macrolides?

A

Erythromycin
Clarythromycin
Azithromycin

52
Q

What antibiotics affect nucleic acids?

A

Metronidazole
Trimethoprim
Fluoroquinolones

53
Q

What is the primary use of trimethoprim?

A

UTIs

54
Q

What is metronidazole active against?

A

Anaerobes

55
Q

What is the mode of action of quinolones?

A

Bind to the A subunit of DNA gyrase and prevent supercoiling of DNA to indirectly inhibit DNA synthesis

56
Q

What are inhibitors of folic acid synthesis?

A

Thymidine
Purines
Methionine

57
Q

What are common side effects of antibiotics?

A

Nausea
Vomiting
Diarrhoea

58
Q

Why are antibiotics sometimes given in combinations?

A

To cover a broad range of possible infecting organisms
To prevent the development of resistance
For the synergistic effect of combination

59
Q

What should you never combine?

A

Bacteriostatic and bactericidal

60
Q

What antibiotics should be avoided and why?

A 
Cephalosporins
Co-amoxiclav
Ciprofloxacin
Clindamycin
Particularly associated with an increased risk of c. diff

Principles - Microbiology (6 decks)

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