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Advanced Pharmacology > Antibiotic therapy > Flashcards

Antibiotic therapy Flashcards

1
Q

How do Beta Lactam antibiotics work?

A

interfere with bacterial cell wall structure by competing with PBP protein to destabilize peptidoglycan strands of cell wall

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2
Q

What are primary targets of antibiotics

A

Cell wall
bacterial protein synthesis
bacterial DNA replication

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3
Q

What are the Beta Lactam Antibiotics?

A

Penicillins
Cephalosporins
Primaxin
Azactam

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4
Q

How did antibacterial resistance occur for beta lactams?

A

bacteria developed beta lactamases to inactivate beta lactam structure

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5
Q

When are use of beta lactams appropriate?

A
  1. bacteria must have cell wall to destroy

2. bacteria does produce beta lactamases (i.e. staph)

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6
Q

How do protein synthesis inhibitors work?

A
  • They bind to one of the ribosomal subunits to prevent amino acid assembly
  • most inhibit 30s or 50s ribosomal subunits
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7
Q

When are protein synthesis inhibitors appropriate?

A
  1. bacteria produce beta lactamases

2. bacterial cell wall is able to be penetrated (protein sythesis is an intracellular event)

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8
Q

What are the 30s protein synthesis inhibitors?

A

Aminoglycosides- Gentamycin, Tobramycin, Streptomycin, etc

Tetracyclines- Doxycycline, Minocycline, ect

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9
Q

Aminoglycosides

A

Protein synthesis inhibitor abx (30s)

  • narrow safety margin- monitor therapeutic levels
  • often given with another antibiotic because they need transport to gain entry into cell
  • Gentamycin, Tobramycin, Streptomycin, etc
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10
Q

Tetracyclines

A

Protein synthesis inhibitor abx (30s)

  • Broad spectrum
  • useful in atypical diseases that don’t have traditional cell wall (lyme, mycoplasma pneumo., cholera, chlamydia, rickettsia)
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11
Q

What are the 50s protein synthesis inhibitors?

A

Macrolides- clarithromycin, erythromycin, azithromycin

Clindamycin

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12
Q

Macrolides

A

50s protein synthesis inhibitors (abx)

  • excellent respiratory penetration
  • consider CYP450 interactions
  • clarithromycin, erythromycin, azithromycin
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13
Q

Clindamycin

A

50s protein synthesis inhibitors (abx)

  • drug of choice for GI anaerobes
  • associated with c.diff since it’s often given to sick guts
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14
Q

How do DNA synthesis inhibitors work?

A

Prevent bacteria from making new DNA

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15
Q

Bactrim

A

DNA synthesis inhibitors (abx)

-blocks folate synthesis in 2 places along the pathway

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16
Q

Fluoroquinolones

A

DNA synthesis inhibitors (abx)

-prevent unwinding of DNA strands so they can’t replicate (DNA gyrase inhibitors)

17
Q

What are the DNA synthesis inhibitors (abx)?

A

Bactrim

Fluoroquinolones- ciprofloxacin, levofloxacin, etc

18
Q

What are the common URI bacteria?

A

Strep. pneumoniae (gram +)
H. Flu (gram -)
Moraxella catarrhalis (gram -)
- have to cover gram +, -, and beta lactamases

19
Q

Streptococcus pneumonia

A
  • most common URI organism- makes people the sickest
  • primary target of antibacterial treatment
  • Amoxicillin
20
Q

Haemophilius influenzae

A
  • second most common URI organism
  • more likely in smokers
  • more than half produce beta lactamase
  • Augmentin
21
Q

Moaxella catarrhalis

A
  • uncommon URI and often resolves spontaneously
  • almost all are beta lactamase producers
  • Augmentin
22
Q

What are common community acquired pneumonia bacteria?

A
  • Strep. pneumoniae
  • H. Flu
  • Mycoplasma pneumoniae & Chlamydophila pneumoniae- atypical with no cell wall
23
Q

What are the drugs of choice for CAP?

A
  • macrolides (azythromycin, erythromycin, clarithromycin)
  • or doxycycline
  • Beta lactam only for those at risk for drug resistant strep and must be with a second drug
24
Q

What bacteria most causes abscesses and what antibiotics are used to treat it?

A
  • Staph aureus

- Bactrim, Clinda, Zyvox, or Vanco (IV)

25
Q

What bacteria most causes cellulitis and what antibiotics are used to treat it?

A
  • Streptococcus species

- PCN, erythromycin, cephalosporins, fluoroquinolones

26
Q

What bacteria most causes UTIs and what antibiotics are used to treat it?

A
  • E. Coli
  • Bactrim (first line)
  • urinary fluoroquinolone
  • cephalosporin

Advanced Pharmacology (9 decks)

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