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Antibiotics Flashcards

1
Q

Name 4 antibiotic targeted mode of actions?

A
  • Cell wall
  • DNA
  • Protein synthesis
  • Mycobacterium
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2
Q

Name an antibiotic used that is a fungus

A

Penicillin

It causes the bacterial cell wall to rupture by autolysis.

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3
Q

What is the site of action for penicillin?

A

Transpeptidase

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4
Q

How does Penicillin work?

A

It works by binding to active site on the transpeptidase to inhibit its ability to cross link the peptiglycan. Making the cell wall more flexible and susceptible to regenerate which affects the cell membrane.

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5
Q

What kind of antibiotics are penicillins and why?

A

They are B-lactam antibiotics as they contain a B-lactam ring.

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6
Q

Are penicillins enzyme inhibitors?

A

Yes, they are irreversible enzyme inhibitors.

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7
Q

Name 4 types of penicillin

A

1) Penicillins
- Pen V
- Pen G
2) Broad spectrum
- Ampicillin
- Amoxicillin
3) B-lactamase resistant
- Flucoxacillin
- Co-amoxiclav
4) Anti-pseudo-monal
- Piperacillin with tazobactin

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8
Q

Give 3 facts for Phenoxymethylpenicillin (Pen V)

A

1) Effective against gram -
2) Narrow spectrum of activity therefore does not affect the gut area.
3) Variable absorption from the GI tract.

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9
Q

Give 4 facts for Benzylpenicillin (Pen G)

A

1) Effective against gram +
2) Unstable in acid, must only be given by IV/IM
3) Given in large doses and for severe infections
4) Given for following infections:
- Streptococcal (Pneumonia and endocarditis)
- Clostradia (tetanus)
- Meningococcal (meningitis and septisemia)

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10
Q

When would you prescribe Pen V?

A

Phenoxymethylpenicillin is prescribed to treat infections such as chest infections, tonsillitis, cellulitis, ear infections, and dental abscesses. It is used in particular for respiratory infections in children

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11
Q

Name 2 broad spectrum antibiotics

A
  • Amoxicillin

- Ampicillin

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12
Q

When would you prescribe amoxicillin?

A

Amoxicillin is an antibiotic used to treat a number of bacterial infections. These include middle ear infection, strep throat, pneumonia, skin infections, and urinary tract infections among others.

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13
Q

What can Ampicillin cause?

A

1) Overgrowth of C.diff
2) Diarrhoea due to it being broad spectrum
3) Not metabolised by stomach acid

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14
Q

What are broad spectrum antibiotics used for?

A
  • Pneumonia
  • UTIs
  • HAP
  • H Pylori related infections
  • Peptic ulcers
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15
Q

What are two side effects of penicillins?

A

1) Hypersensitivity

2) Neurotoxicity

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16
Q

How can penicillins cause Neurotoxicity?

A

When it gets to the brain, influences GABA-A receptor. thus, leading to seizures.

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17
Q

How can penicillins cause Hypersenstivity?

A

Hypersensitivity is classified into 3 types:

1) Immediate reactions
- 20 mins
- Mediated with IgE
2) Accelerated reaction
- 1-72 hours
- consists of urticaria
3) Late reaction
- 72 hours to several weeks
- usually a skin rash

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18
Q

How should penicillins be NEVER administered and why?

A

Intrathecal injection, cause a seizure.

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19
Q

Name 4 Cephalosporins

A

1) Cefalexin
2) Cefradine
3) Cefaclor
4) Cefradoxil

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20
Q

How do Cephalosporins work?

A

They work by inhibiting peptidoglycan cross linking.

They are more resistant to B-lactamases than penicillins. Therefore, 2nd/3rd line of treatment for Resp/UTI.

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21
Q

When can IV Cephalosporins be used?

A

Only for severe/complicated antibiotic resistance.

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22
Q

What are side effects of Cephalosporins?

A

1) Can cause diarrhoea
2) Hypersenstivity
3) Seizures
4) Vitamin K deficiency
- Reduces bacteria in the gut that produces Vit K

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23
Q

How should Cephalosporins be prescribed to patients with kidney impairment?

A

Should be given in less dose

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24
Q

What are carbapenems?

A
  • Resistance against B-lactamases.

- Resistant against gram - & +

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25
Which carbapenems is broad spectrum?
Meropenem (gram - & +)
26
Which carbapenems is less broad spectrum?
Ertapenem
27
Give one advantages of carbapenems?
Longer duration of action
28
What are monobactams?
Monobactams are a subgroup of beta-lactam antibiotics, where the beta-lactam ring is alone (not attached to another B-lactam ring)
29
What do they work against?
They only work against aerobic gram - | Must only be given IV/IM
30
How do monobactums work?
Monobactams work by inhibiting the peptidoglycan synthesis process; as a result, the bacteria lose the ability to resist and burst, leading to cell death.
31
Give examples of monobactums
Azactam Aztreonam Aztreonam inhalation
32
What is vancomycin used for?
Gram positive infections - Endocarditis - Antibiotic associated colitis (caused by C.diff)
33
How does vancomycin work?
It works by inhibiting growth and cross linking of peptidoglycan. Inhibiting synthesis of the cell wall of gram +, thus killing the bacteria. Affects the polymerisation of the sugar layer.
34
Why is vancomycin not effective against gram - bacteria?
Because it's structure is too large to get through the walls of gram - bacteria.
35
When is vancomycin given orally?
Vancomycin is only given orally to treat C.diff colitis
36
How do you administer vancomycin for systemic infections?
Through IV otherwise it will not be absorbed well.
37
Which other drug work similar to vancomycin?
Teicoplanin
38
How does Bacitracin (Tracy's antibiotic)?
Works by inhibiting enzyme dephosphorylation, preventing peptiglycogen building blocks from attaching to cell wall.
39
What and How is Bacitracin used?
Helps to prevent minor skin injuries such as cuts, scrapes, and burns from becoming infected, tattoo and circumcision. Topically for: Ear/nose/skin infections
40
How do polymixins work?
The only antibiotics that work on the lipopolyscharides layer outside the cell wall.
41
What type of bacteria is treated by polymixins?
Serious gram - bacteria
42
What type of infections does polymixins treat?
They are used to treat systemic infections caused by Pseudomonas aeruginosa.
43
How many types of polymixins are there?
2 - Colistin - Polymyxin B
44
How is polymixins used in cystic fibrosis?
As a nebuliser
45
What is the structure of mycobacterium?
Mycolic layer Arabinoglycon Peptidoglycan Phospholipids
46
Name 4 drugs used for the treatment of TB
1) Isoniazid 2) Ethambutol 3) Rifampicin 4) Pyrazinamide
47
How does Isoniazid work?
It works by influencing the mycolic layer and FAS 2 (Fatty acid synthase 2).
48
What does Isoniazid's metabolism dependant on?
Genetic polymorphism - This drug is under genetic control so genetically determined into fast/slow metabolism.
49
What organ is affected by ethambutol?
The eyes
50
Name 4 antibiotics that work on DNA
1) Sulphonamides 2) Quinolones 3) Metronidazole 4) Rifampicin
51
Name 3 Quinolones
1) Ciprofloxacin 2) Moxifloxacin 3) Levofloxacin
52
What species is Trimethoprim for?
Effective against gram -/+ - Stap species - Enterabacter species - E.Coli - Proteus mirabilis - Klebsiella pneumonia
53
Why is Trimethoprim used as a first line treatment for UTIs?
Because it is secreted unchanged by kidneys, thus high concentration in the urine (compared to blood).
54
When should Trimethoprim be avoided?
First trimester of pregnancy
55
What are 4 side effects of Trimethoprim?
1) GI upset 2) Hypersensitivity 3) Haematological disorder 4) Hyperkalemia
56
Why can nitrofurantoin not be used as a systemic antibiotic?
Due to it's low plasma concentration
57
What is nitrofurantoin activated?
By Nitro-reductase
58
How does metronidazole work?
Generates free radicals in anaerobic cells which break strands in DNA.
59
Why should metronidazole be avoided with alcohol?
- It inhibits acetaldehyde dehydrogenase - increases concentration of acetaldehyde - Gives you glueing, headaches, nausea, vomiting, hypotension.
60
What do fluroquinololes?
- DNA gyrase | - Topoisomerase
61
Name the 4 fluroquinoloes?
1) levofloxacin 2) ciprofloxacin 3) ciprofloxacin 4) moxifloxacin
62
What are side effects of fluroquinololes?
1) Increases risk of arrhythmias 2) Rupture of muscle tendons 3) Promote C.diff colitis
63
Name two interactions for fluroquinololes?
1) NSAIDs increase risk of seizures | 2) Theophylline - inhibits CYPR2
64
How does rifampicin work?
It inhibits RNA polymerase in prokaryotic cells.
65
What is the role of Pyrazinamide for the treatment of TB?
It doesn't work directly but enhances the effects of other drugs.
66
What does Pyrazinamide affect?
It's target site is ribosomes.
67
Name 5 proteins that work on protein synthesis
1) Tetracyclins 2) Aminoglycosides 3) Cholramphenicol 4) Macrolides 5) Linezolid
68
Give 2 examples of tetracyclins
- Doxycyclin | - Lymecyclin
69
How do tetracyclins work?
They bind to 30s segment of ribosome to prevent tRNA binding at a site.
70
What are common indications of tetracyclins?
Acne, LRTI, Ecercebation of COPD, chlamidya, malaria, anthrax, lyme disease.
71
What happens during tetracyclin resistance?
pump tetracyclin out of the cell
72
What are side effects of tetracyclins?
Avoid in pregnancy/breastfeeding/young children as it can stick to bones and teeth (teeth discolouration).
73
Name 3 Aminoglycasides
- Gentamycin - Amikacin - Neomycin
74
How are Aminoglycasides administered?
IV/IM
75
What organs do Aminoglycasides have toxic effects towards?
Kidney | Ear (kills inner ear auditory hair cells/loss of frequency leading to deafness)
76
What other antibiotics work well with Aminoglycasides ?
Penicillins
77
Treatment of C.diff
- Metronidazole | - Vancomycin
78
How does Chloramphenicol work and it's indications?
Inhibits transpeptidation (interferes with substrate binding) - Otitis externa - Bacterial Conjunctivitis
79
How do macrolides work?
Inhibit aminoacyl translocation.
80
Give example of macrolides
Erythromycin - Bacteriostatic - Can be used as an alternative to penicillins (in case of allergies) - Can be used in triple therapy for peptic ulcers.
81
Give a side effect of erythromycin
prolonged QT interval
82
How does linezolid work?
Binds to 50s segment | - Inhibits the initiation
83
Give examples of linezolids
- Used to treat aerobic Gram-positive bacteria. | - Should not be used

Pharmacology (15 decks)

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