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Foundations of Medicine > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

What 3 classes of antibiotic are ß-lactam antibiotics?

A

Penicillins
Cephalosporins
Carbepanems

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2
Q

What are the 2 types of antibiotic?

A

Bactericidal - kills bacteria
Bacteriostatic - slows bacterial growth

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3
Q

What is the target of a ß-lactam antibiotic?

A

Penicillin Binding Proteins

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4
Q

How are peptidoglycan chains joined?

A

Transpeptidases cleave terminal D-alanine D-alanine, releasing energy for the formation of peptide bonds

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5
Q

How do ß-lactams work?

A

The ß-lactam ring mimics the D-alanine D-alanine cross link. It permanently binds to transpeptidase so prevents formation of more cell wall.

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6
Q

What are some advantages of penicillins?

A

They have very few side effects
They are safe in pregnancy
They are excreted safely by the kidneys

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7
Q

What are some limitations of penicillins?

A

Patients can often be allergic
Rapid excretion means many doses are required
Bacteria can develop resistance to penicillins

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8
Q

What is an example of a gram +ve penicillin?

A

Flucloxicillin

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9
Q

What are examples of gram +ve and -ve penicillins?

A

Amoxicillin
Pipericillin
Phenoxymethylpenicillin

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10
Q

What is Co-amoxiclav?

A

A compound made up of Amoxicillin and Clavulonic acid

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11
Q

What is a ß-lactamase?

A

A compound that breaks down the ß-lactam ring

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12
Q

What is the function of clavulonic acid?

A

It is an inhibitor of ß-lactamase so prevents the degradation of penicillins

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13
Q

What is the function of tazobactam?

A

It is an inhibitor of ß-lactamase so prevents the degradation of penicillins

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14
Q

What is Tazosin?

A

A compound formed from Pipericillin and tazobactam

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15
Q

What is an example of a gram -ve penicillin?

A

Temocillin

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16
Q

What are the 3 principle compounds of penicillin?

A

Benzylpenicillin - Intravenous
Phenxymethylpenicillin - Oral
Benzathine penicillin - Intramuscular

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17
Q

Which 2 species are targeted by flucloxicillin?

A

Streptococci and staphylococci

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18
Q

What is MRSA?

A

Methicillin (Flucloxacillin) Resistant Staphylococcus aureus

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19
Q

What infections can be treated by flucloxacillin?

A

Skin and soft tissue infection
Wound infections
Cellulitis

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20
Q

What is cellulitis?

A

An infection of the soft tissue beneath the skin

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21
Q

What organisms are targeted by Temocillin?

A

Coliforms e.g. E.coli, salmonella, enterobacter
Very useful against ESBLs

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22
Q

What is an ESBL

A

An Extended Spectrum ß-Lactamase

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23
Q

What are the advantages of Cephalosporins?

A

They have a longer half-life in plasma
Reduced risk of allergy
More resistant to ß-lactamases
Safe in pregnancy

24
Q

What are the disadvantages of cephalosporins?

A

They kill a large portion of the normal gut flora, which allows the growth of Clostridium difficile infections

25
Q

Does a 1st generation cephalosporin have a broader spectrum than a 4th?

A

Yes

26
Q

What are examples of 1st generation cephalosporins?

A

Cefalexin
Cefalozin

27
Q

What are examples of 2nd generation cephalosporins?

A

Cefuroxime
Cefaclor

28
Q

What are examples of 3rd generation cephalosporins?

A

Ceftrioxone
Cefixime
Cefotaxime
Ceftazidime

29
Q

What is an example of a 4th generation cephalosporin?

A

Cefepime

30
Q

How do Glycopeptide antibiotics work?

A

They bind to D-alanine-D-alanine terminal ends and block transpeptidase action

31
Q

What are the disadvantages of Glycopeptides?

A

They are excreted via the kidneys which, in kidney failure, can build up and increase damage
They only work on gram +ve cell walls

32
Q

What are some examples of glycopeptides?

A

Vancomycin (IV)
Teicoplanin (IV)

33
Q

What are some examples of antibiotic classes that target protein synthesis?

A

Aminoglycosides
Tetracycline
Macrolides
Lincosamides

34
Q

What is an example of an aminoglycosides?

A

Gentamicin

35
Q

What are some examples of Tetracyclines?

A

Doxycycline
Minocycline

36
Q

What is an example of a lincosamide?

A

Clindamycin

37
Q

How do aminoglycosides (Gentamicin) work?

A

It binds to the 30S ribosome irreversibly, thus preventing the production of proteins

38
Q

What are the risks of gentamicin use?

A

It is toxic and can cause damage to kidneys and VIIIth cranial nerve (Vestibulocochlear)

39
Q

How do tetracyclines work?

A

They are actively transported into the cell and bind to the 30S subunit, preventing attachment of tRNA to acceptor sites

40
Q

What are the risks of tetracycline?

A

They can destroy the normal gut flora, resulting in increased risk of secondary infection. It also causes staining and impairment of bones and teeth

41
Q

What are examples of macrolides?

A

Erythromycin
Clarythromycin
Azithromycin

42
Q

How are macrolides excreted?

A

They are excreted into the liver, into the biliary tract and then into the gut

43
Q

What are examples of antibiotics that affect nucleic acids?

A

Metronidazole
Trimethoprim
Fluoroquinolones

44
Q

What are the uses of metronidazole?

A

Useful against anaerobes and parasites

45
Q

How does metronidazole work?

A

It is activated by reduction, requiring intracellular low Eh. This forms a toxic intermediate that induces DNA strand breakage

46
Q

How do Quinolones work?

A

They bind to the A subunit of DNA gyrase (topoisomerase) and prevent supercoiling of DNA, indirectly inhibiting DNA synthesis

47
Q

What are examples of quinolones?

A

Ciprofloxacin
Nalidixic acid

48
Q

What are examples of fluoroquinolones?

A

Ciprofloxacin
Levofloxacin

49
Q

What antibiotics target folic acid synthesis?

A

Sulphonamides
Trimethoprim

50
Q

What are the uses of trimethoprim?

A

Useful against some gram +ve and -ve bacteria
Commonly used for UTIs e.g. E.coli

51
Q

What are the 3 most common side effects of antibiotics?

A

Nausea, vomiting and diarrhoea

52
Q

What drugs classes action may be disrupted by antibiotics?

A

Oral contraceptives

53
Q

What is a side effect of ciprofloxacin?

A

Tendonitis

54
Q

What substance should not be taken with metronidazole?

A

Alcohol

55
Q

What are the 4 Cs that can increase risk of Clostridium difficile?

A

Ciprofloxacin
Clindamycin
Cephalosporins
Co-amoxiclav

56
Q

What disease is caused by the fungus Candida albicans?

A

Thrush

Foundations of Medicine (56 decks)

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