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Therapeutics/Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Difference between Antimicrobials and Antibiotics

A

Antimicrobials are drugs that act on microorganisms
Antibiotics are Antimicrobials derived from micro organisms

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2
Q

What/where are the microbacterial sites of action

A

Cell wall- Beta lactams, Glycopeptides
DNA synthesis- Quinolone, Rifampicin, Sulphonamides (via folate)
Protein synthesis- Microlides, Aminoglycopeptides, Tetracyclines

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3
Q

Mechanisms of Antimicrobial Resistance

A

-Bacterium or the species has always been resistance to the antimicrobial so it can’t get in e.g. gram negative bacilli such as Pseudomonas
-Antimicrobials are degraded by enzyme produced by the micro organisms as soon as they enter eg beta lactams, aminoglycoside enzymes
-Mutation in the target site of antimicrobial(drug gets in by can’t bind to its receptor because it’s altered) eg Quinolones, Macrolides, Penicillin binding proteins)

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4
Q

How does Resistance arise

A

Intrinsic eg Enterococci and cephalosporins
Mutation resipulting in altered binding side
Transferable DNA (usually due to exposure to antimmicrobials) plasmids and transposons

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5
Q

Which organism or micro bacteria is resistant to every antibiotic in South Africa

A

Ace inhibitor Baxter

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6
Q

Which antimicrobials are concentration dependent

A

Aminoglycosides
Quinolones

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7
Q

Which antimicrobials are time dependant

A

Beta Lactams
Glycopeptides

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8
Q

Indications for antimicrobial infections

A

Reduce infection in those immunocompromised
Prevent surgical infections
Prevent disease in close contact (meningococcal)
Prevent endocarditis in valvular heart disease
Prevent recurrent of rheumatic fever

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9
Q

4 different classes of Beta lactams

A

Penicillin
Cephalosporins
Lavlanic acid
Carbapenem

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10
Q

Explain the Mechanism of action of beta lactams

A

Inhibit formation of peptidoglycan crosslinks, hindering bacterial cell wall synthesis

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11
Q

Which classes of drugs have hypersensitivity type 1 as main adverse effect

A

Beta lactams

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12
Q

How long does long acting injectable benzathine penicillin last for

A

21 days

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13
Q

What can benzathine penicillin be used to treat ? (3)

A

Strep tonsillar pharyngitis
rheumatic fever
syphilis

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14
Q

Which penicillin is only useful in IV

A

Ampicillin

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15
Q

Which penicillin is well absorbed when taken orally

A

Amoxicillin

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16
Q

2 types of aminopenicillins and how are they administered

A

Ampicillin - IV
Amoxicillin- orally

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17
Q

Which penicillins are for gram positive bacteria

A

Penicillin 1 : benzathine penicillin
Drugs for staph aureus, syphilis, enterococci, Listeria, Actinomyces

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18
Q

Which penicillins are for gram negative bacteria

A

Penicillins 2 : Aminopenicillins: ampicillin and amoxicillin
Penicillin 3 : Cloxacillin, flucloxacillin(orally)

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19
Q

What is the commonest cause of resistance in beta lactams

A

Production of enzyme beta lactamases by bacteria

Beta lactamases inhibitors (developed to assist beta lactams by inhibiting the enzyme that acts against them) are beta lactam drugs that bind covalently to the active site of beta lactamases rendering the enzyme inactive

Irreversible inhibitors of beta lactamases by:
Clavulanate
Tazobactam

Combined with beta lactams, can reverse resistance,
Amoxicillin-clavulanate (coamoxiclav)

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20
Q

Which class of drugs is ceftriaxone

A

3rd generation cephalosporins
( good CSF penetration)

21
Q

Which class of drug is cefazolin and how is it administered

A

1st generation cephalosporins, IV

22
Q

Where is cefazolin used

A

Used at Induction for surgical prophylaxis

23
Q

Which drug to prescribe for bacterial meningitis

A

Ceftriaxone IV/IMI

24
Q

Drug of choice for gonorrhoea

A

Ceftriaxone

25
Q

Drug of choice for typhoid

A

Ceftriaxone

26
Q

Which antibiotics are only used nasocomial infections that are hospital acquired

A

Carbapenems

Not active against cloxacillin-resistant staph
Very expensive

27
Q

List the Manifestations of IgE mediated hypersensitivity reactions (Type 1 hypersensitivity) (5)

A

Angioedema
Urticaria
Bronchospasm
Cardiovascular collapse
Anaphylaxis

28
Q

Which cephalosporins are safe to use in penicillin allergy

(Considering cross reactions between beta lactams and other drugs)

A

It is safe to use 3rd generation cephalosporins (ceftriaxone) in penicillin allergy if hypersensitivity reaction was not IGE mediated

29
Q

What classes of drugs are used only for hospital acquired, gram positive only.

A

Glycopeptides eg Vancomycin

30
Q

Which classes of drugs are polar and do not penetrate tissues well

A

Aminoglycosides

31
Q

3 types of toxicity caused by Quinolones

A

CNS (headache, dizziness, excitation, seizures)
Tendinitis
Rashes

32
Q

2 types of toxicity associated with Aminoglycosides

A

Ototoxicity (irreversible)
Nephrotoxicity (reversible)

33
Q

Why are Aminoglycosides associated with toxicity

A

Due to Prolonged elevated trough concentrations

34
Q

What drug class is ciprofloxacin and what is it used for

A

2nd generation Quinolone

Bacterial dystentry
Pyelonephritis and prostatitis
Alternative to aminoglycosides

35
Q

Which drug is used for MDR TB

A

Moxifloxacin

It is a thirds generation Quinolone

36
Q

Type of toxicity caused by Macrolides

A

Common GIT toxicity

37
Q

What is the therapeutic use of Macrolides

A

Alternative to penicillin (for patients allergic to penicillin)
Atypical caused pneumonia (legionella, chlamydia, mycoplasma)

38
Q

3 causes of atypical pneumonia

A

Legionella
Chlamydia pneumonia
Mycoplasma pneumonia

39
Q

Treatment for atypical pneumonia

A

Macrolides

40
Q

An example of a Macrolides drug

A

Azithromycin

41
Q

Type of drug class for doxycycline

A

Tetracyclines

42
Q

Types of toxicity for Tetracyclines

A

Nausea/vomiting
Photosensitivity
Teeth discolouration (avoid in pregnancy and younger than 8yrs)

43
Q

Therapeutic use for tetracyclines

A

Rickettsia
Brucellosis
Acne

(Binds to calcium)

44
Q

Prophylaxis for falciparum malaria

A

Tetracyclines

45
Q

Toxicity due to cotrimaxazole

A

Sulphonamide hypersensitivity
(skin rashes)
-Steven jones syndrome
-Toxic epidermal Necrolysis

46
Q

Therapeutic use of Cotrimaxazole

A

In HIV, drug if choice for:
-pneumocystis jirovecii pneumonia
-Toxoplasmosis
Cystoisospora belli diarrhoea

Primary prophylaxis in HIV, prevents and reduces infections

47
Q

Which antibiotic drug has metallic taste and disulfiram-like effect

A

Metronidazole

48
Q

Long term effects of metronidazole

A

Neurotoxicity and neutropenia

49
Q

Therapeutic use of metronidazole

A

Anaerobes
Protozoa that lacks mitochondria
-entamoeba histolytica
-trichinoma vaginitis
-giardia lamblia

Therapeutics/Pharmacology (14 decks)

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