Antibiotics

Question 1

____ ____ is the ability of antibiotics to target bacteria rather than the host. Most often they target things that are unique to the bacteria such as cell wall

Answer 1

Selective toxicity

Question 2

The antibiotic spectrum refers to the ability of the drug to be _____ or ___.

Answer 2

Narrow
Broad

Question 3

Penicillin is a _____ antibiotic

Answer 3

Narrow

Question 4

Beta lactam antibiotics all have a ____ ___, penicillin is included in this class

Answer 4

Beta lactam ring

Question 5

All B-lactams inhibit ___ ___ synthesis

Answer 5

Cell wall

Question 6

Penicillin inhibits the _____ enzyme that catalyzes the formation of the protein cross link in the cell wall. The cell wall can no longer be synthesized and ____ ___ kills the cell

Answer 6

Transpeptidase
Osmotic pressure

Question 7

Antibiotic resistance is a ____ problem. Two common antibiotic resistant diseases are ____ and ____

Answer 7

Global
MRSA
C. Diff

Question 8

Bacteria have many mechanisms of resistance from antibiotics:
_______ catalyzes the hydrolysis of the beta-lactam ring, making it inactive

Answer 8

Beta-lactamase

Question 9

Gram negative bacteria have an extra defense against antibiotics due to their ___ ___

Answer 9

Outer membrane

Question 10

Bacteria can use ____ ____ to remove the antibiotic out of the cell

Answer 10

Efflux pump

Question 11

Penicillin binding proteins (PBP) on the bacteria can undergo _____ making it so that the antibiotic cannot bind to the bacteria

Answer 11

Modifications

Question 12

Penicillin binds to the enzyme _____. In contrast, vancomycin binds to _____ which is a substrate of the enzyme. This blocks transpeptidase from being able to bind alanine and the cell wall is not formed properly

Answer 12

Transpeptidase
Alanine

Question 13

First level of penicillins:
_____ and _____ can fight non-beta lactamase producing gram positive bacteria such as strep and anaerobes and syphilis

Answer 13

Penicillin V
Penicillin G

Question 14

Second level of penicillins:
_____ and _____ are good for strep, syphilis, and some gram negative bacteria such as E. coli. Others include _____ , ____, and ____ ____

Answer 14

Amoxicillin (orally)
Ampicillin (IV)
H.pylori, listeria, and otitis media

Question 15

_____ ____ ____ are the third line of antibiotics. They include dicloxacillin, methicillin, nafcillin, oxacillin. They can evade _____ and treat staph infections including MSSA

Answer 15

B-lactamase

(Naf for staph)

Question 16

Sulbactum, and clavulanate are _____ ____ that can be combined with a Beta-lactate antibiotic that is unable to evade Beta-lactamase. Often used for poly microbial infection including anaerobes

Answer 16

Beta-lactamase inhibitors

Question 17

Bacteria that produce Beta-lactamase include:

Answer 17

Staph, hemophilus influenza, enterobacterales, and anaerobes

Question 18

______ _____ (IV Zosyn) is an anti-pseudomonal Penicillins. It is very broad, streams gram positive cocci except for MRSA, gram negative bacteria, and anaerobes

Answer 18

Piperacillin tazobactam

Question 19

Answer 19

Amoxicillin-clavulanate

Question 20

Answer 20

Nafcillin

Question 21

A 60 year old with mild strep cellulitis of the left foot. The best option is:

Answer 21

Penicillin

Question 22

Penicillin adverse effects usually result in:

Answer 22

Nausea, vomiting
Serious but rare: anaphylaxis

Question 23

____ therapy is treatment before you know what the bacteria is
_______ therapy is when you know what the bacteria is

Answer 23

Empiric
Pathogen-directed

Question 24

________ therapy is when we know what the bacteria is and want it’s susceptible to

Answer 24

Susceptibility-guided

Question 25

_____ anti microbial treatment is prior to surgery

Answer 25

Prophylaxis

Question 26

_____ therapy is used before you know what the bacteria is because cultures can take 2 to 3 days and sometimes, the patient does not have that kind of time

Answer 26

Empirical

Question 27

Scenarios where empiric therapy is used:

Answer 27

Question 28

Always send ____ prior to antibiotics are given to the patient

Answer 28

Cultures

Question 29

_____ _____ is a diagram of drug susceptibility testing for a patient in a particular scenario that

Answer 29

Hospital antibiogram

Question 30

If you are treating cellulitis, the common causes are staph and strep, treat with ____

Answer 30

Vancomycin

Question 31

If the gram stain shows gram positive cocci in clusters, it is most likely _____

Answer 31

Staphylococcus aureus

Question 32

____ ____ ____ is the lowest concentration of a specific antibiotic that inhibits the growth of a specific microorganism

Answer 32

Minimum inhibitory concentration (MIC)

Question 33

Combination therapy is used when there is a ___ infection. For enterococcus endocarditis, two antibiotics together have a higher cure rate.

Answer 33

Severe

Question 34

Sometimes two antibiotics counter act each other known as ______

Answer 34

Antagonism

Question 35

Bacteria can develop ____ during treatment

Answer 35

Resistance

Question 36

An _____ often needs to be drained for adequate treatment

Answer 36

Abscess

Question 37

Anti microbials have been associated with ____ of adverse effects in hospital patients, and ____ of all emergency department visits for adverse drug events

Answer 37

23%
19%

Question 38

Types of superinfections:

Answer 38

C. Difficile
MRSA
yeast
VRE

Question 39

Take home message

Answer 39

Question 40

Take home message:

Answer 40