Antibiotics Flashcards
____ ____ 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
Selective toxicity
The antibiotic spectrum refers to the ability of the drug to be _____ or ___.
Narrow
Broad
Penicillin is a _____ antibiotic
Narrow
Beta lactam antibiotics all have a ____ ___, penicillin is included in this class
Beta lactam ring
All B-lactams inhibit ___ ___ synthesis
Cell wall
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
Transpeptidase
Osmotic pressure
Antibiotic resistance is a ____ problem. Two common antibiotic resistant diseases are ____ and ____
Global
MRSA
C. Diff
Bacteria have many mechanisms of resistance from antibiotics:
_______ catalyzes the hydrolysis of the beta-lactam ring, making it inactive
Beta-lactamase
Gram negative bacteria have an extra defense against antibiotics due to their ___ ___
Outer membrane
Bacteria can use ____ ____ to remove the antibiotic out of the cell
Efflux pump
Penicillin binding proteins (PBP) on the bacteria can undergo _____ making it so that the antibiotic cannot bind to the bacteria
Modifications
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
Transpeptidase
Alanine
First level of penicillins:
_____ and _____ can fight non-beta lactamase producing gram positive bacteria such as strep and anaerobes and syphilis
Penicillin V
Penicillin G
Second level of penicillins:
_____ and _____ are good for strep, syphilis, and some gram negative bacteria such as E. coli. Others include _____ , ____, and ____ ____
Amoxicillin (orally)
Ampicillin (IV)
H.pylori, listeria, and otitis media
_____ ____ ____ are the third line of antibiotics. They include dicloxacillin, methicillin, nafcillin, oxacillin. They can evade _____ and treat staph infections including MSSA
B-lactamase
(Naf for staph)
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
Beta-lactamase inhibitors
Bacteria that produce Beta-lactamase include:
Staph, hemophilus influenza, enterobacterales, and anaerobes
______ _____ (IV Zosyn) is an anti-pseudomonal Penicillins. It is very broad, streams gram positive cocci except for MRSA, gram negative bacteria, and anaerobes
Piperacillin tazobactam
Amoxicillin-clavulanate
Nafcillin
A 60 year old with mild strep cellulitis of the left foot. The best option is:
Penicillin
Penicillin adverse effects usually result in:
Nausea, vomiting
Serious but rare: anaphylaxis
____ therapy is treatment before you know what the bacteria is
_______ therapy is when you know what the bacteria is
Empiric
Pathogen-directed
________ therapy is when we know what the bacteria is and want it’s susceptible to
Susceptibility-guided
_____ anti microbial treatment is prior to surgery
Prophylaxis
_____ 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
Empirical
Scenarios where empiric therapy is used:
Always send ____ prior to antibiotics are given to the patient
Cultures
_____ _____ is a diagram of drug susceptibility testing for a patient in a particular scenario that
Hospital antibiogram
If you are treating cellulitis, the common causes are staph and strep, treat with ____
Vancomycin
If the gram stain shows gram positive cocci in clusters, it is most likely _____
Staphylococcus aureus
____ ____ ____ is the lowest concentration of a specific antibiotic that inhibits the growth of a specific microorganism
Minimum inhibitory concentration (MIC)
Combination therapy is used when there is a ___ infection. For enterococcus endocarditis, two antibiotics together have a higher cure rate.
Severe
Sometimes two antibiotics counter act each other known as ______
Antagonism
Bacteria can develop ____ during treatment
Resistance
An _____ often needs to be drained for adequate treatment
Abscess
Anti microbials have been associated with ____ of adverse effects in hospital patients, and ____ of all emergency department visits for adverse drug events
23%
19%
Types of superinfections:
C. Difficile
MRSA
yeast
VRE
Take home message
Take home message:
