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Antimicrobials > Antibiotics > Flashcards

Antibiotics Flashcards

0
Q

What does clindamycin target?

A

Clindamycin Inhibits protein synthesis. It targets the 50s subunit of the ribosome and prevents ribosomal translocation so is only bacteriostatic.

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1
Q

What class of antibiotic is clindamycin in?

A

Clindamycin is a lincosamide.

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2
Q

What is clindamycin used for?

A

Mostly gram positive infections and anaerobic infections.
It cannot penetrate well into gram negative bacteria.
Often used for MRSA/MSSA skin infections and bone and joint infections.
Sometimes used to treat malaria.
May be used in combination with Vancomycin for TSS as it inhibits release of toxins.

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3
Q

What adverse effects can clindamycin cause?

A

It can be hepatotoxic as is excreted by the liver.
Clindamycin is associated with CDAD.

Should not be given in combination with macrolides or chloramphenicol as will antagonise.

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4
Q

What class of antibiotic is Erythromycin and what does it target?

A

Erythromycin is a macrolide antibiotic. It targets the 50s ribosomal subunit preventing ribosomal translocation, inhibiting protein synthesis. It is bacteriostatic.

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5
Q

Name four macrolide antibiotics

A

Erythromycin
Azithromycin
Clarithromycin
Spectromycin

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6
Q

What is the spectrum of erythromycin?

A

Targets gram pos staphs and streps, limited gram negatives (no coliforms) and anaerobes.

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7
Q

What is erythromycin used for?

A

Often used in patients who are allergic to penicillin as has a similar spectrum.
RTIs - targets legionella and mycoplasma/ atypical RTIs as well.

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8
Q

What are the adverse effects of erythromycin?

A

It is excreted by the liver so can be hepatotoxic.

It can also cause nausea and a rash.

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9
Q

Name 3 quinolone antibiotics

A

Ciprofloxacin
Levofloxacin
Nalidixic acid

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10
Q

What target does ciprofloxacin have?

A

It targets DNA gyrate preventing unwinding of DNA strands during replication.

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11
Q

What is the spectrum of ciprofloxacin?

A

Gram neg mostly and some gram positives.

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12
Q

What syndromes is ciprofloxacin mostly used for?

A

Uti’s
Osteomyelitis
CAP
Gastroenteritis

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13
Q

What side effects of ciprofloxacin are there?

A

Nausea
Vomiting
Cartilage erosion in young
CDAD

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14
Q

How can ciprofloxacin be administered?

A

IV or orally

It is the only oral antibiotic effective against pseudomonas

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15
Q

Name a sulphonamide

A

Co-trimoaxazole

Trimethoprim-sulphamethoxazole

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16
Q

What is Bactria and what is it used for?

A

Co-trimoaxazole

Mainly UTI’s

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17
Q

What does chloramphenicol target?

A

It targets the 50s subunit - bacteriostatic

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18
Q

What is the spectrum of chloramphenicol?

A

Broad
G+ve, g-ve and anerobic

Can be give IV, orally or topically
Can enter CSF

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19
Q

What side effects does chloramphenicol have?

A

It can cause bone marrow suppression so has restricted uses.

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20
Q

What class is daptomycin in?

A

It is a lincosamide.

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21
Q

What does daptomycin target?

A

Inhibits DNA/RNA synthesis

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22
Q

What is the spectrum of daptomycin

A

G+ve only

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23
Q

What class is linezolid in?

A

It is an oxazolidinone.

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24
Q

What does linezolid target?

A

It binds the 30s subunit and inhibits protein synthesis.

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25
Q

What is the spectrum of linezolid?

A

Gram positives only

Includes MRSA, VRE, mycobacterium

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26
Q

What side effects can linezolid have?

A

Bone marrow suppression
Optic neuropathy
Peripheral neuropathy

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27
Q

What does fusilier acid target?

A

It targets protein synthesis.

It targets the G-factor and inhibits ribosomal translocation.

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28
Q

What is the spectrum of fusidic acid?

A

Staphylococci mostly
Never used alonE
IV, oral, topical

29
Q

What are the side effects of fusidic acid?

A

Hepatotoxic

Thrombophlebitis

30
Q

What does tetracycline target?

A

Binds the 30s subunit - inhibits ribosomal translocation

Inhibits protein synthesis.

31
Q

What is the spectrum of tetracycline?

A

Broad spectrum
G+ve, g-ve and anaerobes

Give IV/oral

32
Q

What are the side effects of tetracycline?

A

Causes teeth and bone discolouration in children
Don’t give to children or pregnant women

Can cause photo sensitivity

33
Q

What is the target of Quinupristin/Dalfopristin (Synercid)??

A

It targets protein synthesis

50s subunit

34
Q

What is the spectrum of synercid?

A

G+ve only (MRSA and VRE but not E. faecalis)

35
Q

What side effects does synercid have?

A

Venous inflammation

Hepatotoxic

36
Q

What does Rifampicin target?

A

Inhibits RNA polymerase

37
Q

What is the spectrum of Rifampicin?

A

Broad spectrum
G+ve, G-ve, Anaerobes and Mycobacteria
DO NOT give alone
IV/Oral

38
Q

What are the side effects of Rifampicin?

A

Hepatotoxic
Can cause Type I hypersensitivity reactions
Thrombocytopaenia
Induction of liver enzymes

39
Q

What does Trimethoprim target?

A

Dihydrofolate reductase

-inhibits DNA synthesis

40
Q

What is the spectrum of Trimethoprim

A

Broad spectrum
G+ve and G-ve
Doesn’t reach brain, skin or fat
Used for UT

41
Q

What are the side effects of Trimethoprim?

A

Gastrointesinal upsets
Type I hypersensitivity
Bone marrow depression
can be teratogenic in the first trimester.

42
Q

What does metronidazole target?

A

it is non-enzymatically reduced by reacting with reduced ferredoxin. Many of the reduced nitroso intermediates will form sulfinamides and thioether linkages with cysteine-bearing enzymes, thereby deactivating these critical enzymes.

43
Q

What is the spectrum of metronidazole?

A

Anaerobes

Parasites

44
Q

What are the side effects of metronidazole?

A 
Nausea
Reduced WCC
Neurotoxic
Rash
Reacts with alcohol
45
Q

What class of antibiotics is Astreonam in?

A

Monobactams

46
Q

What is the spectrum of Astreonam?

A

G-ve mostly

47
Q

What is the target of Astreonam?

A

Targets PbP3 at low concentrations

Low susceptibility to b-lactamases

48
Q

Name four third generation cephalosporins

A

Cefotaxime
Ceftazidime
Cefixime
Ceftriaxone

49
Q

Name a fourth generation cephalosporin

A

Cefipime

50
Q

What is the spectrum of cephalosporins

A

Broad - more active against g-ve b-lactamases
Active against pseudomonas
Can cross the BBB
Risk of CDAD

51
Q

Name 2 second generation cephalosporins

A

Cefuroxime

Cefoxitin

52
Q

What spectrum is Tazocin?

A

Extended spectrum pseudomonas B-lactam
G+ve, G-ve, some anaerobes
Used to treat pneumonia

53
Q

What is the spectrum of Flucloxacillin?

A

G+ve Staphylococci/Streptococci

stable to b-lactamases

54
Q

What is the spectrum of ampicillin/amoxicillin?

A 
Streptococci
Neisseria
Haemophilus
E. Faecalis
Some staphs
Some coliforms
Used for UTIs, Otitis Media, and in combination with flucloxacillin for cellulitis
55
Q

What is the spectrum of benzylpenicillin?

A

Streptococci
Neisseria
some staphs - quite narrow spectrum
Synergistic with aminoglycosides

56
Q

What class does Imipenem belong to?

A

Carbapenems

57
Q

What is the spectrum of imipenem?

A

Very broad spectrum
Resistant to beta lactamases
Covers pseudomonas
NOT active against MRSA

58
Q

What class does Teicoplanin belong to?

A

Glycopeptides

Cell wall active - bind terminal D-ala-D-ala residues

59
Q

What is the spectrum of Teicoplanin?

A

Gram positives only - too large for G-ve

Used for MRSA/MRSE

60
Q

What are the side effects of Teicoplanin?

A

Ototoxic
Nephrotoxic
Excreted renally

61
Q

What class is vancomycin in?

A

Glycopeptides

62
Q

what is the spectrum of vancomycin?

A

Gram positives only - too large for G-ve
IV only
Use for MRSA/MRSE

63
Q

what are the side effects of vancomycin?

A

Ototoxic
Nephrotoxic
excreted renally

64
Q

What class is Tobramycin in?

A

Aminoglycosides

65
Q

What does Tobramycin target?

A

The 30s ribsosomal subunit (protein synthesis)

66
Q

What is the spectrum of tobramycin

A 
Staphylococci
Coliforms
Pseudomonas
NOT streptococci
Use for UTIs and septicaemia as poor tissue penetration
67
Q

WHat side effects does tobramycin have?

A

Ototoxic
Nephrotoxic
Excreted renally

68
Q

WHat class is gentamicin in?

A

Aminoglycosides

69
Q

What does gentamicin target in the cell?

A

30s subunit of ribosome (protein synthesis)

70
Q

What is the spectrum of gentamicin?

A

Coliforms,
Pseudomonas
Staphylococci (NOT streps)
IV or topical
show synergy with b-lactams for enterococci
Mainly used for sepsis and UTIs as poor penetration of tissues

71
Q

What side effects does gentamicin have?

A

Nephrotoxic
Ototoxic
Excreted renally

Antimicrobials (2 decks)

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