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Semester 6 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

What are the 2 main mechanisms of antimicrobial action

A
  1. Time dependent killing
  2. Concentration dependent killing
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2
Q

Where do beta lactams act

A

They act on the cell wall of the bacteria

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3
Q

What is the mechanism of killing in a betalactam

A

They use time dependent killing

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4
Q

What is the mechansim of elimination

A

Renal elimination

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5
Q

What is the main adverse effects of beta- lactams

A

Hypersensitivity

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6
Q

What is the most common resistance method in bacteria against beta lactams

A

Beta- lactamases: These are enzymes that are able to degrade β-lactam antibiotics and it can not be overcome by increasing the conc.

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7
Q

What is the method of resistance in betalactams that can be overcome by increasing the dose

A

Mutations in penicillin binding protein, reducing the ability of β-lactam antibiotics to bind and inhibit their activity

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8
Q

How do beta lactams work

A

They work by binding to Penicillin-Binding Proteins, these Penicillin-Binding Proteins catalyze the final step in peptidoglycan synthesis and so it weaken or increased the cell wall permeability leading to death of the cell

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9
Q

What are the microbe classes that are susceptible to beta lactams

A

Gram positive and spirochetes

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10
Q

What types of bacteria are susceptible to penicillin 5

A

Streptococci
Syphilis
Enterococci
Listeria
Actinomyces

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11
Q

What are aminopenicillins and what are the 2 main types

A

They are subclass of penicillins within the β-lactam class of antibiotics. They are distinguished by an added amino group (-NH2) on the penicillin structure, which enhances their spectrum of activity against certain Gram-negative bacteria while retaining activity against Gram-positive bacteria. They 2 main types are Ampicillin and Amoxicillin

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12
Q

What is the main benefit of Cloxacillin and what bacteria is it used on

A

It is good at working in beta lactamase enviroments

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13
Q

Which bactria can cloxacillin and flucloxacillin be used in and what is the difference

A

They are both only able to be used in gram positive patients, the are very simiar flucloxacillin is just better absorbed orally

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14
Q

What are the 2 main beta-lactamase inhibitors

A

Clavulanate and Tazobactam

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15
Q

What is the benefit to beta-lactamase inhibitors

A

If used in combination with penicillin they can reverse resistance

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16
Q

What is the drug of choice for Resp tract infections

A

Amoxicillin

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17
Q

What is the drug of choice for Staph infections

A

Cloxacillin/flucloxacillin

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18
Q

What are the 2 types of 1st generation cephalosporins and what are they used for

A

Cefazolin and Cephalexin mainly used for Strep and Staph.

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19
Q
A
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20
Q

What is the second generation of cephalosporin

A

Cefuroxime it can be used against Strep, Staph, Haemophilus, community acquired gram negative infections

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21
Q

What are the 2 main 3rd generation cephalosporins and what are they effective against

A

Ceftriaxone and Ceftazidime effective against Strep, Staph, CAP gram negatives and Haemophilus as well as spirochetes and typhoid

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22
Q

What drug is given as surgical prophylaxis

A

Cefazolin 1g to prevent Staphylococcal infection

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23
Q

What is the main excretion method used by ceftriaxone

A

Bile

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24
Q

What is the drug of choice in empirical treatment of bacterial meningitis

A

Ceftriaxone because of its good CSF penetration

25
Q

What is the function of a carbapenems

A

These are very broad spectrum antibiotics that cover most types of infection

26
Q

Which antibiotic classes fall into the beta lactam family 4

A

Penicillins, cephalosporins, carbapenems, and monobactams

27
Q

What are the 3 main manifestations of penicillin allergies

A
  1. Maculopapular Rash
  2. Anaphylaxis
    3.Angioedema, Urticaria(hives), and Bronchospasm
28
Q

What is the mechanism of killing used by Glycopeptides

A

Time dependent killing

29
Q

What are the microbes that are killed by glycopeptides

A

Gram positive bacteria

30
Q

What is the MOA of glycopeptides

A

They interfere with the synthesis of the cell wall by binding to specific components of the bacteria peptidoglycan

31
Q

What is the main glycopeptide used and its side effects

A

Vancomycin is the main glycopeptide used and the main side effects is that it is nephro and oto toxic

32
Q

What are aminoglycosides most effective against

A

Aerobic gram negative bacilli

33
Q

What is the MOA of a aminoglycoside

A

They act as bactericidal inhibitors of protein synthesis

34
Q

What is the mechanism of killing of an aminoglycoside

A

They kill by concentration dependent killing

35
Q

What are 2 examples of aminoglycosides

A

Gentamicin and Amikacin

36
Q

What is gentamicin used to treat

A

Pyelonephritis and is often combined with beta lactams for polymicrobial infections or for its synergistic effects

37
Q

What is the mechanism of action of a quinolone

A

It targets gyrase and topoisomerase enzymes used in DNA synthesis

38
Q

What are the signs of toxicity in Quinolones

A
  1. Rashes
  2. CNS disturbances
39
Q

What are examples of 2nd generation quinolones and what is the uses

A

Ciprofloxacin, They are used in very serious infections and are the drug of choice in conditions like bacterial dysentery and pyelonephritis

40
Q

What is an example of a 3r generation Quinolone and what is it main use

A

Levofloxin, MDR TB

41
Q

What is the MOA of a macrolide

A

It inhibits the 50s ribosomal component thus inhibiting protein synthesis

42
Q

What are macrolides most effective against

A

The are active against gram positive bacteria. and are also used for S. pneumoniae resistance

43
Q

What is the most common side effect

A

GIT disturbance

44
Q

What are 2 examples of macrolides and what is the benefit of the one over the other

A

Erythromycin and Azithromycin
Macrolides inhibit CYP450 metabolism but azithromycin does not

45
Q

What is the main therapeutic use of macrolides

A

They are used in atypical pneumonias like Legionella, Mycoplasma and Chlamydophila

46
Q

What is the MOA of tetracyclines

A

They function by inhibiting the synthesis of proteins by inhibiting 30s ribosomes

47
Q

What are the 2 main mechanisms of resistance in tetracycline

A
  1. Efflux
  2. Enzymatic breakdown
47
Q

What are the forms of toxicity that occur in doxycycline

A
  1. Nausea
  2. Photosensitivity
  3. Teeth discolouration
48
Q

Why should tetracyclines be avoided in children

A

It causes permanent discolouration of the teeth

49
Q

Which infections are treated with tetracyclines

A

Rickettsia
Brucellosis
Acne in low doses

50
Q

What infection can tetracycline be given as prophylaxis

A

Falciparum malaria

51
Q

What are the 2 active components in Cotrimoxazole

A

Sulfamethoxazole and trimethoprim

52
Q

What is the function of Trimethoprim

A

Enzyme that reduces dihydrofolic acid to tetrahydrofolic acid, which is needed for the synthesis of nucleotides and ultimately DNA.

52
Q

What is the function of Sulfamethoxazole

A

It interferes with the folic acid pathway to thus inflencing the DNA synthesis in bacteria

53
Q

What is the main side effect of sulphonamide hypersensitivity

A

Stevens-Johnson Syndrom

54
Q

What is the main use of cotrimoxazole in HIV patients

A
  1. Pneumocystis jirovecii pneumonia
  2. Toxoplasmosis
  3. Cystoisospora belli diarrhoea
55
Q

What is the MOA of metronidazole

A

It is toxic to DNA and forms free radicals in anaerobic metablism

56
Q

What is the main side effects of long term metronidazole use

A

Neurotoxic and neutropenia

57
Q

Which protozoans are affected by metronidazole

A
  1. Entamoeba histolytica
  2. Trichomonas vaginalis
  3. Giardia lamblia

Semester 6 (14 decks)

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