Antibiotics Flashcards

1
Q

Microbe

A

Microorganism which usually results to disease

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2
Q

Why use antimicrobial chemotherapy

A

treat infections caused by microorganisms such as bacteria, viruses, fungi, and parasites. The goal of antimicrobial chemotherapy is to selectively target and destroy these harmful pathogens without causing significant harm to the host.

Can also be used as a prophylaxis (prevents infection in those at high risk e.g. immunosuppressed)

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3
Q

Where do antibiotics come from and do

A

Usually comes from bacteria and fungi that produce these compounds to kill or inhibit the growth of other microorganisms

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4
Q

What is the difference between Bacteriocidal and bacteriostatic

A

Bacteriocidal:
Kill bacteria
Destroy cell wall

Bacteriostatic:
Stop cell replication
Inhibit protein and nucleic acid synthesis

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5
Q

What does Penicillin do

A

-inhibit cell division
-inhibit cell wall formation
-causes cell death

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6
Q

Inherent resistance

A

Particular grams stains are resistant to antibiotics owing to their wall structure.

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7
Q

Acquired resistance

A

Induced resistance of a bacteria to an antibiotic it was originally sensitive to the antibiotics.

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8
Q

How can bacteria become resistant

A
  • Change target / replace sensitive pathway
  • Reduced membrane permeability
  • Pump the antibiotic out
  • Destroy the antibiotic

Occurs through
* Mutation of genes
* Acquisition of genes

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9
Q

What is MRSA

A

Methicillin-Resistant Staphylococcus aureus. It is a type of bacteria that is resistant to many common antibiotics, including methicillin, penicillin, and other beta-lactam antibiotics.

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10
Q

How does MRSA cause resistance?
(mecA gene)

A

Acquisition of mecA gene which encodes for PBP2a (penicillin binding protein 2a). Normally anitbioitcs target PBPs which are enzymes that result in bacterial cell wall synthesis.

Antibiotic binds to PBPs and inhibit formation of cell wall, leading to cell death.

But in mecA gene PBP2a is different structure to PBP so antibiotics don’t bind effectively so cell wall formation continues

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11
Q

How does MRSA cause resistance to antibiotics (beta-lactamase)

A

Bacteria possess an enzyme
known as beta-lactamase that destroys the antibiotic

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12
Q

Overcoming bacterial resistance
(Beta lactamase inhibitors)

A

Adding beta lactam ring such as clavulanic acid and amoxillcin allows for beta lactamase inhibitors.

Other beta lactamase inhibitors include:
* Piperacillin and Tazobactam (Zosyn®)
* Ticarcillin and Clavulanate (Timentin®)

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13
Q

How is an antibiotic chosen

A

Patient
Allergies / renal & hepatic function / susceptibility / age / severity of illness / pregnancy / breastfeeding / tolerate oral drugs?

Organism
Local bugs / multi-drug resistance (MDR)

PO or IV

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14
Q

Why multiple Antibiotic

A

To prevent the emergence of resistant strains
To treat mixed infections
To treat emergency / life threatening cases before a firm diagnosis
To take advantage of antibiotic synergism
To use lower doses of a toxic drug

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15
Q

Side effect of antibiotics

A

Continuous Antibiotic use destroys gut flora:
Diarrhoea
Reduced absorption of nutrients
Anaemia due to abnormal absorption of vitamin B12

Allergic reactions / Anaphylaxis

Toxicity:
renal / hepatic

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16
Q

Before administering antibiotics

A

Allergies/ sensitivities
Consider renal / liver status (at prescribing and during course of administration)
Resistance to infection
Severity of illness

17
Q

Monitoring Effect of antibiotics

A

GI disturbances
Allergies and Anaphylaxis
Drug level

18
Q

Patient Education about antibiotics

A

Separating oral antibiotics from laxatives and antacids
Adverse effects
Risk of drug interaction

19
Q

Blood Tests

A

Peak / trough level of antibiotic (therapeutic drug monitoring).
Efficacy of antibiotic may be time & concentration dependent
Renal function
Hepatic function

20
Q

Drug interaction

A

Addition of an antibiotic may influence other drug levels

Antacids and laxatives contain metals like aluminium, calcium and magnesium which tend to bind (chelate) antibiotics in the GI tract. This reduces absorption of many antibiotics, eg Ciprofloxacin, Tetracyclines

21
Q

Nursing responsibilities in terms of antibiotic course

A
  • Inappropriate dosage or incomplete courses lead to antibiotic resistance.
  • Patients frequently feel better after 2-3 days of antibiotics and stop taking them, especially if GI tract disturbance occurs
  • Ensure that patient takes complete course of antibiotic
22
Q

Teixobactin

A

*Effective against gram positive microbes
*Inhibits formation of type II lipids involved in the production of peptidoglycan
*More resistant to mutation as it acts on lipids rather than proteins.
*4-5 years until introduction into clinical practice?
Currently effective against MRSA, VRE, Anthrax and TB

23
Q

Clovibactin

A

Identified 2023
*Effective against resistant gram-positive microbes
*Inhibits a number of targets involved in peptidoglycan production