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Infectious Disease > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

What are the antibiotics that work by cell wall synthesis inhibition?

A 
Beta-lactams
- penicillins
- cephalosporins
- carbapenums
- monobactams
Glycopeptides
- vancomycin
- teicoplanin
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2
Q

What antibiotics act by inhibiting protein synthesis through the 30s ribosomal sub unit?

A

Amino glycosides

Tetracyclines

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3
Q

What antibiotics act by inhibiting the 50s ribosomal sub-unit?

A

Chloramphenicol
Clindamycin
Macrolides
Fusidic acid

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4
Q

What antibiotics act by blocking folic acid synthesis?

A

Trimethoprim

Sulphonamides

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5
Q

What antibiotics act by inhibiting nuclei acid synthesis by DNA gyrase inhibition?

A

Fluroquinolones

- cirofloxacin, norfloxacin

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6
Q

What antibiotics inhibit nucleoside acid synthesis through RNA polymerase inhibition?

A

Rifamycin

- rifampicin

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7
Q

What are inhibitors of cell membrane function?

A

Colistin
Polyene anti fungal drugs
- amphotericin B, nystatin

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8
Q

What are the four mechanisms of antibiotic resistance?

A
  1. Antibiotic inactivation through inactivating enzymes
  2. Alteration AF antibiotic target sites
  3. Decreased antibiotic permeability of the cell wall preventing drug access to target
  4. Active antibiotic eflux from bacteria
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9
Q

What are some examples of inactivating enzymes?

A

B-lactamases

Amino glycoside modifying enzymes

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10
Q

What are some inhibitors of beta-lactamases?

A

Clavulanic acid
Tazobactam
Sulbactam

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11
Q

What are the antibiotics that exhibit inducible chromosomal mediated beta-lactamase production?

A 
Enterobacter
Serratia
Citrobacter
Acinetobacter
Pseudomonas
Proteus vulgaris
Morganella morganii
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12
Q

What are the two main types of b-lactamase?

A

ESBL - extended spectrum B lactamases which have enzymes encoded by a plasmid which can be passed between bacteria
Inducible chromosomal mediated b lactamase production from escappm

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13
Q

What are the usual organisms that harbour ESBLs?

A

E.coli

Klebsiella pneumoniae

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14
Q

What antibiotics do ESBLs inactivate?

A

All cephalosporins

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15
Q

What antibiotics do the ESCAPPM group inactivate?

A

3rd generation cephalosporins

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16
Q

What is the mechanism of resistance of MRSA?

A

Alteration in penicillin binding proteins (PBP target site) meaning methicillin cannot bind and act on the bacteria

17
Q

What is the concern with use of Rifampicin alone?

A

Rapid development of resistance due to single step mutations that reduce the affinity of rifampicin for the RNA polymerase

18
Q

What is the difference in cell wall structure between gram positive and gram negatives?

A

Gram positive
- simple cell wall structure that drugs can easily penetrate
Gram negative
- more complex cell envelope that requires drugs to travel through porins

19
Q

What are some examples of penicillin/b-lactamase inhibitor combinations?

A

Amoxicillin + clavulanate
Ticarcillin + clavulanate
Piperacillin + tazobactam (tazocin)

20
Q

What are some examples of first generation cephalosporins?

A

Cephazolin
Cephalexin
Cephalothin

21
Q

What are some second generation cephalosporins?

A

Cefaclor

Cefuroxime

22
Q

What are some third generation cephalosporins?

A

Cefotaxime
Ceftriaxone
Ceftazidime

23
Q

What is a fourth generation cephalosporin?

A

Cefepime

24
Q

What carbapenem does not have action against pseudomonas?

A

Ertapenem

25
Q

What is the mechanism of Vancomycin resistance in enterococci?

A

Van A, B and C genetic mutations which prevent binding of vancomycin to cell wall components

26
Q

What is are some differences between Van A , B and C?

A

A - also resistant to Teicoplanin (another glycopeptide), can be transferred between strains
B - transferred between strains
C - not able to be transferred between strains

27
Q

Types of enterococcus and resistance?

A

All enterococci are instrinsically resistant to cephalosporins

Faecium = more resistant
Faecalis = less resistant

Faecium is often resistant to amoxicillin and occasionally to Vancomycin
Faecalis is usually sensitive to amoxicillin

28
Q

What drugs work via time above MIC?

A

B-lactams
Clindamycin
Macrolides
Linezolid

29
Q

What drugs work via peak concentration above MIC?

A

Aminoglycasides - ie gentamicin

30
Q

What drugs work as a AUC dependant killing?

A

Vancomycin

Fluroquinolones

31
Q

What are examples of carbapenemases?

A

New Dehli metalloproteinase

Klebsiella pneumoniae carbapenemase

32
Q

What are carbapenemases resistant to and how do you treat them?

A

Resistant to all B lactams

Treat with Colistin

33
Q

What is a risk factor for development of Vancomycin resistant enterococci?

A

Use of anerobic cover - ie metronidazole

VRE genes are initally in anaerobes which are then killed and the enterococci takes up the genes and becomes VR

34
Q

What drugs provide anaerobic cover?

A 
Metronidazole
Augmentin/Tazocin (B-lactamases)
Clindamycin
Meropenum
Chloramphenicol

Infectious Disease (8 decks)

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