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Drug Profiles > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

what drug class does amoxicillin belong to?

A

penecilliin

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2
Q

How does amoxicillin work?

A

inhibits enzymes responsible for cross-linking PEPTIDOGLYCANS in bacterial cell walls.

causes cell wall to weaken, swell, lysis and death.

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3
Q

What structure do penicillins contain which is responsible for its antimicrobial activity?

A

B lactam ring

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4
Q

what are penicillin indicated for?

A

pneumonia
UTI (escherichia coli)
HAI or Intra-abdominal sepsis (i.e. co-amoxiclav)
as part of combo treatment for H.Pylori assoc PUD

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5
Q

give an example of a gram +ve and gram -ve pathogen responsible for causing pneumonia

A 
streptococcus pneumonia (g +ve) 
haemophilus influenzae (g-ve)
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6
Q

what are the contraindications for penicillins

A

penicillin allergy
pts at risk of C difficile infection
severe renal impairment

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7
Q

what are the side effects of penicillin?

A

GI upset
antibiotic associated colitis
allergic reaction - presenting as skin rash

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8
Q

what are the possible drug interactions for penecillins?

A

increase toxicity of methotrexate and warfarin

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9
Q

what drug class does cephradine belong to?

A

cephalosporins

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10
Q

what structure is responsible for the antimicrobial activity of cephalosporins such as cephradine?

A

B lactam ring

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11
Q

what is the mechanism of action for cephalosporins?

A

inhibitis enzymes responsible for cross linking peptidoglycans in bacterial cell wall

weakens cell, cell swelling, lysis, death

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12
Q

what spectrum do cephalosporins have?

A

broad spectrum

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13
Q

what are cephalosproins indicated for?

A

oral - 2nd and 3rd line for UTI and Respiratory tract infections

IV- reserved for very severe/complicated antibiotic resistant organisms

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14
Q

what are the contraindications for cephalosporins?

A

risk of c.difficile infection
elderly
allergy/anaphylactic reaction to penicillin, cephalosporin
caution in epilepsy
dose reduction needed in renal impairement

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15
Q

what are the side effects of cephalosporins?

A 
GI upset 
antibiotic associated colitis 
hypersensitivity 
CNS toxicity - seizures 
cross reactivity may occur in pts with penecillin allergies because of similar structure
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16
Q

what are the possible drug interactions with cephalosporins?

A

enhances anticoagulant effect of WARFARIN

increases nephrotoxicity of aminoglycosides

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17
Q

how are penicillins and cephalosporins eliminated?

A

renal

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18
Q

how does trimethoprim work?

A

inhibits bacterial folate synthesis - bacteriostatic

however its clinical utility is reduced due to widespread bacterial resistance

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19
Q

what spectrum does trimethoprim have?

A

broad spectrum

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20
Q

what is trimethoprim indicated for?

A

1st line - UTI

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21
Q

what are the contraindications for trimethoprim?

A

1st trimester of pregnancy
pts with folate deficiency
renal impairement - needs dose reduction

22
Q

who are susceptible to adverse reactions of trimethoprim?

A

neonates
elderly
pts with HIV

23
Q

what are the side effects of trimethoprim?

A 
GI upset
skin rash
hypersensitivity 
hematological disorders (e.g megaloblastic anaemia, thrombocytopenia - due to its effect on folate)
hyperkalaemia
24
Q

what are the possible interactions for trimethoprim?

A

use with K+ elevating drugs risks hyperkalaemia - i.e. aldosterone antagonists, ACE-I, ARBs

use with other folate antagonists (methotrexate) and drugs that increase folate metabolism (phenytoin) increases risk of heamatological effects

25
Q

how is trimethoprim eliminated?

A

renal! its excreted unchanged making it really good for UTIs

26
Q

what is the mechanism of action for nitrofurantoin?

A

metabolised by bacterial cells to give active metabolite. this damages bacterial DNA

it is bacteroicidal

27
Q

what organisms if nirtofurantoin commonoly used against?

A

gram -ve = escheria coli

gram +ve. staphylococcus saprophyticus

28
Q

what is nitrofurantoin indicated for?

A

uncomplicated lower UTI

29
Q

what are the contraindications for nitrofurantoin?

A

pregnant women toward term
babies in first 3 months of life
renal impairment

long term use - caution required

30
Q

what are the side effects of nitrofurantoin?

A

GI upset
hypersensitivity
can turn urine dark yellow/brown
haemolytic anemia in neonates

31
Q

how is trimethoprim and nirtofurantoin excreted?

A

renal

32
Q

what is the mechanism of action for tetracyclines such as doxcycline?

A

bacteriastatic

inhibits bacterial protein synthesis by binding to ribsomal 30s subunit in bacteria.

33
Q

what drug class does doxycycline belong to and what spectrum does this class have?

A

tetracyclines

broad spectrum

34
Q

what is tetracycline (such as doxycycline) commonly indicated for?

A

acne vulgaris
LRTI - infective exacerbation COPD, typical and atypical pneumonia
pelvic inflammatory disease

35
Q

what are the contraindications of tetracyclines?

A

pregnancy
breastfeeding
children =12 yrs
renal impairment

36
Q

what are the side effects of tetracyclines?

A

GI upset
hypersensitivity
oesophageal irritation, ulceration, dysphagia
photosensitivity
discolouration and/or hypoplasia of tooth enamel

37
Q

what are the possible drug interactions of tetracyclines?

A

enhances anticoagulatory effect of WARFARIN

dont use within 2 hrs of giving calcium, iron or antacids as this will prevent its absorption

38
Q

how are tetracyclines excreted?

A

renal and biliary (urine and faeces)

39
Q

what drug class does gentamicin belong to?

A

aminoglycoside

40
Q

what is the mechanism of action of aminoglycosides such as gentamicin?

A

bacteriacidal

inhibits bacterial protein syntheis by irreversibly binding to ribosomal 30s subunit

41
Q

which bacterial organsisms do aminoglycosides (i.e.gentamicin) work against?

A

gram -ve aerobic bacteria = staphylococci and mycobacteria

42
Q

what are aminoglycosides (gentamicin) indicated for?

A

severe sepsis (biliary and intra-abdo sepsis)
complicated LUTI
pyelonephritis
endocarditis

43
Q

what are the contraindications for aminoglycosides (gentamicin)?

A

neonates
elderly
renal impairment
myasthenia gravis

44
Q

what are the side effects of aminoglycosides (gentamicin)?

A

irreversible ototoxicity

reversible nephrotoxicity

45
Q

what are the possible interactions with aminoglycosies (gentamicin)?

A

use with loop diuretics or nacomycin increases ototoxicity risk

use with ciclosporins, vancomycin, cephalosporins, plaitnum and chemotherapy increases nephrotoxicity risk

46
Q

how is gentamicin or any aminoglycoside excreted?

A

renal

47
Q

what are common nephrotoxic drugs?

A

LIGANDS!

lithium, loop diuretics 
iodine 
gentamicin 
ACE-I, ARBs
NSAIDs
digoxin 
steroids
opiods
beta blockers (water soluble) - atenolol
amphotericin 
ciclosporin 
tacrolimus
48
Q

which drug class does erythromycin belong to?

A

macrolides

49
Q

what is the mechanism of action for macrolides (such as erythromycin)

A

bacteriostatic
inhibtis bacterial protein synthesis
binds to ribosomal 50s subunit

50
Q

what are macrolides indicated for?

A

respiratory and skin and soft tissue infections
alternative to penicillin if CI
severe pneumonia -combo with penecillin - to cover atypical organisms
H. Pylori - in combo with PPi and amoxicillin or metronidazole

Drug Profiles (1 decks)

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