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MD2 Foundation > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Staphylococcus

A

Gram positive
Coccus
Aerobic

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2
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Streptococcus

A

Gram positive
Coccus
Aerobic

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3
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Enterococcus

A

Gram positive
Coccus
Aerobic

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4
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Peptostreptococcus

A

Gram positive
Coccus
Anaerobic

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5
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Propionibacterium

A

Gram positive
Coccus
Anaerobic

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6
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Listeria

A

Gram positive
Bacillus
Aerobic

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7
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Clostridium

A

Gram positive
Bacilllus
Anaerobic

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8
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Bacillus

A

Gram positive
Bacillus
Aerobic

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9
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Corynebacterium

A

Gram positive
Bacillus
Aerobic

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10
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Neisseria

A

Gram negative
Coccus
Aerobic

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11
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Coliforms

A

Gram negative
Bacillus
Aerobic

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12
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Haemophilus

A

Gram negative
Coccobacillus
Aerobic

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13
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Bordetella

A

Gram negative
Coccobacillus
Aerobic

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14
Q

What antibiotic classes are inhibitors of cell wall synthesis?

A

Beta-lactams

Glycopeptides

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15
Q

What antibiotic classes are inhibitors of the 30S ribosomal subunit?

A

Aminoglycosides

Tetracyclines

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16
Q

What antibiotic classes are inhibitors of the 50S ribosomal subunit?

A

Lincosamides
Macrolides
Fusidic acid
Linezolid

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17
Q

What antibiotic classes are inhibitors of folic acid synthesis?

A

Trimethoprim

Sulphonamides

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18
Q

What antibiotic classes are inhibitors of DNA gyrase?

A

Fluoroquinolones

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19
Q

What antibiotic classes are inhibitors of RNA polymerase?

A

Rifamycins

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20
Q

What antibiotic classes are disrupts of DNA strands?

A

Nitroimidazoles

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21
Q

What antibiotic classes are inhibitors of cell membrane function?

A

Colistin

Daptomycin

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22
Q

What antibiotic classes are bactericidal?

A 
Penicillins
Cephalosporins
Carbapenams
Glycopeptides
Fluoroquinolones
Rifamycins
Aminoglycosides
Metronidazole
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23
Q

What antibiotic classes are bacteriostatic?

A 
Macrolides
Lincosamides
Tetracyclines
Trimethoprim
Sulphonamides
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24
Q

What sort of infection does discoloured sputum suggest?

A

Bacterial, rather than viral

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25
Q

What are the typical causes of community acquired pneumonia?

A 
Streptococcus pneumoniae
Haemophilus influenzae type b
Staphylococcus aureus
Streptococcus pyogenes
Moraxella catarrhalis
Anaerobes
Aerobic and facultative Gram negative rods
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26
Q

What are the atypical causes of community acquired pneumonia?

A 
Mycoplasma pneumoniae
Legionella
Chlamydophila pneumoniae
C psittaci
Chlamydia trachomatis
Coxiella burnetii
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27
Q

What are examples of narrow spectrum penicillins?

A 
Penicillin G
Penicillin V
Procaine penicillin
- Procaine slows absorption rate
Benzathine pencillin
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28
Q

What are examples of moderate spectrum penicillins?

A

Amoxycillin

Ampicillin

29
Q

What are examples of broad spectrum penicillins?

A

Piperacillin

Ticarcillin

30
Q

Against which bacteria do broad spectrum penicillins have?

A

Pseudomonas aeruginosa

31
Q

When would you use broad spectrum penicillins?

A

If complicating factors present

32
Q

What do beta-lactamase inhibitors do?

A

Inhibit most beta-lactamases produced by bacteria

33
Q

What are examples of beta-lactamase inhibitors?

A

Clavulanic acid

Tazobactam

34
Q

What are examples of beta-lactam/beta-lactamase inhibitor combinations?

A

Amoxycillin-clavulanate
Piperacillin-tazobactam
Ticarcillin-clavulanate

35
Q

If a patient develops a rash within 24 hours of commencing penicillin, which antibiotics would you use?

A

Cephalosporins

36
Q

What should you keep in mind when using cephalosporins as an alternative antibiotic in people with penicillin allergies?

A

Some cross-reactivity between true penicillin allergy and some cephalosporins
Rare

37
Q

What are examples of first generation cephalosporins?

A 
Oral
- Cephalexin
IV
- Cephazolin
- Cephalothin
38
Q

What is the spectrum of first generation cephalosporins?

A

Gram positives

Some common Gram negatives; eg: E coli

39
Q

What are examples of second generation cephalosporins?

A

Oral

  • Cefuroxime
  • Cefaclor
40
Q

What is the spectrum of second generation cephalosporins?

A

Same as 1st generation

Slightly enhanced activity against Gram negatives; eg: H influenzae

41
Q

What are examples of third generation cephalosporins?

A

IV

  • Ceftriaxone
  • Cefotaxime
42
Q

What is the spectrum of third generation cephalosporins?

A

Enhanced Gram negative activity

Less Gram positive activity, especially against S aureus

43
Q

What are examples of fourth generation cephalosporins?

A

IV

  • Ceftazidime
  • Cefepime
44
Q

What is the spectrum of ceftazidime?

A

Gram negatives, including Pseudomonas aeruginosa

Poor against Gram positives, especially S aureus

45
Q

What is the spectrum of cefepime?

A

Gram negatives, including P aeruginosa

Some Gram positive activity, including against Streptococcus and S aureus

46
Q

When are fourth generation cephalosporins used a lot?

A

Febrile neutropaenia

47
Q

What are examples of fifth generation cephalosporins?

A

IV

  • Ceftaroline
  • Ceftolozane
48
Q

What is the spectrum of ceftaroline?

A

Gram positives, including MRSA

Gram negatives except Pseudomonas

49
Q

What is the spectrum of ceftolazane?

A

Pseudomonas

Gram negative activity

50
Q

Which antibiotic classes have intracellular activity?

A

Tetracyclines
Macrolides
Fluoroquinolones

51
Q

What differential diagnoses should you consider when considering community acquired pneumonia?

A 
Upper respiratory tract infections
Acute exacerbation of chronic bronchitis
Cardiac failure
Pulmonary embolus
Endocarditis
Liver abscess
52
Q

What antibiotic classes have Gram negative activity?

A 
Minimal/some
- Moderate spectrum penicillins
- 1st and 2nd generation cephalosporins
Penicillin/beta-lactamase inhibitor combinations
3rd and 4th generation cephalosporins
Gentamicin
Fluoroquinolones
53
Q

What antibiotic classes have anaerobic activity?

A 
Penicillin
Metronidazole
Beta-lactam/beta-lactamase inhibitor combinations
Carbapenems
Clindamycin
Moxifloxacin
54
Q

Why is vancomycin given orally in the treatment of Clostridium difficile?

A

Oral vancomycin not absorbed very well > stays in gut - where you need it
Also undergoes 1st pass hepatic metabolism, so not much enters systemically

55
Q

What cause true rigors?

A

Influenza

Bacteria

56
Q

Is there a clinical benefit in treating asymptomatic bacteriuria?

A

No
Exceptions
- Pregnancy
- Patients undergoing urology procedures

57
Q

Why is asymptomatic bacteriuria usually not treated?

A

Exposes patient to complications

Promotes antibiotic resistance

58
Q

Signs of splinter haemorrhages and Janeway lesions suggest what?

A

Infective endocarditis

59
Q

What is MRSA resistant to?

A

All beta-lactams

60
Q

Describe penicillin G

A

Beta-lactam
Also called benzylpenicillin
Narrow spectrum
Mainly active against Gram positive bacteria
Inactivated by beta-lactamases
IV administration
Treatment of choice for susceptible infections; eg: pneumococcal pneumonia

61
Q

Describe flucloxacillin

A 
Beta-lactamase
Food impairs absorption
Dosed at 6-hourly intervals
Usually well tolerated
Rarely associated with
- Cholestatic jaundice, especially in older patients on prolonged therapy
IV/oral
62
Q

Describe ceftriaxone

A

3rd generation cephalosporin
Broad spectrum
- Including majority of community-associated enteric Gram negative rods
- Less active against Staphylococcus
Inactive against MRSA
Anti-staphylococcal activity dose dependent
Not useful against enterococci
Effective in meningitis
Risk-benefit ratio in neonates
Shouldn’t be mixed with Ca-containing IV solutions

63
Q

Describe gentamicin

A

Aminoglycoside
Broad spectrum activity against Gram negative bacteria
- Including P aeruginosa

64
Q

Describe ciprofloxacin

A 
Quinolone
Reserved for 
- Infections resistant to other drugs
- Oral therapy when alternative antibiotics not available
Broad spectrum activity against Gram negative bacteria
- Haemophilus influenzae
- Enteric Gram negative rods
- P aeruginosa
- Gram negative cocci
- Some Gram positive cocci
- Legionella
- Several mycobacteria
Not active against anaerobes
Poor activity against streptococci
65
Q

Describe vancomycin

A

Glycopeptide
Broad spectrum activity against Gram positive bacteria
Primary indication: treatment for
- MRSA
- Methicillin-resistant coagulase negative staphylococci; eg: S epidermidis
- Enterococcus faecium
Used in people with penicillin hypersensitivity
Oral vancomycin reserved for severe cases/those not responding to metronidazole when treating C difficile
- To avoid development of VRE

66
Q

Describe metronidazole

A 
Nitroimidazole
Broad spectrum activity against 
- Gram negative anaerobic bacteria
- Gram positive anaerobic bacteria
- Helicobacter pylori
- Protozoa
Can cause disulfiram-like reaction when used with alcohol
- Abstain during treatment for up to 72 hours after completing course
67
Q

Describe doxycycline

A

Tetracycline
Broad spectrum
- Gram positive and negative bacteria
- Chlamydia
- Rickettsia
- Mycoplasma
- Spirochetes
- Some non-TB mycobacteria
- Some protozoa; eg: malaria-causing Plasmodium
Can cause oesophagitis
Should be taken with food and full glass of water
Can cause photosensitivity
Tooth discolouration and enamel dysplasia in children
- Reactions minimal if single short courses used

68
Q

Describe acyclovir

A 
Nucleic acid analogue
Primarily used for treatment of 
- HSV
- Chickenpox (VZV)
- Shingles (VZV)
Other uses
- Prevention of CMV infections after transplant
- Severe complications of EBV
IV/oral

MD2 Foundation (42 decks)

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