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YR3 Therapeutics > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Examples of commonly used penicillins

A

Amoxocillin

Co-Amoxiclav

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2
Q

Mechanism of action of penicillins

A

Prevent cross bridging between peptidoglycan cell walls
Weakens cell wall > swelling, lysis then death of bacteria
Beta lactic ring provides antimicrobial properties
Side chains are modifiable

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3
Q

Spectrum of activity of amoxocillin

A

Broad spectrum gram -ve

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4
Q

Spectrum of activity of co-amoxiclav

A

Broad spectrum, gram -ve + beta lactase organisms

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5
Q

Indications for use of pencillin

A
  1. Emprical in pneumonia
  2. Empirical in UTI (trimethoprim and nitrofur. are alts.)
  3. As combo therapy in H. pylori associated PUD
  4. Co-amox: HAIs and abdominal sepsis
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6
Q

Contraindications of use of penicillins

A
  1. allergy
  2. reduce dose in renal impairment
  3. CDIFF risk
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7
Q

Side effects of penicillin

A
  1. CDIFF
  2. Alelrgic reaction
  3. GI disturbances
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8
Q

Interactions of penicillins

A
  1. MTX (may cause toxicity in body)

2. Enhance the effect of warfarin

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9
Q

Examples of first generation cephalosporins

A

Cephradine

Cefalexin

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10
Q

Examples of third generation cephalosporins

A

Cefotaxime

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11
Q

Mechanism of action of cephalosporins

A

Same as penicillin

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12
Q

Spectrum of activity of cephalosporins

A

Broad spectrum
Gram negative bacteria
Naturally more resistant to beta lactamases

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13
Q

Indications for use of cephalosporins

A
  1. PO: 2nd/3rd line treatment of UTI or RTI

2. IV: very severe or complicated infections or resistant organisms

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14
Q

Contraindications for use of cephalosporins

A
  1. allergy
  2. CDIFF risk
  3. reduce dose in renal impairment
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15
Q

Which condition should carbapenems be carefully prescribed in

A

Epilepsy

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16
Q

Side effects of cephs and carbs

A
  1. CDIFF
  2. Allergic reaction i.e. nausea to hypersensitivity
  3. CNS toxicity (carbs) esp. in renal impairment
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17
Q

Interactions of cephs and carbs

A

Increase activity of warfarin

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18
Q

Mechanism of action of trimethoprim

A

Inhibits folate synthesis in bacterial cells so slows bacterial cell growth

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19
Q

Spectrum of activity of trimethoprim

A

Gram + and -

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20
Q

Which antibiotic is trimethoprim used with to make it bactericidal

A

Sulfonamide

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21
Q

Indications for the use of trimethoprim

A
  1. First line UTI

2. Prevent and treat pneumocystis pneumonia in immunocompromised

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22
Q

Contraindications to trimethoprim

A
  1. do not give in trim 1 of preg
  2. folate deficient patients - take care
  3. renal impaired - reduce dose
  4. neonates, old and HIV people most susceptible to SEs
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23
Q

Side effects of trimethoprim

A
  1. GI upset
  2. Hypersensitivity reactions (uncommon)
  3. Haematological disorders (uncommon)
  4. hyperkalaemia
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24
Q

Interactions of trimethoprim

A
  1. if used with potassium elevating drugs - hyperkalaemia
  2. if used with folate antagonists/drugs that increase folate metabolism - haematological disorders
  3. Enhance the effect of warfarin
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25
Q

Mechanism of action of nitrofurantoin

A

Metabolised by bacterial cells. Active metabolite damages DNA and kills cell

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26
Q

Spectrum of activity of nitrofurantoin

A

Gram +/- bacteria common to urinary tract infections

Does not work against klebsiella and proteus spp

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27
Q

Indications for use of nitrofurantoin

A

Uncomplicated UTI as 1st line treatment

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28
Q

Contraindications of nitrofurantoin

A
  1. Pregnancy
  2. Neonates
  3. Renal impariment
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29
Q

Side effects of nitrofurantoin

A

Nausea, vomiting, diarrhoea
Chronic pulmonary reactions
Peripheral neuropathy
Haemolytic anaemia in neonates

30
Q

How do tetracyclines work?

A

They prevent the polypeptide chain from growing at the ribosome

31
Q

Indications for use of tetracyclines

A
  1. Acne
  2. LRTI: COPD exacerbation, Pneumonia
  3. Chlamydia
32
Q

Contraindications of tetracylines

A
  1. Pregnancy
  2. Breastfeeding
  3. Child<12
  4. Renal impairment
33
Q

Side effects of tetracyclines

A

General abx side effects: nausea, nom, diarrhoea

Specific: oesophagus irritation, photosensitivity, discolouration of teeth in children

34
Q

Interactions of tetracycline

A
  1. Increase effect of warfarin

2. Do not give within 2 hours of calcium, antacids or ion

35
Q

Gentamicin is an example of what class of aBX

A

Aminoglycoside

36
Q

How do aminoglycosides work?

A

Bind to the 30s subunit and inhibit protein synthesis.

Bactericidal

37
Q

Spectrum of activity of aminoglycosides

A 
Gram neg aerobic bacteria:
Mycobacteria
Pseudomonas
E. coli
many more
38
Q

Which organisms have innate resistance to ahminoglycosides?

A

Streptococci

Anaerobic bacteria

39
Q

Indications for use of aminoglycosides

A
  1. Severe sepsis
  2. Complicated UTI or pylenephritis
  3. Endocarditis
40
Q

Which drugs should ahminoglycosides be combined with if the causative organism is unknown?

A

Penicillin or metronidazole

41
Q

Contraindications to the use of aminoglycosides

A
  1. Renal impairment (take care)

2. Neonates and elderly (can but should be monitored)

42
Q

Side effects of aminoglycosides

A

Nephro/Ototoxicity

43
Q

Interactions and aminoglycosides

A

Ototoxicity risk higher when taken with loop diuretics or vancomycin

Nephrotoxocity risk higher when taken with vancomycin, cyclosporine or cephalosporins

44
Q

Examples of macrolides

A

Erythromycin
Clarithromycin
Azithromycin

45
Q

How do macrilides work

A

Bind to the 50s subunit and block elongation of the polypeptide chain

46
Q

Spectrum of activity of erythromycin

A

Gram +ve and some gram -ve

47
Q

Spectrum of activity of clarithromycin and azithromycin

A

Increased activity against gram negative + positive inc H. influenza

48
Q

Indication for use of a macrolide

A
  1. severe pneumonia with a penicillin
  2. Resp and soft tissue infections]
  3. Eradication of H. pylori with PPU + amoxicillin or metronidazole
49
Q

Contraindications for use of a macrolide

A
  1. Severe hepatic impairment
  2. Renal impairment
  3. Allergy
50
Q

Side effects of macroldies

A

Nausea and vomiting
Abdominal pain
DIarrhoea
Prolongs QT interval

51
Q

floxacin suffix indicates which drug type?

A

Quinolones

52
Q

Mechanism of action of quinolones

A

Inhibit DNA synthesis

53
Q

Which common quinolone have activity against both positive and negative bacteria

A

Moxifloxacin

Levofloxacin

54
Q

Indications for use of quinolones

A

Reserved as 2/3 line treatment

  1. UTI
  2. Moxi/Levofloxacin: LRTI
  3. Severe GI infection
  4. Ciprofloxacin: Pseudomnonas
55
Q

CI of quinolones

A

Use in caution in people with:

Risk of seizure
Prolonged QT
Those who are growing

56
Q

Side effects of quinolone

A

General and side effect: GI disturbance

Specific: neurological (lowers seizure threshold), muscle tendon rupture, prolong QT interval, promote C.Diff

57
Q

Interactions and quinolones

A
  1. Ciprofloxacin is a Cytp450 inhibitor
  2. Used with NSAIDs may increase risk of seizure
  3. Used with prednisone increases risk of tendon rutpure
58
Q

Example of an aerobic abx

A

Metranidazole

59
Q

MoA of metranidazole

A

Passive diffusion into bacterial cell
Converted to free radical
Causes DNA damage and degradation and cell death

60
Q

Spectrum of activity of metranidazole

A

Anaerobic bacteria and protozoa

61
Q

Indications for use of metranidazole

A
  1. Abx associated colitis
  2. Dental abscesses
  3. Aspiration pneumonia
  4. Protozoal infection
  5. surgical infections caused by anaerobes
62
Q

CI of metranidazole

A

Do not take with alcohol

Reduce dose in hepatic impaired

63
Q

Side effects of metrandizaole

A 
GI upset
Hypersensitivity 
Optic and peripheral neuropathy
Seizures
Encephalopathy
64
Q

Interactions of metrandizaole

A

Can act as inhibitor of Cytop450 enzymes:

  • reduce metabolism of warfarin = bleeding
  • reduce metabolism of phenytoin = toxicity
65
Q

Example of a glycopeptide

A

Vancomycin

66
Q

Mechanism of action of glycopeptides

A

Inhibit synthesis of the bacterial cell wall

67
Q

Spectrum of activity of glycopeptides

A

Gram positive aerobic and anaerobic bacteria

68
Q

Indications for use of glycopeptides

A
  1. Endocarditis

2. Antibiotic associated colitis caused by C.Diff

69
Q

CI of glycopeptides

A

Careful monitoring required

Reduce dose in renal impairment/elderly

70
Q

Side effects of glypoeptides

A

Thrombophlebitis
Red man syndrome if infused rapidly
Nephrotoxicity / Ototoxicity if given IV
Blood disorders if given IV

71
Q

Interactions and glycopeptide

A

Increased risk of oto/nephrotoxicity if given with loop diuretics, ciclosporin and aminoglycosides

YR3 Therapeutics (8 decks)

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