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Year 3 Drugs + Core Conditions > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

what are the 5 main classes of antibiotic

A 
Cell wall synthesis inhibitors
Protein Synthesis Inhibitors
DNA synthesis inhibitors
RNA synthesis inhibitors
Plasma membrane agents
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2
Q

Example of cell wall synthesis inhibitors

A

Beta lactams

Glycopeptides

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3
Q

examples of protein synthesis inibitors

A

aminoglycosides
macrolides
tetracyclines
oxazolidinones

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4
Q

examples of DNA synthesis inhibitors

A

trimethroprim
sulphonamides
quinolones
fluoroquinolones

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5
Q

example of RNA synthesis inhibitors

A

rifampicin

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6
Q

example of plasma membrane agents

A

daptomycin

polymycin

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7
Q

which abx are beta-lactams

A

penicillins, cephalosporins, monobactams, carbapenems

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8
Q

examples of some glycopeptides

A

vancomycin

teicoplanin

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9
Q

examples of an aminoglycoside, and some of their side effects

A

gentamycin

nephrotoxic and ototoxic

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10
Q

examples of some macrolides

A

erythromycin
clarithromycin
clindamycin

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11
Q

which bacteria are penicillins active against

A

broad spectrum
gram +ve infections = streptococcus, staphylococcus
gram -ve infections = H. influenzae, E.coli
H. pylori

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12
Q

why isn’t amoxicillin used in staph aureus infections

A

Staph aureus secretes beta-lactamase - destroys beta lactam ring

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13
Q

which penicillin is only active against gram +ve infections

A

flucloxacillin

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14
Q

what combination antibiotic can treat infections with beta-lactamase secreting organisms

A

amoxicillin + clavalunic acid = co-amoxiclav

can now target staph aureus, gram-ve anaerobes

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15
Q

what is amoxicillin typically used to treat

A

gram +/-ve pneumonia (strep pneum/h. influenzae)
UTI - E. coli
HAP, inta-abdominal sepsis

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16
Q

what is the main alternative to amoxicillin in allergic patients?

A

Clarithromycin

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17
Q

if a patient is allergic to amoxicillin, which other drugs are they allergic too?

A

Cephalosporins (cefradine, cefuroxime, Cefotaxime)

monobactams, carbapanems (meropenem)

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18
Q

indications of Cephradine?

A

2nd/3rd line treatment of urinary/respiratory tract infections
IV reserved for severe/complicated infections
Abx resistant organisms

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19
Q

what effect do most abx have on warfarin

A

abx kill gut flora, which synthesis vitamin K

warfarin effect increased

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20
Q

what class of drug is trimethroprim, and how does it work

A

antifolate Abx

bacteriostatic as slows folate synthesis

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21
Q

which bacteria is trimethroprim effective against

A

gram +ve and -ve

particularly E.coli

22
Q

important contraindications of trimethoprim and nitrofurantoin

A

pregnancy - both will cause fetal abnormalities

23
Q

what effect does trimethoprim have on potassium

A

increases is

caution with potassium raising drugs - e.g. aldosterone antagonists, ACEi, AT blockers

24
Q

how does nitrofurantoin work?

A

metabolised by bacterial cells

active metabolite damages bacterial DNA and causes cell death

25
Q

which organisms is nitrofurantoin active against

A

gram -ves - E.coli
Gram +ves - staph saprophyticus, enterococcus
common UTI

26
Q

mechanism of action of tetracyclines and aminoglycosides

A

inhibits bacterial protein synthesis

binds to 30S unit of ribosome

27
Q

indications of doxycycline

A

acne vulgaris

Lower respiratory tract infections - infective exacerbation of COPD, pneumonia

28
Q

contraindications of tetracyclines

A

bind to teeth and bones during fetal development
don’t prescribe in pregnancy, or children under 12
avoid in renal impairment

29
Q

mechanism of action of macrolides

A

inhibit protein synthesis

bind to 50S sub-unit, block translocations

30
Q

which bacteria is gentamicin active against

A

gram -ve aerobes = E.coli, ESBL, pseudomonas

Gram +ve = MRSA, MSSA

31
Q

indications for gentamicin

A

pyelonephritis, complicated UTI
biliary/intr-abdominal sepsis
endocarditis

32
Q

what makes the side effects of gentamicin more likely

A 
Ototoxic = loop diuretics, vancomycin
Nephrotoxic = ciclosporin, cephalosporin, vancomycin
33
Q

which infections are macrolides used for?

A

Gram +ve: staph aureus, streptococcus

Gram -ve: atypical pneumonias

34
Q

side effects of erythromycin

A 
N+V, abdo pain
thrombophlebitis if given IV
Cholestatic jaundice
Prolong QT interval - arrhythmias
ototoxic at high doses
35
Q

effects of macrolides on the CyP450 system

A

inhibitory, increase plasma concentrations of other drugs

36
Q

which other drugs prolong the QT interval

A

ciprofloxacin
amiodarone
antipsychotics
SSRIs

37
Q

class and mechanism of action of ciprofloxacin

A

Quinolone

inhibits DNA synthesis

38
Q

Indications for ciprofloxacin

A

Gram -ves:

H. influenzae, E.coli, atypical pneumonias

39
Q

how does metronidazole work and what is it used against?

A

DNA destroyer

only affective against anaerobic bacteria and protozoa

40
Q

indications for metronidazole

A

anaerobic infection
abx associated c.diff (gram +ve anaerobe)
dental abscess
aspiration pneumonia
surgical/gynae infections by anaerobes from the colon

41
Q

what is important to remember about metronidazole

A

patient cannot drink alcohol!

otherwise, flushing, headache, nausea, vomiting

42
Q

mechanism of action of glycopeptides

A

inhibits bacterial cell wall synthesis in gram +ve aerobes/anaerobes
inactive against gram -ves

43
Q

indication for vancomycin

A

endocarditis, MRSA, C.diff (second line)

44
Q

side effects of vancomycin

A

if infused rapidly - can cause erythema, hypotension, bronchospasm
IV can cause nephron/ototoxicity

45
Q

what type of cell are gram +ves

name some examples

A

cocci

enterococcus, staph aureus, MRSA, streptococcus

46
Q

what type of cell are gram -ves

name some examples

A

rods (bacilli)

Neisseria meningitides, H.influenzae, E.coli, EBSL, psuedomonas

47
Q

are anaerobes and atypical pneumonias gram +ve or -ve

A

Gram -ve

apart from C. diff

48
Q

What are the cephalosporin generations and what are the differences between them

A

each new generation has greater gram-ve activity, although less gram +ve action
1st generation = Cefradine
2nd generation = Cefuroxime
3rd generation = cefotaxime

49
Q

common side effect to be aware of when using cephalosporins

A

abx associated colitis

50
Q

what is flucloxacillin used for?

A

MSSA - methicillin sensitive staphylococcus aureus (++++)
Streptococcus (+)
skin infections, endocarditis

51
Q

most effective drug for treating streptococcal infection

A

benzylpenicillin

Year 3 Drugs + Core Conditions (23 decks)

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