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YEAR 3 DRUGS > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

An example of a broad spectrum penicillin?

A

Amoxicillin

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2
Q

An example of a narrow spectrum penicillin?

A

Benzylpenicillin (Pen G)

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3
Q

What diseases are penicillins used in?

A

Strep Infections
Endocarditis
Meningitis - meningoccal infections
Tetanus

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4
Q

What spectrum of bacteria do narrow and broad treat in penicillins?

A

Narrow spectrum is just gram positive

Broad spectrum is gram positive and negative

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5
Q

How do penicillins work?

A

Inhibit crosslinking of cells walls in bacteria
Weakens wall
Caused uncontrolled entry of water in many ways
Beta Lactam ring is responsible for this

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6
Q

What are penicillins ineffective against?

A

MRSA, Staph Aureus - have beta lactamase

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7
Q

What is so special about flucloxacillin?

A

Has a side chain which prevents bacteria beta lactamase from binding and having an effect

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8
Q

What are the side effects of Penicillins?

A

Hypersensitivity

GI disturbances

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9
Q

What are the contraindications of Penicillin?

A

History of allergy

Renal impairment

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10
Q

What are the important interactions of penicillins?

A

Reduce renal excretion of MTX - can cause toxicity

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11
Q

Name an example of a cephalosporin and give its spectrum?

A

Cephradine/Cefotazime - broad spectrum

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12
Q

What diseases are cephalosporins used in?

A

Urinary
RT organisms
Complicated infections - meningitis, septicaemia, pneumonia
Surgical prophylaxis

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13
Q

How do cephalosporins work?

A

Beta lactam ring, so same effect as penicillins

More resistant to beta lactamase though

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14
Q

What are the side effects of cephalosporins?

A

Hypersensitivity reactions

Antibiotic associated colitis

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15
Q

What are the contraindications of cephalosporins?

A

C.dif risk

Allergy to penicillins

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16
Q

What are the important interactions of cephalosporins?

A

Enhance warfarin effect by killing vit K gut bacteria
Can increase nephrotoxicity of aminoglycosides
Decrease effectiveness of OCP

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17
Q

What drug class is erythromycin?

A

Macrolide

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18
Q

What are macrolides indicated for?

A

Alternative to penicillin
Gram positive and some negatives
Mycoplasma pneumoniae (clarithromycin especially)
Eradication of H pylori

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19
Q

How do macrolides work?

A

Broad spectrum bacteriostatic

Inhibits protein synthesis

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20
Q

What are the side effects of macrolides?

A

GI irritant
Antibiotic associated colitis
Liver abnormalities
Ototoxicity at high doses

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21
Q

What are the contraindications of macrolides?

A

Renal/hepatic impairment

Allergy

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22
Q

What are the important drug interactions of macrolides

A

Erythromycin and Clarithromycin inhibit P450 enzymes
Statins increased chance of myopathy
Warfarin increased risk of bleeding
Drugs that prolong the QT interval - SSRIs, quinolones, amiodarone

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23
Q

What drug class is trimethoprim?

A

Trimethoprim

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24
Q

What is Trimethoprim indicated for?

A 
Uncomplicated UTI
Pneumocystis pneumonia (co-trimoxazole)
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25
Q

How does Trimethoprim work?

A

It interferes with folic acid absorption from host and therefore bacteria are unable to replicate DNA

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26
Q

What are the side effects of Trimethoprim?

A

GI disturbance
Pruritus
Rashes
Hyperkalaemia

27
Q

What are the contraindications of Trimethoprim?

A 
First trimester pregnancy
Folate deficiency
Renal impairment
Neonates
Elderly
28
Q

What are the important drug interactions of Trimethoprim?

A

Potassium elevating drugs (ACEi, angiotensin blockers) - hyperkalaemia
MTX is a folate antagonist as well
Phenytoin increases folate metabolism - increase risk of haematological effects

29
Q

What are Tetracyclines indicated for?

A 
Acne
LRTI
Used in malaria prophylaxis
Chlamydia
Lyme disease
Syphilis
30
Q

How do Tetracyclines work?

A

Inhibits protein synthesis in bacteria - binds to 30s

31
Q

What are the side effects of Tetracyclines ?

A 
GI disturbance
Allergy
Oesophageal irritation
Photosensitivity
Discolouration and hypoplasia of tooth enamel in children
32
Q

What are the contraindications of Tetracyclines ?

A

Renal impairment
Pregnancy
Breastfeeding
Children <12 yrs

33
Q

What are the important drug interactions of Tetracyclines ?

A

Enhance warfarin effect due to Vit k bacteria killed

34
Q

What drug class is Gentamicin?

A

Aminoglycosides

35
Q

What are Aminoglycosides indicated for?

A 
Aerobic gram negative
Severe sepsis
Pyelonephritis
Biliary problems
Endocarditis
36
Q

How do Aminoglycosides work?

A

Inhibit protein synthesis

Irreversibly bind to 30s subunit

37
Q

What are the side effects of Aminoglycosides ?

A

Nephrotoxicity

Ototoxicity - tinnitus (irreversible cochlear damage)

38
Q

What are the contraindications of Aminoglycosides ?

A

Neonates and elderly susceptible to renal impairment

Myasthenia gravis - can impair neurotransmitter

39
Q

What are the important drug interactions of Aminoglycosides ?

A

Loop diuretics increase chance of ototoxicty

Nephrotoxicity more likely with ciclosporin, cephalosporins, vancomycin, chemotherapy

40
Q

What drug class is Ciprofloxacin?

A

Quinolones

41
Q

What are Quinolones indicated for?

A

UTI
Severe GI infection
LRTI
Psuedomonas Aeruginosa

42
Q

How do Quinolones work?

A

Kills bacteria by inhibiting DNA synthesis

43
Q

What are the side effects of Quinolones?

A 
GI upset
Allergy
Lowers seizure threshold
Rupture of muscle tendons
Prolong QT interval
Colitis - antibiotic associated
44
Q

What are the contraindications of Quinolones?

A

If at risk of seizures
Not in growing children due to risk of arthropathy
Cardiac Disease

45
Q

What are the important drug interactions of Quinolones?

A

Increased toxicity of drugs metabolised by P450
In particularly theophylline
When given with NSAIDs increases risk of seizures
Prednisolone increases risk of tendon rupture
Problem in drugs that prolong QT interval - inc macrolides

46
Q

What drug class is Nitrofurantoin?

A

Nitrofurantoin

47
Q

What is Nitrofurantoin indicated for?

A

Uncomplicated lower UTI
Gram negative E. Coli
Gram positive Staph Saprophyticus

48
Q

How does Nitrofurantoin work?

A

Is metabolised by bacterial cells

The active metabolite damages DNA

49
Q

What are the side effects of Nitrofurantoin ?

A 
GI upset
Delayed hypersensitivity reactions
Turn urine dark yellow or brown
Chronic pulmonary reactions e.g. fibrosis
Hepatitis
Peripheral neuropathy
Haemolytic anaemia
50
Q

What are the contraindications of Nitrofurantoin ?

A

Pregnant women close to term
Babies in the first three months of life
Renal impairment
Chronic use causes adverse effects in elderly population

51
Q

What are the important drug interactions of Nitrofurantoin ?

A

No significant ones

52
Q

What is resistant to Nitrofurantoin?

A

Klebsiella

53
Q

What drug class is Metronidazole?

A

Anaerobic antimicrobials

54
Q

What is Metronidazole indicated for?

A

C.Dif infection (gram positive)
Gram negative anaerobes:
- oral infections: aspiration pneumonia
- surgical or gynaecological infections from colon
Protozoal infections - amoebic dysentery, giardiasis

55
Q

How does Metronidazole work?

A

Enters bacterial cells via passive diffusion
Anaerobic bacteria reduce the metronidazole thus generating nitroso free radicals
Causes widespread damage
Aerobic bacteria are incapable of doing this

56
Q

What are the side effects of Metronidazole?

A 
GI upset
Delayed hypersensitivity reaction
Prolonged high dose course:
-Optic neuropathy
-Seizures
-Peripheral neuropathy
-Encephalopathy
57
Q

What are the contraindications of Metronidazole?

A

Metabolised by P450, so if liver disease reduce dose

Do not drink alcohol - disulfiram like effect

58
Q

What are the important drug interactions of Metronidazole?

A

Has an inhibitory effect on P450 enzymes as well
So will increase effect of warfarin and phenytoin
P450 inducers will reduce plasma conc of metronidazole though and therefore reduce efficacy

59
Q

What drug class does Vancomycin belong to?

A

Glycopeptides

60
Q

What is Vancomycin indicated for?

A

Gram positive endocarditis: MRSA

C. Dif

61
Q

How does Vancomycin work?

A

Inhibits growth and cross linking of peptidoglycan chains
Inhibits synthesis of cell wall in Gram positive bacteria
Is inactive against most gram negative bacteria

62
Q

What are the side effects of Vancomycin?

A 
Thrombophlebitis: pain and inflammation of vein at IV site
Anaphylatic reactions - redman syndrome
IV Vancomycin:
- Nephrotoxicty
- Ototoxicity 
Delayed hypersensitivity reaction
63
Q

What are the contraindications of Vancomycin?

A

Renal impairment

Ototoxicity in elderly

64
Q

What are the important drug interactions of Vancomycin?

A

Aminoglycosides, diuretics, ciclosporin increase risk of nephrotoxicity or ototoxicity

YEAR 3 DRUGS (8 decks)

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