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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
How does Trimethoprim work?
It interferes with folic acid absorption from host and therefore bacteria are unable to replicate DNA
26
What are the side effects of Trimethoprim?
GI disturbance Pruritus Rashes Hyperkalaemia
27
What are the contraindications of Trimethoprim?
``` First trimester pregnancy Folate deficiency Renal impairment Neonates Elderly ```
28
What are the important drug interactions of Trimethoprim?
Potassium elevating drugs (ACEi, angiotensin blockers) - hyperkalaemia MTX is a folate antagonist as well Phenytoin increases folate metabolism - increase risk of haematological effects
29
What are Tetracyclines indicated for?
``` Acne LRTI Used in malaria prophylaxis Chlamydia Lyme disease Syphilis ```
30
How do Tetracyclines work?
Inhibits protein synthesis in bacteria - binds to 30s
31
What are the side effects of Tetracyclines ?
``` GI disturbance Allergy Oesophageal irritation Photosensitivity Discolouration and hypoplasia of tooth enamel in children ```
32
What are the contraindications of Tetracyclines ?
Renal impairment Pregnancy Breastfeeding Children <12 yrs
33
What are the important drug interactions of Tetracyclines ?
Enhance warfarin effect due to Vit k bacteria killed
34
What drug class is Gentamicin?
Aminoglycosides
35
What are Aminoglycosides indicated for?
``` Aerobic gram negative Severe sepsis Pyelonephritis Biliary problems Endocarditis ```
36
How do Aminoglycosides work?
Inhibit protein synthesis | Irreversibly bind to 30s subunit
37
What are the side effects of Aminoglycosides ?
Nephrotoxicity | Ototoxicity - tinnitus (irreversible cochlear damage)
38
What are the contraindications of Aminoglycosides ?
Neonates and elderly susceptible to renal impairment | Myasthenia gravis - can impair neurotransmitter
39
What are the important drug interactions of Aminoglycosides ?
Loop diuretics increase chance of ototoxicty | Nephrotoxicity more likely with ciclosporin, cephalosporins, vancomycin, chemotherapy
40
What drug class is Ciprofloxacin?
Quinolones
41
What are Quinolones indicated for?
UTI Severe GI infection LRTI Psuedomonas Aeruginosa
42
How do Quinolones work?
Kills bacteria by inhibiting DNA synthesis
43
What are the side effects of Quinolones?
``` GI upset Allergy Lowers seizure threshold Rupture of muscle tendons Prolong QT interval Colitis - antibiotic associated ```
44
What are the contraindications of Quinolones?
If at risk of seizures Not in growing children due to risk of arthropathy Cardiac Disease
45
What are the important drug interactions of Quinolones?
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
What drug class is Nitrofurantoin?
Nitrofurantoin
47
What is Nitrofurantoin indicated for?
Uncomplicated lower UTI Gram negative E. Coli Gram positive Staph Saprophyticus
48
How does Nitrofurantoin work?
Is metabolised by bacterial cells | The active metabolite damages DNA
49
What are the side effects of Nitrofurantoin ?
``` GI upset Delayed hypersensitivity reactions Turn urine dark yellow or brown Chronic pulmonary reactions e.g. fibrosis Hepatitis Peripheral neuropathy Haemolytic anaemia ```
50
What are the contraindications of Nitrofurantoin ?
Pregnant women close to term Babies in the first three months of life Renal impairment Chronic use causes adverse effects in elderly population
51
What are the important drug interactions of Nitrofurantoin ?
No significant ones
52
What is resistant to Nitrofurantoin?
Klebsiella
53
What drug class is Metronidazole?
Anaerobic antimicrobials
54
What is Metronidazole indicated for?
C.Dif infection (gram positive) Gram negative anaerobes: - oral infections: aspiration pneumonia - surgical or gynaecological infections from colon Protozoal infections - amoebic dysentery, giardiasis
55
How does Metronidazole work?
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
What are the side effects of Metronidazole?
``` GI upset Delayed hypersensitivity reaction Prolonged high dose course: -Optic neuropathy -Seizures -Peripheral neuropathy -Encephalopathy ```
57
What are the contraindications of Metronidazole?
Metabolised by P450, so if liver disease reduce dose | Do not drink alcohol - disulfiram like effect
58
What are the important drug interactions of Metronidazole?
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
What drug class does Vancomycin belong to?
Glycopeptides
60
What is Vancomycin indicated for?
Gram positive endocarditis: MRSA | C. Dif
61
How does Vancomycin work?
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
What are the side effects of Vancomycin?
``` Thrombophlebitis: pain and inflammation of vein at IV site Anaphylatic reactions - redman syndrome IV Vancomycin: - Nephrotoxicty - Ototoxicity Delayed hypersensitivity reaction ```
63
What are the contraindications of Vancomycin?
Renal impairment | Ototoxicity in elderly
64
What are the important drug interactions of Vancomycin?
Aminoglycosides, diuretics, ciclosporin increase risk of nephrotoxicity or ototoxicity

YEAR 3 DRUGS (8 decks)

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