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Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Antibiotic targets

A

Peptidoglycan cell wall (Beta-lactams, Vancomycin)

Ribosomes (Macrolides, Clindamycin, Chloramphenicol, Gentamicin, Doxycycline)

DNA (Quinolones, Rifampicin)

Metabolism (Trimethoprim, Metronidazole)

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2
Q

Bactericidal

A

Sterilises infected site by directly killing bacteria

Releases toxins and inflammatory material

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3
Q

Bacteriostatic

A

Suppresses growth but doesn’t achieve sterility

Requires additional immune cell-mediated killing

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4
Q

Anaerobic bacteria

A

Bacteroids

Clostridium

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5
Q

Aerobic gram + bacteria

A

Thick peptidoglycan cell wall, stain purple

Streptococcus
Enterococcus
Staphylococcus

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6
Q

Aerobic Gram - bacteria

A

Thin peptidoglycan cell wall, stain pink
Outer membrane and periplasm

E. coli
Other coliforms
Neisseria
Haemophilus
Pseudomonas
Klebsiella pneumoniae
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7
Q

Guided therapy

A

Antibiotic selected specific to identified bacteria

Narrow spectrum - little impact on colonisation/resistance

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8
Q

Empirical therapy

A

Used when cannot wait for culture result
Best educated guess based on clinical presentation

Broad spectrum - big impact on colonisation/resistance

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9
Q

Beta-lactams

A

Inhibits cross linking of peptidoglycan cell wall

Frequent gram -ve and Staph resistance due to beta-lactamase production

Penicillins
Cephalosporins
Carbapenems
Monobactams

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10
Q

Benzylpenicillin

A

Strep
Neisseria
Clostridium

Main use in Erysipelas

IV

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11
Q

Flucloxacillin

A

Staph / Strep soft tissue infection

Oral

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12
Q

Amoxicillin

A 
Strep
Enterococcus
Neisseria
Haemophilus
Clostridium

Oral

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13
Q

Co-amoxiclav

A

Amoxicillin with Clavulonic acid (beta-lactamase inhibitor)

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14
Q

Tazocin

A

Piperacillin with tazobactam (beta-lactamase inhibitor)

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15
Q

Adverse effects of penicillins

A

GI toxicity

  • Nausea, vomiting
  • Diarrhoea
  • Cholestasis

Hypersensitivity

  • Type I or IV
  • Interstitial nephritis
  • Cross-reactivity low

Infection

  • Candidiasis
  • C. diff
  • Resistant bacteria

Seizure
Haemolysis
Leukopaenia

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16
Q

Ceftriaxone (cephalosporins)

A

Broad spec - except pseudomonas and enterococcus

More resistant to beta-lactamases than penicillins

17
Q

Meropenem (carbapenems)

A

Ultra-broad spec

Resistant to beta-lactamases

18
Q

Vancomycin (glycopeptides)

A

TREATS MRSA

Not dependent on PBP so effective against resistant bacteria

IV (oral for C.diff)

Adverse effects

  • nephrotoxicity, red-man syndrome, ototoxicity
  • narrow therapeutic range
  • beware under/overdosing
19
Q

50s subunit targets

A

Macrolides
Clindamycin
Chloramphenicol

20
Q

Erythromycin, Clarithromycin, Azithromycin (macrolides)

A

Gram +
Resp gram -
Atypicals

Oral

Adverse effects

  • diarrhoea, vomiting
  • QT prolongation
  • hearing loss
  • Clarithromycin has >400 drug interactions including simvastatin, atorvastatin and warfarin
21
Q

Clindamycin

A

Staph
Strep
Anaeobes

Stops exotoxin production so used in toxic shock syndrome and necrotising fascitis

Oral

22
Q

Chloramphenicol

A

Broad spec

Bacterial meningitis when beta-lactam allergy

Very toxic - BM suppression, aplastic anaemia, optic neuritis

23
Q

30s subunit targets

A

Aminoglycosides

Tetracyclines

24
Q

Gentamicin (aminoglycoside)

A

Broad spec

Once-daliy dose for 3 days only

Initial high dose to achieve bactericidal effect
Bacteriostatic effect lasts long post-antibiotic

Trough level measured to monitor clearance

Very toxic - nephrotoxicity, ototoxicity, neuromuscular blockade in myasthenia gravis

Not used in pregnancy

25
Q

Quinolones

A

Inhibit DNA gyrate

Ciprofloxacin - UTI/abdo infections

Levofloxacin - resp tract

Not used in pregnancy

26
Q

Rifampicin

A

Inhibits RNA polymerase

TB

Interactions - CYP450 inducer, affects hepatic metabolism of drugs

27
Q

Trimethoprim

A

Inhibit folate metabolism

28
Q

Metronidazole

A

Uncomplicated UTI

Oral

Elevates serum creatinine/K+

Not used in pregnancy during 1st trimester

29
Q

Metronidazole

A

Used for C. diff infection

Nasty reaction when alcohol consumed - projectile vomiting!

30
Q

Which two antibiotics can be used in an uncomplicated lower UTI?

A

Trimethoprim

Nitrofurantoin

31
Q

C. differgic antibiotics

A

Clindamycin
Co-amoxiclav
Cephalosporins
Ciprofloxacin

32
Q

Which antibiotics are safe to use in pregnancy?

A

Beta-lactams
Macrolides
Anti-tuberculants

33
Q

Which antibiotics are NOT safe to use in pregnancy?

A 
Tetracyclines
Trimethoprim
Nitrofurantoin
Aminoglycosides
Quinolones
34
Q

ESBL

A

Extended spectrum beta-lactamases

Resistant to beta-lactams AND cephalosporins

Treatment options include ciprofloxacin, temocillin, gentamicin and meropenem

Pharmacology (10 decks)

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