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Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

What are the main targets of antibiotics

A

Cell wall synthesis
Protein synthesis
DNA synthesis

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2
Q

What are the types of antibiotics that target cell wall synthesis

A

Beta lactams:
Penicillins
Cephalosporin
Carbopenems

Glycopeptides:
Vancomycin
Teicoplanin

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3
Q

What is mechanism of action of beta lactams

A

Remove cross links between peptidoglycan cell wall layers

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4
Q

Give examples of penicillins and their indications

A

Amoxicillin: Broad spectrum
Flucloxacillin: staphylococcal soft tissue infections
Benzylpenicllin: Gram +ves
Co-amoxiclav, Tazobactam: beta lactaminase inhibitor combinations

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5
Q

Give examples of cephalosporins and their indications

A

Ceftriaxone

Meningitis

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6
Q

Give examples of carbopenems and their indications

A

Meropenem
Sepsis
V broad spectrum (inc anaerobes)

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7
Q

What is mechanism of action of glycopeptides

A

Prevents cross link formation between peptidoglycan cell wall layers

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8
Q

Give examples of glycopeptides and their indications

A

Vancomycin, Teicoplanin
Gram -ves

Narrow therapeutic window - monitoring required

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9
Q

What are types of antibiotics that target protein synthesis

A

Aminoglycosidases
Tetracyclines
Macrolides

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10
Q

What is mechanism of action of aminoglycosidases

A

Inhibit 30s ribosome

Inhibit mRNA translation into proteins

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11
Q

Give examples of aminoglycosidases and their indications

A

Gentamicin
Gram -ve sepsis

Narrow therapeutic window - monitoring required

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12
Q

What is mechanism of action of tetracyclines

A

Lock tRNA to septal site of mRNA

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13
Q

Give examples of tetracyclines and their indications

A

Tetracycline, Doxycycline
Broad spectrum
Chlamydia, Mycoplasma, Atypical pathogens of pneumonia

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14
Q

What is mechanism of action of macrolides

A

Inhibit 50s ribosome

Inhibit translation of mRNA to proteins

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15
Q

Give examples of macrolides and their indications

A

Erythromycin, gentamicin, azithromycin
Similar spectrum to penicillins
Penicillin allergic patients
Azithromycin - gonadal chlamydia trachomatis infection

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16
Q

What are types of antibiotics that target DNA synthesis

A

Quinolones
Folic acid inhibitors
Metronidazole

17
Q

What is mechanism of action of quinolones

A

Inhibit DNA gyrase
Inhibit supercoiling of DNA
Leads to DNA damage

18
Q

Give examples of quinolones and their indications

A 
Ciprofloxacin 
Broad spectrum: G +ve, -ve, Atypicals
Urinary tract sepsis 
Biliary tract sepsis 
Campylobacter food poisoning
19
Q

What is mechanism of action of folic acid antagonists

A

Inhibit DHFR, inhibit folic acid metabolism

Inhibit nucleic acid synthesis

20
Q

Give examples of folic acid antagonists and their indications

A

Trimethoprim, sulphonamide
Uncomplicated UTI
PCP Prophylaxis and treatment - co-trimoxazole

21
Q

What is mechanism of action of metronidazole

A

Form toxic metabolites that inhibit nucleic acid synthesis

22
Q

What are indications of metronidazole

A

Pseudomembranous colitis

Protozoan infection: Giardia, Trichomonas vaginalis, Entamoeba

23
Q

What are mechanisms of antibiotic resistance

A

Vertical: Chromosomal gene mutations

Horisontal:
Transduction - gene transfer by bacteriophage
Conjugation - uptake of plasmids
Transformation - uptake of foreign DNA

24
Q

What are the types of antibiotic resistance

A

Antibiotic inactivation: e.g. beta lactaminase
Altered target site
Altered uptake: increased efflux mechanism, decreased permeability

25
Q

How can you prevent antibacterial resistance

A 
Antimicrobial stewardship: 
Right antibiotic
Right time
Right dose, frequency, duration
Right route
26
Q

What factors determine right antibiotic

A

Cause of infection: history, duration of infection, site of infection
Drug efficacy: level of resistance (community/hospital acquired), immune status, severity of infection
Safety: allergy, toxicity, drug interactions

27
Q

What factors determine right dose, frequency, duration

A

PK and PD of antibiotic

28
Q

What are PD effects of antibiotic dependent on

A

Minimum inhibitory concentration
Time above MIC
Concentration above MIC

29
Q

What is time dependent killing

A

Successful treatment depends on prolonged presence at infection site
Time>MIC value high

30
Q

What is concentration dependent killing

A

Successful treatment depends on high concentration at infection site
Cmax:MIC value high

Pharmacology (19 decks)

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