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Phase 3 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Name the antibiotics that work on the peptidoglycan wall:

A

Beta Lactams

Glycopeptides

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2
Q

Name the antibiotics that work in proteins/ ribosomes:

A

50S -

  • Macrolides
  • Clindymicin
  • chlorpenical

30S

  • Aminoglycosides
  • tetracyclines
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3
Q

What drugs contraindicated with statins, because they increase the blood levels of the statin? and what enzyme do they block?

A

Macrolides

Block the enzyme CYP3A4 which breaks down statins

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4
Q

What drug is highly associated with ototoxicity?

A

Gentamicin

(macrolides also cause it but not as severely or as commonly)

**need to ask a patient every 3 days how their hearing is.

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5
Q

Which drug is used in high concentrations then deep troughs, due to its double effect on bacteria: initially killing cell wall, then working on the proteins?

A

Gentamicin

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6
Q

Which Drugs increase the QT interval?

A

Quinolines

Macrolides

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7
Q

What drug increase serum K+ levels, and why?

A

Trimethoprim

acts as a K+ sparring diuretic

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8
Q

What drug is used for anaerobic organisms and kills them via oxidative stress?

A

Metronidazole

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9
Q

What are the two Beta Lactamases used, and what are their combinations?

A
  • Co-amoxiclav
  • Clavulanic acid
  • amoxicillin
  • Tazocin
  • Tazobactam
  • Piperacillin
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10
Q

What is the first choice for serious Strep infections?

A

benzylpenicillin

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11
Q

What Beta lactam targets both Strep and Staph (not MRSA)?

A

Flucloxacillin

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12
Q

What Beta lactam has acitivity against almost all bacteria but MRSA?

A

Meropenem

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13
Q

What drug is highly associated with nephrotoxicity?

A

Vancomycin

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14
Q

What drugs are typically used for upper respiratory tract infections?

A

Macrolides

  • clarithromycin
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15
Q

What drugs are useful for targeting the atypicals?

A

Macrolides

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16
Q

What drugs have excellent endotoxin neutralisation? and what are they not good against?

A

Clindamycin

No affect on:
- Aerobic gram negative

  • Atypicals
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17
Q

What drug can cause bone marrow suppression? leading to aplastic anemia

A

Chloramphenicol

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18
Q

What drug causes increased action of CYP450 enzymes?

A

Rifampicin

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19
Q

When is trimethprim used?

A

Uncomplicated UTIs

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20
Q

What drug is used really only for Gram negative bacteria?

A

Gentamcin

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21
Q

What antibitics are heavily associated with causing C.Diff?

A

Ciprofloxacin (all quinolones)

Clindamycin

Cephalosporins

Co-amociclav

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22
Q

List some key ways bacteria develop resistance:

A
  1. producing enzymes that destroy the drug
  2. Modification to the drug target
    - 23S rubunits
  3. Decreased permeability
    - down regulation of porins
  4. Exporters to push drug out of the cell
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23
Q

How do these mutations of resistance come about?

A
  1. Chromosomal Mutations
  2. Acquisition of genetic information
  3. Transformation
  4. Transduciton
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24
Q

Whats the three main ways bacteria acquire new genetic information?

A
  1. Transduciton
    - bacterial phages
  2. Conjugation
    - mating
  3. Transformation
    - destruction of the bacteria and spreading of information
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25
Q

In order to become resistant bacteria will often give up its speed of growth. what is this referred to as?

A

Fitness cost

26
Q

What gene is associated with MRSA being resistant?

A

MecA

27
Q

Where are the genetic codes for Beta lactamases usually found?

A

Plasmids

28
Q

How do beta lactamases work?

A

Hydrolyse the Beta lactam ring

29
Q

What drugs can be used in the treatment of extended spectrum beta lactamases?

A

Ciprofloxacin

Temocillin

Gentamicin

Meropenem

30
Q

There are some bacteria that are now resistant to carbapenems, what are these called and what is the gene associated with them?

A

Carbapenemases

NDM-1

31
Q

What bacteria is especially good at drug resistance by increasing efflux pumps?

A

Pseudomonas Aeruginosa

32
Q

What non- genetic factors can seriously inhibit the functioning of antibiotics?

A

Abscess formation

Biofilm

Foriegn bodies

Slowly/ non replicating bacteria

33
Q

In Sepsis what is the standard set of antibiotic treatment?

A
  • Iv Amoxicillin 2g/6hrly
    +
    Gentamicin

+/- flucloaxacillin is Staph is suspected

if allergic to penicillin or MRSA then:
*IV vancomycin
+
Gentamicin

if severe Strep infection then:
+ IV clindamycin 600mg/6 hrly

34
Q

What are the antibiotic treatments for Nectrotizing facititis?

A

Flucloxacillin

Benzylpenicillin

Gentamicin

Metronidazole

Clindamycin

35
Q

Which antibiotic stops the oral contraceptive working?

A

Rifampcin

36
Q

What must one always think about before prescribing empirical antibiotics:

A
  • previous antibiotic treatment
  • Previous microbiology culture tests - thinking about resistance
  • drug allergies
  • travel history - some places of travel have higher incidences of resistance than others.
37
Q

If you have an organisms which is resistant to beta lactams , co - amoxiclav, cephalosporins (very wide spectrum of beta lactams) what is it said to be?

What bacteria typically call this? and what is the problem with this?

A

Extended spectrum Beta Lactamase

  • hydrolyse the beta lactams ring

**E. Coli. they often also have resistance to gentamicin

38
Q

What would be used to treat ESBL organisms?

A

Meropenam

39
Q

What do quinolones target as their mode of action?

A

DNA gyrase of the bacteria

40
Q

Name two sets of bacterial-static antibiotics:

A

Macrolides

Tetracyclines

41
Q

Name the 30S inhibitors:

A

Aminoglycosides
- gentamicin

Tetracyclines
- doxycycline

Nitrofurantoin

42
Q

Whats a common cause of resistance to gentamicin?

A

plasmid encoded enyzmes

43
Q

What’s a common cause of resistance to tetracyclines?

A

Up regulation of efflux pumps

44
Q

What’s a common cause of resistance to Penicillins?

A

Change in the PBP

45
Q

Is conjugation common?

A

Yes

46
Q

Which class of bacteria most typically produce beta lactamases?

A

E.Coli

47
Q

Which drug may red Man syndrome be seen in?

A

Vancomycin

48
Q

What does OHPAT stand for?

A

Outpatient and Home parental antibiotic therapy

49
Q

When would Clindmycin be used in S. Aureus infection?

A

To neutralise Exotoxins when there is toxic shock syndrome

50
Q

Out with exotoxins, what other class of bacteria is clindmycin good at destroying?

A

Anaerobics

this is why it is so effective at killing G.I bacteria leading to C. Diff infections

51
Q

When would you avoid use of nitrofutoin?

A

In poor renal clearance

52
Q

What antibiotic therapy is given for biliary sepsis?

A

Gentamcin - gram negatives

Amoxicillin - enterococci

Metranidazole - anaoerobics

53
Q

Which antibiotics can’t be used during pregnancy?

A

Trimethoprime
- first trimester

Tetracyclines

Quinolones

54
Q

How many days can gentamicin be used for?

A

up 4 days

55
Q

What antibiotic is heavily associated with Steven’s JOhnson syndrome and toxic epidermal necrolysis?

A

Co - Trimoxazole

  • trimethoprim
  • sulphamethaxole
56
Q

What beta lactam can be used when there is a pencillin allergy?

A

Monobactams

  • Aztreonam
57
Q

When there is an invasive Strep Pyogenes what antibiotic should be used?

A

Clindamycin

58
Q

What drug is quinolones combined with that increases the risk of tendon rupture?

A

Prednisolone

59
Q

What should tetracyclines not be given with?

A

Milk

60
Q

How does nitrofurantoin work?

A

Increases metabolite damage of DNA

Phase 3 (50 decks)

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