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CPTP stage 4 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Amoxicillin, ampicillin

Class + MoA
which bacteria they work against

A

Broad spectrum penicillin

MoA: beta lactam

(for all bacteria)

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2
Q

Flucloxacillin, methicillin

Class + MoA
which bacteria they work against

A

Beta lactamase resistant penicillin

MoA: beta lactam

(only for Gram POSITIVE bacteria)

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3
Q

Piperacillin

Class + MoA
which bacteria they work against

A

Extended spectrum penicillin

MoA: beta lactam

(most effective against pseudomonas,
effective against most Gram NEGATIVE except Klebsiella)

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4
Q

Mecillinam, Temocillin

Class + MoA
which bacteria they work against

A

Reverse spectrum penicillin

MoA: beta lactam

(more for gram POSITIVE bacteria)

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5
Q

Vancomycin

Class + MoA
which bacteria they work against

A

Glycopeptide

MoA: inhibits cell wall integrity by preventing transglycosylation (binds to D-ala at end of peptidoglycan chain)

(for serious Gram POSITIVE infx e.g. MRSA, C diff)

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6
Q 
Name the MoA of the following TB drugs:
Isoniazid
Ethambutol
Rifampin
Pyrazinamide
A

ISONIAZID
-inhibits formation of mycolic acid in mycobacteria

ETHAMBUTOL
-inhibits arabinosyl transferase (which synthesizes mycobacteria cell wall)

RIFAMPIN
-blocks initiation of transcription by interacting with beta subunit of RNA polymerase

PYRAZINAMIDE
-unknown MoA

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7
Q

Carbapenems

Class + MoA
which bacteria they work against

A

Beta lactam

for all bacteria

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8
Q

Aztreonam

Class + MoA +
which bacteria they work against

A

Monobactam (beta lactam)

(for gram NEGATIVE bacteria, especially Enterobacteria & Pseudomonas)

Enterobacteria incude Salmonella, E Coli, Yersinia, Klebsiella, Shigella

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9
Q

Cefuroxime

Class + MoA +
which bacteria they work against

A

2nd gen cephalosporin
(beta lactam)

(broader specificity against Gram -ve e.g. Hib, Neisseria)

Can be used for all UTI

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10
Q

Ceftriaxone, Cefotaxime, Ceftazidime

Class + MoA +
which bacteria they work against

A

3rd gen cephalosporin
(beta lactam)

passes through CSF so can be used to treat meningitis bacteria

Gram NEGATIVE: Neisseria, Hib, E Coli

Gram POSITIVE: Strep pneumo (most common), Listeria (if young/old/immunocompromised)

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11
Q

Metronidazole

Class + MoA +
which bacteria they work against

A

Inhibits nucleic acid synthesis

used against C diff

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12
Q

Ciprofloxacin

Class + MoA +
which bacteria they work against

A

Quinolone

Inhibits DNA gyrase (involved in removing DNA supercoiling)

Used for UTI

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13
Q

Trimethoprim

MoA +
which bacteria they work against

A

Blocks dihydrofolate reductase

Used for UTI

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14
Q

Sulfonamides

MoA +
which bacteria they work against

A

Blocks dihydrofolate synthase

Sulphasalazine used for ulcerative colitis as active in gut

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15
Q

Polymyxins

MoA +
which bacteria they work against

A

Disrupt inner and outer membranes

Used for gram NEGATIVE bacteria

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16
Q

Erythromycin, Clarithromycin, Azithromycin

Class + MoA +
which bacteria they work against

A

Macrolides

Bind reversibly to 50S subunit, blocks P site

(Work against Gram POSITIVE e.g. Strep + Gram NEGATIVE e.g. Hib, pertussis)

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17
Q

Clindamycin

MoA +
which bacteria they work against

A

Bind reversibly to 50S subunit, blocks P site (similar action to macrolides)

(Work against MRSA, Staph, Strep)

Note:
Most aerobic gram negative bacteria (Pseudomonas, Legionella, Hib) are resistant

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18
Q

Doxycycline

Class + MoA +
which bacteria they work against

A

Tetracyclines

Bind reversibly to 30S subunit, interferes with binding of tRNA to mRNA

(broad spectrum action, for all)

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19
Q

Gentamycin

Class + MoA +
which bacteria they work against

A

Aminoglycoside

Binds IRREVERSIBLY to 30S subunit, ribosome not fitted properly, mRNA slips out

(works against gram NEGATIVE bacteria)

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20
Q

If someone is allergic to penicillins, what other types of a/b should not be given to them

A

Cephalosporins

Carbapenams

(monobactams are ok. usually dont have cross reactivity with other beta lactams)

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21
Q

Which a/b is Hib resistant to

A

Amoxycillin/ampicillin

Clindamycin

22
Q

Enterobacteria are gram negative. What do they consist of?

A
  • E Coli
  • Salmonella
  • Klebsiella
  • Shigella
  • Yersinia
23
Q

Is Neisseria gram positive or gram negative

A

Neisseria = gram negative

24
Q

Is Streptococcus gram positive or gram negative

A

Strep = gram positive

25
Q

What bacteria can cause meningitis in immunocompromised/ >55yo patients?

What a/b should be added to cover this?

A

Listeria.

Add amoxicillin/ gentamycin to cover

26
Q

Alcohol can induce vomiting if consumed within 48 hours of taking what antibiotic

A

Metronidazole

27
Q

What a/b(s) are used to treat MRSA

A
  • vancomycin
  • teicoplanin

(prontoderm to get off skin)

28
Q

What a/b(s) are used to treat anaerobic bacteria

A

Metronidazole

add to broad spectrum cephalosporin

29
Q

What a/b to give asymptomatic contacts of syphilis patient

A

Doxycycline

14 days

30
Q

What a/b to give purulent conjunctivitis

A

Chlormaphenicol eye drops

31
Q

What a/b to give otitis externa

A

Topical tx (see BNF)

Flucloxacillin if spreading cellulitis

32
Q

What a/b to give otitis media

A

NOTE: usually viral, no need a/b

Ampicillin/Amoxicillin if no improvement after 72h

33
Q

What a/b to give sinusitis

A

NOTE: only give if persistent symptoms + purulent discharge for 7 days

Ampicillin/Amoxicillin
7 days

34
Q

Which classes are beta lactams?

A
  • penicillins
  • cephalosporins
  • carbapenems
  • monobactams
35
Q

How do beta lactams work as a/b?

A

Disrupt cell wall synthesis

36
Q

Name example(s) of beta lactamase resistant a/b

A
  • flucoxacillin

- methylcillin

37
Q

Define bacteriocidal vs bacteriostatic

A

Bacteriocidal = kills bacteria

Bacteriostatic = stops replication of bacteria

38
Q

Examples of classes of bacteriocidal a/b

A
  • penicillins
  • cephalosporins
  • carbapenams
  • monobactams
  • glycopeptides eg vancomycin
  • metronidazole
  • nitrofurantoin
39
Q

Examples of classes of bacteriostatic a/b

A

INHIBIT FOLATE SYNTHESIS

  • trimethoprim
  • sulfonamides

INHIBIT PROTEIN SYNTHESIS

  • clindamycin
  • macrolides
  • tetracyclines
  • aminoglycosides
40
Q

Which a/b might cause Steven Johnson syndrome

A

Vancomycin

41
Q

Which a/b might cause Red Man syndrome

A

Vancomycin

and other glycopeptides

42
Q

Describe Steven Johnson syndrome

A

Type 4 hypersensitivity reaction

Fever + flu-like symptoms then skin blisters and peels

43
Q

Describe Red Man syndrome

A

Red rash

44
Q

Severe complications of Steven Johnson syndrome

A
  • Multiple organ failure

- scar tissue inside eyelids leading to impaired vision

45
Q

How to avoid Red Man syndrome

A

Infuse vancomycin slowly (over >60min interval)

46
Q

Main side effects of gentamycin

A
  1. ototoxic

2. nephrotoxic

47
Q

Main side effects of co-trimoxazole (trimethoprim + sulfamethoxazole)

A
  1. Nausea
  2. Nephrotoxic, hepatotoxic
  3. Steven Johnson syndrome
  4. Bone marrow suppression
48
Q

Generally, what a/b should be given as replacement in penicillin allergy

A

Macrolide (erythromyin/ clindamycin)

49
Q

Which antibiotics are hepatotoxic

A
  1. Tetracycline
  2. Nitrofurantoin
  3. Anti TB drugs
  4. Chloramphenicol
  5. Erythromycin
50
Q

Which a/b causes cholestasis

A

Erythromycin

51
Q

Which a/b may cause BM suppression

A

Chloramphenicol

CPTP stage 4 (21 decks)

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