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Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

Infection types; Structural features of bacteria, Guidance for abx use; Types of bacteria; Mechanisms of abx; 5 Classes of abx; Abx resistance; Viruses; Monitoring infections

1
Q

What are the names of the two areas where health acquired infection can occur?

A

Community and healthcare

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2
Q

4 types of infection

by what

A

Bateria
Fungal
Viral
Parasitic

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3
Q

9 general full body symptoms of infection

A 
Pyrexia 
Headache 
Sore throat 
Abdominal pain 
Lethargy 
Joint/muscle pain 
Nausea / vomiting 
Diarrhoea 
Rash
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4
Q

4 key structural features of bacteria

A

No nucleus
2x forms of DNA
Peptidoglycan cell wall
Ribosomal subunit different to that in eukaryotes (mammalian cells)

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5
Q

Names and functions of the 2 forms of DNA in bacteria

A

Plasmid DNA - allows for self replication

Nucleoid - chromosomes, protein synthesis, RNA molecules

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6
Q

What is the generic name for the treatment of parasitic infections?

A

Anti-protozoal

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7
Q

Names of the 2 types of bacteria

staining

A

Gram positive

Gram negative

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8
Q

What structural feature is it of gram negative bacteria that make them difficult to treat with abx?

A

Protective outer membrane

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9
Q

What ideally is the first action that should be carried out before abx administration?

A

Bacteria cultures and sensitivities sent to the lab

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10
Q

What 4 investigations/tests are used to guide abx use?

A

Blood tests
Urine samples
Swabs
Stool samples

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11
Q

What 3 blood tests and results (i.e.higher/lower) would indicate infection?

A

White cell count - >11= bacterial infection, <5 = viral infection
Neutrophils - increased during bacterial infection
C-Reactive Protein - increased during infection/injury

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12
Q

What do bactericidal antibiotics do and name 3 examples?

A

Kill bacteria.

Penacillin, cephalosporins, quinolones

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13
Q

What do bacteriostatic antibiotics do and name 2 examples?

A

Inhibit bacterial growth.

Tetracyclines, macrolides

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14
Q

What is the intention of bacteriostatic abx therapy? What may it detrimentally result in in terms of stopping infection?

A

Intends to suppress bacterial division so that body’s own immune system is able to eradicate infection.
Detrimentally, it is the reason infections may continue to occur despite abx treatment.

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15
Q

Name 5 mechanisms of which abx ihibit bacteria

A 
Peptidoglycan synthesis - cell wall 
Cell metabolism 
DNA/RNA metabolism
Degrade plasma membrane 
Protein synthesis
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16
Q

What two mechanisms of abx mean they will only effect bacteria and why?

A

Peptidoglycan synthesis - because human cells have no cell wall
Protein synthesis - because bacteria have a different subunit to that of human ribosomes

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17
Q

Name 5 classes of abx

A 
Beta-lactams 
Macrolides 
Cephalosporins 
Penacillins 
Tetracyclines
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18
Q

What is a key structural feature of beta-lactam abx and how may bacteria become resistant to them?

A

All abx with a beta-lactam ring
Bacteria may develop to synthesise beta-lactamase which hydrolyses the beta-lactam ring leaving abx ineffective and bacteria resistant.

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19
Q

What might be included in abx to combat bacteria producing beta-lactamase to make them effective?

A

Beta-lactamase inhibitors

20
Q

Mechanism for how penicillin works?

bacteriostatic/cidal, inhibit what

A

Bactericidal

Inhibit peptidoglycan synthesis and DNA/RNA metabolism - preventing bacterial growth/division

21
Q

What spectrum of abx is penicillin and what gram of bacteria does it work on?

A

Broad spectrum

Works on gram -ve and +ve bacteria

22
Q

5 ADRs of penicillin

A 
Rash 
Nausea/vomiting 
Pyrexia 
Diarrhoea 
GIT disturbance
23
Q

2 ADRs of penicillin given IV

A

Increase in sodium

Convulsions

24
Q

Mechanism for how cephalosporins work?

bacteriostatic/cidal, inhibit what

A

Bactericidal

Inhibit peptidoglycan synthesis

25
Q

What spectrum of abx are cephalosporins and what generation is most effective on which gram of bacteria?

A

Broad spectrum
Old generation most effective on gram -ve
New generation most effective on gram +ve

26
Q

4 ADRs of cephalosporins

A

GIT disturbance
Caution in pts with penicillin allergy
Rash
Pyrexia

27
Q

Which abx (of the other 4) contain a beta-lactam ring?

A

Penicillin

Cephalosporins

28
Q

Mechanism for how macrolides work?

bacteriostatic/cidal, inhibit what

A

Bacteriostatic and bactericidal

Inhibit protein synthesis via irreversibly binding to ribosomal subunit, preventing replication or repair.

29
Q

What spectrum of abx are macrolides and what gram of bacteria are they most effective on?

A

Narrow spectrum

Works on gram +ve bacteria

30
Q

2 ADRs of macrolides

A

Liver damage

GIT disturbance

31
Q

Interaction of macrolides and resulting effect

CYP

A

CYP450 inhibitors - reduce drug metabolism leading to drug accumulation

32
Q

Mechanism for how tetracyclines work?

bacteriostatic/cidal, inhibit what

A

Bacteriostatic

Inhibit protein synthesis by binding irreversibly to ribosomal subunit preventing mRNA synthesis

33
Q

What spectrum of abx are tetracyclines and what gram of bacteria are they most effective on?

A

Broad spectrum

Work on gram -ve and +ve bacteria

34
Q

3 ADRs of tetracyclines

A

GIT disturbance
Photosensitivity
AVOID use in children as slows bone growth and alters colour of teeth

35
Q

What interacts with tetracyclines to form an insoluble compound?

A

Milk

36
Q

Name the two types of bacterial resistance

A

Natural innate resistance

Acquired resistance

37
Q

How does innate bacterial resistance develop?

A

Over time to the environment bacteria lives within

38
Q

How does acquired bacterial resistance develop?

A

Bacteria sharing their resistance between one another

39
Q

3 ways innate ways bacterial are resistant to abx

A

Impenetrable peptidoglycan wall/cell membrane
No receptor on bacteria for abx to bind to
Abx susceptible to enzymes produced by bacteria

40
Q

2 ways in which acquired antibiotic resistance occurs

A

Production of enzymes that inactivate abx

Changes to abx structure preventing binding of abx

41
Q

6 ways in which bacteria become resistant to abx

A 
Selection of resistant bacteria 
Mutated to be resistance 
Transferred resistance 
Production of abx inactivating enzymes 
Impermeability of cell wall/membrane 
Altered structure abx unable to bind
42
Q

What ADR is seen in all abx?

A

GIT disturbance

43
Q

3 steps in the prescribing of abx

A

Send cultures and sensitivities before commencing abx.
Indication and duration of abx use.
Review need, dose or type of abx in 48hrs

44
Q

What are viruses and two features?

A

Intracellular parasites, have no metabolism, require host to replicate

45
Q

6 steps of monitoring/assessing infection

A 
Obtain symptom onset /pt history 
White cell count 
Temperature 
CRP 
Erythrocyte sedimentation rate 
Exposure to infection 
Cultures

Pharmacology (10 decks)

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