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2MB Clasp Sepsis > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

What are the Beta Lactam Antibiotics?

What do they do?

A

These are antibiotics which contain Beta Lactam Rings in their chemical structures.
Inhibit enzymes in the cell wall to cause bacterial cell death (Bactericidal)

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2
Q

Give examples of Beta Lactam Antibiotics

HINT: Think “-cillin”

A

Penicillin
Flucloxacillin
Amoxicillin

DON’T FORGET CEPHALOSPORINS - A SUBCLASS OF BETA LACTAMS

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3
Q

When should you not administer Beta Lactams?

A

Anaphylaxis
Occurs due to Degradation of the Beta Lactam Ring

Also in cases of resistance (obviously)

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4
Q

Why is it important to consider anaphylaxis with Beta Lactams?

A

Because if you are anaphylactic to one, you are likely to be anaphylactic to the rest.

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5
Q

Which is better absorbed; Oral Penicillin or Oral Amoxicillin?

A

Oral Amoxicillin

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6
Q

What route of Administration is NOT Recommended in C.Difficile Infection?

A

IV

This is because as C.Difficile is a gut pathogen, you need oral administration to coat the inside of the bowels.

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7
Q

What route of administration is recommended for mild infections?

A

Oral as not much drug is needed.

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8
Q

What route of administration is needed in severe infections e.g. Bacteraemia or Sepsis?

A

IV to take on the huge bacterial overload

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9
Q

What is the main antibiotic for gram negatives and how it is USUALLY administered?

A

Gentamicin

Once a day in a high dose to get in in the system quickly and out the system quickly to avoid renal toxicity.

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10
Q

Name sites which are difficult for Antibiotics to penetrate?

A

CNS, Eyes and Prostate (in Prostate, the type of antibiotic matters more than the route administered)

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11
Q

What route of administration is generally considered for areas that are difficult to penetrate with antibiotics?

A

High Doses with IV administration

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12
Q

What Antibiotic is used in severe C.Difficile Infection?

Is recurrence of C.Difficile infection possible?

A

Oral Vancomycin

Yes as C.Difficile forms spores

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13
Q

What aspect of the Gram Negative Bacterial structure drives Sepsis?

A

Liposaccharides

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14
Q

Which classes of antibiotics work against Gram Negative Bacteria?

A 
Beta Lactams 
Monobactams
Aminoglycosides 
Macrolides 
Tetracyclines 
Co-Trimoxazole
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15
Q

What are Monobactam antibiotics?

How do they work?

A

Monobactams are a subgroup of Beta Lactams with a slightly different chemical structure.
Binds to bacterial proteins to kill them (Bactericidal)

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16
Q

What are Monobactam antibiotics ineffective against?

A

Gram Positives and Anaerobes

They do not bind well to the proteins in these bacteria

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17
Q

Give an example of a Monobactam antibiotic

HINT: Think “-nam”

A

Aztreonam (only one in use currently)

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18
Q

What are Aminoglycoside antibiotics?

How do they work?

A

Antibiotics that consist of 2+ Amino Sugars.

Bind to Ribosomal Proteins to inhibit protein synthesis and accelerate cell death (Bactericidal)

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19
Q

What are Aminoglycoside antibiotics ineffective against?

A

Anaerobes

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20
Q

Give an example of an Aminoglycoside

HINT: Think “-cin”

A

Gentamicin

Amikacin

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21
Q

When is Gentamicin contraindicated?

What antibiotic can be used as an alternative?

A

In patients with Myasthenia Gravis or Renal Impairment (as it causes Renal Toxicity)
Aztreonam is used as an alternative

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22
Q

What are Macrolide antibiotics?

How do they work?

A

Naturally-derived antibiotics which consist of a large macrocyclic lactone ring.
Bind to a Subunit of the Bacterial Ribosome to inhibit Protein Synthesis (Bacteriostatic)

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23
Q

Give an example of a Macrolide

HINT: Think “-mycin”

A

Clarithromycin
Azithromycin
Erythromycin
Clindamycin

NOT VANCOMYCIN WHICH IS A GLYCOPEPTIDE ANTIBIOTIC

24
Q

What are Tetracycline antibiotics?

How do they work?

A

Antibiotics with 4 Hydrocarbon Rings.

Inhibits the bacterial ribosomes, inhibiting protein synthesis (Bacteriostatic)

25
Q

Give an example of a Tetracycline

HINT: Think “-cycline”

A

Doxycycline

Tetracycline

26
Q

What are Quinolone antibiotics?

How do they work?

A

Antibiotics which all chemically consist of a bicyclic ring.
Inhibit protein synthesis (Bacteriostatic)

Note that Fluoroquinolones are a modern, modified subset of Quinolones.

27
Q

Give an example of a Quinolone antibiotic

HINT: Think “-flocaxin”

A

Ciprofloxacin

Ofloxacin

28
Q

Give examples of ESBL-producing bacteria

A

E.coli

Klebsiella

29
Q

Which antibiotic does NOT work too well on E.coli in Tayside?

A

Amoxicillin, due to 40% resistance

30
Q

What are Cephalosporin antibiotics?

How do they work?

A

Class of Beta Lactam Antibiotics!

Inhibit enzymes in the cell wall to cause bacterial cell death (Bactericidal)

31
Q

Give an example of a cephalosporin

HINT: Think “-ime”

A

Ceftazidime

Cefixime

32
Q

Which antibiotics are used to treat Strep. Pneumoniae infection in individuals who have returned from countries of high penicillin resistance?

A

Vancomycin with Rifampicin

33
Q

Which form of Penicillin is no longer sensitive to Strep. Pneumoniae?

A 
Penicillin G (Benzylpenicillin)
Modified drug target means that it can no longer attach to strep. pneumoniae
34
Q

Which antibiotics are used to treat H. Influenzae?

A

Amoxicillin

Doxycycline

35
Q

In regards to the Enterococci, what antibiotic resistance do you need to be aware of?

A

Vancomycin-Resistant Enterococcus

36
Q

What is Atypical Pneumonia?

A

Pneumonia that is NOT caused by the Streptococci species

37
Q

What antibiotics can be used to treat Atypical Pneumonia?

A

Doxycycline

Clarithromycin

38
Q

What antibiotic is used in Mild C.Difficile Infection?

How do you differentiate between a Mild and Severe C.Difficile infection?

A

Oral Metronidazole

WBC Count > 15 cells x 10^9

39
Q

How is ESBL treated?

A

Gentamicin

If resistant, then IV Carbapenems e.g. Ertapenem, Meropenem etc.

40
Q

What is used to treat Strep. Pneumoniae infection first line?

A

Penicillin

41
Q

Which group of Antibiotics are used to treat CNS infections?

A

Penicillins, as they cross the Blood Brain Barrier

42
Q

What bacteria does Clindamycin not cover?

A

Gram Negatives

43
Q

What antibiotic is used in infection prophylaxis in HIV?

A

Co-trimoxazole

44
Q

What are side effects of Gentamicin?

A

Nephrotoxicity

45
Q

What are side effects of Vancomycin?

A

Red Man Syndrome

46
Q

What are side effects of Macrolides?

A

GI Disturbances

47
Q

What are side effects of Doxycycline?

A

Photosensitivity

48
Q

What are side effects of Penicillins?

A

Rash/Hypersensitivity (most patient take this to mean allergy but it is not!)

49
Q

What are GENERAL Side Effects of Antibiotics?

A

Nausea, Vomiting, Rash

50
Q

What effect does Metronidazole have on Lithium?

A

Reduces Lithium concentration

51
Q

What interactions does Rifampicin have?

A

Turns contact lenses orange and reduces Warfarin effect.

52
Q

What are severe associations with Quinolones?

A

AAA
Psychiatric Disturbances
Diffuse Tendinitis or Tendon Rupture

53
Q

Which antibiotic should NEVER use as Monotherapy?

A

Rifampicin

54
Q

What kind of antibiotic should you use FIRST in infection?

A

The most narrow-spectrum antibiotic to that infection

55
Q

What antibiotic is used in Surgical Prophylaxis?

How long should surgical prophylaxis be done for?

A

Co-amoxiclav

24 hours

56
Q

What is the Reserve List?

A

List of antibiotics which are NOT RECOMMENED for use

2MB Clasp Sepsis (9 decks)

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