Antibiotics Flashcards

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1
Q

5 main mechanisms for anti-microbials

A
  1. Inhibiting cell wall synthesis - B-lactam a, vancomycin
  2. Inhibiting nuclei acid synthesis - fluroquinolones, rifamycins
  3. Stopping metabolite production - fluroquinolones, rifamycins
  4. Ihinting cell membrane synthesis - daptomycin
  5. Inhibiting protein synthesis - linezolid, tetracyclines, macrolides, aminoglycosides
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2
Q

Difference between bactericidal and bacteriostatic

A

Bactericidal - destroying or killing bacteria (work optimally normal rapidly dividing bacteria)

Bacteriostatic - stop divisions & replication of bacteria, slow growth, still alive & rely on body’s usual mechanisms

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3
Q

For the class of penicillin, give examples, mechanism and static or cidal?

A

Amoxicillin
Flucloxicillin

Cell wall

Bactericidal

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4
Q

For the class of ceflasporins, give examples, mechanism and static or cidal?

A

Ceftriaxone
Cephalexin

Cell wall

Bactericidal

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5
Q

For the class of quinolones , give examples, mechanism and static or cidal?

A

Ciprofloaxin
Levofloxacin

DNA/ RNA synthesis

Both depends dose/ infection

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6
Q

For the class of macrolides, give examples, mechanism and static or cidal?

A

Erythromycin
Clarythromycin

Protein synthesis

Bacteriostatic

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7
Q

For the class of tetracycline, give examples, mechanism and static or cidal?

A

Doxycline

Protein synthesis

Bacteriostatic

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8
Q

For the class of aminoglycosides, give examples, mechanism and static or cidal?

A

Gentamicin

Protein synthesis

Both

Requires monitoring

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9
Q

For the class of glycopeptides, give examples, mechanism and static or cidal?

A

Vancomycin

Cell wall

Bactericidal

Requires monitoring

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10
Q

For the class of carbopenams , give examples, mechanism and static or cidal?

A

Meropenem

Cell wall

Bactericidal

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11
Q

4 mechanisms of drug resistance and examples

A

Efflux pumps e.g. fluroquinolones, aminoglycosides, tetracyclines, b-lactams, macrolides

Immunity & bypass - tetracyclines, trimethoprim, sulfonamides, vancomycin

Target modification - fluroquinolones, rifamycins, vancomycin, penicillins, macrolides, aminoglycosides

Inactivating enzymes - b-lactams, aminoglycosides, macrolides, rifamycins

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12
Q

Why do we need to monitor drugs? Give an example

A

Narrow therapeutic window
Max effect of antibiotic
Risks of toxicity

E.g. vancomycin blood test every 4th dose before 5th is due

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13
Q

Difference between time-dependant and concentration- dependent antibiotics

A

Time- dependant: higher concentration of drug does not result in greater killing, long half lives and spend longer at binding site. The concentration exceeds the minimum inhibitory concentration of the microorganism

Concentration- dependent: the higher the concentration the greater the effect (to a point), need a certain concentration at binding sites to be effective. Optimal when = or higher to X10 the minimum inhibitory concentration of the microorganism

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14
Q

What is co-amoxiclav made up of? Why is it given in this way?

A

Made up of clavulanic acid (inhibits effect something beta lactamase enzymes so amoxicillin can work better) & amoxicillin (acts on cell walls of bacteria)

Synergistic effect

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15
Q

What factors govern antibiotic choice?

A

Likely source of infection
Common groups of bacteria
High risk patient
Trends, previous results, resistance

Special groups:
Hepatic, renal Impairment, pregnancy

Allergies
Reactions

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16
Q

Anti- microbial treatment and i-fiving patients

A

Start broad/ empirical treatment then narrow to more appropriate antibiotics, restricted antibiotics need authorisation form microbiology department

Identify (A to F - abroad, blood bourne virus, colonised, diarrhoea (&v), expectorating (cough), funny looking rash 
Isolate
Investigate
Inform 
Initiate treatment
17
Q

When to give aciclovir and how is it given?

A

To treat herpes simples - non genital:
By mouth
Adults: 200mg 5/day usually for 5 days (longer if new lesion appears or healing incomplete)

If immunocompromised or absorption is impaired:
Adults - 400mg 5times/ day usually for 5 days

Oral- type 1 (mouth ulcers)
Topical - type 2 (genital ulcers)