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Clinical Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

What does bactericidal mean?

A

Destroying or killing bacteria

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2
Q

What does bacteriostatic mean?

A

Stopping division and replication of bacteria, slowing growth

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3
Q

Why might it be counterintuitive to give a bactericidal and bacteristatic antibiotic at the same time?

A

Bactericidal antibiotics work optimally when bacteria are dividing at their normal rate. As bacteriostatic antibiotics slow rate of division, bactericidal agents don’t work as well.

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4
Q

What are the 5 main ways by which anti-microbials work?

A
  1. Inhibiting cell wall synthesis
  2. Inhibiting nucleic acid synthesis
  3. Stopping metabolite function
  4. Inhibiting cell membrane synthesis
  5. Inhibiting protein synthesis
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5
Q

How does penicillin work?

A
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6
Q

Name 4 types of penicillin

A
  • Amoxicillin
  • Flucloxacillin
  • Co-amoxiclav
  • Phenoxymethylpenicillin (penicillin V)
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7
Q

How do ceflasporins work?

A

Act on the cell wall → bactericidal

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8
Q

Give an example of a cephalosporin

A

Cephalexin

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9
Q

How do Quinolones work?

A

Inhibit bacterial DNA/RNA synthesis

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10
Q

Give an example of a quinolone

A

Ciprofloxacin

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11
Q

How do macrolides work?

A

Inhibit bacterial protein synthesis → bacteriostatic

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12
Q

Give 2 examples of macrolide antibiotics

A

Azithromycin

Clarithromycin

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13
Q

How do tetracycline antibiotics work?

A

Inhibit bacterial protein synthesis → bacteriostatic

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14
Q

Give an example of a tetracyline antibiotic

A

Doxycylcine

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15
Q

How do aminoglycosides antibiotics work? e.g. gentamycin?

A

Inhibit protein synthesis of bacteria

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16
Q

How do glycopeptide antibiotics work e,g, vancomycin

A

Act on bacterial cell wall → bactericidal

17
Q

How do carbopenam antibiotics work?

A

Act on bacterial cell wall → bactericidal

18
Q

How can bacteria develop resistance to antibiotics?

A
  1. Develop efflux pumps
  2. Develop inactivating enzymes
  3. Develop immmunity that bypasses damage to bactiera
  4. Target modification
19
Q

Why do antibiotics need to be monitored? Give examples of 2 antibiotics in particular that need monitoring

A
  • Narrow therapeutic window
  • Maximum effect of antibiotic
  • Risk of toxicity
  • e.g. vancomycin and gentamicin
20
Q

What is time dependent killing of bacteria (with antibiotics)?

A

For effective killing, minimum inhibitory concentration needs to be maintained over a period of time

Increasing concentration won’t have any more effect

21
Q

What is concentration dependent killing of bacteria?

A

Aim it to get the maximum dose (CMax) of antibiotic for effective killing

High doses at high concentration

22
Q

For what reasons might you use antibiotics?

A
  • Short term management of a bacterial infection
  • Prophylaxis in acute setting e.g. high risk procedures (joint/ bowel operations)
  • Long term prophylaxis (if suitable, often not reccommended)
23
Q

What are the 2 ‘ingredients’ of co-amoxiclav? What is the purpose of each?

A

Clavulanic acid:

  • Inhibits the effects of beta lactamase enzymes so amoxicillin can work better

Amoxicillin:

  • Acts on cell walls of bacteria
24
Q

What factors govern antiobiotic choice?

A

Multifactorial:

  • What is the likely source of infection?
  • Source of infection lends themselves to common bacteria groups
  • Is the patient ‘high risk’ (immunosuppressed/ neutropenic)
  • Previous results with antibiotics
  • Special groups: renally impaired, pregnancy, hepatic impaired
  • Allergies and reactions
25
Q

What are the 5 ‘i’s of antimicrobial stewardship?

A
  • Identify
  • Isolate
  • Investigate
  • Inform
  • Initiate treatment
26
Q

Give an example of an antiviral drug?

A

Aciclovir

27
Q

What are the principles of anti-microbial stewardship?

A
  • Does the patient need antibiotics
  • Start broad (empitical treatment) and narrow to more appropriate antibiotics
28
Q

When would you use aciclovir?

A

Herpes simplex virus

Dose depends on whether it’s 1st presentation vs relapse

Clinical Pharmacology (25 decks)

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