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MD2 ID > Antibiotics for interns > Flashcards

Antibiotics for interns Flashcards

1
Q

Narrow spectrum penicillins

A

Penicillin

Fluclox

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2
Q

Moderate spectrum penicillins

A

Amoxi

Amp

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3
Q

Broad spectrum penicillins

A

Ticarcillin

Piperacillin

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4
Q

1st gen cephalosporins

A

Cephazolin

Cephalexin

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5
Q

2nd gen cephalosporins

A

Cefaclor

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6
Q

3rd gen cephalosporins

A

Ceftriaxone

Cefotaxime

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7
Q

4th gen cephalosporins

A

Ceftazidime

Cefepime

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8
Q

5th gen cephalosporins

A

Ceftaroline

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9
Q

Carbapenems

A

Meropenem
Imipenem
Ertapenem

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10
Q

Mechanism of action of B-lactams

A

Bind to PBPs in bacterial cell walls to inhibit peptidoglycan (and therefore cell wall) synthesis)

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11
Q

B-lactams: bacteriostatic or bactericidal?

A

Bactericidal (except for Enterococcus)

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12
Q

Is bacterial killing by B-lactams concentration-dependent or -independent? Relevance to management?

A

Concentration-independent (TIME above MIC is what dictates efficacy)
Give frequent low doses

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13
Q

Absorption of B-lactams

A

Variable oral absorption (gastric acid degrades many penicillins, food delays rate and extent of absorption)

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14
Q

3 mechanisms of resistance to B-lactams (including examples of bacteria which utilise these)

A

Production of B-lactamase (MSSA, E. coli)
Alteration in PBPs to decrease binding affinity (MRSA, Strep pneumo)
Alteration of outer membrane to decrease penetration

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15
Q

Benzylpenicillin (pen B), amoxi, amp spectrum of activity

A

Strep/enterococci
E.coli/Klebs/Haem (amp)
Anaerobes (gram+ oral)

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16
Q

B-lactams

A

Pencillins
Cephalosporins
Carbapenems

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17
Q

Typical administration of amp vs amoxi

A

Amp: IV
Amoxi: oral

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18
Q

MSCNS

A

Methicillin-susc coag-negative Staph

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19
Q

Amoxiclav spectrum of activity

A

MSSA, MSCNS
Strep/enterococci
E.coli/Klebs/Haem
Some bowel anaerobes

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20
Q

Fluclox/diclox

A

MSSA, MSCNS

Some activity against Strep pyogenes

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21
Q

Ticarc/clav, piper/tazobactam spectrum of activity

A 
MSSA, MSCNS
Strep/enterococci
E.coli/Klebs/Haem
Pseudomonas
Anaerobes
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22
Q

Cephalosporins CANNOT be used for?

A

Enterococci

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23
Q

1st gen ceph spectrum of activity

A

MSSA, MSCNS
Strep
E.coli/Klebs/Haem (generally not)

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24
Q

3rd gen ceph spectrum of activity

A

MSSA, MSCNS
Strep
E. coli/Klebs/Haem
Some anaerobes

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25
Q

4th gen ceph spectrum of activity

A

Same as 3rd gen + pseudomonas

26
Q

Carbapenems spectrum of activity

A 
MSSA, MSCNS
Strep/enterococci
E.coli/Klebs/Haem
Enterobacter etc
Pseudomonas
Anaerobes
27
Q

Mechanism of B-lactam anaphylaxis

A

Immune response directed to B-lactam ring (don’t use ANY B-lactams)

28
Q

Mechanism of non-anaphylactic B-lactam allergies

A

Immune response directed to side-chain (may be able to give OTHER B-lactams)

29
Q

B-lactam adverse effects

A 
GI: increased LFTs, N+V, diarrhoea, pseudomembranous colitis
Interstitial nephritis (type IV  HS)
Phlebitis, seizures, cytopenias
30
Q

Glycopeptides

A

Vancomycin

Teicoplanin

31
Q

Mechanism of action of glycopeptides

A

Inhibits synthesis and assembly of 2nd stage of peptidoglycan polymers by binding D-alanyl-D-alanine portion of cell wall precursors

32
Q

Glycopeptides: bacteriostatic or bactericidal?

A

Bactericidal (except for Enterococcus)

33
Q

Glycopeptide dosing

A

Based on weight and renal function

34
Q

Glycopeptide spectrum of activity

A

MSSA, MSCNS
MRSA
Strep/enterococci

35
Q

Metronidazole adverse effects

A 
GI: N+V, stomatitis, metallic taste, intolerance with alcohol
Peripheral neuropathy (seizures)
36
Q

Metronidazole spectrum of activity

A

Anaerobes (esp bowel)

37
Q

Clindamycin mechanism of action

A

Inhibits protein synthesis

38
Q

Clindamycin: bacteriostatic or bactericidal?

A

Bacteriostatic

39
Q

Clindamycin spectrum of activity

A

Staph
Strep
Gram+ oral anaerobes

40
Q

ESCAPPM

A

Organisms with chromosomally-mediated inducible B-lactamase activity (Enterobacter, Serratia, Citrobacter freundi, Aeromonas, Proteus, Providencia, Morganella morganii)

41
Q

Clindamycin adverse effects

A

C. difficile colitis

42
Q

Fluoroquinones mechanism of action

A

Inhibit bacterial topoisomerases (necessary for DNA synthesis)

43
Q

Is bacterial killing by FQs concentration-dependent or -independent? Relevance to management?

A

Concentration-dependent

Give infrequent high doses

44
Q

FQs: bacteriostatic or bactericidal?

A

Bactericidal

45
Q

FQs spectrum of activity

A

E.coli/Klebs/Haem
ESCAPPM (beware resistance)
Pseudomonas (beware resistance)

46
Q

Ciprofloxacin

47
Q

FQ adverse effects

A 
Hepatitis
Tendonopathy
Damage to developing cartilage
Long QT
Resistance develops easily
48
Q

Absorption of FQs

A

Good oral

Good penetration to many tissues (e.g. prostate, bone)

49
Q

Macrolides

A

Erythromycin (not really used)
Clarithromycin
Roxithromycin
Azithromycin

50
Q

Macrolides mechanism of action

A

Inhibits protein synthesis by reversibly binding the 50S ribosomal subunit to suppress RNA-dependent protein synthesis

51
Q

Macrolides: bacteriostatic or bactericidal?

A

Typically bacteriostatic

52
Q

Is bacterial killing by macrolides concentration-dependent or -independent? Relevance to management?

A

Concentration-independent

Give frequent low doses

53
Q

Macrolides adverse effects

A

Long QT

Interactions

54
Q

Aminoglycosides mechanism of action

A

Inhibition of protein synthesis by irreversibly binding the 30S ribosomal subunit

55
Q

Aminoglycosides

A

Gentamicin

56
Q

Aminoglycosides: bacteriostatic or bactericidal?

A

Bactericidal

57
Q

Aminoglycoside route of administration

A

IV with monitoring of levels

58
Q

Aminoglycoside spectrum of activity

A

Gram- (including Pseudomonas)

Some Gram+

59
Q

Aminoglycosides adverse effects

A

Nephrotoxicity (reversible)

Ototoxicity (irreversible, can occur at any dose/duration; for this reason rarely used at TNH)

60
Q

Lincosamide

A

Clindamycin

61
Q

“Red-man” syndrome

A

Administration of glycopeptides too fast; erythema and hypotension due to widespread histamine release

MD2 ID (8 decks)

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