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Respiratory > Antibiotics MOA + classification > Flashcards

Antibiotics MOA + classification Flashcards

1
Q

Define eukaryote and give examples

A

cells with nuclei/membrane-bound organelles
protozoa, fungi, helminths

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2
Q

Define prokaryote and give examples

A

cells without nuclei/membrane-bound organelles
bacteria

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3
Q

How do viruses replicate?

A

utilise metabolic machinery of host in order to replicate

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4
Q

What are the 4 main sites of action of antimicrobials?

A

cell wall
cell membrane
ribosomes
DNA

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5
Q

How is an antibiotic chosen?

A

penetrates site of infection
fewest number of side effects
no drug interactions

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6
Q

What is a big part of gram +ve bacteria cell wall?

A

peptidoglycan

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7
Q

Which antibiotics inhibit cell wall synthesis?

A

Beta lactam agents (penicillins, cephalosporins, carbapenems, monobactams)

glycopeptides (vancomycin, teicoplanin)

Fosfomycin

Bacitracin

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8
Q

What bacteria does flucloxacillin specifically target?

A

Staphylococcus Aureus

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9
Q

How do beta lactams work?

A

bind to penicillin-binding proteins (PBPs) that have transpeptidase activity

disruption of peptidoglycan synthesis

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10
Q

How do bacteria become resistant to Beta lactams?

A

alterations in penicillin-binding proteins (PBPs):
- hyperproduction of existing PBPs - saturates reaction
- production of new PBP
- modification of existing PBP by recombination

enzyme inactivation by some bacteria - beta lactamases

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11
Q

Name 2 beta lactamase inhibitors, what is the benefit of these?

A

to overcome resistance

Clavulanic acid

Tazobactam

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12
Q

How do glycopeptides work?

A

interfere with gram +ve cell wall peptidoglycan synthesis
- prevent addition of new units to peptidoglycan
- unable to crosslink
- autolysis and cell death

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13
Q

Toxicities of glycopeptides (eg. vancomycin)

A

nephrotoxic
audotoxic (hearing loss)

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14
Q

Which antibiotics disrupt ribosomal function and protein synthesis?

A

macrolides
aminoglycosides
tetracyclines

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15
Q

Macrolides examples

A

erythromycin
clarithromycin

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16
Q

Aminoglycosides examples

A

gentamicin
tobramycin
amikacin

17
Q

Tetracyclines examples

A

doxycycline
tigecycline (a glycylcycline)

18
Q

How do macrolides, aminoglycosides and tetracyclines become resistant?

A

efflux pumps (antibiotic out)
membrane impermeability
modifying enzymes
modification of target site (eg. alteration of rRNA)

19
Q

Which antibiotics interfere with DNA synthesis?

A

trimethoprim
sulphonamides (hard to tolerate)

quinolones (inhibit DNA super coiling)
metronidazole (reduction products break DNA)
nitrofurantoin (causes DNA strand breaks)

20
Q

What drug must not be given with methotrexate and why?

A

trimethoprim
both dihydrofolate reductase inhibitors

21
Q

What is the main use of metronidazole?

A

anaerobic bacteria

22
Q

What factors affect the choice of antibiotic?

A

likely organism and site of infection
culture and sensitivity results
patient characteristics (diseases, allergies, medications, renal/hepatic function, pregnancy, breastfeeding)
infection/severity indicators
spectrum of antimicrobial activity
formulations available (route)
cautions/contraindications/side effects
risk of C.difficile

23
Q

Antibiotics used for gram +ve bacteria

A

Rifampicin
Fusidic acid
Clindamycin
Macrolides
Oxazolidinones
Glycopeptides
Penicillin G + Oxicillins

24
Q

Antibiotics used for gram -ve bacteria

A

Polymyxin
Aminoglycosides
Monobactams
Temocillin

25
Q

Antibiotics used for both gram -ve and gram +ve bacteria

A

Carbapenems
Cephalosporins
Penicillins
Chloramphenicol
Tetracycline

26
Q

Which antibiotics can penetrate the lungs?

A

Clarithromycin (high rates of S.pneumoniae resistance)
Levofloxacin
Amoxicillin
Vancomycin
Ceftriaxone
Piperacillin/Tazobactam
Co-trimoxazole

27
Q

Which antibiotics can penetrate the urinary system?

A

trimethoprim
co-amoxiclav
penicillins
ciprofloxacin
pivmecillinam
nitrofurantoin for uncomplicated (poor tissue penetration)

28
Q

Which antibiotics can cross the blood-brain barrier (BBB)?

A

IV Ceftriaxone
IV Vancomycin
IV Meropenem
IV Benzylpenicillin

29
Q

Which antibiotic can cross the blood-testis barrier?

A

Ciprofloxacin

30
Q

Which Abx are nephrotoxic?

A

aminoglycosides
vancomycin
nitrofurantoin

31
Q

Which Abx are contraindicated in pregnancy?

A

sulphonamides
tetracyclines
trimethoprim (safe after 1st trimester)

32
Q

Isoniazid MOA

A

blocks fatty acid synthase
disrupts mycolic acid synthesis

33
Q

Rifampicin MOA

A

inhibits DNA-dependent RNA polymerase

34
Q

Pyrazinamide MOA

A

blocks fatty acid synthase

35
Q

Ethambutol MOA

A

inhibits arabinosyl transferase
mycolic acid unable to bind to peptidoglycans

Respiratory (32 decks)

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