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Infection & Immunity > Antiinfectives > Flashcards

Antiinfectives Flashcards

1
Q

what are high level chrmical sterilants

A

destroy all microorganisms

aldehydes, hypochlorites, peroxygenes

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2
Q

what are low level disinfectants

A

destroy most bacteria, some viruses and fungi

excludes TB, some viruses, fungi, bacterial spores, prions

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3
Q

what are some intermediate-level disinfectants

A

destroy all bacteria, most viruses and fungi

excludes some viruses, bacterial spores and prions; like alcohols, phenolics, iodine

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4
Q

what are antisepsis disinfectants

A

work on living tissues
decrease wound infections/normal skin flora prior to surgery
decrease spread of infection by hand cleansing

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5
Q

what are the properties of 4% chlorhexidine gluconate antiseptic

A

high activity in immediate, persistent, residual disinfectants

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6
Q

what are the properties of alcohol and chlorhexidine antiseptic

A

high activity in immediate, persistent and residual disinfectants

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7
Q

what factors affect choice of chemical agent

A

higher bioburden required higher concentrations and longer expsore times
biofilms are more resistant to disinfectants

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8
Q

what is transient bacteria

A

gram negative

like e.coli

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9
Q

what is resident bacteria

A

gram positive

staph.a

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10
Q

what effect does organic matter have on sterilisation

A

can reduce antimicrobial capacity

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11
Q

what effect do divalent cations have on sterilisation

A

reduced activity and stabalise cell walls, block disinfectant adsorption sites

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12
Q

what effect does dilution have on sterilisation

A

higher conc of disinfectant increases efficacy and reduces exposure time, but dilution does not affect killing capacity of all disinfectants in the same way

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13
Q

what is the suspension test

A

dilutions of disinfectant added to standardised bacterial suspension in water and albumin at set temp
at specific time interval, sample removed, disinfectant neutralised, determines viable count

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14
Q

what validation does the suspension test give

A

know viable count of innoculum, experimental conditions validation, neutraliser toxicity validation, disinfectant neutralisation validation

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15
Q

what qualatative test estimates bacteriostasis

A

minimum inhibitory concentration

estimation of bacteriostasis

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16
Q

how are minimum inhibitory concentrations tested

A

double dilutions of test agent prepared, innoculated with test organism, incubate overnight, score for growth, MIC is lowest conc with no growth

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17
Q

what is the disc susceptability test

A

agar spread with test organism, filter paper disc impregnates with known conc test agent placed on plate, zone of growth inhibition indicates antimicrobial activity, measure, compare to standards

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18
Q

how to evaluate antiseptics with time kill

A

for each microorganism and antimicrobial; dilute each test agent, innoculate with test organism, at designated time intervals remove sample/neutralise antimicrobial and determine viable count

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19
Q

what classes of agent are used as disinfectants

A

organic acids and esters, aliphatic alcohols, aldehydes, biguanides, halogens, hydrogen peroxide and peracetic acid, phenolics, surface acting agents

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20
Q

what are the advantages of using aliphatic alcohols

A

broad antimicrobial activity- active against bacteria including fungi, rapid kill, water soluble, relatively non-toxic, no residues

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21
Q

what are the disadvantages of using aliphatic alcohols

A

non sporicidal, isopropranolol not virucidal, poor penetration of organic matter, high dilution coefficient, flammable

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22
Q

what are examples of aliphatic alcohols

A

ethanol, isopropanol

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23
Q

what are examples of aldehydes

A

glutaraldehyde, formaldehyde

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24
Q

what are advantages of aldehydes

A

broad spectrum, sporicidal, rapid kill, not affected by organic matter

25
Q

what are disadvantages of aldehydes

A

unstable, activity lowered by polymerisation, toxic

26
Q

what is an example of biguanides

A

chlorhexidine

27
Q

what are advantages of biguanides

A

good bacterial activity, non toxic

28
Q

what are disadvantages of biguanides

A

not active against mycobacteria or viruses, not sporicidal or virucidal, not very soluble in water, activity decreased by anionic compounds

29
Q

what are some examples of halogens

A

Cl2
active against bacteria, fungi, viruses and spores
irritant

30
Q

what are some advantages of hypochlorites

A

readily available, cheap/compatible, broad spectrum, rapid kill

31
Q

what are some disadvantages of hypochlorites

A

corrosive, irritant, inactivated by organic matter, unstable

32
Q

what are advantages of using iodine

A

broad spectrum, rapid kill, less affected by pH/temp/organic matter compared to Cl2 compounds

33
Q

what are some disadvantages of using iodine

A

stains skin and fabric, irritant

34
Q

what are idophores

A

allow slow release of I2 from a complex

35
Q

what are some examples of iodophores

A

povidone-iodine

36
Q

what are some advantages of peroxygen compounds

A

powerful antimicrobials and sporicides, active in presence of organic matter

37
Q

what are some disadvantages of peroxygen compounds

A

unstable in sunlight, irritant, corrosive

38
Q

what are some advantages of phenolics

A

good antimicrobial activity, poor sporicide, cheap

39
Q

what are some disadvantages of phenolics

A

activity decreased by dilution, some are harmful/toxic, some have strong odour, some corrosive

40
Q

what are examples of substituted phenols

A

phenolic tar acids, cresols, xylenols, ethyl phenols

41
Q

what are some advantages of substituted phenols

A

broad spectrum, rapid kill, cheap, not affected by organic matter

42
Q

what are some disadvantages of substituted phenols

A

not sporicidal, leave residues

43
Q

what are cationic surface-active agents

A

quaternary ammonium compounds

44
Q

what are advantages of cationic surface agents

A

water soluble, most effective, stable, non-toxic, non-corrosive, broad spectrum, active at low conc

45
Q

what are some disadvantages of cationic surface active agents

A

not sporicidal, activity decreased by organic matter

46
Q

what are examples of drugs with narrow therapeutic window

A

theophylline, digoxin, lithium, amoniglycosides, antiepileptic drugs

47
Q

what does TDM stand for

A

therapeutic drug monitoring

48
Q

what is TDM

A

intervention that improves pt response and decreases adverse reactions, intervention to optimise clinical outcome and manage pt condition with measured drug conc

49
Q

what are some commonly monitored drugs

A

anticonvulsants (primidone, valoprate), antiarrythmias (digoxin, lidocaine), antiasthmatics (theophylline), immunosuppressives (cyclosporin), antidepressants (lithium, TCAs), antineoplasics (methotrexate), abx (aminoglycides, glycopeptides)

50
Q

what is the ideal therapeutic level for gentamicin

A

5-10microns/mL

51
Q

what are some reasons for TDM

A

narrow therapeutic range, assessment of adherance to medication, suspected toxicity, lack of response, unpredictable dose, no clear endpoint to observable therapeutic success, C-at steady state, assess therapy following change in dosing regime, change in pt state, drug interaction, toxicity and disease symptoms are similar

52
Q

what are the physiochemical properties of gentamicin

A

very water soluble, poorly lipid soluble, poor oral absorption

53
Q

what is the primary phase of aminoglycoside action

A

rapid, drug conc dependent action

54
Q

what is the secondary phase of aminoglycoside action

A

slow, independentt of drug conc, postantibiotic effect is prolonged, surviving bacteria may not be able to metabolise for up to 8hours after extracellular aminoglycoside has been washed away
exposure of surviving bacteria to second dose of amoniglycoside before they have recovered from the first impairs bactericidal effect of second dose

55
Q

what are the risks of using gentamicin

A

nephro and ototoxicity can occur after accumulation in tissues
important to ensure that preak drug concs are high enough but also that values sufficiently low to avoid accumulation

56
Q

how does gentamicin work

A

active transport into cells of the inner ear and renal proximal tubule
kidneys are the major site of drug deposition

57
Q

what is gentamicin toxicity related to

A

the duration of the treatment

58
Q

how to reduce nephrotoxicity of gentamicin

A

once daily administration; saturable uptake into renal cortex

Infection & Immunity (22 decks)

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