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Medications > Antimicrobial > Flashcards

Antimicrobial Flashcards

1
Q

What are the four major classes of antibacterial meds

A 
Inhibitors of bacterial: 
cell wall synthesis
protein synthesis
DNA replication
metabolic pathways
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2
Q

Antibacterial meds can be administered…

A

Topically or systematically

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3
Q

E.g. of inhibitors of bacterial cell wall synthesis

A

Beta-lactams, cephalosporins, carbapenems

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4
Q

E.g. of beta-lactams

A

Penicillin (amoxicillin, amoxicillin with clavulanic acid, ampicillin, benzathine benzylpenicillin, benzylpenicillin, dicloxacillin, flucloxacillin, phenoxymethylpenicillin)

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5
Q

What do beta-lactams do

A

Beta-lactam ring essential for antibacterial activity and specific enzymes can disrupt the ring and inactivate their mechanism of action

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6
Q

Beta-lactams are

A

Safe, effective and widely used

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7
Q

Extensive use of beta lactams leads to…

A

Resistance in staph

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8
Q

How do beta lactams work

A

Work by inhibiting synthesis of the bacterial cell wall binding with proteins, producing a defective cell wall which destroyed microorganism

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9
Q

What type of bacteria is penicillin primarily used for

A

Gram-positive

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10
Q

Who is penicillin contraindicated for

A

Use in patients with hypersensitivity/allergic reaction to any penicillin preparation and a potential exists for cross-allergenicity with cephalosporins and carbapenems. Penicillin is generally well tolerated

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11
Q

In life-threatening allergic reaction to penicillin…

A

Cephalosporin and carbapenem shouldn’t be used coz similar to penicillin action

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12
Q

Common AEs of beta-lactams

A

Diarrhoea, nausea, pain and inflammation at injection site, superinfection with prolonged treatment, allergy

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13
Q

E.g. of carbapenems

A

Ertapenem, imipenem, meropenem

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14
Q

Mechanism of action of carbapenems

A

Inhibit synthesis of bacterial cell walls by binding with penicillin-binding proteins

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15
Q

Common AEs of carbapenems

A

Nausea, vomiting, diarrhoea, headache

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16
Q

Characteristics of carbapenems

A

Broad-spectrum, bactericidal, beta-lactam

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17
Q

Characteristics of cephalosporins

A

Widely used and derived from a fungus, broad-spectrum.

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18
Q

Cephalosporins against what kind of bacteria?

A

Activity against gram positive and negative but more active against negative than penicillin is

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19
Q

E.g. of cephalosporins

A

Cefaclor, cefalexin, cefalotin, cefazolin, cefepime, cefotaxime, cefoxitin, ceftaroline, ceftazidime, ceftriaxone and cefuroxime.

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20
Q

Clinical uses of cephalosporins

A

Surgical prophylaxis, treatment of infections of resp tract, urinary tract, skin, soft tissues, bones, joints, CNS, septicaemia

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21
Q

Mechanism of action of cephalosporins

A

Damage cell wall by binding to penicillin-binding proteins leading to cell lysis and death

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22
Q

Common AEs of cephalosporins

A

Diarrhoea, nausea, vomiting, rash, headache

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23
Q

Contraindications for cephalosporins:

A

Previous anaphylactic reaction to penicillin or a cephalosporin allergy

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24
Q

Aminoglycosides characteristics

A

Widely used for gram negative, bactericidal, similar to penicillin in pharmacologic, antimicrobial and toxiocologic characteristics

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25
Q

How is aminoglycosides administered

A

Parentally cos poorly absorbed from GI tract

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26
Q

E.g. of aminoglycosides

A

Amikacin, gentamicin, streptomycin, tobramycin

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27
Q

How do aminoglycosides work

A

Work by penetrating the cell walls of the bacteria and preventing protein synthesis

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28
Q

Common AEs of aminoglycosides

A

Nephrotoxicity, ototoxicity, anaphylaxis, bronchospasm, oliguria, peripheral neuropathy

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29
Q

E.g. of inhibitors of bacterial protein synthesis

A

Aminoglycosides and macrolides

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30
Q

Effects of macrolide

A

Have immunomodulatory and anti-inflammatory effects

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31
Q

Macrolides have a similar spectrum of antimicrobial activity to…

A

Benzylpenicillin, can be used for people with penicillin and cephalosporin allergy

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32
Q

E.g. of macrolides

A

Azithromycin, clarithromycin, erythromycin, roxithromycin

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33
Q

Macrolide properties:

A

Bactericidal or bacteriostatic depending on dose and bacteria

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34
Q

Common AEs of macrolides

A

Nausea, vomiting, diarrhoea, abdo pain, cramps, candida infections

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35
Q

E.g. of inhibitors of bacterial metabolic pathways

A

Sulfonamides

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36
Q

Sulfonamides are bacteriostatic against…

A

Wide range of Gm + and -, however decreasing in efficacy due to AMR

37
Q

When can you use sulfonamides

A

Should only be used after susceptibility is proven by culture and sensitivity testing

38
Q

E.g. of sulfonamides

A

Sulfadiazine, sulfisoxazole, trimethoprim-sulfamethoxazole, mafenide, silver sulfadiazine

39
Q

Common AEs of sulfonamides

A

Burning, itch, rash, transient leucopoenia

40
Q

E.g. of inhibitors of bacterial DNA replication

A

Quinolones/ fluoroquinolones

41
Q

E.g. of quinolones/ fluoroquinolones

A

Ciprofloxacin, moxifloxacin, norfloxacin, ofloxacin

42
Q

Properties of quinolones/ fluoroquinolones

A

Synthetic bactericidal, active against gram + and –, well absorbed orally

43
Q

What are quinolones/ fluoroquinolones used for

A

Used for infections of resp tract, genitourinary tract, GI tract, bone, joints, skin, soft tissues

44
Q

Mechanism of action of quinolones/ fluoroquinolones?

A

Interferes with bacterial DNA enzyme synthesis

45
Q

Common AEs of quinolones/ fluoroquinolones?

A

Rash, itch, nausea, vomiting, diarrhoea, abdo pain, dyspepsia

46
Q

What do most antifungals target

A

Most target fungal cell membrane and disrupt the structure and function of fungal cell components. Can produce potentially serious toxicities and drug interactions

47
Q

Antifungals can be applied

A

Superficially or systemically

48
Q

E.g. of antifungals

A

Azoles, echinocandins, amphotericin B

49
Q

E.g. of azoles

A

Fluconazole, isavuconazole, itraconazole, ketoconazole, miconazole, Posaconazole, voriconazole

50
Q

How do azoles work

A

Work by impairing the synthesis of ergosterol in fungal cell membranes causing cell breakdown, cell leakage and cell death

51
Q

E.g. of echinocandins

A

Anidulafungin, caspofungin, micafungin

52
Q

How do echinocandins work

A

Inhibit 1,3-beta-D-glucan synthase which inhibits synthesis of 1,3-beta-D-glucan in the fungal cell wall and alters cell membrane permeability

53
Q

Common AEs of echinocandins

A

Nausea, vomiting, diarrhoea, rash, hypokalaemia

54
Q

How does amphotericin B work

A

Works by binding irreversibly to ergosterol in fungal cell membranes causing cell death by altering their permeability and allowing leakage of intracellular components

55
Q

Common AEs of amphotericin B

A

Infusion reactions, thrombophlebitis, anaemia, nephrotoxicity, hypoxia, hyperglycaemia, tachycardia, hyponatraemia

56
Q

What do antiprotozoal drugs do

A

Either destroy or inhibit protozoa growth and ability to reproduce

57
Q

What are the two main types of antiprotozoals

A

Antimalarial and antiprotozoal

58
Q

What do antimalarials do

A

Kill or inhibit growth by affecting different stages of the parasitic lifecycle

59
Q

E.g. of antimalarials

A

Atovaquone with proguanil (combination is synergistic), clindamycin, doxycycline, hydroxychloroquine

60
Q

What else can antimalarials be used for

A

Hydroxychloroquine can be used as an anti-inflammatory

61
Q

Most common side effects of antimalarials:

A

Nausea, vomiting, diarrhoea, anorexia, abdo cramps, rash and itch

62
Q

E.g. of antiprotozoals

A

Metronidazole and tinidazole

63
Q

What do metronidazole and tinidazole do

A

Work by interfering with DNA synthesis

64
Q

What are metronidazole and tinidazole often used for

A

In treating non-protozoal infections

65
Q

Common side effects of metronidazole and tinidazole

A

Nausea, anorexia, abdo pain, vomiting, diarrhoea

66
Q

What can and can’t antivirals do

A

They inhibit viral replication but can’t eliminate virus from host tissue

67
Q

What are neuraminidase inhibitors used for

A

In the treatment and prevention of influenza A and B

68
Q

What do neuraminidase inhibitors do

A

Reduce virus replication

69
Q

E.g. of neuraminidase inhibitors

A

E.g. oseltamivir, peramivir, zanamivir

70
Q

AEs of neuraminidase inhibitors

A

Bronchospasm, dyspnoea and allergy

71
Q

What are the meds for herpes simplex or cytomegalovirus treatment

A

Acyclovir, famciclovir, ganciclovir, valaciclovir

72
Q

How do herpes simplex or cytomegalovirus meds work

A

Work by inhibiting viral DNA polymerase and DNA synthesis

73
Q

Common side effects of herpes simplex or cytomegalovirus meds

A

Nausea, vomiting, diarrhoea, hallucinations, headache and encephalopathy

74
Q

What are the different types of meds for HIV

A

Antiretrovirals, nucleoside reverse transcriptase inhibitors (NTRI), non-nucleoside reverse transcriptase inhibitors, HIV protease inhibitors, integrase inhibitors

75
Q

How do antiretrovirals work

A

Work by stopping the virus replicating in the body to prevent further damage

76
Q

Antiretrovirals usually require a…

A

Combination of drugs

77
Q

NTRI are used in the treatment of

A

HIV infection or transmission

78
Q

E.g. of NTRIs

A

Abacavir, emtricitabine, lamivudine, zidovudine

79
Q

How do NTRIs work

A

Work by inhibiting viral reverse transcriptase and viral DNA synthesis

80
Q

Side effects of NTRIs

A

Headache, nausea, vomiting, anorexia, myalgia, asymptomatic hyperlactataemia

81
Q

E.g. of non-NTRIs

A

Efavirenz, etravirine, nevirapineor, rilpivirine

82
Q

How does rilpivirine work

A

By inhibiting HIV-1 reverse transcriptase and thus reducing viral DNA synthesis

83
Q

Common side effects of rilpivirine

A

Rash, malaise, nausea, vomiting, elevated liver enzymes, headache, fever

84
Q

How do HIV protease inhibitors work

A

By inhibiting HIV-1 and HIV-2 proteases thus preventing virus replication

85
Q

E.g. of HIV protease inhibitors

A

Atazanavir, darunavir, fosamprenavir, ritonavir, saquinavir, tipranavir

86
Q

Side effects of HIV protease inhibitors

A

Headache, nausea, vomiting, abdo pain, elevated liver enzymes, weight gain, hyperglycaemia, new-onset of or worsening diabetes, hypertriglyceridemia, hypercholesterolaemia

87
Q

What do integrase inhibitors do

A

Inhibit HIV integrase and thus stop the insertion of viral DNA into the host DNA

88
Q

E.g. of integrase inhibitors

A

Bictegravir, dolutegravir, elivetigravir, raltegavir

89
Q

Common side effects of integrase inhibitors

A

Headache, fatigue, nasopharyngitis, increased liver enzymes, increased creatine kinase, rash, nausea

Medications (10 decks)

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