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4 Pharm Unit > Antimicrobial Agents Intro > Flashcards

Antimicrobial Agents Intro Flashcards

1
Q

What are the 3 classes of antimicrobial agents?

A

antibacterialantiviralsantifungals

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2
Q

T-F–life destroys life among the lower species?

A

True

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3
Q

When was penicillin discovered? by who

A

1929, fleming

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4
Q

When was sulfanilamide discovered?

A

1936

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5
Q

The ideal antimicrobial agent acts selectively on what? What 4 ways is this achieved?

A
  1. the pathogen and not the host2. unique cell structure, unique biochem paths, altered component affinities, prodrug converted only by pathogen
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6
Q

Review/memorize the 5 factors that determine cidal vs. static activity

A
  1. drug’s mechanism2. microbe’s state of growth3. concentration of drug on organism4. type of microbe5. drug’s spectrum of activity
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7
Q

What is the general rule of thumb for antibiotics in the blood?

A

should exceed theMIC by 2-8X to offset tissue barriers to infection site

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8
Q

What does narrow spectrum antibiotic mean?

A

mainly effective against G+ or G- microbes, lower risk for superinfections

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9
Q

What does extended spectrum antibiotic mean?

A

affects a variety of G+ and G- bacteria

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10
Q

What does broad spectrum antibiotic mean?

A

Affects both G+ and G-, and other organisms

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11
Q

Are all the broad spectrum antibacterials bacteriostatic or bactericidal?

A

bacteriostatic

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12
Q

What reflects the margin ofsafety expected when using an antimicrobial agentat its effective dose?

A

Chemotherapeutic indexTD50/ED50

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13
Q

Does clinical effectiveness depend on maximal efficacy more or less than potency?

A

maximal efficacy

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14
Q

Review the list of factors influencing efficacy

A
  1. Host-immune function, pharmacokinetics, age, preg, genetics, allergy, eidemiologic exposure, compliance2. Microbe-type and variability, body burden, growth rate, environment/site3. drug drug interaction- synergy, antagonism, PK effects
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15
Q

What are the 3 reasons for antimicrobial drug resistance?

A
  1. Misdiagnosis2. inherent microbial resistance3. Acquired microbial resistance
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16
Q

What are the 3 ways microbial resistance is acquired?

A

a. Drug fails to reach targetb. Drug is inactivatedc. Drug target is altered

17
Q

What are the common ways of genetic drug resistance? non-genetic?

A
  1. chromosomal resistance, sex-plasmid and transposon mediated (transformation, transduction, conjugation)2. growth latency, anaerobic conditions, protoplasts
18
Q

Review some epidemiology of resistance problems

A

2 million patients get infection in hospital–90,000 of them die-70% of bacteria causing infections are drug resistant

19
Q

What are the 3 major drug resistant bacteria?

A

strep pneumoniae, MRSA, VRE

20
Q

What are 4 methods of avoiding drug resistance?

A
  1. use only when needed2. select the best antibiotic for the organism3. use doses to establish effective concentrations for effective times4. Use multiple drug therapy only when indicated
21
Q

When is combination antimicrobial therapy valid? 4

A
  1. severe infection of unknown cause2. polymicrobial infections3. enhancement of antibacterial effects in treatment of specific infections4. prevent emergence of resistant microorganisms
22
Q

What are the 3 potential results of combination antimicrobial therapy?

A
  1. antagonism2. addition3. synergism
23
Q

What are the 2 main characteristics of antagonism between drugs?

A

a. Cidal plus static agentsb. Metabolizing enzyme induced

24
Q

What are the 3 main types of synergy in combination antimicrobial therapy?

A

a. Blockade of sequential steps in pathwayb. Inhibition of drug-inactivating enzymec. Enhancement of drug uptake

25
Q

What are the 3 main disadvantages of combination antimicrobial therapy?

A
  1. Super-toxicity2. Antagonism3. Selection for drug-resistant bugsINCREASED COST TOO
26
Q

Prophylaxis represents 30-50% administered antibiotics in the US. When is prophylaxis commonly used?

A
  1. pre-surgery in patients with indwelling medical devices2. prevent wound infection following surgery3. sexual contacts of patients with STDs
27
Q

Review the general considerations for appropriate antibiotic use?

A
  1. General health of patient (immune function,severity of infection)2. Where advisable, narrow spectrum agentspreferred3. Nosocomial infections – drug resistance4. Cost5. Cidal vs static6. Dose alteration7. Drug delivery• Oral, parenteral (IV, IM, insoluble salts), topical
28
Q

What are 4 adverse effects of antimicrobial therapy?

A
  1. Allergy2. super infection3. organ toxicity4. Selection of resistant microorganisms

4 Pharm Unit (7 decks)

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