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0. Foundations of Medicine > Antimicrobial Chemotherapy 2 > Flashcards

Antimicrobial Chemotherapy 2 Flashcards

1
Q

<p>What are some commonly used B-lactams (penicillins)?</p>

A

<p>Benzyl penicillin</p>

<p>Amoxicillin, ampicillin</p>

<p>Co-amoxicaly</p>

<p>Flucloxacillin</p>

<p>Piperacillin</p>

<p>Imipenem, meropenum</p>

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2
Q

<p>What does benzyl penicillin act against?</p>

A

<p>Gram positive bacteria</p>

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3
Q

<p>What does amoxicillin and ampicillin act against?</p>

A

<p>Gram negative bacteria</p>

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4
Q

<p>What does co-amoxicaly act against?</p>

A

<p>B-lactamase producing coliforms</p>

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5
Q

<p>What is flucloxacillin the best treatment for?</p>

A

<p>Staphyloccocal infection</p>

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6
Q

<p>What does piperacillin treat?</p>

A

<p>Extended gram negative coverage</p>

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7
Q

<p>What does imipenem and meropenem treat?</p>

A

<p>Most bacteria, including anaerobes</p>

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8
Q

<p>What is a class of B-lactams other than penicillin?</p>

A

<p>Cephalosporins</p>

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9
Q

<p>How does the activity of cephalosporins change against gram negative and positve bacteria through the generations?</p>

A

<p>Activity against gram negative bacteria increases</p>

<p>Activity against gram positive bacteria decreases</p>

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10
Q

<p>What are the 3 generations of cephalosporins?</p>

A

<p>1) Cephradine</p>

<p>2) Cefluoxime</p>

<p>3) Ceftrixone</p>

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11
Q

<p>What are some commonly used agents other than B-lactams?</p>

A

<p>Aminoglycosides</p>

<p>Glycopeptides</p>

<p>Macrolides</p>

<p>Quinolones</p>

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12
Q

<p>How are aminoglycosides administered?</p>

A

<p>Only parenterally</p>

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13
Q

<p>What are aminoglycosides useful against?</p>

A

<p>Gram negative bacteria</p>

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14
Q

<p>What gram positive bacteria is sensitive to aminoglycosides?</p>

A

<p>Only staphylococci</p>

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15
Q

<p>What is an example of an aminoglycoside?</p>

A

<p>Gentamicin</p>

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16
Q

<p>How are glycopeptides administered?</p>

A

<p>Parenteral use only</p>

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17
Q

<p>What are glycopeptides active against?</p>

A

<p>Gram positive bacteria (anaerobic and aerobic)</p>

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18
Q

<p>What are examples of glycopeptides?</p>

A

<p>Vancomycin</p>

<p>Teicoplanin</p>

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19
Q

<p>What are macrolides mainly active against?</p>

A

<p>Gram positive bacteria</p>

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20
Q

<p>When are macrolides often used?</p>

A

<p>As an alternative to penicillin for people who are allergic</p>

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21
Q

<p>What are examples of macrolides?</p>

A

<p>Clarithromycin</p>

<p>Erythromycin</p>

<p>Azithromycin</p>

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22
Q

<p>What are quinolones active against?</p>

A

<p>Nearly all gram negative bacteria</p>

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23
Q

<p>What are some miscellaneous commonly used agents?</p>

A

<p>Metranidazole</p>

<p>Fusidic acid</p>

<p>Co-trimoxazole</p>

<p>Tetracyclines</p>

<p>Clindamycin</p>

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24
Q

<p>What is metronidazole used against?</p>

A

<p>Anaerobes, both gram positive and negative</p>

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25
Q

<p>What is fusidic acid used against?</p>

A

<p>Staphyloccocus</p>

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26
Q

<p>What is co-trimoxazole?</p>

A

<p>A combination of trimethoprim and sulphamethoxazole</p>

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27
Q

<p>What kinds of infection are tetracyclines useful for?</p>

A

<p>Some genetial tract and respiratory tract infections</p>

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28
Q

<p>What is clindamycin useful against?</p>

A

<p>Gram positive and anaerobes</p>

29
Q

<p>What are some commonly used new agents?</p>

A

<p>Linezolid</p>

<p>Daptomycin</p>

30
Q

<p>What is linezolid used against?</p>

A

<p>MRSA</p>

31
Q

<p>What is daptomycin active against?</p>

A

<p>Only gram positive bacteria</p>

32
Q

<p>What is daptomycin useful for the treatment of?</p>

A

<p>Serious MRSA infections</p>

33
Q

<p>What is a positive of linezolid compaired to glycopeptides?</p>

A

<p>It can be given orally</p>

34
Q

<p>What are some agents that are only used for urinary tract infections?</p>

A

<p>Nalidixic acid</p>

<p>Nitrofurantoin</p>

35
Q

<p>What is nalidixic acid active against?</p>

A

<p>Only against gram negative aerobes (coliform) bacteria</p>

36
Q

<p>What is nitrofurantoin effective against?</p>

A

<p>Most gram negative bacteria</p>

<p>Some gram positive bacteria</p>

37
Q

<p>What are most antimicrobials associated with?</p>

A

<p>Adverse reactions</p>

38
Q

<p>What does the incidences of adverse reactions depend on?</p>

A

<p>Dose of therapy</p>

<p>Duration of therapy</p>

39
Q

<p>What are some different kinds of adverse reactions?</p>

A

<p>Allergic reaction</p>

<p>Immediate hypersensitivity</p>

<p>Delayed hypersensitivity</p>

<p>Gastrointestinal side effects</p>

<p>Thrush</p>

<p>Liver toxicity</p>

<p>Renal toxicity</p>

<p>Neurological toxicity</p>

<p>Haematological toxicity</p>

40
Q

<p>What is an example of immediate hypersensitivity?</p>

A

<p>Anaphylactic shock</p>

41
Q

<p>What are some common gastrointestinal side effects?</p>

A

<p>Nausea</p>

<p>Vomiting</p>

<p>Diarrhoea</p>

42
Q

<p>What is thrush?</p>

A

<p>Surpress normal flora in parts of the body resulting in overgrowth of resistant organisms</p>

43
Q

<p>What are examples of liver toxicity?</p>

A

<p>Transient elevators of liver enzymes</p>

<p>Severe hepatitis</p>

44
Q

<p>What is haematological toxicity?</p>

A

<p>Toxic effects on the bone marrow resulting in selective depression of one cell line (neutropenia) or unselective depression of all bone marrow elements (pancytopenia)</p>

45
Q

<p>What is neutropenia?</p>

A

<p>Selective depression of one cell line of bone marrow</p>

46
Q

<p>What is pancytopenia?</p>

A

<p>Unselective depression of all bone marrow elements</p>

47
Q

<p>How can adverse side reactions be minimised?</p>

A

<p>Antimicrobials should only be used when indicated and in the minimum dose and duration to achieve efficacy</p>

48
Q

<p>Who should adverse reactions be reported to?</p>

A

<p>Commitee on safety of medicines</p>

49
Q

<p>What has been set up on each health board to monitor antimicrobial prescribing and develop policy?</p>

A

<p>Antimicrobial management teams</p>

50
Q

<p>What are factors that should be considered when deciding which antimicrobial agents to use are?</p>

A

<p>Age</p>

<p>Renal function</p>

<p>Liver function</p>

<p>Pregnancy</p>

51
Q

<p>What is prophylaxis?</p>

A

<p>Administration of antimicrobials to prevent the future occurence of infection</p>

52
Q

<p>What should happen when the organism causing infection is unknown?</p>

A

<p>Empirical antimicrobial therapy (broad spectrum) should be commenced if urgent treatment is required</p>

53
Q

<p>What should we consider when deciding which drug to use?</p>

A

<p>Spectrum of antimicrobial agent</p>

<p>Monotherapy v combination</p>

<p>Penetration to site of infection</p>

<p>Monitoring</p>

<p>Dose and duration of therapy</p>

54
Q

<p>What can mixing drugs do?</p>

A

<p>Cover mixed infections by more than one organism</p>

<p>Could have enhanced effect together</p>

<p>Minimise the development of resistant strains</p>

55
Q

<p>Why is monitoring done?</p>

A

<p>Difference between a therapeutic and toxic dose is small in a drug with a low therapeutic index</p>

56
Q

<p>What are the 3 possible outcomes when we use antimicrobials in combination?</p>

A

<p>Anatagonistic and combined effect is less than the sum of their individual contribution</p>

<p>Synergistic and their combined effect is greater than the sum of their individial contribution</p>

<p>Their effects are addictive</p>

57
Q

<p>What is a cidal antibiotic (bactericidal)?</p>

A

<p>One that kills bacteria without reliance on the patient's immune system to help</p>

58
Q

<p>What is a static antibiotic (bacteriostatic)?</p>

A

<p>One that prevents the organism multiplying but it is the patient's immune system which kills off the bacteria</p>

59
Q

<p>What is the combination of two cidal or two static drugs?</p>

A

<p>Synergistic or addictive</p>

60
Q

<p>What is the combination of one static and one cidal drug?</p>

A

<p>Antagonistic</p>

61
Q

<p>What is the role of the laboratory, and of medical microbiologists?</p>

A

<p>Give advice on the choice of antimicrobial</p>

62
Q

<p>What are the 2 reasons for monitoring the serum levels of an antimicrobial?</p>

A

<p>Ensure that therapeutic levels have been achieved</p>

<p>Ensure that levels are not so high to be toxic</p>

63
Q

<p>What does the serum levels being the same as the tissue depend on?</p>

A

<p>Antimicrobial's ability to penetrate</p>

64
Q

<p>What is serum levels?</p>

A

<p>Amount of medication in your blood</p>

65
Q

<p>What is the simplest way to measure the minimum inhibitory concentration (MIC) of an antibiotic agent?</p>

A

<p>E-test</p>

66
Q

<p>What is an E-test?</p>

A

<p>Commercially available paper strip which has a gradient of antibiotic concentration from the point where the organism intersects the strip</p>

67
Q

<p>What are methods of measuring the minimum inhibitory concentration (MIC) an an antibiotic agent other than an E-test?</p>

A

<p>Automated, which labs use, where growth of individual isolates are measured in the presence of different concentrations of each antibiotic and MIC is calculated</p>

68
Q

<p>What does in vitro laboratory test give?</p>

A

<p>A prediction whether the infection is likely to be cured by the antibiotic in question</p>

69
Q

<p>What are factors that influence the outcome of using antibiotics?</p>

A

<p>Route of administration</p>

<p>Dosing schedule</p>

<p>Penetration of antibiotic to target site</p>

<p>Interaction with other drugs</p>

0. Foundations of Medicine (167 decks)

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