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Principles of Disease > Antimicrobial Chemotherapy 2 > Flashcards

Antimicrobial Chemotherapy 2 Flashcards

1
Q

What penicillin is used for gram positive?

A

Benzyl Penicillin

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2
Q

What penicillin is used for gram negative?

A

Amoxicillin

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3
Q

What penicillin is used for beta-lactamase producing coliforms?

A

Co-amoxiclav

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4
Q

What penicillin is used for staph infections?

A

Flucloxacillin

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5
Q

What penicillin is used for extended gram negative cover?

A

Piperacillin

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6
Q

What penicillin is used for all active bacteria?

A

imipenem

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7
Q

What do cephalosporins work against?

A

Gram negative

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8
Q

What decrease gram positive activity?

A

Proportionally through first to third generation drugs.

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9
Q

What is the cheapest and most common aminoglycoside?

A

Gentamicin

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10
Q

What must be monitored when using gentamicin?

A

Serum levels because of toxicity.

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11
Q

What must be monitored when using glycopeptides?

A

Vancomycin levels as toxic.

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12
Q

What do quinolones provide the only oral therapy for?

A

Pseudomonas infections

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13
Q

Quinolones against strep is good/bad.

A

Bad

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14
Q

What is metronidazole effective against?

A

Anaerobes (Positive and negative).

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15
Q

What is fusidic acid used for?

A

Anti-staph

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16
Q

What is the thing to ensure doesn’t happen when using trimethoprim?

A

That it does not predispose to C.Diff

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17
Q

What do tetracyclines inhibit?

A

Bacterial protein synthesis.

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18
Q

Where are tetracyclines deposited?

A

Teeth and bones

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19
Q

What type of antibiotics are clindamycin?

A

Lincosamide

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20
Q

What do clindamycin work against?

A

Gram postive

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21
Q

What new agent has activity against MRSA?

A

Linezolid

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22
Q

What can linezolid cause?

A

Bone marrow suppression

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23
Q

What new agent has activity against gram positive organisms?

A

Daptomycin

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24
Q

What new agent is active against C.Diff?

A

Fidaxomicin

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25
Q

What two agents are there for UTIs?

A

Nalidixic acid

Nitrofurantoin

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26
Q

What are antimicrobials associated with?

A

Adverse reactions

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27
Q

Approx. __% of hospitalised patients will develop adverse reactions to antimicrobials.

A

5

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28
Q

What are most adverse reactions upon withdrawal of antimicrobial?

A

Reversible

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29
Q

What are the 3 allergic reactions?

A

Immediate hypersensitivity
Delayed hypersensitivity
GI side effects

30
Q

Immediate hypersensitivity is Ig_ mediated.

A

E

31
Q

What is a common sign of delayed hypersensitivity?

A

Skin rash

32
Q

What is Stevens-Johnson syndrome related to?

A

Sulphonamides

33
Q

What are common side effects associated with GI?

A

Vomiting

Nausea

34
Q

What is associated with toxin production by C.Diff?

A

Diarrhoea

35
Q

How does C.Diff produce toxins?

A

Overgrow normal flora during antibiotic therapy.

36
Q

How is C.Diff diagnosed?

A

Toxins in stool sample. Use enzyme immunoassay.

37
Q

What causes thrush?

A

Candida albicans

38
Q

What can happen to the liver?

A

Elevation of liver enzymes

Severe hepatitis

39
Q

Where are all the drugs metabolised?

A

Liver

40
Q

What is the most important route of drug excretion?

A

Kidney

41
Q

What is dose related and common in patients with preexisting renal disease?

A

Nephrotoxicity

42
Q

When does ototoxicity occur?

A

Following aminoglycoside or vancomycin use

43
Q

What causes optic neuropathy?

A

Ethambutol

44
Q

What causes encephalopathy and convulsions?

A

High dose penicillin, especially if dose isn’t reduced.

45
Q

What causes peripheral neuropathy?

A

Metronidazole

46
Q

What are the 2 things haematological toxicity can cause?

A

Toxic effect on bone marrow resulting in selective depression of one cell line
Unselective depression of all bone marrow elements.

47
Q

How do co-trimoxazole act?

A

Competitive inhibition

48
Q

How can we minimise adverse reactions?

A

Only use antimicrobials when indicated, with the minimum dose and duration necessary.

49
Q

Who needs to be treated carefully in prescription?

A

Extremes of age
Pregnant
Liver/renal insufficiency

50
Q

What must the therapeutic margin be?

A

Low

51
Q

Where should adverse reactions be reported?

A

Committee on safety of medicines.

52
Q

Define prophylaxis.

A

Administration of antimicrobials to prevent the future occurrence of infection.

53
Q

What can mutagenic antimicrobials do to foetus?

A

Induce mutation

54
Q

What can teratogenic antimicrobials cause?

A

Congenital abnormalities.

55
Q

What type of operation would prophylaxis be used for?

A

Abdominal

56
Q

What might have to happen if the organism causing infection is unknown?

A

Antimicrobial therapy

57
Q

What should be taken into account in therapy?

A

Site of infection

Type of infection

58
Q

Why may you have to use combined antimicrobials?

A

To cover mixed infection
Two have an enhanced effect
Minimise development of resistant strains

59
Q

What are the 3 outcomes of using combination antimicrobials?

A

Additive
Antagonistic
Synergistic

60
Q

Combination of two cidal drugs or two static drugs is…

A

Additive

Synergistic

61
Q

Combination of one static and one cidal drug is…

A

Antagonism

62
Q

What is of little use in clinical practice?

A

Antimicrobial which is unable to penetrate the site of infection.

63
Q

Gentamicin and vancomycin have ______ therapeutic index.

A

Low

64
Q

The difference between a therapeutic and toxic dose is small/large.

A

Small

65
Q

What are the considerations of dose and duration of therapy?

A 
Seriousness of infection
Expert opinion
Age/liver or renal failure
Time
Intravenous therapy
66
Q

Who gives advice on urgent treatment?

A

Medical microbiologists

67
Q

What are the 2 reasons for monitoring serum levels?

A

Ensure therapeutic levels are achieved

Ensure levels are not high enough to be toxic.

68
Q

What is the simplest way to measure MIC?

A

E-test

69
Q

What is an E-test?

A

Paper strip with gradient of antibiotic conc.

MIC can be read where organism growth intersects the strip.

70
Q

In vitro lab tests only give a ______

A

Prediction

71
Q

What factors influence outcome of E-test?

A

Route of admin
Dosing schedule
Penetration
Interactions with other drugs

Principles of Disease (42 decks)

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