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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
What two agents are there for UTIs?
Nalidixic acid | Nitrofurantoin
26
What are antimicrobials associated with?
Adverse reactions
27
Approx. __% of hospitalised patients will develop adverse reactions to antimicrobials.
5
28
What are most adverse reactions upon withdrawal of antimicrobial?
Reversible
29
What are the 3 allergic reactions?
Immediate hypersensitivity Delayed hypersensitivity GI side effects
30
Immediate hypersensitivity is Ig_ mediated.
E
31
What is a common sign of delayed hypersensitivity?
Skin rash
32
What is Stevens-Johnson syndrome related to?
Sulphonamides
33
What are common side effects associated with GI?
Vomiting | Nausea
34
What is associated with toxin production by C.Diff?
Diarrhoea
35
How does C.Diff produce toxins?
Overgrow normal flora during antibiotic therapy.
36
How is C.Diff diagnosed?
Toxins in stool sample. Use enzyme immunoassay.
37
What causes thrush?
Candida albicans
38
What can happen to the liver?
Elevation of liver enzymes | Severe hepatitis
39
Where are all the drugs metabolised?
Liver
40
What is the most important route of drug excretion?
Kidney
41
What is dose related and common in patients with preexisting renal disease?
Nephrotoxicity
42
When does ototoxicity occur?
Following aminoglycoside or vancomycin use
43
What causes optic neuropathy?
Ethambutol
44
What causes encephalopathy and convulsions?
High dose penicillin, especially if dose isn't reduced.
45
What causes peripheral neuropathy?
Metronidazole
46
What are the 2 things haematological toxicity can cause?
Toxic effect on bone marrow resulting in selective depression of one cell line Unselective depression of all bone marrow elements.
47
How do co-trimoxazole act?
Competitive inhibition
48
How can we minimise adverse reactions?
Only use antimicrobials when indicated, with the minimum dose and duration necessary.
49
Who needs to be treated carefully in prescription?
Extremes of age Pregnant Liver/renal insufficiency
50
What must the therapeutic margin be?
Low
51
Where should adverse reactions be reported?
Committee on safety of medicines.
52
Define prophylaxis.
Administration of antimicrobials to prevent the future occurrence of infection.
53
What can mutagenic antimicrobials do to foetus?
Induce mutation
54
What can teratogenic antimicrobials cause?
Congenital abnormalities.
55
What type of operation would prophylaxis be used for?
Abdominal
56
What might have to happen if the organism causing infection is unknown?
Antimicrobial therapy
57
What should be taken into account in therapy?
Site of infection | Type of infection
58
Why may you have to use combined antimicrobials?
To cover mixed infection Two have an enhanced effect Minimise development of resistant strains
59
What are the 3 outcomes of using combination antimicrobials?
Additive Antagonistic Synergistic
60
Combination of two cidal drugs or two static drugs is...
Additive | Synergistic
61
Combination of one static and one cidal drug is...
Antagonism
62
What is of little use in clinical practice?
Antimicrobial which is unable to penetrate the site of infection.
63
Gentamicin and vancomycin have ______ therapeutic index.
Low
64
The difference between a therapeutic and toxic dose is small/large.
Small
65
What are the considerations of dose and duration of therapy?
``` Seriousness of infection Expert opinion Age/liver or renal failure Time Intravenous therapy ```
66
Who gives advice on urgent treatment?
Medical microbiologists
67
What are the 2 reasons for monitoring serum levels?
Ensure therapeutic levels are achieved | Ensure levels are not high enough to be toxic.
68
What is the simplest way to measure MIC?
E-test
69
What is an E-test?
Paper strip with gradient of antibiotic conc. | MIC can be read where organism growth intersects the strip.
70
In vitro lab tests only give a ______
Prediction
71
What factors influence outcome of E-test?
Route of admin Dosing schedule Penetration Interactions with other drugs

Principles of Disease (42 decks)

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