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Antimicrobial Chemotherapy > Antimicrobial Chemotherapy > Flashcards

Antimicrobial Chemotherapy Flashcards

1
Q

An antimicrobial that kills bacteria

A

Bactericidal (e.g.Penicillin)

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2
Q

An antimicrobial that inhibits growth of bacteria

A

Bacteriostatic (e.g. erythromycin)

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3
Q

An organism is considered this is it is inhibited or killed by levels of antimicrobial that are available at the site of infection

A

Sensitive

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4
Q

An organism is considered this if it is not killed or inhibited by levels of antimicrobial that are available at the site of infection

A

Resistant

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5
Q

Minimum concentration of antimicrobial needed to inhibit visible growth of a given organism

A

Minimum Inhibitory Concentration (MIC)

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6
Q

Minimum concentration of antimicrobial needed to kill a given organism

A

Minimum Bacterialcidal Concentration (MBC)

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7
Q

Applied to a surface, usually skin or mucous membranes

A

Topical e.g. conjunctiva

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8
Q

Taken internally, either orally or parenterally

A

Systemic

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9
Q

Administered either intra-venously (IV) or intra-muscular (IM), occaisonally subcutaneously

A

Parental

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10
Q

Sites of antibiotic action

A

Inhibition of cell wall
Inhibition of protein synthesis
Inhibition of nucleic acid synthesis

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11
Q

Antibiotics that inhibit cell wall synthesis

A

B lactams

Glycopeptides

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12
Q

B lactam antibiotics

A

Penicillin and Cephalosporin

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13
Q

Mode of action of Penicillin and Cephalosporin

A

Disrupt peptidoglycan synthesis by inhibiting enzymes responsible for crosslinking

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14
Q

Original naturally occurring B-lactam discovered by Fleming

A

Benzyl Penicillin (Penicillin G)

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15
Q

Glycopeptide Antibiotics

A

Vancomycin

Teicoplanin

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16
Q

Mode of action of Vancomycin and Teicoplanin

A

Inhibit assembly of a peptidoglycan precursor.

Only act on Gram positive- cannot penetrate gram negative cell wall

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17
Q

Route of administration for Glycopeptide

A

Parentally

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18
Q

Toxic Glycopeptide

A

Vancomycin

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19
Q

Antibiotics that inhibit protein synthesis

A

Aminoglycosides
Macrolides and Tetracyclines
Oxazolidinones
Cyclic Lipopeptide

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20
Q

Aminoglycosides antibiotic

A

Gentamicin

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21
Q

Aminoglycosides mechanism

A

Inhibit protein synthesis

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22
Q

Toxic Aminoglycosides

A

Gentamicin

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23
Q

Macrolides and Tetracyclines

A

Erythromycin, Clarythromycin and Tetracyclines

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24
Q

Glycopeptides act on _________ organism

A

Gram positive

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25
Q

Aminoglycosides used for treatment of Gram ______ organism

A

Negative

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26
Q

Macroslides and Tetracyclines are useful for treatment in Gram ____ infection and for people allergic to

A

Positive and Penicillin

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27
Q

Oxazolidinones antibiotic

A

Linezolid

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28
Q

Linezolid is useful for ____ infection and given ____

A

MRSA and orally

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29
Q

Cyclic Lipopeptide

A

Daptomycin

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30
Q

Antibiotics that inhibit nucleic acid synthesis

A

Trimethoprim & sulphamethoxazole

Fluoroquinolones

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31
Q

Mechanism of Trimethoprim & sulphamethoxazole

A

Inhibit different steps in purine synthesis and combined form in the drug co-trimoxazole

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32
Q

Mechanism of Fluoroquinolones

A

Inhibit DNA synthesis directly in gram negative organism

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33
Q

Fluoroquinolones Antibiotics

A

Ciprofloxacin (orally) and Levofloxacin

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34
Q

Types of Resistance

A

Inherent or intrinsic

Acquired resistance

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35
Q

All strains of a given species are naturally resistance

A

Inherent or intrinsic

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36
Q

Resistance present in some strains of the species but not in others

A

Acquired

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37
Q

Acquired resistance can be acquired through_____ and _____

A

A spontaneous mutation during DNA multiplication and genes that code for resistance are spread via plasmids or on transposons due to selective pressure

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38
Q

Two mechanisms for B-lactam resistance

A

B-lactamase production and alteration of penicillin binding protein (PBP) target site

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39
Q

Co-amoxixlav (Penicillin)

A

Amoxicillin +Clavulanic acid

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40
Q

Clavulanic acid

A

B-lactamase inhibitor

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41
Q

Flucloxacillin (Penicillin)

A

Modification of antibiotc side chain to produce an antibiotic which is resistant to B-lactamase

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42
Q

Microbial that can break down third generation cephalosporin and penicillins

A

ESBL (Extended spectrum B-lactamases)

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43
Q

A group of extremely resistant Gram negative organism resistant to carbapenems

A

Carbapenemase Producing Enetrobacteriaceae

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44
Q

Organism that alters PBP

A

MRSA

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45
Q

Vancomycin resistance is unusual in ________

A

Gram positive organism

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46
Q

Two mechanisms of antibiotic resistance

A

Inactivation of antibiotic and alteration of target site of antibiotic

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47
Q

Penicillins

A 
Penicillin G
Amoxicillin
Ampicillin
Co-amoxiclav
Flucloxacillin
Piperacillin
Imipenem
Meropenum
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48
Q

IV treatment for pneumococcal, meningococcal and strep pyogenes (Group A) infection

A

Benzyl penicillin (Penicillin G) oral

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49
Q

Amoxicillin and Ampicillin

A

Streptococci and coliforms infection

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50
Q

Flucloxacillin

A

Staphylococcal infection

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51
Q

Has extended spectrum and is active against Pseudomonas species

A

Piperacillin (used with tazobactam)

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52
Q

Carbapenems with widest spectrum

A

Imipenem, meropenem

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53
Q

Encourage Clostridium difficile

A

Cephalosporins

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54
Q

Only third generation that has action against a pseudomonas species

A

Ceftriaxone (cephalosporins)

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55
Q

Used against gram negative organisms such as pseudomonas

A

Gentamicin

56
Q

Used against gram positive, both aerobic and anaerobic

A

Vancomycin and Teicoplanin

57
Q

Mainly against gram positive organism and used as an alternative to penicillin

A

Clarithromycin and Erythromycin

58
Q

Used against atypical pneumonia (chlamydia psittacci, coxiella burnetti, mycoplasma pneumonia and legionella pneumophilia)

A

Clarithromycin and Erythromycin

59
Q

Chlamydia treatment

A

Azithroymycin

60
Q

Pseudomonas infection (ciprofloxacin) and pneumococci (levofloxacin)

A

Quinolones

61
Q

Metronidazole

A

effective against anaerobes

62
Q

Fusidic acid

A

anti-staphylococcal drug

63
Q

Trimethoprim

A

Urinary infection and chest infections

64
Q

Tetracyclines

A

Genital tract (chlamydia) and respiratory tract infection. Not given to pregnant women and children under 12 as it is deposited in teeth and bone

65
Q

Clindamycin

A

Good at tissue penetration, taken orally and used against gram positive organism (staph and strept)

66
Q

Linezolid

A

MRSA

67
Q

Daptomycin

A

Gram positive orgamism (serious MRSA)

68
Q

Fidaxomicin

A

bactericidal against C.difficle

69
Q

Urinary tract agents (gram negative aerobes)

A

Nalidixic acid

70
Q

Urinary tract agents with exception of proteus and psuedomonas

A

Nitrofurantoin

71
Q

Allergic Reaction

A

Immediate
Delayed
Gastrointestinal

72
Q

Immediate Hypersensitivity allergic reaction

A

IgE mediated within minutes of administration

73
Q

Delayed Hypersensitivity allergic reaction

A

Can take hours or days e.g. Steven’s-Johnson syndrome

74
Q

Gastrointestinal Side effects

A

C. difficile:
Diarrhoea

Pseudomonas colitis

75
Q

CDI treatment from overuse of broad spectrum antibiotics

A

oral metranidazole or oral vancomycin

76
Q

Therapy with broad spectrum penicillins and cephalosporins lead to overgrowth of the yeast Candida albicans

A

Thrush

77
Q

Tetracycline and anti-tuberculosis drugs isoniazid and rifampicin

A

Liver toxicity

78
Q

Aminoglycoside (gentamicin) or vancomycin side effect

A

Renal Toxicity

79
Q

Ototoxicity (side effect)

A

Aminoglycoside or vancomycin use

80
Q

Optic Neuropathy (side effect)

A

Ethambutol (anti-tuberculosis drug)

81
Q

Encephalopathy and convulsions (side effect)

A

High dose of penicillin and cephalosporin

82
Q

Peripheral Neuropathy (side effect)

A

Metronidazole and nitrofurantoin

83
Q

Haematological toxicity (side effect)

A 
Co-trimoxazole
Anti-virals:
Zidovudine (HIV)
Ganciclovir (CMV)
Linezoilid
84
Q

Prevention of Adverse Reactions

A

Used only when indicated and in the minimum dose to achieve efficacy

85
Q

Patient characteristics

A

Age, Renal, Liver function and pregnancy

86
Q

Indications for Antimicrobials

A

Prophylaxis and Therapy

87
Q

Combination Therapy

A

Cover mixed infection
Synergy
Minimise the development of resistance strains

88
Q

Outcomes of combination therapy

A

Additive
Antagonistic
Synergistic

89
Q

Combination of two cidal drugs

A

additive or synergistic

90
Q

Combination of two static drugs

A

additive or synergistic

91
Q

Combination of one static and one cidal

A

anatagonism

92
Q

Macolides are Bacterio______

A

static

93
Q

Standard course of treatment

A

7 days

94
Q

Course for IV therapy for staph.aureus infection

A

14 days

95
Q

Two main reasons for monitoring serum levels

A

Ensure therapeutic levels are being achieved

Ensure levels are not so high to be toxic

96
Q

Antibiotics most commonly measured

A

Gentamicin and Vancomycin

97
Q

How is Vancomycin measured

A

Measure trough level

98
Q

Types of susceptibility testing

A

Automated methods

E test

99
Q

Automated susceptibility methods

A

MIC that determine whether an organism is sensitive or resistant

100
Q

Simplest way to measure MIC using a paper test strip with gradient of antibiotic concentration

A

E test

101
Q

Anti-Fungal Drugs

A

Polyenes
Azoles
Allylamines
Echinocandins

102
Q

Antifungal drugs that bind to ergosterol in fungal cell wall and increase permeability

A

Polyenes

103
Q

Polyenes

A 
Amphotericin B  (IV)
Nyastatin
104
Q

Fungal skin infections, pessaries for vaginal thrush and oesophageal candidiasis

A

Nyastatin

105
Q

Inhibit ergosterol synthesis

A

Azoles

106
Q

Azoles

A

Fluconazole
Voriconazole
Itraconazole

107
Q

Used to treat yeast (not filamentous) infection

A

Fluconazole

108
Q

Not all yeast are sensitive to ______

A

Fluconazole

109
Q

Aspergillosis

A

Voriconazole and itraconazole

110
Q

Supress ergosterol synthesis, but act at a different stage of the synthetic pathway of azoles

A

Allylamines

111
Q

Allylamines

A

Terbinafine

112
Q

Fungal infection of skin and nails

A

Terbinafine

113
Q

Inhibit synthesis of glucan polysaccharide in several types of fungi

A

Echinocandins

114
Q

Used for seriious candida and Aspergillus infections

A

Echinocandins

115
Q

Echinocandins

A

Caspofungin, myafungin and Anidulafungin

116
Q

Types of Anti-Viral Drugs

A

Anti-Herpes
Anti-HIV
Drugs for Chronic Hep B and C

117
Q

Active against Herepes Simplex and Varicella zoster virus

A

Aciclovir

118
Q

Nucleoside analogue

A

Aciclovir

119
Q

used for HSV and shingles with better bioavailability than Aciclovir

A

Famciclovir

120
Q

Nucloside analogue used to treat CMV

A

Ganciclovir

121
Q

Highly nephrotoxic, given IV and is used to treat HSV, VZV and CMV

A

Foscarnet

122
Q

Types of anti-HIV drugs

A

Zidovudine (AZT, ZDV)
Nevirapine, Efavirenz
Saquinavir, Darunavir

123
Q

Nucleoside analogue that interferes with the action of reverse transcriptase

A

Zidovudine (AZT, ZDV)

124
Q

Non-nucleoside reverse transcriptase inhibitors

A

Nevirapine, Efavirenz

125
Q

Protease Inhibitor that inhibits viral protease enzymes

A

Saquinavir, Darunavir

126
Q

Used to treat selected chronic Hep B and C infection

A

IFN-alpha

127
Q

Subcutaneous injection of IFN-alpha and _____ is a common treatment for

A

Ribavarin and Hep C

128
Q

Mainly used for HIV treatment but can be used for Hep B. Given orally

A

Lamivudine

129
Q

Treatment for influenza A and B within 48 hours of symptoms of post exposure prophylaxis

A

Zanamavir and Oseltamivir

130
Q

Nucleoside analogue Used for treatment of Respiratory Synctial Virus infections

A

Ribavarin (inhaled in fine spray)

131
Q

Pseudomembranous colitis usually results from Vancomycin (True/False)

A

False - caused by antibiotic therapy and treated with oral vancomycin or metronidazole

132
Q

Thrush is due to overgrowth of anaerobic bacteria during broad spectrum antibiotic therapy (True/False)

A

False- broad spectrum antibiotic causes the overgrowth of the yeast Candida albicans

133
Q

Vancomycin and Tecoplanin are Glycopeptides suitable to treat gram positive organisms such as _____

A

MRSA

134
Q

Penicillin allergic patients may also be allergic to cephalosporins (True or False)

A

True

135
Q

What type and names are the drugs combines to make co-trimaxazole

A

Trimethoprim and Sulphamethoxazole

Inhibition of DNA synthesis

Antimicrobial Chemotherapy (1 decks)

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