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3rd Year Infection > Antimicrobial Chemotherapy Booklet > Flashcards

Antimicrobial Chemotherapy Booklet Flashcards

1
Q

What is the Minimal Inhibitory Concentration?

A

The minimum concentration of antimicrobial needed to inhibit visible growth of a given organism

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2
Q

What is the Minimal bactericidal concentration?

A

The minimum concentration of the antimicrobial needed to kill a given organism

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3
Q

What are the main sites of antibiotic action?

A
  1. Inhibition of nucleic acid synthesis
  2. Inhibition of protein synthesis
  3. Inhibition of cell wall synthesis
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4
Q

What antibiotics Inhibit of cell wall synthesis?

A

Beta lactams

Glycopeptides

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5
Q

What is the action of penacillins and cephalosporins?

A

Inhibit cell wall synthesis

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6
Q

What antibiotics make up the beta lactams?

A

penacillins and cephalosporins

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7
Q

What enzymes are involved with the action of penicillin and cephalosporin?

A

Penicillin-binding proteins

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8
Q

What antibiotics make up the glycopeptides?

A

Vancomycin

Teicoplanin

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9
Q

Glycopeptides are effective against what?

A

Gram positive organisms

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10
Q

Vancomycin and Teicoplanin are used against what?

A

Gram positive organisms

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11
Q

What risk is associated with Vancomycin?

A

Toxicity

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12
Q

Which antibiotics inhibit protein synthesis?

A
  • Aminoglycosides
  • Macrolides and Tetracyclines
  • Oxazolidinones (Linezolid)
  • Cyclic Lipopeptide (Daptomycin)
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13
Q

Gentamicin is what type of antibiotic?

A

Aminoglycoside

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14
Q

How does gentamicin affect bacteria?

A

Inhibition of protein synthesis

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15
Q

Aminoglycosides/Gentamicin are typically used in the treatment of what?

A

Serious Gram negative infection

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16
Q

Macrolides and Tetracyclines are used in what?

A

Gram +ve infections in penicillin allergic patients

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17
Q

Daptomycin works how? When is it indicated?

A

Daptomicin Inhibits protein synthesis

Gram +ves especially MRSA

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18
Q

How do Trimethoprim and sulphamethoxazole work?

A

Inhibit Nucleic acid synthesis

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19
Q

What are the indications and contraindications of ciprofloxacin?

A

Gram -ve organisms

not used in children

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20
Q

What are the common mechanisms of bacterial resistance?

A

Intrinsic resistance

Acquired resistance

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21
Q

What are the mechanisms of acquired bacterial resistance?

A

Spontaneous mutation

Species - species spread via plasmids or transposons

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22
Q

What are the mechanisms of Resistance to b–lactam antibiotics?

A

Production of beta-lactamase

Alteration of penicillin binding protein target site

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23
Q

Which beta-lactam antibiotics can be used in beta-lactamase producing bacteria i.e. Staph aureus?

A

Co-amoxiclav (beta-lactamase inhibitor clavulanic acid)

Flucloxacillin

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24
Q

MRSA is resistant to what?

A

All penicillins and cephalosporins

25
What is the impact of Extended spectum beta-lactamases?
Produced by some gram -ve bacteria Renders them immune to **all** Beta-lactam agents
26
What agents fall under 'Beta-lactams'?
Penicillins and Cephalosporins
27
Outline the main classes of antibiotics
B-lactams (Cephalosporins and Penicillins) Aminoglycosides Glycopeptides Macrolides Quinolones
28
Name 3 penicillins and their uses
**Benzyl penicillin** - IV use in **Amoxicillin** - streptococci **Co-amoxiclav** - β-lactamase producing coliforms **Flucloxacillin** - Staph **Piperacillin** - Pseudomonas **Carbapenems** - Broad spec
29
Name a cephalosporin and its use
**Ceftriaxone** **Ceftazidime** _Increase risk of *Clostridium difficile*_
30
Name 2 Glycopeptides and their uses?
_Parenteral use only_ **Vancomycin** - (Monitor as _toxic_) **Teicoplanin** Use in gram positives
31
Name 2 Macrolides and their uses?
**Clarithromycin**/**Erythromycin** - alternative to _penicillin_ in gram positives **Azythromycin** - Chlamydia
32
Name 2 Quinolones and their uses?
_Wide action against gram negative bacteria_ Pseudomonas **Ciprofloxacin** **Levofloxacin**
33
What is the indication for metronidazole?
Gram -ve **and** +ve anaerobes
34
What is the indication for fusidic acid?
Used with **flucloxacillin** against *Staphylococcus aureus*
35
What is the indication for Trimethoprim?
**Urinary Tract infections**
36
What are the main drugs which confer a risk of *Clostridium difficile* infection?
**Clindamycin** **C****ephalosporins** **Co-****amoxiclav** **Ciprofloxacin**
37
Outline the use of Tetracyclines?
Broad spectrum _Teratogenic_
38
Outline the use of **Clindamycin?**
Very good tissue penetration vs gram +ves Risk *_C. diff_*
39
Outline the use of **Linezolid**?
Use vs MRSA Bone marrow suppression
40
Outline the use of Daptomycin?
MRSA
41
What antibiotics are used in treatment of *C. difficile* infection?
## Footnote **Vancomycin** **Metronidazole**
42
What antibiotics are indicated in use for _Urinary tract infections_?
**Nalidixic acid** **Nitrofurantoin** **Trimethoprim**
43
Give 5 side effects of antibiotic use?
**Allergy** - Immediate -or- delayed ## Footnote **GI** **Thrush** **Liver toxicity** **Renal toxicity** **Neurotoxicity** **Haemotoxicity**
44
Hepatotoxicity is associated with which antimicrobials?
**Tetracycline** **Flucloxacillin** Isoniazid and Rifampicin
45
Renal toxicity is associated with which antimicrobials?
PMH renal disease Aminoglycosides (Gentamicin) **Vancomycin**
46
Neuro toxicity is associated with which antimicrobials?
Hearing - Aminoglycosides, vancomycin Vision - Ethambutol Encephalopathy Peripheral neuropathy
47
When should combination antimicrobial therapy be considered?
Mixed infection Synergistic effects Avoiding resistant strains - TV, HIV
48
Which antibiotics should have levels monitored for toxicity?
Vancomycin Gentamicin
49
What are the functions of the laboratory in antimicrobial use?
Advice Efficacy and toxicity Susceptibility test (Automated, E test)
50
What are the main classes of Anti-fungal drugs?
Polyenes Azoles Allylamines Echinocandins
51
Outline the use of Polyenes
Amphotericin B - serious fungal infections, _toxic_ Nystatin - topical fungal infections
52
Outline the use of Azoles
Fluclonazole - yeast infections Itraconazole and Voriconazole - aspergillosis
53
Outline the use of Allylamines
Terbafine - skin/nail fungal infections
54
Outline the use of Echinocandins
Serious Candida and Aspergillus infections
55
What drgug is indicated in HSV and Varicella zoster virus?
Aciclovir
56
Outline the use of Anti-herpes drugs?
Aciclovir, Famciclovir - HSV, Varicella Ganciclovir - infections in the immunocompromised Valganciclovir - CMV Foscarnet
57
Outline the use of Anti-HIV drugs?
AZT (nucleoside analogue) 2 nucleoside analogue reverse transcriptase inhibitors plus either: * non-nucleoside reverse transcriptase inhibitor * Protease inhibitor
58
Outline the use of Hep B/C drugs?
Interferon-a(lpha) - serious side effects Lamivudine

3rd Year Infection (16 decks)

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