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Year 3 Infection (JK) > Antimicrobial chemotherapy seminar > Flashcards

Antimicrobial chemotherapy seminar Flashcards

1
Q

Empiric

A

without microbiology result

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2
Q

directed therapy

A

based on microbiology

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3
Q

Primary prophylaxis examples

A

PEP eg HIV
anti-malarial
pre-operative

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4
Q

Secondary prophylaxis example

A

PJP in HIV

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5
Q

6 important patient characteristics

A 
age 
renal function 
liver function 
pregnancy 
allergies 
immunocompromised
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6
Q

Some things to consider when choosing an antimicrobial

A 
guidelines or individualised therapy 
bacteriocidal or bacteriostatic 
likely organism 
empirical therapy or results based 
single agent or combo 
potential adverse effects
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7
Q

Causative bacteria of soft tissue infection

A 
strep pyogenes 
staph aureus 
strep group C or G 
E.coli 
pseudomonas aeruginosa 
clostridium
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8
Q

Causative bacteria of pneumonia

A 
strep pneumonia 
H influenza 
staph aureus 
Moraxella catarrhalis 
mycoplasma pneumonia 
legionella pneumonia 
klebsiella pneumonia
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9
Q

bactericidal - example, action and example conditions

A

beta lactams
act on cell wall to kill the organism
meningitis, neutropenia and endocarditis

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10
Q

bacteriostatic - example and action

A

macrolides

inhibit protein synthesis and prevent colony growth

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11
Q

What is required in the use of bacteriostatic antimicrobials?

A

require the host immune system to mop up the residual infection

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12
Q

Some examples of conditions using combination therapy

A

HIV, TB, severe sepsis, mixed organisms eg faecal peritonitis

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13
Q

Advantages of single therapy

A

cheaper
fewer side effects
fewer drug interactions

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14
Q

Oral bio-availability

A

ratio of drug level when given orally compared to when given IV

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15
Q

When is the oral route given?

A

no vomiting
normal GI function
no shock
no organ dysfunction

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16
Q

When is IV route given?

A

severe or deep seated infection and when oral route is not reliable

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17
Q

2 types of allergic reactions and what happens

A

immediate hypersensitivity - anaphylactic shock

delayed hypersensitivity - maculopapular rash, erythema nodosum

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18
Q

most common antibiotics causing allergic reactions

A

penicillins and cephalosporins

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19
Q

Other adverse effects of antibiotics

A

c.diff infection, ototoxicity, optic neuropathy, thrush, nephrotoxic meds

20
Q

What antimicrobial can cause megablastic anaemia?

A

co-trimoxazole

21
Q

Antimicrobial stewardship

A

making the best use of our current anti-microbials

22
Q

List people in the antimicrobial management team

A 
IPC team 
antibiotic pharmacist
infectious diseases 
acute medicine 
GP 
medical microbiology
23
Q

Multifactorial cause of MRSA

A 
lack of isolation facilities 
bed/staff shortages 
standard precautions 
antibiotic misuse 
poor hygiene, cleaning and disinfection 
readmission of MRSA carriers from community
24
Q

What are all antivirals?

A

virustatic

25
Q

What are viruses in terms of the host and why?

A

intracellular parasites

utilise host enzymes to replicate

26
Q

Toxicity to host cell due to antivirals example

A

mitochondrial

27
Q

What do most antivirals target?

A

intracellular stages with a greater effect being on viral replication than host cell function

28
Q

nucleoside analogues action

A

inhibit nucleic acid synthesis

29
Q

Some sites of antiviral drug action

A

receptor binding
cell entry
release
uncoating

30
Q

prophylaxis - antiviral example

A

prevent infection

acyclovir for Herpes

31
Q

pre emptive therapy + antiviral example

A

evidence of infection before symptoms

ribavirin for HCV

32
Q

overt viral disease treatment

A

acyclovir and oseltamivir

33
Q

suppressive therapy + antiviral example

A

keep viral replication below rate which causes tissue damage in asymptomatic infection patient eg ART

34
Q

do anti virals eradicate virus from latent cells? consequence of this?

A

no

may need suppressive therapy after overt infection treatment

35
Q

HSV manifestations

A

mucocutaneous, oral, genital, eye, skin
encephalitis
any site in immunocompromised

36
Q

Aciclovir toxicity in uninfected cells and why

A

low - only active in herpes infected cell

37
Q

Why only treat severe or life threatening cmv?

A

all drugs are significantly toxic

38
Q

chronic hep B treatment

A

pegylated interferon alpha - subcut

nucleoside analogue

39
Q

chronic hep c treatment

A

12-48 weeks
pegylated interferon alpha and ribavirin (oral)
and protease inhibitor

40
Q

influenza treatment

A

oseltamivir and zanamivir

41
Q

RSV treatment

A

ribavirin

42
Q

phenotypic resistance

A

can virus grow in presence of compound?

43
Q

genotypic resistance

A

sequence genome and identify resistance associated mutations

44
Q

What to use in HSV and CMV resistance

A

foscarnet

45
Q

4 reasons for IV to oral switch

A

swallow and tolerate fluids
temp 36-38
HR <100 for 12 hours
WCC 4-12 x10 (9)

46
Q

5 reasons to not do an IV to oral switch

A 
oral route compromised 
continuing sepsis 
special indication eg meningitis 
febrile neutropenia 
shock

Year 3 Infection (JK) (12 decks)

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