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Yr3 CSP > Antimicrobial Drugs, September 7th > Flashcards

Antimicrobial Drugs, September 7th Flashcards

1
Q

What are the main Classes of Cephalosporins and how do we distinguish them by name?

A 
Class 1 have PHA/FA in their names
Class 2 are random
Class 3 contain ONE/TEN/IME at the ends
Class 4 contain PI in it
Class 5 contain ROL in it

The classes become more capable of dealing with Gram Negative Bacteria as they develop

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2
Q

Which agent that inhibits Protein Synthesis is Bactericidal?

A

Aminoglycosides

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3
Q

Give two examples of Aminoglycosides

A

Gentamicin and Amikacin

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4
Q

Give three examples of Macrolides

A

Azithromycin, Clarithromycin, Erythromycin

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5
Q

What is the Mechanism of Action of Aminoglycosides

A

Acts upon the 30S subunit on the ribosomes

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6
Q

What bacteria can Aminoglycosides affect?

A

Gram (+) (Staph) and Gram (-); Anti-pseudomonal

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7
Q

How are Aminoglycosides administered and what is the dosage?

A

IV Once a Day or TDS/BD (2/3)

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8
Q

What are the main side effects of Aminoglycosides

A
  1. Nephrotoxicity (Reversible)
  2. Ototoxicity (Vestibular is Reversible, Auditory not)
  3. NMJ Blockage at high dose
  4. Damages Eighth Nerve in Pregnancy
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9
Q

What are the main interactions of Aminoglycosides

A

Increased Nephrotoxicity with:

  1. Vancomycin
  2. Colistin (Polymyxin)
  3. Ambisome (Antifungal)
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10
Q

What is the Mechanism of Action of Macrolides

A

Acts upon the 50S subunit on the ribosomes

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11
Q

What bacteria can Macrolides affect?

A

Gram (+) and usually H.influenzae

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12
Q

How are Macrolides administered and what is the dosage

A

Oral and IV (Can cause Thromboplebitis)

Once or Twice a Day

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13
Q

Which Macrolide has shown excellent intracellular penetration

A

Azithromycin

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14
Q

What are the main side effects in Macrolides

A

Though safe in Children, it can:

  1. Erythromycin Inhibits P450
  2. Prolong QT
  3. Nausea and Vomiting
  4. Abdominal Pain
  5. Liver toxicity
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15
Q

Which bacteria are known to cause resistance in Aminoglycosides

A

Gram Negative Organisms (Acquired)

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16
Q

Which bacteria are known to cause resistance in Macrolides

A

Both Staphs and Streps

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17
Q

What drugs can affect Nucleic Acid Metabolism

A
  1. Quinolones (Ciprofloxacin Moxifloxacin, Levofloxacin)
  2. Rifampicin
  3. Metronidazole (Good against most Anaerobes)
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18
Q

What is the Mechanism of Quinolones

A

Inhibits DNA Gyrase and kills Bacteria

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19
Q

What types of Bacteria do Quinolones affect?

A

Gram + : Staph, not Streps

Gram - : Anti-pseudomonal too

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20
Q

How are Quinolones administered and what is the dosage?

A

Oral and IV

Twice a Day

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21
Q

What are the main side effects of Quinolones?

A
  1. Ruptures Tendons
  2. Photosensitivity
  3. Seizures and Prolonged QT
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22
Q

Human cells are known to not synthesise _____ and will lack _____?

A

Folic Acid

Lack Dihydropteroate Synthase

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23
Q

What are examples of Antifolates?

A

Sulphonamides

Trimethoprim

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24
Q

What is the mechanism of action of Sulphonamides?

A

Inhibiting Dihydropteroate Synthase

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25
What is the mechanism of action of Trimethoprim?
Inhibiting Dihydrofolate Reductase
26
What types of drugs can affect the Membranes of Bacteria?
1. Colistin (Polymyxin) 2. Amphotericin (Antifungals) 3. Daptomycin
27
What are qualities required for the IDEAL antibiotic?
1. Magic Bullet (Selectively kills MO without harming body/microbiome) 2. Reach and Concentrates within the Target Organ 3. Reach good levels in Infected Body Fluids 4. Non-Toxic 5. Cheap 6. No selection of resistance
28
Which antibiotics have the greatest influence throughout the Antimicrobial Spectrum?
Meropenem and Imipenem have the greatest, affecting both Gram Positive and Negative Bacteria
29
Which Antibiotics in the Antimicrobial Spectrum can only affect Gram Positive Bacteria?
Benzyl Penicillin Flucloxacillin Vancomycin/Teicoplanin (Glycopeptides)
30
What are the main infection issues with Antimicrobial Resistance?
1. UTI 2. RTI 3. N. gonorrhoea 4. M. tuberculosis 5. Diarrhoea
31
What are the main reasons for Antimicrobial resistance in regards to specific drugs and bacteria?
1. Multidrug Resistance 2. Penicillin Resistance 3. Beta-lactamase producing Coliforms 4. Resistant Pneumococci and H.influenzae 5. Resistant Salmonella and Shingles
32
What are some of the most dangerous resistant bacteria in Hospitals?
1. MRSA 2. Coagulase-Negative Staph 3. Multi-resistant Enterococci 4. Multi-resistant Gram Negative Rods a. Pseudomonas, Klebsiella, Enterobacter, Acinetobacter
33
What is the difference between Synergistic and Antagonistic Combinations?
Synergistic: Combined activity > Sum of individual (Beta Lactam + Aminoglycoside) Antagonistic: Activity of 1 drug is compromised by the other (Tetracylcine/Chloramphenicol with Beta-Lactam or Aminoglycoside, or Two Beta Lactams)
34
Which types of Drugs are mostly ANTI-GRAM Positive?
1. Penicillins 2. Fusidic Acid 3. Macrolides 4. Clindamycin 5. Glycopeptides 6. Oxazolidinones 7. Daptomycin
35
Which types of Drugs are mostly ANTI-GRAM Negative?
1. Trimethoprim 2. Polymyxin (Colistin) 3. Monobactams (Aztreonam) 4. Aminoglycosides (Good against Strep, Staph, Enterococci too) 5. Temocillin
36
What Drugs are Broad Spectrum Antimicrobials?
Beta Lactams 1. Carbapenems 2. Amoxicillin/Clavulanate 3. Piperacilin/Tazobactam 4. Cephalosporins 5. Chloramphenicol 6. Tetracycline (Spirochaetes) (These two can deal with +/-/Atypicals/Anaerobes)
37
Which Drugs act upon the Cell Wall?
Beta Lactams 1. Penicillin 2. Cephalosporins 3. Carbapenems 4. Aztreonam Glycopeptides 1. Vancomycin 2. Teicoplanin
38
Which Drugs act upon the Cell Membrane?
Polymyxin
39
Which drugs affect Nucleic Acid Synthesis?
1. Quinolones (DNA Gyrase) 2. Rifampin (RNAP) 3. Metronidazole (Anaerobic DNA inhibitors) 4. Antifolates (Trimethoprim, Sulfonamides)
40
What bacteria can Penicillin affect?
Gram +
41
What is the route and dosage of Penicillin?
Oral/IV | 4-6 Times a Day
42
What is the Mechanism of Action of Penicillin?
Inhibits CW Synthesis
43
What the main side effects of Penicillin?
Allergies Resistance (Beta Lactamases) Cross Hyper-sensitivity
44
How do bacteria gain resistance from Penicillin?
Alteration of PBPs | Production of Beta Lactamases
45
What Drugs can Penicillin interact with?
Allopurinol | Methotrexate
46
What bacteria can Amoxicillin affect?
Gram + and -
47
What is the route and dosage of Amoxicillin?
Oral/IV | 3 Times a day
48
When do we administer Penicillin?
Streptococcal and Meningococcal Disease
49
When do we administer Amoxicillin?
Streptococcal except sore throat | Listeria
50
What drugs can Amoxicillin interact with?
Allopurinol (Rash) | Can cause Antibiotic-Associated Diarrhoea
51
What is the MOA of Flucloxacillin?
Inhibition of the Cell Wall synthesis
52
What bacteria can Flucloxacillin kill?
Gram + only
53
What is the dosage and route of administration of Flucloxacillin?
Oral/IV | 4 times a day
54
When do we give Flucloxacillin?
All S.aureus infections except MRSA
55
What drugs can Flucloxacillin interact with?
Not many
56
What is Co-Amoxiclav's MOA and what are the Two drugs?
Inhibition of CW Synthesis and Beta-Lactamase Inhibitor Amoxicillin and Clavulanic Acid
57
What bacteria can Co-Amoxiclav kill?
Gram + Gram - Anti-Anaerobic
58
What is the dosage and route of administration of Co-amoxiclav?
Oral/IV | 3 times a day
59
What resists Co-amoxiclav?
MRSA | Hospital Acquired Gram - (Pseudomonas)
60
When do we administer Co-amoxiclav?
Polymicrobial infections | B-lactamase producing Gram +/- infections
61
What is the Mechanism of Action of Piptazobactam and what are the two drugs that make it up?
Inhibition of CW Synthesis and Beta-Lactamase Inhibitor Piperacillin and Tazobactam
62
What types of drugs do Piptazobactam kill?
Gram + Gram - Anti-anaerobes Anti-PSEUDOMONAL
63
What is the route of Administration and Dosage of Piptazobactam?
IV | 3-4 times a day
64
What is Piptazobactam resistant to?
MRSA | Hospital Acquired Gram - (Pseudomonas)
65
When do we administer Piptazobactam
Polymicrobial infections B-lactamase producing Gram +/- infections PSEUDOMONAS
66
What is the MOA of Cefuroxime and what Class is it?
Inhibits CW synthesis | Class 3
67
What types of bacteria does Cefuroxime kill?
Gram + Gram - NOT PSEUDOMONAS
68
What is the route of administration and dosage of Cefuroxime
IV | 3 times a day
69
What is Cefuroxime resistant against?
MRSA | Gram -
70
When would we give Cefuroxime?
Pneumonia | Intra-abdominal and UT infections (Add Metronidazole for ab)
71
Why do bacteria resist Cefuroxime?
Production of ESBL Impermeability Altered PBPs Efflux
72
What is the MOA of Ceftriaxone and what Class is it?
Inhibits CW synthesis | Class 3
73
What types of bacteria does Ceftriaxone kill?
Gram + Gram - NOT PSEUDOMONAS
74
What is the route of administration and dosage of Ceftriaxone
IV | 1 or 2 times a day
75
What are the side effects of Cefuroxime?
C.diff | Diarrhoea
76
What are the side effects of Ceftriaxone?
C.diff Diarrhoea Pseudocholelithiasis (Drug complexes with calcium and mimics gallstones)
77
Which drug can cause Pseudocholelithiasis
Ceftriaxone
78
When would we give Ceftriaxone?
Meningitis Pneumonia Sometimes Gonorrhea
79
Which Cephalosporin is capable of dealing with Pseudomonas aeruginosa?
Ceftazidime
80
What types of bacteria does Ceftazidime kill?
Gram + Gram - YES PSEUDOMONAS
81
What is the route of administration and dosage of Ceftazidime?
IV | 3 times a day
82
What is the MOA of Meropenem?
Inhibits CWS | Beta Lactamase Inhibitor AND ESBLs
83
What bacteria can Meropenem kill?
Gram + Gram - Anti-anaerobic actions Anti-pseudomonal
84
What is the route of administration and dosage of Meropenem?
IV | 3 times a day
85
When would we prescribe Meropenem?
Polymicrobial infections | ESBL producing Gram - infections
86
What is the difference between Antibiotics and Antimicrobials?
Antibiotics: Naturally made by MOs - Fungal (Penicillin/Cephalosporins) - Actinomycetes (Streptomycin) Antimicrobials: Semi-synthetic to stop MO growth - Sulphonamides - Ampicillin - Quinolones
87
Why do bacteria resist Meropenem?
Metallo-B-Lactamase Impermeability Efflux Altered PBP
88
What is the Mechanism of action of Glycopeptides?
Acts on the Cell Wall?
89
Give Two Examples of Glycopeptides
Vancomycin and Teicoplanin
90
What bacteria do glycopeptides kill?
Gram + | Anaerobic C.diff
91
What is the dosage and route of Glycopeptides?
IV | 1-2 times a day
92
What are the side effects of Vancomycin?
Nephrotoxicity | Red Man Syndrome
93
What types of Bacteria can Cephalosporins NOT deal with?
Enterococci

Yr3 CSP (4 decks)

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