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Clinical Pharmacology II > Antimicrobial Introduction > Flashcards

Antimicrobial Introduction Flashcards

1
Q

What are bacteria?

A

microorganisms that are microns large

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2
Q

What are some types of sample specimens that can be collected and then cultured on an agar plate and looked at under a microscope?

A

Sputum
blood
bodily fluids
swabs

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3
Q

What shape are cocci?

A

sphere

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4
Q

What shape are bacillus?

A

rods

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5
Q

What shape are spirilla?

A

Spirochete

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6
Q

Which type of bacteria has a thick layer of peptidoglycan?

A

Gram +

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7
Q

Which type of bacteria has an extra outer membrane?

A

Gram -

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8
Q

What are the types of patterns of bacteria?

A

Clusters
Chains
Pairs

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9
Q

What are the reactive tests for Gram + cocci?

A

Blood Agar Test

Coagulase Test

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10
Q

What type of bacteria does a Blood Agar Test test for?

A

Streptococci

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11
Q

What type of bacteria does a coagulase test test for?

A

Staphylococci

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12
Q

What are the three degree of hemolysis on blood agar?

A

Beta hemolysis = lyse all blood
Alpha hemolysis = partial
Gamma hemolysis = no enzyme to lyse blood

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13
Q

What color do Gram + bacteria stain?

A

purple

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14
Q

What two shapes are Gram + bacteria?

A

Cocci

bacilli

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15
Q

What types of patterns to Gram + cocci produce?

A

Chains
Pairs
Clusters

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16
Q

What types of patterns to Gram + bacilli produce?

A

no pattern

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17
Q

What reactive tests are used for Gram + cocci chain bacteria?

A

Hemolysis +/-

Lancefield Classification

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18
Q

What reactive tests are used for Gram + cocci pairs bacteria?

A

Hemolysis +/-

Lancefield Classification

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19
Q

What reactive tests are used for Gram + cocci cluster bacteria?

A

Coagulase test

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20
Q

What are some common Gram + cocci bacteria?

A

Streptococcus
Staphylococcus
Enterococcus
Peptostreptococcus

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21
Q

What type of bacteria is Peptostreptococcus?

A

anearobic

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22
Q

What are some common types of Gram + Bacilli bacteria?

A

Bacillus anthracis
Clostridium - C. diff
Corynebacterium - mouth flora
Listeria - meningitis

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23
Q

What type of bacteria is Clostridium?

A

anaerobic

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24
Q

What type of bacteria tend to be the most virulent?

A

Gram + cocci

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25
What are reactive tests for Gram Negative rods (GNR)?
Oxidase test | Lactose Test
26
What is a positive oxidase test?
swab turns purple
27
What is a positive lactose test?
pink
28
What color do Gram Negative bacteria stain?
pink
29
What two shapes are Gram Negative bacteria?
Bacilli | Cocci
30
What reactive tests are used for Gram negative bacilli?
Lactose test
31
What reactive tests are used for Gram negative cocci?
Nitrate tests
32
What are some common Gram negative cocci?
Neisseria Gonorrhoeae Neisseria Meningitides Moraxella
33
What are some common Gram Negative, Lactose Fermenting Bacilli Bacteria?
``` Citrobacter E. coli Enterobacter Klebsiella Serratia ```
34
What are some common Gram Negative, Non-lactose fermenting bacilli?
Pseudomonas sp.
35
Is pseudomonas oxidase positive or negative?
positive
36
What is a common Gram negative coccobacilli?
Haemophilus INfluenza
37
What are encapsulated organisms?
bacteria that have an extra thick layer of polysaccharide that are unable to undergo phagocytosis
38
What patients have a high mortality rate from infections of encapsulated organisms?
Patients without B cells or a spleen
39
What are some common encapsulated organisms?
``` Hemophilus influenza type B Streptococcus pneumoniae Neisseria meningtides Group A and B streptococcus Klebsiella pneumoniae Salmonella typhi ```
40
What are atypical bacteria?
DON"T GRAM STAIN Incomplete bacteria Zoonotic Lack a cellular wall Replicate within host cells
41
What are some types of atypical bacteria?
Mycoplasma Pneumoniae Chlamydia Pneumoniae Rickettsias
42
Where are bacteria found?
Environment Objects On us! THEY ARE EVERYWHERE
43
What are normal flora of the eye?
Staphylococcus Haemophilus Streptococcus
44
What are normal flora of the Nose?
Staphylococcus Streptococcus Neisseria
45
What are normal flora of the Mouth?
Streptococcus Staphyloccocus Veilonella
46
What are normal flora of the Small intestine?
Lactobacillus Bacteroides Clostridium
47
What are normal flora of the Large Intestine?
Bacteroides Fuseobacterium Clostridium
48
What are normal flora of the Vagina?
Lactobacillus Peptostreptococcus Diptheroids
49
What are normal flora of the Urethra?
Staphylococcus Diptheroids Streptococcus
50
What are normal flora of the skin?
Staphylococcus Streptococcus Diptheroids
51
What are normal flora of the stomach?
Streptococcus Staphylococcus Lactobacillus
52
What are normal flora of the outer ear?
Staphylococcus Diptheroids Pseudomonas
53
What causes infections?
Bacterial Translocate into a sterile site by break down of protective barrier or translocation of bacteria
54
Exotoxins are produced by?
inside mostly gram + bacteria
55
When are exotoxins secreted?
following lysis of the bacteria
56
Endotoxins are produced by?
part of the outer portion of cell wall of Gram negative bacteria
57
When are endotoxins secreted?
when the bacteria dies and the cell wall breaks apart
58
What does susceptible mean?
that the antibiotic is effective at INHIBITING growth of the bacteria or KILLING bacteria
59
What is susceptibility based on?
The Minimum Inhibitory Concentration (MIC)
60
What is MIC?
the smallest concentration of abtibiotic effective to inhibit bacterial growth
61
What is MIC measured by?
the Zone of Inhibition
62
What tests are used to determine whether antibiotics inhibit bacterial growth?
Disk Diffusion Gradient/Etest method Serial Dilution
63
What are ESKAPE pathogens?
Those bacteria that are more likely to become resistant to antibiotics?
64
What are the common ESKAPE pathogens?
``` Enterococcus Faecium Staphylococcus aureus Klebsiella Acinetobacter Pseudomonas Enterobacter ```
65
What mechanisms do ESKAPE pathogens use to evade antibiotics?
efflux pumps enzymes for antibiotic degradation cell wall alteration protein synthesis variation
66
How do ESKAPE pathogens pass along resistance?
by exchanging plasmids
67
What is Empiric Therapy?
antibiotics are chosen prior to knowing identification and sensitivity of pathogens broad spectrum
68
What is de-escalation?
we narrow therapy from the broad antibiotic used in empiric therapy
69
What is antimicrobial stewardship?
preserves broad spectrum antibiotics and limits development of resistance
70
What is an antibiogram?
shows the trends in susceptibility patterns rows are bacteria; columns are antibiotic varies year to year and region to region
71
What Streptococci are alpha-hemolytic?
S. viridans | S. pneumoniae
72
What Streptococci are beta-hemolytic?
S. pyogenes (Group A) | S. agalactiae (Group B)
73
What are streptococcus?
Gram + chains that are easily to kill They cause a lot of virulence and many infections
74
What are staphylococcus?
Gram + clusters
75
What is Staphylococcus aureus?
Coag + MRSA or MSSA produces toxin
76
What is MRSA?
methicillin resistant staph aureus easily transmitted and increased prevalence of infections
77
What is MSSA?
methicillin sensitive Staph aureus
78
What is Staphylococcus Epidermis?
``` Coag negative common bacteria of the skin not susceptible to many antibiotics usually not virulent can cause wound and bone infections ```
79
What type of bacteria is often a contaminant of blood cultures?
Staphylococcus Epidermis
80
What are Enterococcus?
Gram + chains
81
What is Enterococcus Faecium?
not virulent | VRE vs. VSE
82
What is Enterococcus Faecalis?
not virulent problematic for immunocompromised patients usually susceptible to vancomycin and penicillins
83
What are HNM?
Gram Negative Cocci
84
What bacteria are HNM?
Haemophilus Neisseria Moraxella
85
What are common infections of Haemophilus and Moraxella?
upper and lower respiratory tract infections
86
What are common infections of Neisseria
Meningitis and STDs
87
How do you treat atypical bacteria?
treat without knowing
88
What are common infections of atypical bacteria?
Upper Respiratory Tract Infections | Walking Pneumoniae
89
What are enteric Gram Negatives?
Group of bacteria that include gram negative rods and lactose and non-lactose fermenting organisms Have a potential to develop resistance to antibiotics
90
What are common Gram Negative rod bacteria?
``` E. Coli Proteus Serratia Acinetobacter Citrobacter Klebsiella Legionella pneumoniae ```
91
What are common community infections of GNR?
UTI | Abdominal infections
92
What are common hospital infections of GNR?
Pneumonia UTI These are more resistant to drugs
93
What is pseudomonas?
Gram - Non lactose fermenting oxidase positive
94
What are common infections of Pseudomonas?
Pseudomonia Wounds Osteomyelitis
95
What infections are commonly related to Pseudomonas?
Hospital acquired infections
96
What are types of Gram + anaerobes?
``` Clostridium Actinomyces Lactobacillus Propionibacterium Peptostreptococcus ```
97
What are types of Gram - anaerobes?
Bacteroides fragillis Fusobacterium Porphyromonas Veillonella
98
What are anerobes?
rarely infectious by themselves
99
What type of bacteria are on the rise?
C. diff MRSA VRE S.P.A.C.E organism
100
What do you need to worry about with anaerobes?
abscesses in peritoneal, brain, and lung
101
What are S.P.A.C.E organisms?
multi drug resistant gram negative rods
102
What bacteria are SPACE organisms?
``` Serratia Pseudomonas Acinetobacter Citrobacter Enterobacter ```
103
What are the types of antibiotic cellular sites of action?
Cell wall Protein synthesis DNA/RNA synthesis and replication
104
What antibiotic works on DNA synthesis?
Metronidazole
105
What antibiotic works on DNA gyrase?
Quinolones
106
What antibiotic works on RNA polymerase?
Rifampicin
107
What is a bactericidal antibiotic?
one that kills the pathogen
108
What is a bacteriostatic antibiotic?
one that inhibits further growth of the pathogen
109
What are most antibiotics?
bacteriocidal
110
What are Type 1 patterns of acitivity of antibiotics?
concentration dependent and prolonged persistent effects High dose, low frequency
111
What anitbiotics are Type 1 patterns?
Aminoglycosides Daptomycin Fluoroquinolones
112
What is the goal of therapy of type 1 patterns?
Maximize concentrations
113
What are the pharmacokinetic parameters of type 1 patterns?
24 hour AUC/MIC | Peak (Cmax/MIC)
114
What are type 2 patterns of activity of antibiotics?
time dependent and minimal persistent effects Low dose, high frequency
115
What antibiotics are type 2 patterns?
B-lactams Linezolid Erythromycin
116
What is the goal of therapy of type 2 patterns?
Maximize duration of exposure
117
What is the pharmacokinetic parameters of type 2 patterns?
T>MIC
118
What are type 3 patterns of activity of antibiotics?
Time dependent and moderate to prolonged persistent effects COMBO
119
What antibiotics are type 3 patterns?
``` Azithromycin Clindamycin Tetracyclines Vancomycin Metronidazole ```
120
What is the goal of therapy of type 3 patterns?
maximize amount of drug
121
What is the pharmacokinetic parameters of type 3 patterns?
24 hour AUC/MIC

Clinical Pharmacology II (25 decks)

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