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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
Q

What are reactive tests for Gram Negative rods (GNR)?

A

Oxidase test

Lactose Test

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26
Q

What is a positive oxidase test?

A

swab turns purple

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27
Q

What is a positive lactose test?

A

pink

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28
Q

What color do Gram Negative bacteria stain?

A

pink

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29
Q

What two shapes are Gram Negative bacteria?

A

Bacilli

Cocci

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30
Q

What reactive tests are used for Gram negative bacilli?

A

Lactose test

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31
Q

What reactive tests are used for Gram negative cocci?

A

Nitrate tests

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32
Q

What are some common Gram negative cocci?

A

Neisseria Gonorrhoeae
Neisseria Meningitides
Moraxella

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33
Q

What are some common Gram Negative, Lactose Fermenting Bacilli Bacteria?

A 
Citrobacter
E. coli
Enterobacter
Klebsiella
Serratia
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34
Q

What are some common Gram Negative, Non-lactose fermenting bacilli?

A

Pseudomonas sp.

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35
Q

Is pseudomonas oxidase positive or negative?

A

positive

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36
Q

What is a common Gram negative coccobacilli?

A

Haemophilus INfluenza

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37
Q

What are encapsulated organisms?

A

bacteria that have an extra thick layer of polysaccharide that are unable to undergo phagocytosis

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38
Q

What patients have a high mortality rate from infections of encapsulated organisms?

A

Patients without B cells or a spleen

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39
Q

What are some common encapsulated organisms?

A 
Hemophilus influenza type B
Streptococcus pneumoniae
Neisseria meningtides
Group A and B streptococcus
Klebsiella pneumoniae
Salmonella typhi
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40
Q

What are atypical bacteria?

A

DON”T GRAM STAIN

Incomplete bacteria

Zoonotic

Lack a cellular wall

Replicate within host cells

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41
Q

What are some types of atypical bacteria?

A

Mycoplasma Pneumoniae
Chlamydia Pneumoniae
Rickettsias

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42
Q

Where are bacteria found?

A

Environment
Objects
On us!

THEY ARE EVERYWHERE

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43
Q

What are normal flora of the eye?

A

Staphylococcus
Haemophilus
Streptococcus

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44
Q

What are normal flora of the Nose?

A

Staphylococcus
Streptococcus
Neisseria

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45
Q

What are normal flora of the Mouth?

A

Streptococcus
Staphyloccocus
Veilonella

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46
Q

What are normal flora of the Small intestine?

A

Lactobacillus
Bacteroides
Clostridium

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47
Q

What are normal flora of the Large Intestine?

A

Bacteroides
Fuseobacterium
Clostridium

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48
Q

What are normal flora of the Vagina?

A

Lactobacillus
Peptostreptococcus
Diptheroids

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49
Q

What are normal flora of the Urethra?

A

Staphylococcus
Diptheroids
Streptococcus

50
Q

What are normal flora of the skin?

A

Staphylococcus
Streptococcus
Diptheroids

51
Q

What are normal flora of the stomach?

A

Streptococcus
Staphylococcus
Lactobacillus

52
Q

What are normal flora of the outer ear?

A

Staphylococcus
Diptheroids
Pseudomonas

53
Q

What causes infections?

A

Bacterial Translocate into a sterile site by break down of protective barrier or translocation of bacteria

54
Q

Exotoxins are produced by?

A

inside mostly gram + bacteria

55
Q

When are exotoxins secreted?

A

following lysis of the bacteria

56
Q

Endotoxins are produced by?

A

part of the outer portion of cell wall of Gram negative bacteria

57
Q

When are endotoxins secreted?

A

when the bacteria dies and the cell wall breaks apart

58
Q

What does susceptible mean?

A

that the antibiotic is effective at INHIBITING growth of the bacteria or KILLING bacteria

59
Q

What is susceptibility based on?

A

The Minimum Inhibitory Concentration (MIC)

60
Q

What is MIC?

A

the smallest concentration of abtibiotic effective to inhibit bacterial growth

61
Q

What is MIC measured by?

A

the Zone of Inhibition

62
Q

What tests are used to determine whether antibiotics inhibit bacterial growth?

A

Disk Diffusion
Gradient/Etest method
Serial Dilution

63
Q

What are ESKAPE pathogens?

A

Those bacteria that are more likely to become resistant to antibiotics?

64
Q

What are the common ESKAPE pathogens?

A 
Enterococcus Faecium
Staphylococcus aureus
Klebsiella 
Acinetobacter
Pseudomonas
Enterobacter
65
Q

What mechanisms do ESKAPE pathogens use to evade antibiotics?

A

efflux pumps
enzymes for antibiotic degradation
cell wall alteration
protein synthesis variation

66
Q

How do ESKAPE pathogens pass along resistance?

A

by exchanging plasmids

67
Q

What is Empiric Therapy?

A

antibiotics are chosen prior to knowing identification and sensitivity of pathogens

broad spectrum

68
Q

What is de-escalation?

A

we narrow therapy from the broad antibiotic used in empiric therapy

69
Q

What is antimicrobial stewardship?

A

preserves broad spectrum antibiotics and limits development of resistance

70
Q

What is an antibiogram?

A

shows the trends in susceptibility patterns

rows are bacteria; columns are antibiotic

varies year to year and region to region

71
Q

What Streptococci are alpha-hemolytic?

A

S. viridans

S. pneumoniae

72
Q

What Streptococci are beta-hemolytic?

A

S. pyogenes (Group A)

S. agalactiae (Group B)

73
Q

What are streptococcus?

A

Gram + chains that are easily to kill

They cause a lot of virulence and many infections

74
Q

What are staphylococcus?

A

Gram + clusters

75
Q

What is Staphylococcus aureus?

A

Coag +
MRSA or MSSA
produces toxin

76
Q

What is MRSA?

A

methicillin resistant staph aureus

easily transmitted and increased prevalence of infections

77
Q

What is MSSA?

A

methicillin sensitive Staph aureus

78
Q

What is Staphylococcus Epidermis?

A 
Coag negative
common bacteria of the skin
not susceptible to many antibiotics
usually not virulent
can cause wound and bone infections
79
Q

What type of bacteria is often a contaminant of blood cultures?

A

Staphylococcus Epidermis

80
Q

What are Enterococcus?

A

Gram + chains

81
Q

What is Enterococcus Faecium?

A

not virulent

VRE vs. VSE

82
Q

What is Enterococcus Faecalis?

A

not virulent
problematic for immunocompromised patients
usually susceptible to vancomycin and penicillins

83
Q

What are HNM?

A

Gram Negative Cocci

84
Q

What bacteria are HNM?

A

Haemophilus
Neisseria
Moraxella

85
Q

What are common infections of Haemophilus and Moraxella?

A

upper and lower respiratory tract infections

86
Q

What are common infections of Neisseria

A

Meningitis and STDs

87
Q

How do you treat atypical bacteria?

A

treat without knowing

88
Q

What are common infections of atypical bacteria?

A

Upper Respiratory Tract Infections

Walking Pneumoniae

89
Q

What are enteric Gram Negatives?

A

Group of bacteria that include gram negative rods and lactose and non-lactose fermenting organisms

Have a potential to develop resistance to antibiotics

90
Q

What are common Gram Negative rod bacteria?

A 
E. Coli
Proteus
Serratia
Acinetobacter
Citrobacter
Klebsiella
Legionella pneumoniae
91
Q

What are common community infections of GNR?

A

UTI

Abdominal infections

92
Q

What are common hospital infections of GNR?

A

Pneumonia
UTI

These are more resistant to drugs

93
Q

What is pseudomonas?

A

Gram -
Non lactose fermenting
oxidase positive

94
Q

What are common infections of Pseudomonas?

A

Pseudomonia
Wounds
Osteomyelitis

95
Q

What infections are commonly related to Pseudomonas?

A

Hospital acquired infections

96
Q

What are types of Gram + anaerobes?

A 
Clostridium
Actinomyces
Lactobacillus
Propionibacterium
Peptostreptococcus
97
Q

What are types of Gram - anaerobes?

A

Bacteroides fragillis
Fusobacterium
Porphyromonas
Veillonella

98
Q

What are anerobes?

A

rarely infectious by themselves

99
Q

What type of bacteria are on the rise?

A

C. diff
MRSA
VRE
S.P.A.C.E organism

100
Q

What do you need to worry about with anaerobes?

A

abscesses in peritoneal, brain, and lung

101
Q

What are S.P.A.C.E organisms?

A

multi drug resistant gram negative rods

102
Q

What bacteria are SPACE organisms?

A 
Serratia
Pseudomonas
Acinetobacter
Citrobacter
Enterobacter
103
Q

What are the types of antibiotic cellular sites of action?

A

Cell wall
Protein synthesis
DNA/RNA synthesis and replication

104
Q

What antibiotic works on DNA synthesis?

A

Metronidazole

105
Q

What antibiotic works on DNA gyrase?

A

Quinolones

106
Q

What antibiotic works on RNA polymerase?

A

Rifampicin

107
Q

What is a bactericidal antibiotic?

A

one that kills the pathogen

108
Q

What is a bacteriostatic antibiotic?

A

one that inhibits further growth of the pathogen

109
Q

What are most antibiotics?

A

bacteriocidal

110
Q

What are Type 1 patterns of acitivity of antibiotics?

A

concentration dependent and prolonged persistent effects

High dose, low frequency

111
Q

What anitbiotics are Type 1 patterns?

A

Aminoglycosides
Daptomycin
Fluoroquinolones

112
Q

What is the goal of therapy of type 1 patterns?

A

Maximize concentrations

113
Q

What are the pharmacokinetic parameters of type 1 patterns?

A

24 hour AUC/MIC

Peak (Cmax/MIC)

114
Q

What are type 2 patterns of activity of antibiotics?

A

time dependent and minimal persistent effects

Low dose, high frequency

115
Q

What antibiotics are type 2 patterns?

A

B-lactams
Linezolid
Erythromycin

116
Q

What is the goal of therapy of type 2 patterns?

A

Maximize duration of exposure

117
Q

What is the pharmacokinetic parameters of type 2 patterns?

A

T>MIC

118
Q

What are type 3 patterns of activity of antibiotics?

A

Time dependent and moderate to prolonged persistent effects

COMBO

119
Q

What antibiotics are type 3 patterns?

A 
Azithromycin
Clindamycin
Tetracyclines
Vancomycin
Metronidazole
120
Q

What is the goal of therapy of type 3 patterns?

A

maximize amount of drug

121
Q

What is the pharmacokinetic parameters of type 3 patterns?

A

24 hour AUC/MIC

Clinical Pharmacology II (25 decks)

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