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Infection And Clinical Practice > Antimicrobials 1 > Flashcards

Antimicrobials 1 Flashcards

0
Q

In terms of chemotherapeutic index, is a higher or lower number better?

A

Higher

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1
Q

How do you calculate chemotherapeutic index?

A

Therapeutic dose

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2
Q

What is the term that refers to the property of antimicrobials causing more harm to pathogens than the host?

A

Selective toxicity

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3
Q

2 methods of action of antimicrobials generally?

A

Bacteriostatic

Bactericidal

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4
Q

What are 3 potential adverse of effects of antimicrobial therapy?

A

Allergic reaction
Toxic or side effects
Suppression of normal flora

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5
Q

2 infections that can arise as a result of the suppression of normal flora by antimicrobial therapy?

A

C Diff pseudomembranous colitis

Candida

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6
Q

How do B lactams work?

A

Inhibition of cell wall synthesis - B lactam ring competitively and irreversibly inhibits the cross-linking between peptidoglycan strands in the bacterial cell wall

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7
Q

What type of bacteria are classified by having a cell wall and are therefore particularly susceptible to B lactams?

A

Gram positive bacteria

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8
Q

What bacterial enzymes convey resistance to B lactam antibiotics?

A

B lactamase

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9
Q

What are 2 examples of aminopenicillins?

A

Amoxicillin

Ampicillin

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10
Q

Why do ampicillin and amoxicillin work against both gram positive and gram negative bacteria?

A

Gram positive because B lactam

Gram negative because very hydrophilic so can diffuse into cells

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11
Q

What is the more common name for penicillin G and by what method must it be administered?

A

Benzylpenicillin

IV

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12
Q

What is the more common name for penicillin V and by what method can it be administered?

A

Phenoxymethylpenicillin

Oral

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13
Q

What is special about flucloxacillin?

A

It has a structure which inhibits B lactamase activity and is therefore useful against penicillinase producing staphylococci

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14
Q

What is co-amoxyclav and why/how does it work?

A

Amoxicillin + clavulamic acid aka augmentin

Clavulamic acid inhibits most B lactamases

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15
Q

What are the main indications for co-amoxyclav?

A

Respiratory infection and UTIs by organisms which are proven to be resistant to amoxicillin

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16
Q

4 examples of antimicrobials which work by inhibiting cell wall synthesis?

A

Penicillins
Cephalosporins
Vancomycin
Teicoplanin

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17
Q

2 examples of first gen cephalosporin?

A

Cefadroxil

Cephalexin

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18
Q

Example of second gen cephalosporin?

A

Cefuroxime

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19
Q

3 examples of third gen cephalosporins?

A

Cefotaxime
Ceftazadime
Ceftriaxone

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20
Q

Moving through the generations, what is the pattern of efficacy?

A

First and second - gram positives

Third - less gram positive, more gram negative

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21
Q

What other advantage do third gen cephalosporins have over first and second gen ones?

A

More stable vs B lactamases

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22
Q

Example of a fourth gen cephalosporin?

A

Cefepime

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23
Q

Example of a fifth gen/advanced gen cephalosporin?

A

Ceftaroline

24
Q

What is the most exciting use of fifth gen cephalosporin ceftaroline?

A

Anti-MRSA

25
Q

Uses of vancomycin?

A

IV for septicaemia
MRSA-induced endocarditis
Pseudomembranous colitis caused by C Diff

26
Q

What 2 drugs can be used for pseudomembranous colitis caused by C Diff?

A

Vancomycin

Teicoplanin

27
Q

How do vancomycin and teicoplanin work?

A

By inhibiting peptidoglycan formation rather than cross linking

28
Q

What is tazocin made up of?

A

Tazobactam (a B lactamase inhibitor) and piperacillin

29
Q

What is isoniazid?

A

A cell wall formation inhibitor used first line for TB prevention and treatment

30
Q

4 broad examples of protein synthesis inhibitors?

A

Aminoglycosides
Macrolides
Tetracyclines
Chloramphenicol

31
Q

2 examples of aminoglycosides?

A

Gentamycin and streptomycin

32
Q

How do aminoglycosides work?

A

Bind to the 30S ribosome subunit, blocking initiation of translation

33
Q

Which bacteria are susceptible to aminoglycosides?

A

Mostly gram negatives but some gram positives

34
Q

What are the 3 main risks of aminoglycoside use?

A

Ototoxicity via CN8 damage
Kidney damage
Narrow therapeutic index

35
Q

How do macrolides work? 3 examples?

A

Bind to 50S subunit (halting protein synthesis)

Clarithromycin, erythromycin, azithromycin

36
Q

What type of bacteria are macrolides good against?

A

Gram negatives

37
Q

What side effects can erythromycin have?

A

Nausea and vomiting

38
Q

What is good about azithromycin?

A

Very long half life so one dose works for a week e.g. For chlamydial urethritis

39
Q

What spectrum do terracyclines and chloramphenicol have?

A

Broad spectrum

40
Q

What side effect can tetracyclines have on young kids?

A

Discoloured teeth

41
Q

What are the major risk factors of chloramphenicol?

A

Bone marrow aplasia
Encephalopathy
Optic neuritis

42
Q

What effect can chloramphenicol have on neonates?

A

Grey baby syndrome

43
Q

What is chloramphenicol first line for?

A

Nothing

Apart from topical use for bacterial conjunctivitis

44
Q

4 examples of nucleic acid synthesis inhibitors?

A

Sulphonamides
Quinolones
5-Nitroimidazoles
Rifampicin

45
Q

Examples of sulphonamides? How do they work?

A

Folic acid synthesis inhibitors

Trimethoprim and co-trimoxazole (sulfamethoxazole)

46
Q

How do quinolones work? 2 examples?

A

GABA antagonists
Ciprofloxacin
Nalidixic acid

47
Q

2 examples of 5-nitroimidazoles?

A

Metronidazole

Tinidazole

48
Q

How does polymixin B work?

A

Binds to plasma membrane of gram negative bacteria, altering permeability and leading to leakage of contents

49
Q

What method of delivery is used for polymixin B and why?

A

Topical, because it can work on eukaryotic cells as well

50
Q

What is the fifth method of antimicrobial action?

A

Inhibition of synthesis of essential metabolites

51
Q

What is trimethoprim an example of?

A

Sulfonamide

52
Q

What is ciprofloxacin an example of?

A

Fluoroquinolone

53
Q

What are the carbapenems examples of?

A

B lactams

54
Q

What are vancomycin and teicoplanin examples of? What is their clinical significance?

A

Glycopeptide - good vs MRSA

55
Q

What are gentamicin and streptomycin? How do they work?

A

Aminoglycosides - inhibition of protein synthesis

56
Q

Common carbapenem used in nec fasc infection? With what?

A

Meropenem (+ clindamycin)

57
Q

What is clindamycin?

A

A protein synthesis inhibitor

58
Q

3 examples of tetracyclines?

A

Tetracycline
Doxycycline
Tigecycline

Infection And Clinical Practice (13 decks)

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