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MD Olivia Drugs > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

what drug do you use to treat giadia infection that causes diarrhoea?

A

Tinidazole or metronidazole

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2
Q

what drug do you use to treat clostridium difficile infection causing pseudomembranous colitis?

A

metronidazole

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3
Q

What antibiotics and antivirals would you give post transplant

A

Bactrim (pcp) and valgancyclovir (cmv) and niostatin (anti fungals)

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4
Q

What antimicrobials are nephrotoxic?

A

Gentamicin, sulfonimides, penicillins, rifampicin, acyclovir

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5
Q

A 13 year-old female presented to the emergency department looking unwell and septic. She was started on ceftriaxone IV. A diagnosis of pyelonephritis was subsequently made, with no evidence of obstruction on ultrasound.

You are notified by the microbiology lab that her urine culture results are consistent with a urinary tract infection, with a pure culture of Enterobacter cloacae that is sensitive to ceftriaxone. Would you prescribe ceftrioxone?

A

No. enterobacter cloacae are part of the ESCAPPM organisms that develop resistance to ceftriaxone.
They all share a chromosomally-encoded cephalosporinase (a type of beta-lactamase) that is inducible. Thus they tend to develop cephalosporin resistance during treatment.

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6
Q

What drug would you use for an Ecoli UTI?

A

Trimethoprim

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7
Q

what drug do we use for PCP

A

bactrim= co trimoxole

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8
Q

what would you use if a patient needed penicillin but was hypersensitive to it? (think alternatives)

A

ceftriaxone

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9
Q

as you move from first gen cephalosporins to 3rd gen, what organisms do you increase cover of?

A

First gen–> mostly staph; then by the time you get to 3rd gen you get more gram negative cover

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10
Q

what groups of antibiotics are bacteriocidal in general?

A

those that target the bacterial cell wall or membrane, as well as those that interfere with bacterial enzymes
e.g. penicillin, cephalosporins, polymyxins, aminoglycosides and sulfonamides

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11
Q

what groups antibiotics are bacteriostatic?

A

those that target protein synthesis. For example, macrolides, and tetracyclines

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12
Q

give an example of an amino glycoside, and tell me how it works.

A

Gentamycin, tobramycin, neomycin. Aminoglycosides have strong gram negative cover, and inhibit bacterial protein synthesis

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13
Q

what does penicillin, carbapenams, cephalosporins and monobactams have in common?

A

beta lactam ring

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14
Q

what is another name for benzylpenicillin?

A

penicillin G

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15
Q

give examples of macrolides?

A

erythromycin, azithromycin. Inhibit cytochrome p450 system

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16
Q

what are some SEs of tetracyclines

A

oesophagitis, enamel decay

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17
Q

what are the narrow spectrum penicillins?

A

benzylpenicillin IV, benzathine penicillin IM, phenoxymethylpenicillin PO

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18
Q

which cephalosporins treat enteroccocus?

A

only 5th generation cephalosporins

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19
Q

what are the antimicrobials that inhibit DNA synthesis

A

trimethoprim, sulfonamides, metronidazole

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20
Q

first generation of cephalosporins?

A

cephazolin –> good for MSSA

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21
Q

what is an example of 3rd gen cephalosporins?

A

ceftriaxone –> not good for staph, but more for gram negatives

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22
Q

what kind of drug is vancomycin

A

glycopeptide antibiotic therapy

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23
Q

contraindication to bactrim?

A

G6PD deficiency and pregnancy

24
Q

SE of bactrim?

A

steven johnson syndrome

25
Q

how do fluoroquinolones work?

A

interfere with DNA gyros, prevents bacterial replication

26
Q

Se of fluoroquinolones?

A

tendonitis

27
Q

How does nitrofurantoin? what is it used for?

A

It inhibits enzymes and DNA activity. Prophylactic measures for UTIs

28
Q

what SE is due to nitrofurantoin?

A

pulmonary fibrosis

29
Q

what does hydronephritis

A

dilation of the urinrary collecting system

30
Q

what do you think if you saw a younger male with gas in the urinary system?

A

emphysematous pyelonephritis

31
Q

what are the classical features of acute pyelonephritis?

A

temp, fever, loin pain +/- dysuria frequency and urgency

32
Q

what are some SE of ethambutol?

A

Optic neuritis

And changes to colour vision

33
Q

side effects of pyrazinamide?

A 
Gout
Hepatic toxicity
GIT upset
Fever
Malaise
34
Q

how does isoniazid work

A

Inhibits synthesis of mycolic acid in cell wall of mycobacterium

35
Q

what kind of drug is metronidazole?

A

nitroimidazole. Used to be an antiprotozoal drug but now used for anaerobic bacteria

36
Q

what would you want to advise a patient who is about to commence metronidazole

A

abstain from alcohol

37
Q

how do quinolones work

A

inhibit topoisomerase II (a bacterial DNA gyrase)

38
Q

what are some adverse effects of chloramphenicol?

A

pancytopenia and grey baby syndrome and HS reaction

39
Q

what is the difference between gentamicin and chloramphenicol in terms of how they inhibit ribosomal protein synthesis?

A

chloramphenicol (and macrolides) inhibits 50s subunit, gentamicin inhibit 30s subunit

40
Q

are tetracyclines bacteriostatic or bactericidal?

A

bacteriostatic

41
Q

how do sulphonamides work?

A

they have a structural analogue to PABA. PABA is needed for folate synthesis. So they inhibit folate synthesis (by competing for the same Dihydropterate synthetase enzyme as PABA) and thus interfere with DNA synthesis and replication

42
Q

how do trimethoprim work?

A

inhibits enzyme dihydrofolate reductase in folate synthesis pathway

43
Q

SE of vancomycin?

A
  • Ototoxicity
    • Nephrotoxicity
    • Red man syndrome- dosing consideration
44
Q

How does vancomycin work? how does resistance to Vancomycin develop?

A
  • Acts on GRAM POSITIVE BACTERIA ONLY- MRSA usually
  • BINDS TO D-ALA, D-ALA preventing crosslinking of NAM/NAG polymers that make up the backbone of peptidoglycan cell wall

RESISTANCE TO VANCOMYCIN:
D-ALA gets converted to D-LAC so vancomycin cannot bind.

45
Q

name the beta lactams

A 
• Penicillins
	• Cephalosporin's
	• Antipseudomonals
	• Carbapenams
Monobactams
46
Q

how do beta lactams work?

A

Inhibit the synthesis of bacterial cell walls by inhibiting penicillin binding proteins, i.e. enzymes transpeptidase and carboxypeptidase.

47
Q

how does resistance to beta lactams occur?

A
  1. beta lactamase enzyme encoded in plasmid

2. change in penicillin binding proteins

48
Q

what is a haematological consideration you would have before prescribing antimalarials?

A

A patient with G6PD deficiency–> as it can cause oxidative haemolysis

49
Q

what drug protocol do we use for Multi drug resistant TB?

A 
• Pyrazinamide, Ethambutol
	• 5 active agents
	• Injectable AMIKACIN
	• Moxifloxacin 
--> treat for 2 years
50
Q

What empirical therapy do we give for severe CAP?

A

Severe CAP- ceftriaxone (cephalosporin) IV daily + AZITHROMYCIN (macrolide)

51
Q

What antibiotic do you prescribe for an infective exacerbation of COPD without consolidation on CXR?

A

doxycycline

52
Q

What empirical antibiotics for a man who presents with LIF abdo pain and fever? (worried about perforated diverticulitis)

A

Tazocin OR Ampicillin, metronidazole, gentamicin

53
Q

When would tazosin be contraindicated

A

Contraindicated when there is a hx of jaundice or liver problems

54
Q

Adverse effects of clindamycin?

A

TEN, taste disturbance, C. difficile colitis

55
Q

what constitutes tazocin?

A

Piperacillin + tazobactam

56
Q

why might you prescribe flucloxacillin and rifampicin?

A

for staphyloccocal dermatitis infections and osteomyelitis. Rifampicin reduces the amount of flucloxacillin required

MD Olivia Drugs (27 decks)

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