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ESA2 - Infection > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

In what ways can antibacterial agents be classified?

A

1) Bactericidal or bacteriostatic
2) Broad spectrum or narrow spectrum
3) Target site
4) Chemical structure

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2
Q

What are the ideal feature of antimicrobial agents?

A
  • Selectively toxic
  • Few side effects
  • Able to reach infection site
  • Available as oral/IV formulation
  • Long half life (so infrequent dosing)
  • No interference with other drugs
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3
Q

What are the four ways in which antibacterials can work?

A

1) Interruption of cell wall synthesis
2) Interruption of protein synthesis
3) Interruption of nucleic acid synthesis
4) Interruption of cell membrane function

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4
Q

Which classes of antibacterials interrupt cell wall synthesis?

A

Beta lactams and glycopeptides

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5
Q

What is an example of a beta lactam antibiotic?

A

Penicillins

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6
Q

What is an example of a glycopeptide antibiotic?

A

Vancomycin

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7
Q

Which classes of antibacterials interrupt protein synthesis?

A

Tetracyclines, aminoglycosides and macrolides

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8
Q

Which class of antibacterials interrupts cell membrane function?

A

Polymixins eg colistin

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9
Q

Which antibacterials work by interrupting nucleic acid synthesis?

A

Quinolones
Trimethoprim
Rifampicin

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10
Q

How does penicillin work as an antibacterial?

A

Inhibit cell wall biosynthesis by inhibiting the formation of peptidoglycan cross-links

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11
Q

What are some examples of penicillins?

A

Amoxicillin, Co-amoxiclav, Benzylpenicillin, Flucloxacillin

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12
Q

What is amoxicillin usually used to treat?

A

Upper respiratory tract infections

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13
Q

What are penicillins not effective against?

A

Staphylococcus

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14
Q

What is Co-amoxiclav usually used to treat?

A

Pneumonia

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15
Q

What is co-amoxicillin?

A

Amoxicillin and clavulanic acid

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16
Q

What is flucloxacillin often used to treat?

A

Cellulitis, MSSA

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17
Q

What is trimethoprim mainly used to treat?

A

Uncomplicated UTIs/bladder infections

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18
Q

How does trimethoprim work?

A

Preventing the bacteria from producing folate. Without folate, the bacteria cannot produce DNA.

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19
Q

What is rifampicin used to treat?

A

TB, meningitis prophylaxis

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20
Q

What are the 3 types of resistance?

A

Intrinsic (usually permanent)

Acquired (new genetic material/mutates - usually permanent)

Adaptive (response to stress, usually reversible)

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21
Q

What are some mechanisms of resistance?

A
  • Drug inactivating enzymes (eg b-lactamases)
  • Altered target (target enzyme has lowered affinity for antibacterial)
  • Altered uptake (eg reduced permeability or increased efflux)
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22
Q

How does rifampicin work?

A

Inhibits RNA synthesis (inhibition of RNA polymerase)

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23
Q

How can bacteria acquire resistance?

A

Chromosomal gene mutation or horizontal gene transfer

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24
Q

What is conjugation?

A

Process by which one bacterium transfers genetic material to another through direct contact

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25
Q

What is transduction?

A

Process by which foreign DNA is introduced into a bacterial cell by a virus (bacteriophage)

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26
Q

What is transformation?

A

Direct uptake, incorporation and expression of exogenous genetic material from the surroundings

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27
Q

How can you measure antibiotic activity?

A

Disc sensitivity testing and minimum inhibitory concentration

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28
Q

What does clavulanate inhibit?

A

B lactamase

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29
Q

What inhibits b lactamase?

A

Clavulanate, tazobactam

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30
Q

What are some cephalosporins?

A

Ceftriaxone, cefalexin, cefuroxime, cefotaxime

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31
Q

What is the cephalosporin group associated with?

A

C diff

32
Q

What is ceftriaxone used to treat?

A

Meningitis (good activity in CSF)

33
Q

What are some carbapenems?

A

Meropenem, imipenem

34
Q

What is meropenem used to treat?

A

V broad spec

Most gram negs

35
Q

What are the 4 classes of beta-lactams?

A

Penicillins, cephalosporins, carbapenems, monobactams

36
Q

What are the generations of cephalosporins effective against?

A

First generation predominantly active against Gram-positive bacteria and successive generations have increased activity against Gram-negative bacteria

Broad spectrum

37
Q

What type of bacteria is vancomycin active against?

A

Most Gram positive bacteria (not Gnegs)

38
Q

How does vancomycin work?

A

Inhibits cell wall synthesis

39
Q

Why is vancomycin usually given intravenously?

A

It is not absorbed (oral for C diff only)

40
Q

What is vancomycin usually given to treat?

A

C difficile, MRSA

41
Q

What is vancomycin active against?

A

Staph auerus, streptococci, C difficile

42
Q

How is tetracycline and doxycycline administered?

A

Orally

43
Q

What is doxycycline usually used to treat?

A

Chlamydia, pneumonia (also alternative to penicillin)

44
Q

Why shouldn’t tetracyclines be given to children under 12?

A

Causes yellowing of teeth and bones

45
Q

What is the most common aminoglycoside?

A

Gentamicin

46
Q

How doe doxycycline work?

A

Inhibits protein synthesis

47
Q

Which type of bacteria do aminoglycosides eg gentamicin have profound activity against?

A

Gram negative bacteria

48
Q

True or False:

Aminoglycosides have good activity in the CSF

A

False!

Aminoglycosides have good activity in the blood/urine

49
Q

What is gentamicin usually used to treat?

A

Serious abdominal infections
Serious UTIs
Endocarditis
Gram neg sepsis

50
Q

What can macrolides be used for?

A

Alternative to penicillin for mild Gram positive infections

Also active against atypical respiratory pathogens

51
Q

What is the most common example of a quinolone?

A

Ciprofloxacin

52
Q

What do quinolones eg ciprofloxacin inhibit?

A

DNA gyrase

53
Q

Which type of bacteria are quinolones active against?

A

Gram negative bacteria

54
Q

Why is the use of quinolones limited?

A

Association with C difficile antibiotic-associated diarrhoea

55
Q

What are azoles active against?

A

Yeasts +/- molds

56
Q

What do azoles inhibit?

A

Cell membrane synthesis

57
Q

What is used to treat Candida?

A

Fluconazole, nystatin (topical)

58
Q

What are some polyenes?

A

Nystatin and amphotericin

59
Q

What is used for the IV treatment of systemic fungal infections like aspergillus?

A

Amphotericin

60
Q

What do polyenes inhibit?

A

Cell membrane function

61
Q

What are some antivirals?

A

Aciclovir, oseltamivir

62
Q

How does aciclovir work?

A

When phosphorylated, inhibits viral DNA polymerase

63
Q

What is aciclovir used to target?

A

Herpes simplex and varicella zoster

64
Q

How does oseltamivir work?

A

Inhibits viral neuraminidase

65
Q

What is oseltamivir used to target?

A

Influenza A and B

66
Q

What is metronidazole?

A

Antibacterial and antiprotozoal agent

67
Q

How do cephalosporins work?

A

Inhibit cell wall synthesis

68
Q

How does metronidazole work?

A

Inhibits nucleic acid synthesis

69
Q

How does doxycycline wokr?

A

Interrupts protein synthesis

70
Q

What is benzylpenicillin used to treat?

A

Strep endocarditis, neonatal sepsis

71
Q

What is tazocin?

A

Piperacillin + tazobactam

72
Q

What is tazocin used to treat?

A

Pseudomonal infections

73
Q

How does gentamicin work?

A

Interrupts protein synthesis

74
Q

What are some macrolides?

A

Erythomycin and clarithromycin

75
Q

How does erythromycin work?

A

Interrupts protein synthesis

76
Q

What is ciprofloxacin active against?

A

G negs

ESA2 - Infection (12 decks)

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