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Infection > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

How can antimicrobials be classified

A

Antibacterial

Antifungal

Antiprotozoal

Antiviral

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2
Q

How are antibacterial agents classified

A

Bactericidal or bacteriostatic

Spectrum - broad or narrow

Target site

Chemical structure

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3
Q

What are the idea features of antimicrobial agents

A

Selectively toxic

Few adverse affects

Reach site of infection

Oral/IV formulation (preferentially both)

Long half-life

No interference with other drugs

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4
Q

Name the mechanisms of action of antibacterials

A

Cell wall synthesis

Protein synthesis

Cell membrane function

Nucleic acid synthesis

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5
Q

Which antibacterials affect cell wall synthesis

A

Beta-lactams

Glycopeptides

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6
Q

Which antibacterials affect protein synthesis

A

Tetracyclines

Aminoglycosides

Macrolides

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7
Q

Which antibacterials affects cell membrane function

A

Polymixins

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8
Q

Which antibacterials affect nucleic acid synthesis

A

Quinolones

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9
Q

What are the types of resistance and are they permanent

A

Intrinsic - permanent

Aquired - permanent

Adaptive - usually reversible

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10
Q

What are the mechanisms of resistance

A

Drug inactivating enzyme

Altered target - target enzyme has lower affinity for drug

Altered uptake - decreased permeability or increased efflux

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11
Q

How does a bacteria develop antibiotic resistance

A

Chromosomal gene mutation

Horizontal gene transfer - conjunction, transduction or transformation

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12
Q

What is minimum inhbitory concentration (MIC)

A

Minimum concentration of antibiotic needed for no bacterial growth

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13
Q

What are the catalgories of beta-lactam antibacterials

A

Penicillins

Cephalosporins

Carbapenems

Monobactams

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14
Q

What does penicillin affect and name some penicillins

A

Affects cell wall synthesis

Penicillin

Amoxicillin

Flucloxacillin

Co-amoxiclav

Piperacillin

Tazobactam

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15
Q

What do cephalosporins affect and give examples

A

Affects cell wall synthesis

Affects Gram -ve but not Gram +ve

Is a good broad spectrum but no anaerobe activity

Cetriaxone

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16
Q

What do carbapenems affect and give an example

A

Affects wall synthesis

Meropenem - very broad (incl anaerobes), active against most Gram -ves

17
Q

What do glycopeptides affect and give an example

A

Affects cell wall synthesis

Vancomycin - against most gram +ve, given as IV as not absorbed, must be monitored

18
Q

What do tetracyclines affect and give examples

A

Affect protein synthesis

Tetracycline and doxycycline - broad spectrum, oral only

19
Q

What do aminoglycosides affect and give an example

A

Affect protein synthesis

Gentamicin - gram -ve, good activity in blood/urine (bacteraemia), usually reserved for severe gram -ve sepsis

20
Q

What do macrolides affect and give an example

A

Affect protein synthesis

Erythromycin

21
Q

What do quinolones affect and give an example

A

Affect nucleic acid synthesis

Ciprofloxacin

22
Q

Name some antifungals and how they function

A

Azoles (against yeasts +/- molds) - inhibt cell membrane synthesis. Fluconazole (Candida)

Polyenes - inhibit cell membrane function

23
Q

Name some antivirals and their mechanism of action and what they can be used to treat

A

Aciclovir - when phosphorylated inhibits viral DNA polymerase. Used for herpes simplex and varicella zoster

Oseltamivir (tamiflu) - inhibits viral neuraminidase. Influenza A and B

24
Q

What is metronidazole

A

Antimicrobial and antiprotozoal agent

Active against anaerobic bacteria and protozoa

25
Q

What are the consequences of antibacterial resistance

A

Treatment failure

Prophylaxis failure

Economic costs

26
Q

Define the types of antimicrobial resistance

A

MDR (multi-drug resistant) - non-susceptibility to at least one agent in three or more antimicrobial categories

XDR (extensively drug resistant) - non-susceptibility to at least one agent in all but two or fewer antimicrobial categories

PDR (pan-drug resistant) - non-susceptibility to all agents in all antimicrobial categories

27
Q

What are the IDSA’s antimicrobial stewardship objectives

A

Appropriate use of antimicrobials

Optimal clinical outcomes

Minimise toxicity and other adverse events

Reduce cost of health care for infections

Limit selection for antimicrobial resistant strains

Infection (23 decks)

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