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CPT > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

What are some general mechanisms of action of antibacterials?

A

Disrupt cell wall synthesis
Disrupt protein synthesis
Disrupt cell membrane function
Disrupt nucleic acid synthesis

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2
Q

Which classes of abx disrupt cell wall synthesis?

A

β-lactams

Glycopeptides

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3
Q

Which classes of abx disrupt protein synthesis?

A

Tetracyclines
Aminoglycosides
Macrolides

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4
Q

Which class of abx disrupt cell membrane function?

A

Polymixins

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5
Q

Which class of abx disrupt nucleic acid synthesis?

A

Quinolones

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6
Q

What are some examples of β-lactams?

A

Penicillins
Cephalosporins
Carbapenems
Monobactams

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7
Q

What are some penicillins, and what are they active against?

A

Penicillin; mainly Streptococci

Amoxicillin; some gram -ve

Flucloxacillin; Staph and Strep

Co-amoxiclav; Staph, Strep, anaerobes and gram -ve

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8
Q

What is an example of cephalosporin, and what is it active against?

A

Ceftriaxone

Broad spectrum, no anaerobe activity
Good activity in CSF (used for meningitis)

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9
Q

What is an example of a carbapenem, and what is it active against?

A

Meropenem

V broad spectrum
Most gram -ve
Generally used in penicillin allergy
Empiric treatment for sepsis

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10
Q

What is an example of a glycopeptide, and what is it active against?

A

Vancomycin

Active against most gram +ve
Requires therapeutic drug monitoring

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11
Q

What is an example of a tetracycline, and what is it active against?

A

Doxycycline

Broad spectrum, used in penicillin allergy for gram +ve

Used against atypical pathogens in pneumonia, chlamydia and some protozoa

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12
Q

What is an example of an aminoglycoside and what is it active against?

A

Gentamicin

Active against gram -ve
Reserved for gram -ve sepsis

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13
Q

What is an example of a macrolide, and what is it active against?

A

Erythromycin

Alternative to penicillin for mild gram +ve infections
Atypical respiratory pathogens

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14
Q

What is are examples of quinolones?

A

Ciprofloaxacin

Trimethoprim

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15
Q

How does ciprofloxacin exert its actions?

A

Inhibits DNA gyrase

V active against gram -ve and atypical pathogens

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16
Q

How does trimethoprim exert its actions?

A

Inhibits folic acid synthesis

Used for UTIs

17
Q

When are abx used for prophylaxis?

A

Peri-operative;
Prevention of surgical site infection
1 dose just before surgery to last duration of procedure

Short term;
For pts who have had contact w/ meningitis - gets rid of N. meningitidis colonising oropharynx

Long term;
Asplenia, immunodeficiency

18
Q

How are abx used to treat bacterial infections?

A

Empirical treatment for suspected infection

Treatment of culture proven infection

19
Q

How is the likely cause of infection determined?

A 
Duration of illness 
PMH 
Occupational hx 
Travel hx 
Time of year 
Age 
Personal background 
Anatomical site
20
Q

How is an effective antibiotic determined?

A

Community or healthcare onset?
Severity of infection
Immune status of pt
Baseline rate of resistance

21
Q

How is antibiotic activity determined?

A

Disc sensitivity testing

22
Q

How do bacteria become resistant to abx?

A

Mutation of their own DNA

Acquiring resistance genes from other bacteria - horizontal transmission

23
Q

What are some adverse effects of abx?

A

Organ toxicity

Allergic reactions

24
Q

What are some specific abx toxicity, and the causative abx?

A

Nephrotoxicity - aminoglycosides, vancomycin
Hepatotoxicity - flucloxacillin
Ototoxicity - aminoglycosides

25
Q

What are mechanisms of and resistance?

A

Antibiotic inactivation;
β-lactamase

Alteration of target site;
Penicillin binding protein

Alteration of metabolic pathways

Reduced intracellular abx accumulation;
Active efflux, decreased permeability of cell membrane

26
Q

What is the minimum inhibitory concentration?

A

Minimum concentration of antibiotic required to inhibit growth of bacterium in vitro

27
Q

How can antibiotic resistance be prevented?

A

Infection control

Appropriate prescribing

CPT (21 decks)

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