ch 70 Flashcards
1st choice uncomplicated UTI
Amoxicillin
1st choice Neisseria Meningitides (meningococcus)
3rd gen cephalosporin
1st choice E.Coli
Cefotaxime, ceftazidime, cefepime, ceftriaxone
klebsiella pneumoniae
cefotaxime, ceftriaxone, cefapime and ceftazidime
Salmonella
ceftriaxone
what antibiotics inhibit bacterial wall synthesis or activate enzymes that disrupt the cell wall
Penicillins cephalosporins imipenem vancomycin caspofungin
what antibiotics increase cell membrane permeability
amphotericin B
daptomycin
itraconazole
what antibiotics cause lethal inhibition of bacterial protein sythesis
aminoglycosides (gentamycin)
what antibiotics cause nonlethal inhibition of protein synthesis
tetracyclines
Clindamycin
erythromycin
Linezolid
what abx inhibit bacterial synthesis of DNA and RNA or disrupt DNA function
rifampin, metronidazole, fluoroquinolones
drugs that are directly lethal to bacteria at clinically achievable concentrations
bacteriocidal
drugs that can slow bacterial growth but do not cause cell death
bacteriostatic
bacteriocidal and bacteriostatic
which needs a working immune system to work
bacteriostatic
what are the 4 ways for bugs to resist drugs
decrease drug concentration at site of action
alter the structure of drug target molecules (changes receptors)
produce a drug antagonist
cause drug inactivation
example of a bug producing a drug antagonist
synthesize increased number of PABA
against sulfa drugs
example of drug inactivation
increased production of penicillinase that inactivates penicillin
also for cephalosporins, carbapenems, fluoroquinolones
what mechanism for acquiring resistance happens primarily among gram neg bacteria
conjugation
what mechanism for acquiring resistance confers resistance to only one drug
Spontaneous mutation
what mechanism for acquiring resistance that confers multiple-drug resistance
conjugation
explain antibiotic use and emergence of drug resistant microbes
You have natural microbes that keep each other in check, using a broad spectrum may kill off some that was keeping other bacteria in check. You kill them and the resistant bacteria take over
a new infection that appears during the course of treatment for primary infection
superinfection
ie) vaginal candida in female treated with a broad spectrum drugs, superinfections are more likely in pt receiving broad spectrum
NDM-1 gene
falls under drug inactivation
code for additional resistance determinants including drug efflux pumps and enzymes that can inactivate (pg 654)
name that bug (2)
Bacterial meningitis
Strep pneumoniae -
Neisseria meningitides - 3rd gen cephalosporin
name that bug (2)
Acute Sinusitis
S. pneumoniae
H. influenzae
name that bug (1)
Pharyngitis
Strep Pyogenes
name that bug -4
Community acquired pneumonia
S. pneumoniae
Mycoplasma spp.
H. influenzae
Staph aureus
name that bug (3)
Hospital acquired pneumonia
Pseudomonas spp
Klebsiella spp
S. aureus
name that bug (4)
Endocarditis
Streptococcus viridans
coagulase-negative
Staph spp
S aureus
name that bug (2)
cholangitis
Enterobacteriaceae
anaerobes
name that bug (2)
UTI, pyleonephritis
E. coli
Enterobacteriaceae
name that bug (1)
osteomyelitis
S. aureus
name that bug (2)
cellulitis
S. aureus
Streptococcus spp
to be effective, an antibiotic must be present at the site of infection in a concentration greater than the
minimal inhibitory concentration (MIC)
treatment for streptococcus pyogenes
Penicillin G
genetic factor that can affect antibiotics
G6PD deficiency - more common in those of African and Mediterranean descent - hemolysis due to deficiency in G6PD for RBCs (ex sulfonamides)
genetics can also effect drug metabolism
infants and antimicrobial
highly vulnerable to drug tox due to poorly developed kidney and liver function
what antibiotic class can produce kernicterus in infants
sulfonamides
kernicterus is severe neurologic disorder caused by displacement of bili from plasma proteins
Children/adolescents - what antibiotic can cause discoloration in developing teeth
tetracyclines
gentamycin in pregnancy
irreversible hearing loss to infant
breastfeeding - levels in milk cause kernicterous
Sulfonamides
treat for E.Coli
cefotaxime
ceftazidime
cefepime
ceftriaxone
Treat for Klebsiella pneumoniae
Cefotaxime
Ceftriaxone
Cefepime
Ceftazidime
Salmonella treatment
Ceftriaxone and a fluoroquinolone
if other than Salmonella typhi
also add a cefotaxime
shigella treatment
A fluoroquinolone
Bordetella pertussis (whooping cough) treatment
Azithromycin
clarithromycin
erythromycin
If you are going into surgery for a perf appy, open fractures, animal bites - abx is treatment or prophylaxis
treatment
treatment for meningitis, epiglottitis, arthritis, and other serious infections with H. Influenzae
Cefotaxime
ceftriaxone
Upper resp infection and bronchitis secondary to H. influenzae
Trimethoprim /sulfamethoxazole
H. pylori treatment
clarithromycin plus amoxicillin plus esmeprazole (PPI)
treatment for psudomonas aeruginosa for UTI
Ciprofloxacin
treatment for mycoplasma pneumoniae
erythromycin
clarithromycin
azithromycin
one of above plus Tetracycline
treatment for chlamydia psittaci
Doxycycline
what abx has antimicrobial action Antimetabolites
Flucytosine
sulfonamides
Trimethoprim
