CPT S5 - Antimicrobials

Question 1

What are the targets for influenza drugs?

Answer 1

1) Antigens. This is vaccines basically
2) M2 receptor. Inhibits viral uncoating
3) Neuraminidase. Prevents viruses leaving the infected cells

Question 2

What are the types of influenza?

Answer 2

In order of declining severity, A, B and C

Question 3

What are some targets for drugs in flu

Answer 3

Antigens
M2
Neuraminidase

Question 4

How can influenza antigens be targeted?

Answer 4

By designing a vaccine that presents these antigens to the immune system so the body is prepared for that selected strain of virus

Question 5

How can M2 be targeted in flu?

Answer 5

Inhibit the M2 channel to prevent viral uncoating

Eg amantadine and rimantadine

Question 6

How can neuraminidase be targeted in flu?

Answer 6

Inhibit neuraminidase to prevent release of virus from cell
Eg oseltamivir (tamiflu) and zanamavir

Question 7

Are neuraminidase inhibitors effective in the treatment of flu?

Answer 7

Yes, if the patient is symptomatic. They are most effective if given within the first 24h of symptom onset.

Question 8

What are the targets of antibiotics?

Answer 8

DNA synthesis
Protein synthesis
Cell wall synthesis
RNA synthesis

Question 9

Give some classes and examples of antibiotics that work by inhibiting DNA synthesis

Answer 9

Quinolones eg ciprofloxacin

Folic acid antagonists eg trimethoprim, sulphonamides

Question 10

Give some classes and examples of antibiotics that affect protein synthesis

Answer 10

Aminoglycosides eg gentamicin
Macrolides eg erythromycin
Tetracyclines eg doxycycline

Question 11

Give some classes and examples of antibiotics that work by inhibiting cell wall synthesis

Answer 11

Beta-lactams eg penecillins, cephalosporins, carbapanems

Glycopeptides eg vancomycin

Question 12

Why would antibiotics be prescribed?

Answer 12

Prevention of infections

Therapy of significant bacterial infections

Question 13

When would antibiotics be prescribed prophylactically?

Answer 13

Peri-operative patients to prevent surgical site infections
Short term eg to meningitis contacts
Long term eg in asplenia or immunodeficiency

Question 14

Give some adverse effects of antibiotic therapy

Answer 14

Pharmacological eg toxicity, drug interaction
Allergy
Impact on normal flora eg C. difficile infection

Question 15

With what antibiotics would you use therapeutic drug monitoring?

Answer 15

Aminoglycosides, gentamicin

Question 16

Why would you use therapeutic drug monitoring?

Answer 16

To ensure the dose of the drug is both adequate for treatment and non-toxic.
Particularly if there is a narrow therapeutic window eg theophylline, warfarin.