deck_1568189 Flashcards
(34 cards)
How can you classify antimicrobials based on?
- What they have an effect on2. Bacteriocidal or bacteriostatic3. Target site and mechanism of action4. Chemical structure
What are the divisions for dividing antimicrobials based on their mechanism of action?
- Cell wall synthesis- Cell membrane function- Protein synthesis- Nucleic acid synthesis
What classes of antimicrobials fall under cell wall synthesis as their site of action?
Beta lactamsGlycopeptides
What classes of antimicrobials fall under cell membrane function as their site of action?
Polymixins- collistin
What classes of antimicrobials fall under protein synthesis as their site of action?
TetracyclinesAminoglycosidesMacrolides
What classes of antimicrobials fall under nucleic acid synthesis as their site of action?
Quinolones- trimethoprim- rifampicin
Give examples of beta lactams
PenicillinAmoxicillinFlucloxacillinCephalexinCo-amoxiclovMeropenem
Give an example of a glycopeptide
Vancomycin
Give an example of an aminoglycoside
Gentamycin
Give an example of a macrolide
Erythromycin
What are some unwanted effects of antimicrobials?
GI upsetsAllergiesHaematological disturbancesOrgan toxicitySuper-infections
What are the three areas of antimicrobial usage?
- Intrinsic empiric therapy2. Specific or definitive treatment3. Prophylaxis
Define intrinsic empirical therapy
Don’t know the exact pathogen but make an educated guess based on symptoms, patient factors etc
Describe specific/definitive therapy
Narrow spectrum and is more effective with the specific treatment. Also helps to minimise damage to the natural flora
Describe prophylaxis
- A single dose given just before surgery2. Given to immunocompromised patients to help protect against bacterial infections e.g. asplenic patients to protect against encapsulated bacteria
What factors should you consider when choosing and antibiotic?
- Should be active against the specific bacteria2. Site of the infection3. Paient factors4. Guidance – national or local guidelines5. Hospital or primary care guidelines
When would you presecribe more than one antibiotic?
- When you need a broad spectrum antibiotic (unknown or multiple pathogens)2. Preventing the emergence of resistance3. When there is enhanced activity of the antibiotics (e.g. infective endocarditis, a second drug helps promote killing from both of them)2.
What are the main penicillins?
Penicillin - streptococciAmoxicillin - active against some gram negativesFlucloxacillin - staphylococci and streptococciCo-amoxiclov - Gram neg adn anaerobesPiperacillin
Give an antibiotic and its class, which has good activity in the CSF
CetriaxoneIs a cephalosporin
Give an example of a carbapenem and when you would use it
MeropenemIs broad spectrumActive against most gram negativesTends to be safe in penicillin allergy
Give an example of a glycopeptide and when you would use it
VancomycinAgainst gram positiveStaph. resistance is rareNeed therapeutic drug monitoring
Give an example of a tetracycline and when you would use it
DoxycyclineOrally onlyBroad spectrum but use specifically in people with penicillin allergiesUsually for gram positiveActive against chlamydia and atypical pathogens in penumonisDo not give to children under 12 years
Give an example of an aminoglycoside and when you would use it
GentamicinWorks well agains gram negativeGood activity in blood an urinePotentially nephrotoxic and ototoxicTends to be reserved fro severe gram negative sepsis
Give an example of a macrolide and when you would use it
Erythromycin and clarithromycinHas good intracellular penetrationIs an alternative to mild gram positive infectionsActive against atypical repiratory pathogens
