deck_1568189

Question 1

How can you classify antimicrobials based on?

Answer 1

1. What they have an effect on2. Bacteriocidal or bacteriostatic3. Target site and mechanism of action4. Chemical structure

Question 2

What are the divisions for dividing antimicrobials based on their mechanism of action?

Answer 2

• Cell wall synthesis- Cell membrane function- Protein synthesis- Nucleic acid synthesis

Question 3

What classes of antimicrobials fall under cell wall synthesis as their site of action?

Answer 3

Beta lactamsGlycopeptides

Question 4

What classes of antimicrobials fall under cell membrane function as their site of action?

Answer 4

Polymixins- collistin

Question 5

What classes of antimicrobials fall under protein synthesis as their site of action?

Answer 5

TetracyclinesAminoglycosidesMacrolides

Question 6

What classes of antimicrobials fall under nucleic acid synthesis as their site of action?

Answer 6

Quinolones- trimethoprim- rifampicin

Question 7

Give examples of beta lactams

Answer 7

PenicillinAmoxicillinFlucloxacillinCephalexinCo-amoxiclovMeropenem

Question 8

Give an example of a glycopeptide

Answer 8

Vancomycin

Question 9

Give an example of an aminoglycoside

Answer 9

Gentamycin

Question 10

Give an example of a macrolide

Answer 10

Erythromycin

Question 11

What are some unwanted effects of antimicrobials?

Answer 11

GI upsetsAllergiesHaematological disturbancesOrgan toxicitySuper-infections

Question 12

What are the three areas of antimicrobial usage?

Answer 12

1. Intrinsic empiric therapy2. Specific or definitive treatment3. Prophylaxis

Question 13

Define intrinsic empirical therapy

Answer 13

Don’t know the exact pathogen but make an educated guess based on symptoms, patient factors etc

Question 14

Describe specific/definitive therapy

Answer 14

Narrow spectrum and is more effective with the specific treatment. Also helps to minimise damage to the natural flora

Question 15

Describe prophylaxis

Answer 15

1. 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

Question 16

What factors should you consider when choosing and antibiotic?

Answer 16

1. Should be active against the specific bacteria2. Site of the infection3. Paient factors4. Guidance – national or local guidelines5. Hospital or primary care guidelines

Question 17

When would you presecribe more than one antibiotic?

Answer 17

1. 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.

Question 18

What are the main penicillins?

Answer 18

Penicillin - streptococciAmoxicillin - active against some gram negativesFlucloxacillin - staphylococci and streptococciCo-amoxiclov - Gram neg adn anaerobesPiperacillin

Question 19

Give an antibiotic and its class, which has good activity in the CSF

Answer 19

CetriaxoneIs a cephalosporin

Question 20

Give an example of a carbapenem and when you would use it

Answer 20

MeropenemIs broad spectrumActive against most gram negativesTends to be safe in penicillin allergy

Question 21

Give an example of a glycopeptide and when you would use it

Answer 21

VancomycinAgainst gram positiveStaph. resistance is rareNeed therapeutic drug monitoring

Question 22

Give an example of a tetracycline and when you would use it

Answer 22

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

Question 23

Give an example of an aminoglycoside and when you would use it

Answer 23

GentamicinWorks well agains gram negativeGood activity in blood an urinePotentially nephrotoxic and ototoxicTends to be reserved fro severe gram negative sepsis

Question 24

Give an example of a macrolide and when you would use it

Answer 24

Erythromycin and clarithromycinHas good intracellular penetrationIs an alternative to mild gram positive infectionsActive against atypical repiratory pathogens

Question 25

Give an example of a quinolones and when you would use it

Answer 25

CiprofloxacinInhibits DNA gyraseVery active against gram negatives and atypical pathogens. Have an increasing resistance towards

Question 26

What is the action of trimethoprim adn when would you use it?

Answer 26

Inhibits folic acid synthesisTreats Pneumocystis carinii pneumonia (PCP) when combined with sulphamethoxazole as cotimoxazole. Has activity against MRSA

Question 27

What is used to treat Candida?

Answer 27

FluconazoleInhibits cell-membrane synthesisIs an azole

Question 28

What are the two type of antifungals?

Answer 28

Azoles Polyenes

Question 29

What is an azole?

Answer 29

Antifungal which inhibits cell-membrane synthesis

Question 30

What is a polyene?

Answer 30

Antifungal which inhibits cell membrane functione.g. nystatin and amphoterecin

Question 31

Give two examples of antivirals

Answer 31

AcicloirOseltamivir

Question 32

Describe aciclovir

Answer 32

Inhibits viral DNA when it is phosphorylatedTreates herpes simplex and varicella zoster

Question 33

Describe Oseltamivir

Answer 33

Inhibits viral neuraminidasefor Influenza A and B

Question 34

What is characteristic about metronidazole?

Answer 34

Is both an antibacterial and an antiprotozoal agent- active against anaerobic bacteria- active against:– amoebae (dysentery)– giardia (diarrhoea)– tricomonas (vaginitis)