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CPT - Other Drugs > Infection > Flashcards

Infection Flashcards

1
Q

What is an example of a cephalosporin?

A

Cefalexin

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2
Q

What is the mechanism of action of Cefalexin?

A

Interfere with synthesis of bacterial cell wall peptidoglycan (bactericidal)

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3
Q

What are the 3 beta-lactam classes?

A
  • Penicillins
  • Cephalosporins
  • Carbapenems
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4
Q

When are cephalosporins used?

A
  • Septicaemia
  • Pneumonia
  • Meningitis
  • Biliary infections
  • UTIs (in pregnancy)
  • Sinusitis

Often need individual sensitivity testing

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5
Q

What are two examples of macrolides?

A
  • Azithromycin

* Clarithromycin

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6
Q

What is the mechanism of action of macrolides?

A

Inhibit bacterial protein synthesis - effect ribosomal translocation (bactericidal/bacteriostatic)

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7
Q

When are macrolides used?

A

Macrolides are similar to penicillins (so clarithromycin is useful in penicillin allergies)

Atypical respiratory pathogens

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8
Q

Give 4 examples of penicillins.

A
  • Amoxicillin
  • Flucloaxcillin
  • Co-amoxiclav
  • Phenixymethylpenicillin (Penicillin V)
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9
Q

What is the mechanism of action of penicillins?

A

Interfere with synthesis of bacterial cell wall peptidoglycan (bactericidal)

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10
Q

What is an example of a quinolone?

A

Ciprofloxacin

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11
Q

What is the mechanism of acton of ciprofloxacin?

A

Inhibits topoisomerase II (bacterial DNA gyros) - inhibits transcription/replication

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12
Q

When is ciprofloxacin often used?

A

Good against gram negative organisms, gram postitoves and atypical

  • Complicated UTIs
  • Psuedomonas aeruginosa
  • Gonorrhoea
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13
Q

What are some ADRs of ciprofloxacin?

A
  • Tendinitis +/- rupture
  • Aortic dissection
  • Central nervous system effects (inc. convulsions)
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14
Q

What is an example of a tetracycline?

A

Doxycycline

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15
Q

What is the mechanism of action of doxycycline?

A

Inhibits protein synthesis - bind to bacterial ribosomes and prevent tRNA from binding, so prevents the initiation (bacteriostatic)

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16
Q

When is doxycycline used?

A

Orally only

  • Atypical respiratory infections
  • Acne
  • Chlamydia
  • Lyme disease
17
Q

What’s a key fact to remember about doxycycline?

A

Shouldn’t be given to under 12s, pregnant or breastfeeding women

18
Q

What is the mechanism of action of trimethoprim?

A

Folate antagonist - prevents bacterial nucleic acid and protein synthesis

19
Q

When is trimethoprim used?

A

UTIs but be careful with females of reproductive age (teratogenic)

20
Q

What kind of bacteria is metronidazole good against?

A

Anaerobic bacteria

21
Q

Why should you definitely avoid alcohol if taking metronidazole?

A

Has a disulfiram like action - hangover effects

22
Q

What is an example of a nitofuran?

A

Nitrofurantoin

23
Q

What is the mechanism of action of nitrofurantoin?

A

Reduced to reactive intermediates by nitrofuran reductase in bacteria - intermediates then attack ribosomal and DNA proteins and inhibit the citric acid cycle

24
Q

Why is nitrofurantoin best for use in UTIs?

A

Up to 50% of an oral dose of nitrofurantoin is excreted in the urine in it’s unchanged form - can concentrate in the urine so more effective in the bladder, etc

25
Q

What is the suggested metronidazole mechanism of action?

A

Metabolised to it’s active form by anaerobes and protozoa - blocks nucleic acid synthesis

26
Q

Give an example of an antiviral agent

A

Aciclovir

27
Q

What is the mechanism of action of aciclovir?

A

Mostly activated in infected cells (thymidine kinase - viral enzyme, is good at activating aciclovir) - then it inhibits viral DNA polymerase

28
Q

When is aciclovir used?

A
  • Herpes simplex infections - genital herpes, encephalitis

* Varicella Zoster - chicken pox, shingles

29
Q

When should you use aciclovir in herpes?

A

If genital - use within 5 days of start of an episode/while new lesions are forming (don’t use topical) and then use for longer if have recurrent episodes

If oral - not suggested unless clinical judgements suggests otherwise or immunocompromised patient

30
Q

Is metronidazole a CYP inhibitor or inducer? And of which CYP enzyme?

A

Inhibitor of CYP2C9

31
Q

Are macrolides CYP inhibitors or inducers? And of which CYP enzyme?

A

Inhibitors of CYP3A4

32
Q

What’s a DDI to consider with oral antibiotics and oral contraception?

A

That the antibiotics will reduce the gut flora so reduce enterohepatic circulation/recycling of drugs, so lower blood concs of the pill, increased risk of getting pregnant

CPT - Other Drugs (11 decks)

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