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PM2A2 Molecules & Medicines > Infections > Flashcards

Infections Flashcards

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Organic Chemistry 101 flashcards
1
Q

chemical method of antiseptics - alcohol

And give MOA

A

Alcohols are fast acting broad-spectrum

commonly used as an antiseptic on the skin
Used as disinfectants

But they can be irritating for mucus membranes

MOA- Denaturation of proteins and destruction of the cell membrane

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2
Q

Biguanides - Chlorhexidine and give MOA

A

Broad-spectrum - Positive and negative bacteria, yeast, mould, virus

It’s non-irritating
Antiseptic

MOA- damage membrane, leakage, precipitation of nucleus acid/protein/cytoplasmic coagulation

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3
Q

Halogens -

Iodine and iodophores

A

Iodine is broad-spectrum
a rapid antiseptic it Iodonates and oxidises the protoplasm

BUT can burn / blister, toxic and stain

Iodophore- povidone iodine - for burns, cuts ulcers etc and used when scrubbing - non toxic and long lasting

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4
Q

What is a more safer antiseptic to use instead of iodine which is toxic/ staining and corrosive but want similar effect?

A

Iodophore- povidone iodine- long lasting and non toxic, more stable than iodine

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5
Q

Halogens - chlorine and chlorophores

A

Chlorine is a potent germicide and it’s fast acting

MOA- it oxidises proteins and lipids

Chlorophore- sodium hyperchlorite- strong disinfectant - for bacteria, fungi, virus

Used in bleach

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6
Q

What is the MOA for chlorine disinfectant?

A

Oxidise proteins and lipids

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7
Q

What is the MOA for iodine disinfectant ?

A

Iodonates and oxidises the protoplasm

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8
Q

Hydrogen peroxide disinfectant

And it’s disadvantages

A

It is an oxidiser - broad spectrum

But it is also an irritant, more used in sterilisation

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9
Q

Phenols -
MOA
Disadvantages
Examples?

A

They are protoplasmatic poisons, they denature proteins and disrupt membranes (like alcohols do)

A disadvantage is that it is corrosive and irritant, it damages skin and cells

Examples are cresol and hexachlorophene

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10
Q

Chlorohexylanol - dettol
What is it?
MOA
ADVANTAGES

A

It is a phenol derivative
however it is non-denaturing noncorrosive and non-irritating in comparison to phenol

MOA- disrupts cell membranes

Advantages- safe, broad spectrum including virus and fungi but not sporicidal

Used as disinfectant and antiseptic

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11
Q

TCP
What is it
Uses

A

Mixture of dilute phenol and halogenated phenols

Used as liquid antiseptic eg for sore throat gargling and cuts, ulcers

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12
Q

Quaternary ammonium compounds
Uses
MOA
Examples

A

Disinfectant and antiseptic more commonly on surface cleaning

MOA alters membrane permeability

Eg benzalkonium chloride, cetrimide

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13
Q

Aldehydes-
MOA
Uses
Disadvantage

A

Denatured proteins, alkylates nucleic acid’s, protoplasmic toxin i.e. cross-linking of molecules

  • bactericial, sporicidal, virucidal

Used for fumigation and preservation

But very toxic

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14
Q

Physical methods include ?

A

Heat and radiation

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15
Q

Describe the 2 types of the use of heat in sterilisation

A

Moist - kills by denaturation- coagulation

Dry- kills by oxidation

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16
Q

Describe 2 types of radiation for sterilisation / disinfecting

A

Ionising- x Ray, gamma - STERILE

NON IONISING- UV- DISINFECTING

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17
Q

What are the mechanical methods of sterilising / disinfecting

A

Filtration-
Air: disinfectant
Liquid: small filters 0.2 micrometer removes the microorganisms so it is STERILE

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18
Q

give methods of sterilisation

A

Steam- autoclaving 121degree 20 min

Dry heat- 171 degree 1 hr dry oven

Cold(chemical) ethylene oxide gas

Radiation(ionising) X-rays

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19
Q

What’s personal protective equipment?

A

Aprons, gloves, masks, overshoes

Often use antimicrobial copper

20
Q

Give examples of tetracyclines

A

Doxycycline, tetraycycline, tigecycline

21
Q

Give examples of aminoglycosides

A

Gentamycin

Streptomycin

22
Q

Give examples of macrolides

A

Clarithromycin
Erythromycin
Azithromycin

23
Q

Give examples of fluoroquinolones

A

Ciprofloxacin, levofloxacin

24
Q

Give examples of drugs that inhibit folate synthesis

A

Trimethoprim

Sulfonamides e.g Sulfadiazine

25
Q

Give example of Beta lactic antibiotics - penicillins?

A

Amoxicillin
Phenoxymethylpenicillin
Benzylpenicillin

26
Q

Common uses of amoxicillin and its MoA

A

Used commonly for UTis, H.pylori infections, otitis media.

MoA: inhibition of the cell wall synthesis peptidoglycan wall - A Beta lactam antibiotic

27
Q

What is common uses of flucloxacillin/dose and MoA

A

Skin and soft tissue infections/bone/joint - broad spectrum e.g cellulitis, pneumonia, impetigo

Dose - 250-500mg QDS

MoA- interference with bacterial cell wall peptidoglycan synthesis

28
Q

what is the MoA of cephalosporins and give examples of drugs?

A

Interfere with cell wall synthesis - binds to Beta lactam binding proteins
- Cefalexin, cefuroxime,

29
Q

A new antibiotic- Ceftaroline - what class is it and what is it used for?

A

Cephalosporins - used for drug resistant infections such as MRSA/CAP - broad spectrum

30
Q

A new antibiotic daptomycin - what class of ABs is this, what is the MoA ?

A

Macrolides

Inhibit protein synthesis - ribosomes

31
Q

Why isn’t the antibiotic daptomycin appropriate for respiratory infections?

A

It is inactivated by pulmonary surfactants

32
Q

What is the MoA of metronidazole?

A

It interferes with nucleic acid (DNA ) synthesis

33
Q

Name a common side effect of metronidazole

A

Dry mouth

34
Q

Name drugs in the Glycopeptide class and their MoA

A

Vancomycin, Teicoplanin

Inhibit cell membrane function - cell wall synthesis But severe side effects such as nephrotoxicity and ototoxicity

35
Q

Outline the mechanism to which MRSA is resistant

A

Usually, PBPs are needed by staph aureus for the cross linking of peptide subunits. The Antibiotic is made so that it is structurally similar to the peptidoglycan subunits - and the PBPs accidentally bind to the drug instead - the Beta lactam drug amide bond then ruptures the covalent bond to serine residue at PBP active site - irreversible, inactivates. HOWEVER in MRSA - They have acquired a mega gene which gives the penicillin binding protein variant PBP2A which has an altered structure - preventing it from binding to the beta lactic AB - thus no reaction

36
Q

What treatments are currently available for MRSA?

A

Vancomycin, tetracyclines, Daptomycin

37
Q

Define vertical and horizontal evolution

A

Vertical - spontaneous mutation occurs without the presence of antibiotics - adapted to survive and thrive

Horizontal - acquire resistance genes from other bacteria, swapping genes via - conjugation, transduction, transformation

38
Q

Outline 4 mechanisms of antibiotic resistance

A
  1. Conversion of active drug to inactive metabolite by an enzyme e.g beta lactamases convert penicillin to penicillinoic acid, carbapenemases
  2. Reduction in cellular permeability to AB e.g. they don’t allow drug to get to toxic levels in the cell - generation of efflux pumps, change membrane
  3. Alter the antibiotic target site so it cannot bind e.g changing structure of ribosomes, changing structure of the target enzyme, changing binding proteins
  4. Altering metabolic pathway e.g increasing its metabolic rate or creating a new pathway
39
Q

Identify one antiseptic and outline its MoA

A

Chlorohexylanol - Dettol (a phenol derivative)

Disrupts cell membranes

40
Q

Outline what properties a good antiseptic should have?

A 
Wide spectrum 
Fast acting 
Non toxic 
Non irritating 
Preferably biocidal
41
Q

Outline what properties a good disinfectant should have?

A 
Sterile 
fast acting 
Non toxic 
Stable 
wide spectrum
42
Q

Outline the role of the Community pharmacist in antimicrobial stewardship

A

Hygiene - hand washing campaigns
Health campaigns e.g Catch it, kill it bin it
Counselling patients e.g taking full course
Vaccinations
Travel medicines e.g anti malarials
First aid - antiseptics, disinfectants, plasters - self care
Needle exchange programmes
Preparation of medicines e.g AB reconstitution

43
Q

Outline the role of the Hospital Pharmacist in antimicrobial stewardship

A

Advising other HCP on the appt use of antimicrobials, optimising dosing, reviews,(start smart then focus), appropriate antibiotic for illness

  • Local practice guidelines enforcing - lead specialist Pharmacist
  • Infection control - bare below elbows, PPE, ties clipped
  • Hand washing
  • Health of other HCP and vaccinations
44
Q

What is start smart then focus?

A

Process of antimicrobial stewardship
Start - do not start if no evidence of infection, get cultures first, give single dose for prophylaxis if necessary, document everything on charts, use guidelines

Focus - review every 48hrs with an action plan and then 5 options - stop, continue, switch e.g IV to oral, change drug, OPAT. Document everything

45
Q

What is antimicrobial stewardship and why is it needed?

A

Overarching programme to change and direct antimicrobial use in healthcare instutions - needed as growing resistance to ABs we have and no newer ones coming to market - risk of going back to pre AB era where people died of infections. There is inappropriate use and we need to reduce this.

46
Q

What is the difference between disinfectant and antiseptic?

A

Disinfectant kills/inhibits microorganisms on non organic surfaces

Antiseptic kills or inhibits microorganisms nonliving surfaces - biocidal e.g dettol & savlon

PM2A2 Molecules & Medicines (3 decks)

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