Infections Flashcards

Question

Give example of Beta lactic antibiotics - penicillins?

Answer 1

Amoxicillin Phenoxymethylpenicillin Benzylpenicillin

Answer 2

Used commonly for UTis, H.pylori infections, otitis media. | MoA: inhibition of the cell wall synthesis peptidoglycan wall - A Beta lactam antibiotic

Answer 3

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

Answer 4

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

Answer 5

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

Answer 6

Macrolides | Inhibit protein synthesis - ribosomes

Answer 7

It is inactivated by pulmonary surfactants

Answer 8

It interferes with nucleic acid (DNA ) synthesis

Answer 9

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

Answer 10

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

Answer 11

Vancomycin, tetracyclines, Daptomycin

Answer 12

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

Answer 13

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

Answer 14

Chlorohexylanol - Dettol (a phenol derivative) | Disrupts cell membranes

Answer 15

``` Wide spectrum Fast acting Non toxic Non irritating Preferably biocidal ```

Answer 16

``` Sterile fast acting Non toxic Stable wide spectrum ```

Answer 17

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

Answer 18

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

Answer 19

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

Answer 20

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.

Answer 21

Disinfectant kills/inhibits microorganisms on non organic surfaces Antiseptic kills or inhibits microorganisms nonliving surfaces - biocidal e.g dettol & savlon