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MD1 SF3 - EXAM 2 > Introduction aux antibiotiques > Flashcards

Introduction aux antibiotiques Flashcards

1
Q

What is an antibiotic?

A

Antimicrobien qui arrête la croissance ou qui une bactérie

What are the names of “les autres antimicrobiens”?

  • Antiviraux —> viruses
  • Antifungiques —> champignons
  • Antiparasitaires —> parasites
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2
Q

What is antibiotherapy?

A

L’art d’utiliser les antibiotiques adéquatement en clinique

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3
Q

What are the steps of antibiotherapy?

A
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4
Q

What are the two important microbiological findings that guide clinicians when selecting an appropriate ATB?

A
  1. Identification de l’agent pathogène (lorsque c’est possible)
  2. Analyse de sensibilité aux antibiotiques
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5
Q

What are the two steps used to identify a pathogen?

A

spécimen clinique —> laboratoire de microbiologie

  1. Examen direct (on the specimen)
    • Gram test —> preliminary result just to narrow down… no ID of species at this point
  2. Confirmation
    • Culture and molecular biology (PCR/mass spectrometry… but not used as much, still quite new)
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6
Q

What is an examen direct?

A

Done directly on the specimen to detect presence bacteria

Preliminary result —> Gram +/-

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7
Q

What are the most common gram + and - bacteria?

A

Gram + —> usually cocci

  • ex: Staphylococcus, Streptococcus, Enterococcus

Gram - —> usually bacilli

  • ex: Enterobacteria, non fermenting bacilli, anaerobes
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8
Q

What is identification de la culture? (step 2)

A

Confirm pathogen

Takes 48 hours

Atmosphères d’incubation: aérobie vs. anaérobie

Bactéries plus fastidieuses: Intracellulaires ou atypiques

  • Legionella, Chlamydia, Chlamydophila
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9
Q

What are the 4 big groups of bacteria targeted by ATP according to microbiological analyses?

A
  1. Gram +: peau et tissus mous
  2. Gram -: infections urinaires
  3. Intracellulaires/atypiques: ITSS
  4. Anaérobies: infections intra-abdominales —> these bacteria are usually already found in the GI tract
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10
Q

What are the 5 principal characteristics of ATB?

A
  1. Mode d’action
  2. Spectre d’activité
  3. Voie d’administration
  4. Pharmacologie
  5. Mécanisme d’action
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11
Q

What are the two kinds of modes d’action?

A
  1. Bacteriostatic: inhibit growth of bacteria w/o killing them… reversible effect
  2. Bactericidal: kill bacteria, irreversible, typically used for more severe infections (bacteremia, endocarditis, meningitis, etc.)
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12
Q

What are the two spectres d’activités?

A
  1. Spectre étroit: specific treatment for an identified pathogen (ex: subcutaneous SARM infection —> IV vancomycin)
  2. Spectre étendu: empiric treatment depending on the “syndrome infectieux”, polymicrobial infection (ex: PAC sans germe identifié —> Ceftriaxone)
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13
Q

What are the three most common voies d’administration?

A
  1. Orale —> per os, PO
  2. Intraveineuse (IV)
  3. Intramusculaire (IM)
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14
Q

What are the different mécanismes d’action used by ATBs?

A

Agissent à différents niveaux du métabolisme bactérien

Interfere with vital functions of bacteria

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15
Q

What are the 6 most important vital functions of bacteria that ATB interfere with?

A

Inhibiting synthesis of:

  1. Paroi bactérienne
  2. Membrane bactérienne
  3. Acides nucléiques
  4. ARN polymérase
  5. Acide folique
  6. Protéines
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16
Q

What are the two classes of antibiotics that inhibit the synthesis of the paroi bactérienne?

A
  1. B-lactamines/lactams
  2. Glycopeptides
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17
Q

What is the common thing in the structure of B-lactamines?

A
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18
Q

What is the mécanisme d’action B-lactamines?

A

Inhibit the synthesis of peptidoglycans (rigid part of cell wall) found in Gram+ and - bacteria

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19
Q

What are the 4 main groups of B-lactamines?

A

Penicillins

Cephalosporins

Carbapenems

Monobactams

20
Q

What are the 5 main kinds of penicillins?

A
  1. Natural
  2. Anti-staph
  3. Aminopenicillins
  4. Broad spectrum (carboxypenicillins, ureidopenicillin)
  5. Penicillin associated with a B-lactamase inhibitor
21
Q

Natural penicillin:

A
22
Q

Anti-staph penicillin:

A
23
Q

Aminopenicillins:

A
24
Q

Broad spectrum (carboxypenicillins, ureidopenicillin) penicillins

A
25
Q

Penicillin associated with a B-lactamase inhibitor:

A
26
Q

Spectre d’action des céphalos?

A
27
Q

First generation céphalos:

A
28
Q

Second generation céphalos:

A
29
Q

Third generation céphalos:

A
30
Q

Fourth and fifth generation céphalos:

A
31
Q

Carbapenems:

A

Atomic bomb of antibiotics… kills everything in its path BUT used too much therefore resistance has started to develop

32
Q

Monobactams:

A

Only one type… Aztreonam

Pure anti-gram negative —> enterobacteria, Pseudomonas

  • Used in resistance cases or allergies
33
Q

What is the most common glycopeptide?

A

VANCOMYCIN!

34
Q

What class of antibiotics inhibit the synthesis of the membrane bactérienne?

A

Lipopeptides: Daptomycine

35
Q

What are the two classes of antibiotics inhibit the synthesis of nucleic acids?

A
  1. Quinolones
  2. Metronidazole
36
Q

Quinolones:

A
37
Q

Matronidazole:

A
38
Q

What are the antibiotics that inhibit the synthesis of folic acids?

A
39
Q

What are the antibiotics that inhibit the synthesis of proteins?

A
40
Q

Aminosides:

A
41
Q

Macrolides:

A
42
Q

Clindamycin:

A

prolonged postantibiotic effect —> It may decrease toxin production and increase microbial opsonization and phagocytosis

43
Q

What are the 3 main ATB resistance mechanisms used by bacteria?

A
  1. Production of an enzyme that modifies the ATB (ex: B-lactamase)
  2. Alteration of the permeability of the cell membrane (GRAM NEGATIVE BACTERIA… ex: pseudomonas and carbapenems)
  3. Alter the “cible” of the ATB (mostly GRAM POSITIVE BACTERIA)
44
Q

What is carbapénémase?

A
45
Q

What are the two ways to alter membrane permeability?

A
  1. Loss of porins:
    • Can’t get in anymore
  2. Pompes à efflux:
    • Gets in… pumped right out
46
Q

How does altering the cible work?

A

MD1 SF3 - EXAM 2 (12 decks)

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