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Pathology Summaries > MICRO: Antimicrobials > Flashcards

MICRO: Antimicrobials Flashcards

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1
Q

Name 2 types of bonds in bacterial cell walls which give rigidity and protect from lysis.

A

Glycosidic bonds
Peptide bond

These are formed between NAM and NAG.

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2
Q

What are transpeptidases?

A

Penicillin binding proteins = involved in terminal stages of cell wall synthesis

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3
Q

What is the MOA of beta lactams?(2)

A

Inhibit transpeptidases
Structural analogues of the enzyme substrate needed

–> bactericidal

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4
Q

What is the MOA of glycopeptides?

A

Stop transpeptidase binding so it cannot form peptide bonds
Stop transglycosidase so no glycosidic bonds form

–> slowly bactericidal

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5
Q

What is the MOA of aminoglyosides?(2)

A

At 30s to prevent ELONGATION of polypeptide chain

At mRNA to cause MISREADING of codons

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6
Q

What is the MOA of tetracyclines?

A

At 30s they reversibly bind and prevent tRNA binding to ACCEPTOR site, inhibiting protein synthesis.

–> bacteriostatic

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7
Q

What is the MOA of macrolides?(2)

A

At 50s they bind and stop TRANSLATION

They also stimulate DISSOCIATION of tRNA so inhibit protein synthesis

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8
Q

What is the MOA of chloramphenicol?

A

At 50s it binds to peptidyl transferase to inhibit formation of PEPTIDE BONDS during translation

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9
Q

What is the MOA of oxazolidinones?

A

At 23s of 50s subunit to prevent formation of 70s INITIATION COMPLEX (required for translation)

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10
Q

What is the MOA of quinolones?

A

Act at alpha-subunit of DNA gyrase

–> bactericidal

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11
Q

What is the MOA of nitromidazole? (e.g. metronidazole)

A

–>rapidly bactericidal

Produce an active intermediate in anaerobic conditions which causes DNA strand breakage

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12
Q

What is the MOA of rifamycins?

A

Bind RNA polymerase which inhibits initiation of protein synthesis

–> bactericidal

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13
Q

What is the MOA of daptomycin?

A

Cyclic lipopetide

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14
Q

What is the MOA of colistin?

A

Polymyxin that destroys the outer cell membrane of gram -ve organisms

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15
Q

What is the MOA of sulfonamides/ diaminopyrimidines?

A

Interfere with folic acid metabolism –> acts on DNA

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16
Q

What is the use of tazobactam in tazocin?

A

Prevents BL breakdown of piperacillin

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17
Q

Which penicillin combo can be used for E coli?

A

Co-amoxiclav a.k.a. augmentin

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18
Q

Which penicillin is stable to BL?

A

Flucloxacillin

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19
Q

Which penicillin is used for HAI and pseudomonas?

A

Piperacillin

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20
Q

Which penicillins are broken down by BLs?

A

Penicillin, Amoxicillin, Piperacillin

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21
Q

Name a first, second, third gen cephalosporin. What is the trend?

A

CePHALexin - 1st
CeFURoxime -2nd
CefoTAXime - 3rd
Increasing activity against gram -ve bacilli

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22
Q

Which cephalosporin is assoc with C diff?

A

Ceftriaxone

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23
Q

Which cephalosporin is similar to amox but stable against BL?

A

CeFURoxime - but less stable against anaerobes

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24
Q

Which cephalosporin is good for pseudomonas?

A

CefTAZidime

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25
What are the only beta lactam group stable to ESBLs?
Carbapenems
26
What is an advantage of carbapenems?
Very broad spectrum
27
What is a disadvantage of carbapenems ?
Klebsiella/Acinetobacter resistance
28
Why are beta lactams used in meningitis?
Cross BBB when inflammed
29
How are beta lactams excreted?
Renally
30
Which organisms are glycopeptides used for?
Gram +ve (can't penetrate wall of gram -ves)
31
Name 2 uses of glycopeptides.
MRSA and C diff
32
What is the C in MLSCOAT of antibiotics which inhibit DNA?
Chloramphenicol
33
Which group is clindamycin?
Lincosamines
34
Which group is gentamicin?
Aminoglycoside
35
Which group is erythromycin?
Macrolide
36
What are 2 complications of aminoglycosides?
Nephrotoxicity and ototoxicity
37
What is a disadvantage of aminoglycosides?
Not good for abscesses as they are inactivated at low pH | Gentamicin not active against anaerobes
38
Which MLSCOAT are good for pseudomonas?
Gentamicin/tobramycin (aminoglycosides)
39
Which MLSCOAT are good for intracellular pathogens?
Tetracyclines (chlamydia, rickettsiae, mycoplasma)
40
Which MLSCOAT is active against MDR?
Tigecycline
41
What is a complication of tetracyclines?
Deposit in bone and discolour teeth . May also cause light sensitive rash
42
List 2 uses of macrolides.
Staph/strep in pen allergic | Atypical pneumonia e.g. legionella, mycoplasma
43
What are macrolides not effective against ?
Minimal activity against gram -ve (although newer ones like azithromycin can be used for Salmonella/bronchiectasis in CF)
44
Why are macrolides and penicillins combined e.g. in strep pyogenes?
Stationary phase will not be affected by beta lactams alone but macrolides will stop toxin production here
45
What are 2 complications of chloramphenicol?
Aplastic anaemia | Grey baby syndrome
46
What is a specific use of chloramphenicol?
Pen allergic meningitis or CAP
47
What are 2 infections which can be treated with oxazolidinones?
VRE MRSA (not gram -ves)
48
What are 2 complications of oxazolidinones?
Thrombocytopenia | Optic neuritis
49
What class if ciprofloxacin?
Fluoroquinolone
50
Name 3 fluoroquinolones in order of gram +ve --> gram -ve activity.
Moxi Levo Cipro -floxacin
51
Which fluoroquinolone can be used for pseudomonas?
Ciprofloxacin - fluoroquinolones have broad activity
52
What are 2 complications of fluoroquinolones?
Tendonitis | C diff
53
Name a nitromidazole used for UTI.
Nitrofurantoin
54
What organisms do nitromidazoles act against?
Anaerobic bacteria | Protozoa
55
Which antimicrobials inhibit RNA synthesis?
Rifamycins
56
What is a disadvantage of rifamycins?
Resistance (altered target single aa) develops quickly so never use alone
57
Apart from TB, what other conditions is rifamycin used to treat?
Prosthetic joint Endocarditis (disrupts biofilms)
58
Is daptomycin only against gram +ve or -ve?
GRAM +VE ONLY e.g. MRSA, VRE
59
Is colistin used against gram +ve or -ve? Name 3 organisms.
Gram -ve e.g. pseudomonas, acinetobacter, klebsiella
60
Name 2 inhibitors of folate metabolism.
Sulfonamide | Diaminopyrimidines (trimethoprim - but 40% E coli are resistant)
61
Name a combination use of a sulfonamide.
Sulphamethoxazole + trimethoprim = CO-TRIMOXAZOLE
62
What is good about sulfonamides?
Very broad spectrum

Pathology Summaries (23 decks)

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