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immunology > micro poop 2. > Flashcards

micro poop 2. Flashcards

1
Q

What factors must be considered in choosing an antimicrobial agent?

A

identity of infecting organism, information about the susceptibility of the infecting organism, factors specific to the patient

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2
Q

What is empiric theory?

A

the application of knowledge of the organisms most likely to cause infection in a given clinical setting and its most likely susceptibility to an antibiotic

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3
Q

Why is knowing the susceptibility of the organism important in choosing an antibiotic?

A

organisms exhibit intrinsic or innate resistance to certain antibiotics so you won’t consider these, while some are universally susceptible to certain antibiotics

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4
Q

What factors to the patient are important to consider when choosing an antibiotic?

A

history of previous reactions, age (gastric acidity changes with age - important for orally ingested), pregnancy, renal/hepatic function, site of infection

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5
Q

pharmacokinetics

A

encompasses all the ways that the body manipulates a drug, including absorption, distribution, metabolism, and excretion

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6
Q

pharmacodynamics

A

describes the biochemical and physiologic effects of the drug and its metabolism of action on the bacteria

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7
Q

bacteriostatic

A

antimicrobial agents that inhibit the growth and/or reproduction of the infecting agent, but fail to actually kill the agent

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8
Q

Why is bacteriostatic typically better than bacteriocidal?

A

normal defenses typically destroy the microorganism

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9
Q

What are examples of bacteriostatic agents?

A

macrolids (erythromycin), clindamycin, sulfamethoxazole, trimethoprim, tetracyclines, chloramphenicol

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10
Q

bacteriocidal

A

antimicrobial agent that is capable of causing irreversible damage or death to the organism

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11
Q

What are examples of bacteriocidals?

A

b-lactam antibiotics (penicillins and cephalosporins), vancomycin, aminoglycosides, fluoroquinolones

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12
Q

What is a factor that can influence if a antimicrobial is bacteriostatic or bacteriocidal?

A

antimicrobial concentration at the site of action - can be bacteriostatic at low concentrations and bactericidal at high concentrations

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13
Q

MIB

A

Minimal bacteriocidal concentration - the lowest concentration which prevents the organism from multiplying

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14
Q

broad spectrum antibiotics

A

active against wide range - usually both gram positive and gram negative

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15
Q

When are broad spectrum typically used?

A

empirically prior to identifying the causative bacteria (wide differential and potentially serious illness)

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16
Q

narrow spectrum antibiotic

A

active against a select group of bacterial types

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17
Q

What are the five mechanisms antibiotics inhibit/kill bacteria?

A

interfere with cell wall synthesis, protein synthesis, cytoplasmic membrane function, nucleic acid synthesis, metabolic pathway

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18
Q

What are antibiotics that interfere with cytoplasmic membrane function tricky?

A

all organisms have a cytoplasmic membrane

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19
Q

What antibiotics interfere with cell wall?

A

beta lactams (penicillin, cephalosporin, carbapenems, monobactams), vancomycin, bacitracin

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20
Q

What antibiotics interfere with cell membrane?

A

polymyxins

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21
Q

What antibiotics interfere with folate synthesis?

A

sulfonamides, trimethoprim

22
Q

What antibiotics interfere with DNA gyrase?

A

quinolones

23
Q

What antibiotics interfere with RNA polymerase?

A

rifampin

24
Q

What antibiotics interfere with ribosome subunits?

A

macrolides, clindamycin, linezolid, cholamphenicol, streptogramins, tetracyclines, aminoglycosides

25
Q

What is the mechanism of action for inhibitors of cell wall synthesis?

A

interfere with peptidoglycan sheet synthesis and murrain assembly

26
Q

What are the beta-lactams?

A

PCCM (P-in, C-in, C-em, M-am) penicillin, cephalosporin, carbapenem, monobactam

27
Q

How do beta lactams work?

A

bind at the active site of the transpeptidase enzyme that cross-links the peptidoglycan strands, irreversibly inhibiting the enzyme - formation of cell wall is prevented (non toxic to human)

28
Q

What is the general structure of a penicillin? What group does it belong to?

A

house with an attached garage, beta lactams that block cell wall synthesis

29
Q

How are cephalosporins categorized?

A

by generation - each generation exhibiting increased spectrum of activity as well as increased resistance to destruction by beta=lactamase enzymes

30
Q

What is the structure of a cephalosporin?

A

weird house with attached garage

31
Q

What are the third and fourth generation cephalosporins more targeted towards?

A

gram negative bacteria

32
Q

carbapenems

A

cell wall inhibition - active against all pathogenic organisms and resistant to destruction by the extended spectrum beta lactamases

33
Q

What is the structure of a carbapenem?

A

house with both attached and detached garage

34
Q

What is the only antibiotic that works against MRSA?

A

vancomycin

35
Q

What is the method of action for vancomycin?

A

blocks residues instead of cleaving like penicillin - prevents crosslinking

36
Q

What bacteria are vancomycin effective against?

A

gram-positive bacteria (including MRSA) - gram negative resistant due to LPS porons

37
Q

What is used for people who are allergic to penicillin? What is the method of action?

A

inhibitors of protein synthesis - infere with formation of 30S complex, 70S ribosome, or block elongation process

38
Q

aminoglycosides - method of action and danger of these drugs

A

inhibit protein synthesis - causes misreading of mRNA —> therapeutic level is high, near toxic level - need to stop and give kidneys a rest

39
Q

linezolid - method of action and when should it be used

A

inhibit protein synthesis - should only be used against gram + bacteria that are resistant to other antibiotics

40
Q

macrolids

A

bacteriostatic - block protein synthesis

41
Q

lincosamides

A

similar to macrolids - inhibit protein synthesis

42
Q

chloramphenicol - method of action and when should it be used

A

inhibits protein synthesis - VERY TOXIC - should only be used against salmonella

43
Q

tetracyclines

A

inhibit protein synthesis - static in nature, immune system must be able to clear the bacteria

44
Q

quinolones/fluorquinolones

A

inhibition of DNA synthesis - esp inhibiting DNA gyrases/topoisomerases required for supercoiling DNA

45
Q

metronidazole

A

inhibition of DNA synthesis

46
Q

rifampin

A

inhibition of RNA synthesis

47
Q

bacitracin

A

inhibition of RNA transcription

48
Q

What is trimethoprim used in combination with?

A

sulfamethoxazole

49
Q

trimethoprim

A

prevention of synthesis of folic acid

50
Q

sulfonamides and dapsone

A

prevents synthesis of folic acid

immunology (18 decks)

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