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Microbiology Antibiotics 1 Flashcards

1
Q

Beta Lactams type

A
  1. Penicillins
  2. Cephalosporins
  3. Carbapenems
  4. Monobactams
  5. Blactamase inhibitors
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2
Q

Penicillin → Discovery

A

Alexander flemming 1929 used finally in 1940

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3
Q

Penicillin → Resistance via

A

Enzymatic digestion of Beta Lactam ring or target site modification (MRSA) – bacteria change confirmation of enzymes and so B lactams canit bind

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4
Q

Penicillin →Absorption

A

Oral: Poor oral absorption

IV

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5
Q

Penicillin →Distribution

A

Body water about 0.2 L/Kg

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6
Q

Penicillin →Metabolism

A

Peak concentration in 1-2h

Little metabolism

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7
Q

Penicillin →Excretion

A

Mainly urinary excretion

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8
Q

Penicillin →Side effects

A

Generally mild
• Allergy important as is assessment of allergy (analphylactive reactions)
• GI upset especially C.difficile in hospital with broad-spectrum agents.
• Hepatic
• Platelet
• CNS – convulsion
• Platelet abnormalities

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9
Q

Penicillin →Indications: Penicillin V/G

A 
B. haemolytic streptococci
Pneumococci
Meningococci
Gonococci (not susceptible anymore)
Anaerobes GPAC and clostridia (gas gangrene)
NB resistance in pneumococci
Gonococci
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10
Q

Penicillin →Indications for flucloxacillin

A

S.aureus (NB resistance MRSA)

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11
Q

Penicillin → Indiciation sfor Ampicillin/amoxicillin + clavunate (inhibitor)

A 
Otitis media
COPD exacerbation
CAP
UTI
Skin and soft tissue infection
Surgical prophylaxis
Intra abdominal surgery
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12
Q

Penicillin → Piperacillin/tazobactam

A

Hospital IV therapy 2nd line

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13
Q

Penicillin →Broad spectrum example

A

Ampicillin/amoxicillin

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14
Q

Penicillin →Blactam/Blactamase inhiitors example

A

Co-amoxiclav (amoxicillin-clavulante)

Piperacillin – tazobactam

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15
Q

Penicillin →Inhibitor action

A

Prevent Beta lactamase action so by introducing an inhibitor it can block the enzyme produced y the bacteria aimed to breakdown the antibiotic and so this allows the antibiotic to act.

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16
Q

Carbapenems: Example

17
Q

Carbapenems: Specification

A

Very broad spectrum

18
Q

Carbapenems: Absorption

A

Injectable only

Used as 2nd/3rd line therapy in hospital

19
Q

Carbapenems:Action

A

Typical Blactam pharmacokinetics

20
Q

Carbapenems:Resistance

A

Remains rare

21
Q

Carbapenems:Not active against

A

MRSA
Stenotrophomonas
Maltophilia
Some enterococci

22
Q

Cephalosporins: Isolated from

A

Fungus cephalosporium acremonium in Sardinia

23
Q

Cephalosporins: Classified based on

A

Generations on chronology and antimicrobial spectrum.

24
Q

Cephalosporins:First generation example

A

Cephalexin

25
Q

Cephalosporins: Second generation example

A

Cefuroxime

26
Q

Cephalosporins: Third generation example

A

Cefotaime, ceftriaxone, ceftazidime

27
Q

Cephalosporins: Fourth generation example

28
Q

Cephalosporins:Bacterial always resistant are:

A
  • MRSA
  • Enterococci
  • Listeria
  • Legionella – no cell wall therefore beta lactams don’t work therefor combine with macrolides
  • C. difficile
  • Campylobacter
  • ESBL producing E.coli, Klebsiella
29
Q

Cephalosporins: Indiciations

A
  • Acute meningitis (cefotaxime/ceftriaxone)
  • Surgical prophylaxis (abdominal, orthopaedic, head and neck, obstetrical)
  • UTI/acute pyelonephritis
  • Chest infection
  • CA sepsis of unknown site: ceftriazxone
  • Hospital acquired sepsos unknow site: ceftazidine + 2nd agent
  • Skin/soft tissue infection
  • Intra abdominal infection + metronidazole
30
Q

First generation: Cephalosporins: Active against

A

Gram positive cocci (Streptococci and Staphylococci) and Gram negatives

31
Q

First generation: Cephalosporins: Used for

A

UTI (E.coli, Klebsiella, Proteus spp)

32
Q

First generation: Cephalosporins: Absorption

33
Q

First generation: Cephalosporins: Commonly used in

34
Q

Second generation: Cephalosporins: Active against

A

Gram positive cocci (Streptococci and Staphylococci)

Gram negatives which cause CAP and exacerbation COPD (H. influenza, M. catarrhalis)

35
Q

Second generation: Cephalosporins: Absorption

36
Q

Third Generation: Cephalosporins: Active against

A 
Hospital gram negative rods
Poor against gram positive
•	Citrobacter
•	Serratia for ceftriaxone/cefotaxime
•	Pseudomonas aeruginosa for ceftazidime
37
Q

Third Generation:Cephalosporins: Absorption

38
Q

Fourth Generation: Cephalosporins: active for

A

Similar spectrum to ceftazidime but also good activity against some gram positive cocci.

39
Q

Blactamase inhibitors: exampe

A

Co-amoxiclav (amoxicillin and clavulanic acid)

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