Microbiology Vaccines Flashcards
Name the types of bacterial vaccines and what type of conferred acquired immunity and treated diseases they have.
-
Live attenuated (Active)
- TB, Typhoid Fever, Tularemia
-
Killed bacteria = whole bacteria (Active)
- Cholera, Typhus, Plague, Q fever
-
Toxoid = Inactive endotoxin/exotoxin (Active)
-
Diphtheria, Pertussis, Tetanus (DPT)
- NOTE: given to all children in the US
-
Diphtheria, Pertussis, Tetanus (DPT)
-
Capsular polysaccharide (Active)
- Pneumonia (strep. pneumonia), Meningitis (N. meningitidis and H. influenzae)
-
Purified protein (Active)
- Pertussis, Lyme disease, Anthrax
-
Antitoxin = preformed antibody to endotoxin/exotoxin (Passive)
- Diphtheria, Tetanus, Botulism
Name the classification information between antibiotic drugs. By:
Spectrum
Activity
- By Spectrum:
- Broad: Effective against several types of bacteria
- Narrow: Effective against only one or a few types of bacteria
- By activity:
- Bacteriocidal: Kills bacteria
-
Bacteriostatic: Inhibits bacterial growth (hose immune cells kill bacteria)
- NOTE: Concomitant administration of bacteriocidal and bacteriostatic antibiotics has an antagonistic effect because each interferes with other’s mechanism of action
Penicillins
Mechanism of action
Activity
Spectrum
Pregnancy Safe
Penicillins
Mechanism of action:
- Inhibits peptidoglycan cross-linking by blocking transpeptidase during the last stage of cell wall synthesis
- Contain beta-lactam rings which are cleaved by bacterial beta-lactamase (penicillinase), inactivating the drug
Activity: Bacteriocidal
Spectrum: Narrow -> Broader
Pregnancy Safe: Yes
Vancomycin
Mechanism of action
Activity
Spectrum
Pregnancy Safe
Vancomycin
Mechanism of action
- Inhibits peptidoglycan cross-linking by binding to D-alanyl-D-alanine during cell wall synthesis
- Treatment choice for MRSA
Activity: Bacteriocidal
Spectrum: Narrow
- Mostly G+ cocci and bacilli (esp. S. aureus)
Pregnancy Safe: Yes
Cephalosporins
Mechanism of action
Activity
Spectrum
Pregnancy Safe
Cephalosporins
Mechanism of action
- Inhibit peptidoglycan cross-linking by blocking transpeptidase during the last stage of cell wall synthesis
- Just like penicillins!!!!
- Contains Beta-lactam rings
Activity: Bacteriocidal
Spectrum: Narrow -> Broader
Pregnancy Safe: Yes
Metronidazole
Mechanism of action
Activity
Spectrum
Pregnancy Safe
Metronidazole
Mechanism of action
- Inhibits DNA synthesis
- Disulfuram-like reaction with alcohol
- Often used to treat pseudomembranous colitis (C. diff)
Activity: Bacteriocidal
Spectrum: Narrow
- Targets anaerobes and some protozoa
Pregnancy Safe: No
Fluoroquinolones
Mechanism of action
Activity
Spectrum
Pregnancy Safe
Fluoroquinolones
Mechanism of action
- Inhibit DNA gyrase (topoisomerase)
- Disulfuram-like reaction with alcohol (like metronidaole)
Activity: Bacteriocidal
Spectrum: Broader
- G+ and G- aerobes/facultative and mycobacteria, but not anaerobes
Pregnancy Safe: No
Aminoglycosides
Mechanism of action
Activity
Spectrum
Pregnancy Safe
Aminoglycosides
Mechanism of action
- Inhibit protein synthesis by binding to 30S ribosomal subunits (blocking the formation of the initiation complex)
Activity: bacteriocidal (in clinical doses)
Spectrum: Broader
- G+ and G- aerobes; ineffective against anaerobes
Pregnancy Safe: No
Macrolides
Mechanism of action
Activity
Spectrum
Pregnancy Safe
Macrolides
Mechanism of action:
- Inhibit protein synthesis by binding 50S ribosomal subunits (blocking the release of tRNA)
- Associated with GI upset
- Erthromycin, Clarithromycin, Azithromycin
Activity: bacteriostatic
Spectrum: Narrow
Pregnancy Safe: yes
Clindamycin
Mechanism of action:
Activity:
Spectrum:
Pregnancy Safe:
Clindamycin
Mechanism of action:
- Inhibit protein synthesis by binding 50S ribosomal subunits (blocking the release of tRNA)
- Associated with diarrhea and pseudomembranous colitis (caused by an overgrowth of Clostridium difficile)
Activity: bacteriostatic (low doses)
Spectrum: Narrow
- Bacteroides sp - Gram + and some Gram - anaerobes
Pregnancy Safe: yes
Chloramphenicol
Mechanism of action:
Activity:
Spectrum:
Pregnancy Safe:
Chloramphenicol
Mechanism of action:
- Inhibit protein synthesis by binding 50S ribosomal subunits (blocking the release of tRNA)
- Associated with bone marrow toxicity, gray baby syndrome
Activity: bacteriostatic
Spectrum: Broad
- Some G+ cocci, G- aerobes/anaerobes, spirochetes, Rickettsia, chlamydia, mycoplasma, and salmonella.
Pregnancy Safe: no
Tetracyclines
Mechanism of action:
Activity:
Spectrum:
Pregnancy Safe:
Tetracyclines
Mechanism of action:
- Inhibit protein synthesis by binding 30S ribosomal subunits (blocks aminoacyl-tRNA binding)
- Divalent and trivalent cations inhibit absorption
- Associated with staining of teeth during their calcification
- Tetracycline, Doxycycline, Minocycline
Activity: bacteriostatic
Spectrum: broad
- G+ and G- aerobes/anaerobes, spirochetes, Mycoplasma, Chlamydia, and Rickettsia
Pregnancy Safe: no
Sulfonamides
Mechanism of action:
Activity:
Spectrum:
Pregnancy Safe:
Sulfonamides
Mechanism of action:
- Inhibit folic acid synthesis by competing with p-aminobenzoic acid (PABA)
Activity: bacteriostatic
Spectrum: Broad
- Targets: G+, many G- actinomyces and chlamydia sp
- Associated with hypersensitivity, renal toxicity, and hematopoietic toxicity
- Sulfadiazine, sulfamethoxazole, Trimethoprim
Pregnancy Safe: no
How can you remember which antibiotics target 30S vs. 50S?
Buy AT 30, CCELL at 50
30S:
- Aminoglycocides
- Tetracycline
50S:
- Clindamycin
- Chloramphenicol
- Erythromycin
- Lincomycin
- Linezolid
Name topical antibiotics commonly used
- Neomycin: An aminoglycoside
- Polymyxin B: Alters cell membrane permeability
- Bacitracin: Inhibits cell wall synthesis
What type of patients requires Prophylaxis prior to dental treatment?
Prophylaxis is recommended for all dental procedures that involve manipulation of gingival tissues or periapical regions of the teeth or perforation of oral mucosa:
- Patients with serious health conditions, such as immunocompromising diseases
- Prosthetic cardiac valves, including transcatheter-implanted prostheses and homografts
- Prosthetic material used for cardiac valve repair, such as annuloplasty ring and chords
- A history of infective endocarditis
- A cardiac transplant with valve regurgitation due to a structurally abnormal valve
- The following congenital heart disease:
- Unrepaired cyanotic congenital heart disease (shunts and conduits)
- Repaired congenital heart defect with residual shunts or valvular regurgitation at site of or adjacent to site of prosthetic patch
What are the guidelines for antibiotic prophylaxis for drug prescription
-
Standard prophylaxis: Amoxicillin (500 mg)
- Disp: 12 tab
- sig: 4 tab. 30-60 min before apt.
-
Allergic to penicillins: Clindamycin (150 mg)
- Disp: 12 tab
- sig: 4 tab. 30-60 min before apt.
- Unable to take oral medication: Ampicillin
- Allergic to penicillin and cannot take oral meds: Clindamycin or Cefazolin
