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2060 Pharmacology > Module 16 Antibiotics > Flashcards

Module 16 Antibiotics Flashcards

1
Q

Bacteria

A
  • Single cell organisms
  • Rod, sphere, spiral shaped
  • Majority harmless to immune system
  • Some beneficial types
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2
Q

Virulence Factors

A
  • Fimbriae & pilli
  • Flagella
  • Secretion of toxins/enzymes
  • Invasion
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3
Q

Fimbriae & Pilli

A
  • Hair like structures
  • Project from surface of bacterial cells
  • Allow bacteria attachment within body
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4
Q

Flagella

A
  • Aqueous environment
  • Swim through body (flagellum)
  • Find site to survive
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5
Q

Toxins & Enzymes

A
  • Cause nausea/vomit, diarrhea, cramps
  • Mediate toxic reactions with body entry
  • Enzymes effect tissue, antibodies
  • Degrade defense against infection
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6
Q

Gram Straining

A
  • Used to classify as positive/negative
  • Cell wall structure of bacteria
  • Amount of peptidoglycan
  • Determine antibiotic choice
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7
Q

Gram Positive Cells

A
  • Thick peptidoglycan wall
  • Purple stains
  • No LPS or outer membrane
  • No porins
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8
Q

Gram Negative Cells

A
  • Thin peptidoglycan layer
  • Pink stains
  • No techoic acid
  • LPS on outer membrane
  • Outer membrane protects againts bile salt/detergents
  • Porins on outer membrane (sugars/ions into bacteria)
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9
Q

Signs of Infection

A
  • Fever
  • Malaise
  • Local redness
  • Swelling
  • Increased respiratory rate
  • Tachycardia
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10
Q

Selective Toxicity

A
  • Treatment of bacterial infection
  • Therapy to destroy bacteria without harming human cells
  • Differences between cellular chemistry of humans/bacteria
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11
Q

Mechanisms of Selective Toxicity

A
  • Disrupting bacterial cell wall
  • Targeting bacteria unique enzymes
  • Disrupting bacterial protein synthesis
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12
Q

Antibiotic Selection

A
  • Identification of bacteria
  • Bacterial sensitivity to antibiotic
  • Antibiotic access to infection site
  • Ability of patient to battle infection
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13
Q

Bacteria Identification

A
  • Prior to treatment selection
  • Gram stain rapid test (structural features)
  • Culturing
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14
Q

Bacteriostatic Antibiotics

A
  • Stops growth & replication of bacteria
  • Stops infection spread
  • Immune system attack & remove cells
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15
Q

Bactericidal Antibiotics

A
  • Kill bacteria directly
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16
Q

Determining Bacterial Sensitivity

A
  • Culture bacteria
  • Determine minimum inhibitory concentration (MIC)
  • Determine minimum bactericidal concentration (MBC) of drug
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17
Q

Difficult Penetration to Site of Action

A
  • Meningitis
  • UTI
  • Osteomyelitis
  • Abscesses
  • Otitis media
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18
Q

Meningitis

A
  • Infection of meninges
  • Membranes cover brain/spinal cord
  • Viral more common than bacterial
  • Antibiotic must penetrate meninges
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19
Q

UTI

A
  • Bacteria enters urinary system
  • Bladder most common (catheterization)
  • Antibiotic must enter urinary system
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20
Q

Osteomyelitis

A
  • Infection of bone
  • Limited treatment options, antibiotic must enter bone
  • 4-6 week antibiotic period
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21
Q

Abscesses

A
  • Pus/infected material collect under skin
  • Difficult to treat, low blood perfusion
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22
Q

Otitis Media

A
  • Infection of middle ear
  • Common in children
  • Antibiotics do not penetrate inner ear
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23
Q

Ability to Battle Infection

A
  • Immunological state of patient determines antibiotic choice
  • Bactericidal used with compromised immune function
  • Bacteriostatic compromised immune function may not respond
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24
Q

Impaired Response to Bacteriostatic Antibiotics

A
  • AIDS
  • Organ transplant
  • Cancer chemotherapy
  • Elderly
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25
Q

Complications of Antibiotic Therapy

A
  • Resistance
  • Allergy
  • Serum sickness
  • Superinfection
  • Destruction of normal bacterial flora
  • Bone marrow toxicity
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26
Q

Resistance

A
  • Bacteria doesn’t respond to antibiotic
  • Sensitivity loss
27
Q

Acquiring Antibiotic Resistance

A
  • Reduction of drug at site of target
  • Increased drug inactivation
  • Alteration of bacterial target
28
Q

Drug Reduction at Target Site

A
  • Bacteria decreases antibiotic uptake
  • Bacteria increase expression of efflux pumps (extrude antibiotics)
29
Q

Increased Drug Inactivation

A
  • Bacteria evolution to produce enzymes to inactivate antibiotics
30
Q

Alteration of Bacterial Target

A
  • Bacteria evolves to contain mutations
  • Within antibiotic target
  • Making antibiotic ineffective
31
Q

Resistance Prevention

A
  • Infection prevention
  • Diagnosis & effective infection treatment
  • Use antibiotics wisely
  • Prevent transmission
32
Q

Allergy Signs

A
  • Urticaria (hives)
  • Anxiety
  • Swelling (hands, feet, throat)
  • Difficulty breathing
  • Hypotension
33
Q

Antibiotic Allergy

A
  • Penicillin most common
  • Within 20 mins of dosing
  • Stop treatment immediately
  • Monitor vitals
  • Treatment with epipen & antihistamine
34
Q

Serum Sickness

A
  • Develops 7-21 days after antibiotic exposure
  • Immune system improperly identifies drug as harmful
  • Producing immune reaction
35
Q

Immune Reaction Symptoms

A
  • Fever
  • Hives
  • Rash
  • Joint pain
  • Itching
  • Angioedema
  • Enlarged lymph nodes
36
Q

Serum Sickness Treatment

A
  • Antihistamine (itching)
  • Analgesics (pain)
  • Corticosteroids (inflammation)
37
Q

Superinfection

A
  • New infection develops during antibiotic therapy
  • Antibiotics kill pathogenic & normal bacterial flora
  • Destruction of bacterial flora allows new bacteria
  • Caused by drug-resistant bacteria
  • Difficult to treat
38
Q

Destruction of Normal Bacteria Flora

A
  • Decreased vit K levels (warfarin)
  • Increase blood drug levels, toxicity
  • Decrease enterohepatic recycling
39
Q

Bone Marrow Toxicity

A
  • Rare complication, serious
  • Aplastic anemia
  • Thrombocytopenia
  • Agranulocytosis
  • Leukopenia
  • Watch for bruising/fatigue/sore throat
40
Q

Penicillin

A
  • Bactericidal
  • Effective against active growing/dividing bacteria
  • No outer membrane
41
Q

Penicillin Mechanism of Action

A
  • Inhibit transpeptidases
  • Activate autolysins
  • Disrupt synthesis of cell wall/promote destruction
  • Bacteria take up excess H2O & die
42
Q

Bacterial Cell Wall

A
  • Composed of peptidoglycan layer
  • Transpeptidases & autolysins form Penicillin binding proteins
  • Transpeptidases form crossbridge with peptidoglycan
  • Autolysins degrade peptidoglycan wall
  • Primary target of antibiotics
43
Q

Penicillin Resistance

A
  • Inability to reach target
  • Inactivation
  • Mutation to PBPs (low affinity)
44
Q

Mechanisms of Penicillin Resistance

A
  • Inactivation by beta lactamases enzyme
  • Target beta lactam ring of penicillin
  • Beta lactase inhibitors block enzyme
45
Q

Penicillin Classes

A
  • Narrow spectrum penicillins
  • Narrow spectrum penicillins resistant penicillins
  • Broad spectrum penicillins
  • Extended spectrum penicillins
46
Q

Narrow Spectrum

A
  • Treatment of gram positive bacteria
  • Destroyed by gastric acid
  • Intravenous/intramuscular administration
  • Pneumonia/meningitis treatment
  • Considered safe
47
Q

Narrow Spectrum Penicillins Resistant Penicillins

A
  • Altered side chain
  • Not effected by beta lactamase enzymes
  • Penicillinase treatment (produce staphylococci)
  • Less effective compared to non-penicillinase
  • MRSA resistant to this class
48
Q

Broad Spectrum

A
  • Effective against gram positive & negative bacteria
  • Pseudomonas aeruginosa treatment
  • Degradation by beta lactase enzymes
49
Q

Cephalosporins

A
  • Same mechanism of action as penicillin
  • Inhibit transpeptidases
  • Activate autolysins
  • Increase in activity against gram negative bacteria
  • Increase resistance to beta lactamases
  • Increase ability to penetrate cerebrospinal fluid
  • Alternative for penicillin allergies
50
Q

Vancomycin

A
  • Potentially toxic
  • Treatment for serious infections caused by MRSA
  • Osteomyelitis, meningitis, pneumonia
  • Cause ototoxicity & rapid infusion (red skin)
51
Q

Vancomycin Mechanism of Action

A
  • Inhibits cell wall synthesis
  • Binds to precursors of cell wall synthesis
  • Block transglycosylation in cross bridge formation
52
Q

Tetracyclines

A
  • Protein synthesis inhibitors
  • Act on ribosomes
  • Prevent addition of amino acids to peptide chain
  • Bacteriostatic
  • Typhus fever, chlamydia, cholera
53
Q

Adverse Effects of Tetracyclines

A
  • GI irritation
  • Photosensitivity (UV)
  • Susceptible to superinfection
54
Q

Macrolid Antibiotics

A
  • Protein synthesis inhibitors
    • Block ribosomes
      Block addition of amino acids to peptide chain
55
Q

Adverse Effects of Macrolide Antibiotics

A
  • GI upset
  • QT interval prolongation
56
Q

Oxazolidinones

A
  • Bacteriostatic (narrow spectrum)
  • Protein synthesis inhibitors
  • Bind to ribosomes
  • Gram positive bacteria
  • MRSA & VRE treatment
57
Q

Adverse Effects of Oxazolidinones

A
  • Reversible myelosuppression
58
Q

Aminoglycosides

A
  • Bactericidal (narrow spectrum)
  • Protein synthesis inhibitors
  • Effective versus gram negative bacteria
  • Bind to ribosomes
  • Rapid & lethal
59
Q

Adverse Effects of Aminoglycosides

A
  • Ototoxicity
  • Reversible nephrotoxicity
60
Q

Sulfonamides & Trimethoprim

A
  • Block folic acid synthesis
  • Bacteria dependant on synthesis of folic acid into DNA
  • Administered together to create bactericidal action
  • UTI treatment
61
Q

Adverse Effects of Sulfonamides & Trimethoprim

A
  • Hypersensitivity
  • Fever
  • Photosensitivity (UV)
  • Stevens-johnson syndrome
62
Q

Fluoroquinolones

A
  • Inhibit DNA replication
  • DNA gyrase & topoisomerase IV enzymes
  • Bactericidal, broad spectrum
  • UTI, soft tissue, osteomyelitis treatment
63
Q

Isoniazid

A
  • Tuberculosis treatment ONLY
  • Inhibit mycolic acid synthesis (cell wall component)
64
Q

Adverse Effects of Isoniazid

A
  • Peripheral neuropathy
  • Hepatotoxicity

2060 Pharmacology (18 decks)

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