Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacy Year 2 Semester 2 > Pseudomonas aureginosa > Flashcards

Pseudomonas aureginosa Flashcards

1
Q

Antibiotics that inhibit DNA gyrase

A

Quinolones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Eradication

A

early intervention can eradicate Psuedomonas for up to 2 years
Oral or inhaled therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Oral antibiotics

P.aureginosa

A

-Ciprofloxacin
5-flouroquinolone
well absorbed from GIT
primarily hepatic metabolism (which is increased in CD patients)
Dose can be therefore increased to 30mg/kg (maximum is 750mg)

-Azithromycin
interferes with adherence of pathogen to epithelium
modifies biofilm structure and growth
10mg/kg daily results in 
-improved FEV1
-fewer courses of IV antibiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Chronic treatment for CF patients

exacerbations

A

-Frequent exacerbations lead to regular IVAB therapy
3 monthly cycles of 2 weeks of therapy
3 monthly sputum samples
antimicrobial choices lead by previous sensitivities

-benefits
reduced admission to hospital (can have IVAB at home)
suppresses development of infection

Risks
resistance
on-going organ damage
colonisation with other bacteria (if done in hospital)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Antibiotics that inhibit folate synthesis

A

Sulfonamides

Trimethoprim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  • Risk of S.aureus infection in first 2 years of life

- does isolation of patient have an impact?

A
  • high

- no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Diagnosis and identification

A
  • urine analysis
  • FBC
  • Corneal scrapings
  • Sweet, fruity odour
  • Florescence under UV light
  • Blood culture on agar (wound/tissue, blood, sputum, discharge, stool)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Antibiotics that inhibit 50S subunit of ribosome

A 
Macrolides
Clindamycin
Linezolid
Chloramphenicol
Streptogramins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe how the generations of cephalosporins differ

A

5 generations
Higher generations have extended spectra against aerobic gram negative bacilli
3rd generation are resistant to beta-lactamases
The two 5th generation cephalosporins are active against MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Antibiotics that inhibit DNA polymerase

A

Rifampicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ESBL?

A

Extended-spectrum beta-lactamase-producing bacteria
caused by overuse of 3rd generation cephalosporins
ESBL genes transferred by plasmid transfer
ESBLs:
-Escherischea coli
-Enterobacter cloacae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Microbiology of P.aureginosa

A
  • Opportunistic, nosocomia pathogen (acquired in hospital)
  • gram negative rod
  • single polar flagellum for motility
  • 0.5-3um in size
  • commonly produces pyocyanin pigment
  • recalcitrance (stubborn)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Aminoglycoside dose for CF patients

A

10kg/kg

no difference in AKI or hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Antibiotics that effect cell wall synthesis

A 
Beta Lactams 
Cephalosporins
Penicillins
Carbapenems 
Monobactams

Vancomycin
Bacitracin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cause of cystic fibrosis

A

-single faulty gene - CFTR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Medical conditions caused by Pseudomonas aureginosa

A
  • respiratory tract infections
  • bacteraemia/sepsis
  • endocarditis
  • meningitis or brain abscess
  • Otitis externa or chronic otitis media
  • keratitis, ocular abscess, orbital cellulitis
  • osteomyletis
  • enterocolitis, enteritis, diarrhoea
  • Genito-urinary tract infection
  • Secondary wound infection, burn wound sepsis, pustular lesions, hot tub folliculitis
17
Q

Pathophysiology in CF patients especially

A

P.aureginosa colonises the mucous in the lower respiratory tract and then grows to cover the epithelium

  • biofilms proliferation
  • scarring and abscess formation
18
Q

Describe Cephalosporins

A
  • B lactam
  • most widely-prescribed antibiotics
  • inhibition of cell wall synthesis
  • bacteriocidal
  • broad spectrum
19
Q

Things associated with pseudomonal colonisation

A
  • mortality

- delayed growth

20
Q

Treatment when cephalosporin resistance

A 
Aminoglycosides 
-synergy with b-lactams
-concentration-dependent action
-Nephrotoxic (trough level dependent)
-Ototoxic (peak level dependent)
-Hypermetabolised in CF patients
standard dose of 7mg/kg not enough for CF patients
21
Q

How does resistance to cephalosporins occur on a microscopic level?

A

Beta-lactamases
Decreased permeability
Altered binding site

22
Q

Antibiotics that target cell membrane

A

Polymyxins

23
Q

Source

A

-water
-soil
-plant and animal surfaces
-part of normal human flora in some populations
-

24
Q

Biofilms affect and influence what?

A

Biofilms represent different strains and sensitivities

affects antibiotic choices

25
Q

Virulence factors

A
  • invasive, toxigenic (exotoxin)
  • Minimal nutritional requirements - shown to even grow in distilled water
  • produces extracellular proteases to aid bacterial adhesion and invasion
  • produces alignates to help biofilm formation
  • resistant to high salt concentrations, temperature changes, weak antiseptics and many antibiotics
26
Q

Emperical antibiotics for subsequent infections

A

-Guided by sensitivity from LAST exacerbation

27
Q

Definition of infective exacerbations

Intervention

A

-reduction of FEV1 to <50% expected
-acute changes on X ray
-increased breathlessness or reduced exercise tolerance
Actions
-sputum sample
-IV access
-emperical antibiotics
-admit

28
Q

Transmission

A

-variable routes
Biofilms:
-environmental sources e.g. sinks and drains
-invasive medical equipment and colonisation of moist equipment e.g. ventilators

Human transmission source

  • colonisation as part of normal human flora
  • limited spread by person-to-person contact
29
Q

Emperical antibiotics for first infection

A

-Ceftazidime
3rd generation cephalosporin
particularly active against Psuedomonas
Reserved in UK for this indication

-Tobramcyin
Aminoglycoside with favourable nephrotoxicity profile
good activity against Pseudomonas

30
Q

% of cystic fibrosis pathogens that are P.aureginosa

A

80%

31
Q

Early infections

A
  • no benefit to prophylaxis against psuedomonal infection
  • rates of infection seem to be related to early viral chest infections
  • newly infected patients should receive appropriate antimicrobial therapy - the goal is ERADICATION if it is a FIRST infection
32
Q

Markers of it

A
  • Positive oxidase reaction
  • non-fermentative
  • Aerobic respiration but will adapt to use NO3
33
Q

Inhaled antibiotics

A

Nebuliser or inhalation solution

  • Discrete and portable
  • no loss of efficacy
  • easy to use, covers all ages (6/12 onwards)
34
Q

Antibiotics that inhibit 30S subunit of ribosome

A

Tetracyclines

Aminoglycosides

35
Q

Cystic fibrosis symptoms

A
  • cough
  • fatty diarrhoea (steatorrhoea)
  • poor weight gain
  • chest infections

Pharmacy Year 2 Semester 2 (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions