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Infection * > S4 Intro to Antibiotics and Resistance > Flashcards

S4 Intro to Antibiotics and Resistance Flashcards

1
Q

What are the 4 classes of antimicrobials?

A
  • antibacterial
  • antifungal
  • antiviral
  • antiprotozoal
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2
Q

What ways can antibacterials agents be classified?

A
  • bactericidal or bacteriostatic
  • broad or narrow
  • what is the target site? (Mechanism of action)
  • what is the chemical structure? (Antibacterial class)
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3
Q

How can you measure antibiotic activity/sensitivity?

A
  • disc testing (disc diffusion testing)

* minimum inhibitory concentration (MIC) - broth microdilution or E test

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4
Q

What are the 4 mechanisms of actions by antibacterials?

A
  • cell wall synthesis
  • protein synthesis
  • cell membrane function
  • nucleic acid synthesis
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5
Q

What antibacterials affect bacteria cell wall synthesis?

A
  • beta-lactams: penicillins, cephalosporins

* glycopeptides

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6
Q

What antibacterials affect bacteria cell membrane function?

A
  • polymixins e.g. colistin
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7
Q

What antibacterials affect bacteria protein synthesis?

A
  • tetracyclines
  • aminoglycosides
  • macrolides
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8
Q

What antibacterials affect bacteria nucleic acid synthesis?

A
  • quinolones
  • trimethoprim
  • rifampicin
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9
Q

What are the 3 types of resistance?

A
  1. Intrinsic
  2. Acquired
  3. Adaptive
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10
Q

Describe intrinsic resistance.

A
  • has no target to access for the drug

* usually permanent

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11
Q

Describe acquired resistance.

A
  • acquires new genetic material or mutates

* usually permanent

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12
Q

Describe adaptive resistance.

A
  • organism responses to a stress e.g. sub-inhibitory levels of antibiotic
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13
Q

What are the 3 mechanisms of resistance?

A
  1. Enzymatic modification/destruction of antibiotics
  2. Enzymatic alteration of antibiotic targets
  3. Mutations of bacterial target sites
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14
Q

How can gene for resistance get to other bacteria cells?

A
  • chromosomal gene mutation then bacterial replication
  • horizontal gene transfer - two bacterial cells can conjugate and transfer plasmids from one to another (pilus conjugates cells, cells “fuse” partially, DNA polymerase replicates plasmid, pilus separate)
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15
Q

What classes of antibiotics are beta-lactams?

A
  • penicillins e.g. amoxicillin, flucloaxcillin, penicillin, etc
  • cephalosporins e.g. cefalexin, ceftriaxone, cefepime, etc
  • carbapenems e.g. meropenem, imipenem
  • monobactams e.g. aztreonam
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16
Q

What is penicillin active against?

A

Streptococci

17
Q

What is amoxicillin active against?

A

Streptococci and some activity against gram-negatives

18
Q

What is flucloaxcillin active against?

A

Staphylococci and streptococci

19
Q

What is Co-amoxiclav active against? What is it’s advantage?

A

Streptococci, staphylococci, gram negatives, anaerobes

It is a beta-lactamase inhibitor combination (between amoxicillin and clavulanate

20
Q

What is piperacillin/tazobactam active against? What is it’s advantage?

A

Streptococci, staphylococci, gram negatives (incl. pseudomonas), anaerobes

21
Q

What are cephalosporins? What is an example of one, where does it have good activity?

A

Broad spectrum antibacterials with no anaerobes activity

Cetriaxone, good activity in the CSF

22
Q

What are 3 carbapenems? Are they broad or narrow spectrum? What are they active against?

A
  • meropenem, ertapenem, imipenem
  • broad
  • most gram negatives
23
Q

What are two types of glycopeptides?

A
  • vancomycin (active against most gram positives)

* teicoplanin (easier to administer)

24
Q

Are tetracycline and doxycycline broad or narrow spectrum? What are they active against? Who shouldn’t they be given to?

A
  • broad spectrum
  • chlamydia and some protozoa
  • children under 12 years, pregnant and breastfeeding women
25
Q

What is the most common aminoglycoside? What do they work against? Where do they have good activity?

A
  • gentamicin
  • gram negatives
  • blood/urine
26
Q

What is an example of a macrolide? What do they act against?

A
  • erythromycin

* alternative to penicillin for mild gram positive infections, also works against atypical respiratory pathogens

27
Q

What is the most common quinolone? What do they inhibit? What are they active against? What if becoming increasingly resistant to them?

A
  • Ciprofloxacin
  • DNA gyrase
  • gram negatives and atypical pathogens
  • C.difficile
28
Q

What do trimethoprim and sulphonamides inhibit? What does trimethoprim treat on its own?

A
  • folic acid synthesis

* UTI

29
Q

What are the two types of antifungals? What do they inhibit?

A
  • azoles - inhibit cell membrane synthesis

* polyenes - inhibit cell membrane function

30
Q

What is an example of an azole? What does it work against?

A

Fluconazole - against candida

31
Q

What is an example of a polyene? What it is used against?

A

Nystatin - topical treatment for candida

32
Q

What does the antiviral, aciclovir do?

A

When phosphorylated, it inhibits viral DNA polymerase (works against herpes simplex and varicella zoster)

33
Q

What does the antiviral, oseltamivir do?

A

Inhibits viral nueraminidase (works against influenza A and B)

34
Q

What is metronidazole? What is it active against?

A

An antibacterial and an antiprotozoal agent

anaerobic bacteria and protozoa - amoebae, giardia and trichomonas

Infection * (18 decks)

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