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SBM > SBM: Pharmacology & therapeutics - Antibiotics > Flashcards

SBM: Pharmacology & therapeutics - Antibiotics Flashcards

0
Q

Examples of Structurally modified penicillins

A

Amoxicillin and ampicilling

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1
Q

Mechanism of beta lactams (5)

A

They block the peptidoglycans synthesis
Beta lactams work against bacteria with PGN walls.
Does not work with chlamydia and mycoplasma.
They target penicillin binding proteins. (PBPs)These are transpeptidase enzymes which is involved in PGN synthesis.

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2
Q

Treat chlamydia with beta lactam antibiotics? True ?

A

False

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3
Q

Pencillin G is also called Benzylpenicillin. They are active against what bacteria ?

A

Streptococci
Staphylococci
Spirochaetes
Neisseria

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4
Q

Pencillin G is also called Benzylpenicillin. They are NOT active against what bacteria

A

Enterobacteriaciae - because of PLPs and penicillinase

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5
Q

And example of aminopenicillin is…

A

Amoxycillin

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6
Q

Why are structurally modified pencillins better than natural?

A

Longer half lives.

Better against Enterobacteria (e.coli)

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7
Q

Structurally modified penicillins: for antipseudomonas are?

A

Ureidopenicillins.

Eg. Piperacillin & ticacillin

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8
Q

3 types of penicillins

A

Natural
Structurally modified
Other beta lactam antibiotics

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9
Q

Ureidopenicillins (Piperacillin) has better activity against what?

A

Pseudomonas

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10
Q

Pencillin is good for pseudomonas?

A

No.
Structurally modified are better.
Ureidopenicillins - Piperacillin

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11
Q

Piperacillin can be given orally as a tablet to treat the pseudomonas?

A

False. It is only IV active.

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12
Q

Bacteria with cell walls are targeted by different antibiotics because they aren’t all equally active. Why is there the variability?

A

The betalactam works by working on PBPs (pencillin binding proteins). Different bacteria have different PBPs.

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13
Q

S.pyogenes. What antibiotics would you give?

A

Penicillin V

Amox and ticarcillin can be used but works with the natural beta lactam.

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14
Q

Enterococcus. What antibiotics would you give?

A

Amoxicillin

Not penicillin - weak

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15
Q

E.coli. What antibiotic?

A

It is an Enterobacteria. Therefore natural beta lactams are not great.
Therefore a structurally modified one is needed.
Amoxycillin is indicated.

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16
Q

Pseudomonas spp. What antibiotic?

A

Only Ureidopenicillins
Ticarcillin or Piperacillin
Not penicillin or Amoxycillin

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17
Q

What are beta lactamases?

A

Enzymes that breakdown the beta lactam ring - rending antibiotic useless.

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18
Q

Three beta lactamases?

A

Penicillinases
Cephalosporinases
Extended spectrum beta lactamases.

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19
Q

What are the mechanism of resistance to beta lactams?

A

1 enzymes hydrolyse the beta lactam ring
2 PBPS don’t bind to the beta lactams at all. Like mrsa
3 efflux of antibiotics

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20
Q

What Antibiotics can be used for beta lactamases producing bacteria?

A

Methicillin

Flucloxacillin

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21
Q

Flucloxacllin is used for what?

A

Beta lactamase producing bacteria of S.Aureus
Active against some strephs
Not useful for gram negatives.

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22
Q

Flucloxacllin is good for gram positive ?

A

True

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23
Q

Flucloxacllin is good for gram negative ?

A

False

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24
Q

Flucloxacllin’s mechanism is what?

A

Same as beta lactam

But is resistant to the enzymes

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25
Q

What can you use to inhibit beta lactamases?

A

Clavulinic acid

Tazobactam

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26
Q

What antibiotics are available by Inhibiting beta lactamase?

A

Co-amoxyclav (augementin)
Timentin - ticarcillin + Clavulinic acid
Tazocin: Piperacillin + tazobactam

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27
Q

What sort of antibiotic is augmentin

A

Amoxicillin and Clavulinic acid

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28
Q

What can augmentin work against

A

Staphs
Strephs
Enterobacteria
Anaerobes

29
Q

What do augmentin NOT work against

A

Mrsa
Some enterococci
Pseudomonas

30
Q

Side effects of augmentin are?

A

GI upset

Cholestatic jaundice

31
Q

Difference between the penicillin and cephalosporin

A

They have a beta lactam ring

But the side chain is different

32
Q

What are first generation cephalosporins.

A

Cefalexin, cefadroxil
For Gram +ve
Oral

33
Q

Describe Second generation of cephalosporins?

A

Cefuroxime

IV and oral

34
Q

Describe 3rd generation cephalosporin.

A

Ceftriaxone

IV only

35
Q

Describe 4th generation cephalosporin.

A

Cefepime
IV only
Gram negative

36
Q

As you go from 1st to 4th gen cephalosporins what changes? ( bioavailability&bacteria type )

A 
1st gen (oral) 4th (IV only)
1st (+ve) 4th (-ve)
37
Q

Cephalexin is good for what bacteria types?

A

Staphs
Streps
Coliforms

38
Q

What antibiotic would be good for UTI?

A

1st gen cephalosporin

Cephalexin

39
Q

What can be used for mild resp and skin infections

A

1st gen cephalosporins

Cephalexin

40
Q

2nd gen cephalosporin and some third gen are useful against what bacteria?

A

Staphs
Streps
Coliforms

41
Q

What can be used for pneumonia? (Cephalosporin)

A

Cefuroxime or ceftriaxone

42
Q

What can be used for cellulitis?

A

Cefuroxime and ceftriaxone

43
Q

Meningitis can be fought using what type of antibiotic?

A

Cephalosporins
2/3gen
Cefuroxime and ceftriaxone

44
Q

3rd gen cephalosporin - ceftazidime are poor against what bacteria?

A

Staphs

Streps

45
Q

3rd gen cephalosporin - ceftazidime are good for what bacteria

A

Coliforms

Pseudomonas

46
Q

Give a specific use of ceftazidime

A

Hospital acquired pneumonia

47
Q

What is the difference between ceftriaxone and ceftazidime

A

Ceftriaxone is good against stapes, streps, and Coliforms,
Ceftriaxone is poor against pseudomonas
Ceftazidime is poor against staphs, streps
Ceftazidime is good for Coliforms and pseudomonas
Use of ceftriaxone is similar to second gen
Ceftazidime is useful against HAP

48
Q

Like penicillinases, there are Cephalosporinases. What bacteria makes this?

A

Enterobacteria

49
Q

S.aureus is responsible for what resistant mechanism?

A

Penicillinase

50
Q

S.aureus is responsible for cephalosporinases? True or false.

A

False

Enterobacteria are

51
Q

What is available against the cephalosporinases in terms of inhibitors?

A

Nothing

52
Q

What are ESBL

A

Extended spectrum beta lactamases

53
Q

Describe ESBL

A

Hydrolyse all beta lactam ring drugs
EXCEPT Carbapenems
Resistant to other antibiotics

54
Q

What are imipenem and meropenem?

A

Carbapenems

55
Q

What are the activity of Carbapenems use?

A

Gram +ve
Gram +ve
anaerobes

56
Q

How are beta lactam drugs excreted

A

Renally

57
Q

What effect does beta lactams have on the neuro system

A

Neurotoxic

58
Q

Side effects associated with beta lactams are?

A

Neurotoxic
Neutropenia
Thrombocytopenia
Interstitial nephritis

59
Q

The most suitable penicillin for s.pyogenes is?

A

Penicillin V

60
Q

Most suitable penicillin for S.Aureus is

A

Flucloxacllin

61
Q

Which beta lactam would be suitable for simple UTI

A

Cephalosporins
1st gen
Cephalexin

62
Q

Which beta lactam would be suitable for a suspected pseudomonas infection?

A

Ureidopenicillins - ticarcillin or Piperacillin

3rd gen cephalosporin - ceftazidime

63
Q

When would you consider giving Cefuroxime to a patient who is penicillin allergic?

A

Cefuroxime is a second gen cephalosporin

So can be used for pneumonia, cellutitis, meningitis

64
Q

Vancomycin and teicoplanin are antibiotics of what class?

A

Glycopeptides

65
Q

How do vancomycin work (glycopeptides)

A

Inhibit PGN synthesis

66
Q

What is different about glycopeptides and beta lactam antibiotics? And why is this useful?

A

Glycopeptides have no beta lactam ring
Therefore useful for beta lcatam resistant infections
GRAM POSITIVES ONLY

67
Q

Glycopeptides work on what bacteria?

A

Gram positive only
Mrsa
Ampicillin resistant enterococci
Penicillin resistant pneumococci

68
Q

Why do glycopeptides not work on gram negatives ?

A

Big molecules

Cannot penetrate membrane

69
Q

What effect do glycopeptides have given that they are big molecules

A

Can’t work on gram negatives
Poor tissue penetration
Conc:MIC ratio is low
Not as effective as beta lactams

70
Q

What is conc:MIC ratio

A

?

71
Q

Describe the glycopeptide pharmokinetics

A

No GI uptake
Renal excretion
Nephrotoxic

SBM (13 decks)

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