SCRIPT Questions Flashcards
What is the difference between antimicrobials and antibacterials?
Antimicrobials - act against all microbial organisms - bacteria, viruses, parasites and fungi.
What are examples of bacteriostatic ABs?
Clarithromycin
Doxycycline
What are examples of bactericidal antimicrobial agents?
Phenoxymethylpenicillin
Ciprofloxacine
Metronidazole
Vancomycin
Gentamycin
When can IV antimicrobials be switched to the oral route?
48-72 hours if P has improved clinically and can tolerate oral meds.
When should antimicrobials be reviewed?
48 hours after starting
- change the route?
- change the antibacterial?
- continue treatment?
- outpatient therapy?
Do you need to check serum gentamicin after the initial dose?
Not after one dose - unless there is a plan to give further doses.
Should check be checked x2 per week (more in renal impairment).
Which is the most appropriate AB to follow a gentamicin dose?
Ciprofloxacin
What is the risk of ciprofloxacin?
It can put elderly Ps at risk of contracting C Diff
In what situation should you start antimicrobials?
When there is clear evidence of infection.
If you identify Red Flag Sepsis or septic shock or life threatening infections, when should you start antimicrobials?
Within the hour.
What is the name of the PHE toolkit towards the use of antimicrobials in hospitals?
Start SMART then FOCUS
What is the difference between gram negative and gram positive organisms?
Gram negative have a thinner cell wall - made of less peptidoglycan and more LPS.
What type of bacteria is E coli?
Gram negative
What type of bacteria is Staph aureus?
Gram positive
Does Vancomycin have activity against G -ve, G +ve or both?
G +ve only
What are the three main antibacterial targets in bacteria?
Cell wall & membrane
Protein synthesis inhibition
DNA/RNA inhibition
Which type of ABs inhibit cell wall formation = rapid death of the organism?
Βeta-lactams
Which ABs inhibit a different stage of cell wall formation than β lactams and, when given in high concentrations, cause cell death?
Glycopeptide antibacterials
How do ABs prevent protein synthesis?
Bind to bacterial ribosomes and interfere with their function.
Which types of ABs prevent protein synthesis?
Macrolides (e.g. clarithromycin)
Tetracyclines (e.g. doxycycline)How
Aminoglycosides (e.g. gentamicin)
How do quinolones work?
They interfere with DNA synthesis (e.g. ciprofloxacin)
How does Metronidazole work?
Damages bacterial DNAW
Which types of bacteria does metronidazole work against?
Anaerobic bacteria
How does trimethoprim work?
Interferes with bacterial folate metabolism, resulting in a lack of analogues for DNA synthesis