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Dent Y3 > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

How are antibiotics mostly cleared from the body?

A

by the bacteria themselves

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2
Q

what is the breakpoint?

A

the concentration at which bacteria are susceptible to successful treatment by an antibiotic

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3
Q

When is a bacteria classed as resistant in regard to the breakpoint?

A

if the antibiotic needs to be at a higher concentration than the breakpoint to treat the infection

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4
Q

What classes an infection as multi-drug resistant?

A

the bacteria are resistant to at least 3 of the major classes of antibiotics

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5
Q

What classes an infection as extensively-drug resistant?

A

the bacteria are resistant to at least 5 of the major classes of antibiotics

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6
Q

What classes an infection as pan-drug resistant?

A

the bacteria are resistant to all known classes of antibiotics

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7
Q

What does antibiotic resistance mean in the lab?

A

when the minimum inhibitory concentration of a drug against a bacteria is greater than the breakpoint

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8
Q

What does antibiotic resistance mean in the patient?

A

when the minimum inhibitory concentration of a drug against the bacteria is not achieved for long enough to cure the infection

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9
Q

What are four factors that can affect the minimum inhibitory concentration (and therefore the level of antibiotic resistance) in a patient?

A

dose size/dose frequency, the pharmacokinetics of the drug in the patient, the infection site, the pharmacodynamics of the drugs against the infecting bacteria

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10
Q

What is the definition of antibiotic resistance?

A

the failure of an antibiotic to kill or arrest a bacterial population

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11
Q

What theory do antibiotics work on?

A

the lock and key theory

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12
Q

In general, how does antibiotic resistance occur?

A

resistance methods stop the antibiotic-target site complex developing

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13
Q

What are efflux pumps?

A

systems in the bacteria that pump out waste products and toxic substances from inside the cell

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14
Q

How are efflux pumps regulated?

A

DNA

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15
Q

What are the two outcomes of a natural, spontaneous DNA mutation?

A

they can be silent mutations or have an affect on how the cell functions

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16
Q

What is the consequence of the bacteria developing resistance?

A

the cell will need to reroute energy from elsewhere

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17
Q

What can happen to bacteria that become resistant to Colistin?

A

they take longer to grow and divide and can eventually be outcompeted for resources

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18
Q

What is the gene that codes for the metallo-beta-lactamase enzyme?

A

NDM-1

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19
Q

What does the metallo-beta-lactamase enzyme do?

A

‘chops up’ beta-lactam antibiotics and renders them inert

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20
Q

Where is the NDM-1 gene carried?

A

on plasmids

21
Q

Which class of antibiotics are the most widely prescribed?

A

beta-lactamase

22
Q

How can plasmids be spread between bacteria?

A

conjugation

23
Q

What is the consequence of the bacteria gaining a plasmid?

A

it needs to use energy to carry and express those genes meaning the ability of the bacteria to cause infection is significantly impacted

24
Q

Is a bacteria always a problem if it is highly resistant?

A

no, if the bacteria cannot spread infection it isn’t clinically relevant

25
Q

Are antbiotics mostly natural or synthetic?

A

natural

26
Q

Which class of antibiotics are entirely chemically synthesized?

A

quinolones

27
Q

What are the four mechanisms of antibiotic resistance?

A

target site modification, replacement of antibiotic target by non-susceptible target, reduced permeability/efflux pumps, enzymatic degradation/modification of the drug

28
Q

Is reduced permeability/efflux pumps more of a problem in gram +ve or gram -ve bacteria?

A

gram -ve due to their outer membrane

29
Q

Are antibiotics lipid or water soluble?

A

water soluble

30
Q

What is the normal method antibiotics use to enter a cell?

A

they hijack a pore

31
Q

How can bacteria prevent the antibiotics entering the cell?

A

reducing the size/number of pores

32
Q

How can you reverse the effect of reduced permeability?

A

improve the penetration of the antibiotics

33
Q

How can some bacterial enzymes affect antibiotics?

A

some actively breakdown the antibiotic, others modify the drug

34
Q

Can plasmids carry more than one resistance gene?

A

yes

35
Q

Does your chance of gaining a resistant strain of bacteria increase or decrease after a course of antibiotics?

A

increase

36
Q

How long does it take for your chance of gaining a resistant strain of bacteria go back to baseline after a course of antibiotics?

A

a year

37
Q

How does a course of antibiotics make you more susceptible to a resistant strain?

A

the antibiotics kill bacteria creating a vacuum where another species fill the gap, this species may carry the resistance gene

38
Q

What are some ways we can combat antibiotic resistance?

A

smart surfaces, inhibition of resistance, improve failed antibiotics, find new antibiotics, improve existing antibiotics, rapid AMR detection

39
Q

How can smart surfaces reduce resistance?

A

a ‘spiky’ silica surface can kill the bacteria before they infect by acting as a physical barrier, this removes the need for antibiotics and reduces the chance of resistance developing

40
Q

How can inhibition of resistance reduce antibiotic resistance?

A

blocking the bacterial methods of resistance chemically, by giving another substance in conjunction with the drug such as to block the enzymes that breakdown antibiotics

41
Q

How can improving failed antibiotics reduce antibiotic resistance?

A

improve penetration to combat reduced permeability, conjugate the antibiotics with iron molecules that will get taken into the bacteria and bring the antibiotic with it

42
Q

What is the bacterial iron molecule that you can conjugate with an antibiotic in order to combat reduced permeability

A

siderophore

43
Q

What is an antibiotic that you can conjugate with a bacterial iron molecule to combat reduced permeability?

A

Cefiderocol

44
Q

How can finding new antibiotics reduce antibiotic resistance?

A

no common circulating resistance genes yet

45
Q

What are some ways being used to try and find new antibiotics?

A

finding the compounds in toad skin or making chemically from fungi

46
Q

How can improving exisiting antibiotics reduce resistance?

A

there may be a strain of the current antibiotic that is better at killing bacteria

47
Q

What are the ways you can try to improve exisiting antibiotics?

A

modify each gene to see if the end chemical is better at killing bacteria

48
Q

What is rapid AMR detection?

A

rapid antimicrobial resistance detection, is a machine that can determine which antibiotics the bacteria are resistant to before you give the treatment to the patient

49
Q

How can rapid AMR detection reduce antibiotic resistance?

A

it allows you to determine which antibiotics will actually work and allows the use of effective narrow spectrum antibiotics

Dent Y3 (23 decks)

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