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BacT RUSVM Summer 15 > Antimicrobials- L2 > Flashcards

Antimicrobials- L2 Flashcards

1
Q

What are antimicrobials?

A

Drugs that destroy microbes, prevent their multiplication or growth, or prevent their pathogenic effect.

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2
Q

What needs to be known to treat a bacterial infection?

A

location, likely pathogens involved, which antimicrobials are likely to be effective for the pathogen at the particular site.

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3
Q

What other factors need to be considered for antimicrobial therapy?

A

Cost, safety, ease of use, and possible resistance

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4
Q

Who and when was penicillin discovered

A

Alexander Fleming 1928

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5
Q

What is an Antibiotic?

A

A chemical substance produced by a microorganism that inhibits the growth of or kills other microorganisms.

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6
Q

What is an Antimicrobial agent?

A

a chemical substance derived from a biological source or produced by chemical synthesis that kills or inhibits the growth of microorganisms.

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7
Q

These antimicrobials are produced by bacteria or fungus.

streptomycin, penicillin, tetracycline

A

Natural (true Antibiotic)

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8
Q

Semi-Synthetic antimicrobials are what?

A

Chemically-altered natural compound

ampicillin, amikacin

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9
Q

What are synthetic antimicrobials?

A

Chemically designed in the lab

sulfonamides, enrofloxacin, marbofloxacin

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10
Q

What are the classifications of Antimicrobial agents?

A

Chemical Family Structure
Mode of Action
Type of Antimicrobial activity
Spectrum of Antibacterial Activity

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11
Q

What does the clinician need to know to treat with antimicrobials?

A

The drugs,
The microbiology
The Patient

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12
Q

What are the modes of action?

A 
inhibitors of cell wall synthesis
inhibitors of protein synthesis
inhibitors of membrane function
inhibitors of nucleic acid synthesis
(Anti-metabolites)
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13
Q

What are the two types of Antibacterial Susceptibility Testing?

A 
1 Dilution (Broth/Agar)
2 Diffusion (Disk)
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14
Q

What is a susceptibility break point?

A

a drug concentration above which an organism is considered resistant and at or below this value organism is susceptible to that drug.

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15
Q

what are the three break point values?

A

Susceptible, Intermediate, and Resistant

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16
Q

What is Minimum inhibitory concentration (MIC)?

A

Minimum amount of drug required to inhibit bacterial growth.

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17
Q

Drugs with _____ MIC values are better choices to use.

A

Lower

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18
Q

What is the likelihood of therapeutic success with a susceptible rating?

A

High

19
Q

what is the likelihood of therapeutic success with an Intermediate rating?

A

UNCERTAIN

20
Q

what is the likelihood of therapeutic success with a resistant rating?

A

none, High likelihood of therapeutic failure

21
Q

what is kirby bauer disk diffusion?

A

A bacterial isolate from pure culture spread on agar plate. single concentration Antimicrobial disks are added to the plate and the diameter of growth inhibition is measured.

22
Q

Is kirby Bauer disk diffusion accurate for MIC?

A

NO

23
Q

What is Broth dilution?

A

Multiple dilutions of antimicrobial agents, measure and report growth inhibition endpoint (MIC).

24
Q

Gradient Diffusion or E-test

A

Agar plate with strips of Antimicrobial agents with varying concentrations ranging from high to low from outside of plate to the middle of the plate.

25
Q

What are broad spectrum antibiotics?

A

Antibiotics that are active against a wide range of bacteria

26
Q

what are narrow spectrum antibiotics?

A

Antibiotics which are only effective against a narrow range of bacteria.

27
Q

What are some things to consider when selecting antimicrobial drugs for treatment?

A 
Time dependent killing
Concentration dependent killing
AUC
Pharmacokinetics
Pharmacodynamics
28
Q

Why would one use Antimicrobial combinations?

A

Mixed infections
Prevention of Antimicrobial resistance
Increase effectiveness in treating some infections

29
Q

What are the two types of resistance?

A

Innate

Acquired

30
Q

What is innate resistance?

A

preexisting genomic property

31
Q

What is acquired resistance?

A

New genetically encoded trait not representative of the species. (acquired by mutation or horizontal gene transfer)

32
Q

What are some mechanisms of resistance?

A

Enzymatic destruction or inactivation of drug
prevention of penetration to target sites within microbe
alteration of drugs target site
Rapid efflux of antibiotics

33
Q

why is there an emergence of antimicrobial resistance?

A 
Widespread antimicrobial use
Microbial adaptation and change
changes in demographics
Medical advances
Changes in ecosystems 
Cutbacks in public health systems
34
Q

What is the potential impact of antimicrobial resistance

A 
Increased mortality to infectious disease
Veterinarian revisits
High treatment costs
Productivity loss and Economic Impact
Zoonotic spread of resistant Microbes
Increased nosocomial infections
35
Q

What are some problematic bacterial organisms?

A

Vancomycin resistant Enterococcus (VRE)
Methicillin resistant Staphylococcus aureus (MRSA)
Extened spectrum Beta Lactamase (ESBL) producing E. coli and Klebsiella sp.
Fluoroquinolone resistant Campylobacter jejuni
Multiple drug resistant (MDR) E. coli and Salmonella
Organisms with innate resistance (Enterococcus, Enterobacter, Pseudomonas, Acinetobacter)
MDR and XDR Mycobacterium tuberculosis

36
Q

How are Antimicrobials missused?

A

Providers- Over prescription use
Patients/clients- compliance, stockpiling, OTC
Industry- over promotion, competition between brands

37
Q

Strategies to Reduce antimicrobial Resistance.

What does prudent Drug use mean?

A

Maximize efficacy of therapeutic regimens
Restrict extra-labe use to high risk patients
observe withdrawal period
Use antimicrobials of limited human health concern
use alternative therapies

38
Q

strategies to reduce antimicrobial Resistance.

what is pathogen control?

A

Animal waste management
Reduce contamination in slaughter and processing
maintain herd health and infection control

39
Q

Strategies to reduce antimicrobial Resistance

What does Policy mean?

A

control of drug use in food animals
National antimicrobial resistance monitoring system
educational efforts

40
Q

Polyene Antifungal drugs what are they and what is their mechanism of action?

A

Amphotericin, Nystatin, and pimaricin

interact with sterols in the cell membrane

41
Q

Azole antifungal drugs what are they and what is their mechanism of action?

A

Fluconazole, itraconazole, and Ketoconazole

inhibits cytochrome P450- dependent enzymes involved in the biosynthesis of ergosterol

42
Q

Allylamine and Morpholine antifungal drugs what are they and what is their mechanism of action?

A

allylamines (naftifine, terbinafine) inhibit ergosterol biosynthesis

43
Q

Antimetabolite antifungal drugs what are they and what is their mechanism of action?

A

5-Fluorocystosine, acts as an inhibitor of both DNA and RNA synthesis

BacT RUSVM Summer 15 (20 decks)

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