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Principles of Disease > Antimicrobial Chemotherapy > Flashcards

Antimicrobial Chemotherapy Flashcards

1
Q

Define MIC.

A

Minimal Inhibitory Concentration (minimum concentration of antimicrobial needed to inhibit visible growth of micro-organisms)

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2
Q

Define MBC.

A

Minimal Bacteriocidal Concentration (minimum concentration of antimicrobial needed to kill a given organism).

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3
Q

Define sensitive.

A

If organism is inhibited or killed by levels of the antimicrobial that are available at the site of infection.

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4
Q

Define resistant.

A

If organism is not killed or inhibited by levels of the antimicrobial that are available at the site of infection.

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5
Q

Define synergy.

A

Two cidal drugs combined or two static drugs combined (enhanced effect together)

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6
Q

Define antagonism.

A

Combination of one static and one tidal drug (less effect together).

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7
Q

Describe the main mechanisms of action of antibiotics.

A
  1. Inhibit cell wall synthesis
  2. Inhibit protein synthesis
  3. Inhibit nucleic acid synthesis
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8
Q

Give examples of antibiotics that inhibit cell wall synthesis.

A

Penicillins, Cephalosporins and glycopeptides

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9
Q

Give examples of antibiotics that inhibit protein synthesis.

A

Amioglycosides, macrocodes, tetracyclines, oxazolidinone, cyclic lipopeptides.

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10
Q

Give an example of antibiotics that inhibit nucleic acid synthesis by direct DNA synthesis inhibition.

A

Fluoroquinolones

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11
Q

Give examples of antibiotics that inhibit different steps in purine synthesis.

A

Nitrofurantoin, Trimethoprim and sulphamethoxazole (co-trimoxazole), Fusidic acid, Metronidazole, Clindamycin

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12
Q

What antibiotics are used for patients with a penicillin allergy.

A

Macrolides (Clarithromycin and erythromycin)

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13
Q

Give an example of an aminoglycoside.

A

Gentamicin

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14
Q

What type of bacteria is gentamicin effective against?

A

Gram negative, pseudomonas and staphylococci.

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15
Q

What antibiotic is used to to treat chlamydia?

A

Tetracyclines e.g doxycycline.

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16
Q

What is Trimethoprim used to treat?

A

UTI’s and respiratory tract infections.

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17
Q

What is nitrofurantoin used for?

A

Gram negative bacteria e.g in urinary tract infections.

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18
Q

Why is Ciprofloxacin contraindicated in children?

A

Interfere with cartilage growth.

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19
Q

Describe the mechanism of action of beta-lactams.

A

Prevent cross-linking of peptidoglycan chains by inhibiting PBP on cell wall.

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20
Q

What is the mechanism of action of clavulonic acid?

A

Inhibits beta-lactamases.

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21
Q

What type of bacteria do beta-lactams target?

A

Gram positive.

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22
Q

What is the first line therapy for staphylococcus aureus?

A

Flucloxacillin (beta lactam)

23
Q

What type of antimicrobial targets gram positives only and is used for MRSA and C.difficile?

A

Vancomycin

24
Q

Name a class of broad spectrum antibiotic which also targets anaerobes.

A

Carbapenems.

25
Q

Name an indication for use of Nalidixic acid.

A

Urinary antiseptic.

26
Q

Name indications for the use of metronidazole.

A

Intra-abdominal abscess and C.difficile.

27
Q

Describe the mechanism of action of Polyenes.

A

Bind to ergosterol in cell wall which increases permeability.

28
Q

What are polyenes used to treat?

A

Systemic fungal and yeast infections.

29
Q

Give two examples of polyenes.

A

Amphotericin B and Nystatin.

30
Q

Describe the mechanism of action of azoles.

A

Inhibit ergosterol synthesis in the fungal cell wall.

31
Q

Give an example of an azole.

A

Fluconazole.

32
Q

What are azoles used to treat?

A

Yeasts, filamentous fungi and aspergillus.

33
Q

Describe the mechanism of action of Echinocandins.

A

Inhibit glucan polysaccharide synthesis.

34
Q

Describe the mechanism of action of allylamines.

A

Suppress ergosterol synthesis at different stages in the pathway.

35
Q

What are allylamines used to treat?

A

Dermatophytes.

36
Q

What are Echincoandins used to treat?

A

Candida and aspergillus.

37
Q

What drug is used to treat HSV and VZV?

A

Acliclovir

38
Q

What is the mechanism of action of anti-herpes drugs?

A

Nucleoside analogue, converted to active form by thymidine kinase.

39
Q

What combination of drugs are used in for the treatment of HIV?

A
  1. Two nucleoside analogue reverse transcriptase inhibitors.
  2. One non-nucleoside reverse transcriptase inhibitor (nivirapine, efavirenz) OR a protease inhibitor (saquinavir, darinavir)
40
Q

What drug is sometimes used to treat RSV?

A

Ribavarin (nucleoside analogue)

41
Q

What is used to treat chronic hep B and C?

A

Interferon - alpha (Pegylated to PEG)

42
Q

What protein synthesis inhibitor is used to treat MRSA?

A

Linezolid.

43
Q

What causes the toxicity associated with polyenes?

A

Binds to other sterols (e.g cholesterol) in cell membranes.

44
Q

Describe the resistance mechanisms of Beta-lactam antibiotics.

A
  1. Beta-lactamase production

2. Alteration of penicillin binding protein target site.

45
Q

Describe glycopeptide resistance.

A

Vancomycin resistance enterococci - peptidoglycan precursor in which vancomycin binds has altered structure.

46
Q

List factors to be considered in choosing suitable anti-microbial agents.

A

Age, renal function, liver function, pregnancy, risk of resistance, mono therapy vs combination therapy, monitoring, dose, duration.

47
Q

List common side-effects.

A

Allergy, GI side effects, thrush, liver toxicity, renal toxicity, neurological toxicity, haematological toxicity.

48
Q

Explain the role of the lab in influencing usage in clinical practice.

A
  1. Advice on choice of antibiotic.
  2. Monitoring and efficacy of toxicity.
  3. Susceptibility testing - automated methods to calculate MIC of antibiotic.
49
Q

What antibiotics inhibit purine synthesis?

A

Trimethoprim.

50
Q

Name one drug used in HIV therapy?

A

Saquinavir

51
Q

What is Nitrofurantoin used for?

A

UTIs

52
Q

MRSA is treated intravenously with?

A

Vancomycin

53
Q

Serious gram negative organisms such as E. coli should be treated intravenously with?

A

Gentamicin

54
Q

Serious systemic fungal infections are treated with?

A

Amphotericin B

Principles of Disease (9 decks)

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