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Pharmacology > Infection > Flashcards

Infection Flashcards

1
Q

What class of medications do cefalexin, cefotaxime, cefaclor belong to?

A

Cephalosporins

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2
Q

What class of medication is meropenem?

A

Carbapenem

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3
Q

What are the indications for oral cephalosporins such as cefaclor, cefotaxime?

A

Third line treatment option for urinary and respiratory tract infections

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4
Q

What would IV cephalosporins and carbapenems be used for?

A

Reserved for treatment of infections that are very severe, complicated, or caused by antibiotic resistant organisms. Broad spectrum so can be used for most indications in this instance.

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5
Q

What is the mechanism of action of carbapenems and cephalosporins?

A

Antimicrobial activity due to beta lactam ring. Inhibit enzymes which cross link peptidoglycans in bacterial cell walls. Resulting breakdown of bacterial cell walls and osmotic lysis of cells. Generally more resistant to beta lactamase than penicillins.

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6
Q

Describe the different cephalosporins categories

A

Generational, first to fifth, with each successive generation having increasing gram negative activity and less oral activity.

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7
Q

What class of medication are doxycycline, lymecycline, oxytetracycline?

A

Tetracyclines

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8
Q

What are the indications for prescribing a tetracycline such as doxycycline?

A

Lower respiratory tract infections, including infective exacerbations of COPD, pneumonia
Chlamydia infection, including pelvic inflammatory disease
Acne vulgaris
Other infections such as typhoid, anthrax, malaria and Lyme disease

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9
Q

What is the mechanism of action of tetracyclines?

A

Inhibit bacterial protein synthesis. Bind to ribosomal 30s subtype, found specifically in Bacteria, preventing transfer of RNA to mRNA by preventing binding of amino acids to grow polypeptide chain.
Relatively broad spectrum of antibacterial activity.

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10
Q

What class of drugs are gentamicin, amikacin, neomycin?

A

Aminoglycosides

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11
Q

What are the indications for prescribing aminoglycosides, such as gentamicin?

A

Severe infections, particularly those caused by gram negative aerobes
Severe sepsis, pyelonephritis and complicated UTI, biliary and intra abdominal sepsis, endocarditis
Lack activity against streptococci and anaerobes so often combined with penicillin or metronidazole if unknown organism

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12
Q

What is the mechanism of action of aminoglycosides?

A

Bind irreversibly to bacterial (30s) ribosomes, and inhibit protein synthesis. Active against gram negative aerobes, staphylococci and mycobacteria. Enter backfires via oxygen dependent transport system, so ineffective against streptococci and anaerobes which lack this.
Nephrotoxic

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13
Q

What type of medication is clarithromycin, erythromycin, azithromycin?

A

Macrolide

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14
Q

Hat are the indications for prescribing macrolide so such as clarithromycin?

A

Treatment of respiratory tract and soft tissue infections, as an alternative to penicillin if allergic
In severe pneumonia, added to penicillin to cover atypical organisms
Eradication of Helicobacter pylori, in combination with a PPI and amoxicillin.

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15
Q

What is the mechanism of action of macrolide such as clarithromycin?

A

Inhibit bacterial protein synthesis. Bind to bacterial ribosome and block translocation.
Inhibit cytochrome P450 enzymes

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16
Q

What are the indications for prescribing vancomycin?

A

Treatment of severe or resistant gram positive infection e.g. endocarditis
Treatment of antibiotic associated colitis, caused by C. Diff infection (often where metronidazole is ineffective or contraindicated)

17
Q

What is the mechanism of action of vancomycin?

A

Inhibits synthesis of cell wall of gram positive bacteria, thus has specific activity against gram positive bacteria but is ineffective against gram negative.

18
Q

What are the drugs given for TB?

A

Ethambutol, isoniazid, pyrazinamide, rifampicin

19
Q

What are the important side effects of TB medications?

A

Isoniazid - need vitamin B6 alongside to reduce risk of nerve damage. LFT function test before commencing.
Ethambutol - potential risk of eye damage, jaundice, nausea
Rifampicin - reduces effectiveness of contraception e.g. combined contraceptive pill. Orange urine.

20
Q

What might amantadine be used to treat?

A

Parkinson’s disease
Parkinsonism symptoms
NMDA antagonist (weak) increasing dopamine release and blocking reuptake
Originally used for influenza A although not recommended now due to resistance. Inhibits viral replication

21
Q

What is rimantadine used for?

A

Influenzae
Not preferred medication any more as a result of resistance
Inhibits viral replication

22
Q

What is zanamivir used for and what is its mechanism of action?

A

Influenza A and B
Binds to active site of neuraminidase protein, rendering virus unable to escape host cell and infect others. Also inhibits viral replication.

23
Q

What is oseltamivir used for and what is its mechanism of action?

A

Influenza A and B
Also known as tamiflu
Neuraminidase inhibitor, so prevents virions from exiting cells and infecting others

24
Q

What is aciclovir used for and what is its mechanism of action?

A

Antiviral medication, primarily used to treat herpes simplex virus infections such as genital herpes, chickenpox and shingles. Also used for cytomegalovirus CMV and EpsteinBarr virus infections.

25
Q

What class of drugs are nystatin, clotrimazole, fluconazole, amphotericin?

A

Antifungal drugs

26
Q

What might antifungal drugs be prescribed for?

A

Treatment of local fungal infections such as those of the oropharynx, vagina or skin.
Systemic treatment of invasive or disseminated fungal infections, usually requiring specialists

27
Q

What is the mechanism of action of antifungal drugs?

A

Fungal cell membrane contain ergosterol, unlike human cells.
Polyene antifungals e.g. nystatin, bind to ergosterol and cause Intracellular ion to leak out of cell, killing it or slowing its growth
Imidazole e.g. clotrimazole, and Triazole antifungals e.g. fluconazole, inhibit ergosterol synthesis, impairing cell membrane synthesis, cell growth and replication.

28
Q

What are the indications for metronidazole?

A

Antibiotic associated colitis caused by C Diff
Oral infections or aspiration pneumonia caused by gram negative ANAEROBES from mouth
Surgical and gynaecological infections caused by gram negative ANAEROBES from the colon
Effective treatment of protozoan infections including trichomonal vaginal infection, amoebic dysentery, giardiasis

29
Q

What is the mechanism of action of metronidazole?

A

Enters bacterial cells by passive diffusion. In anaerobes is reduced to produce a nitroso free radical which binds to DNA, reducing synthesis and causing widespread damage, DNA degradation and cell death. Aerobic bacteria don’t reduce metronidazole in the same way so it isn’t effective against them.
Inhibits cytochrome P450

30
Q

What is chloroquine used for?

A

Malaria,
Plasmodium ovale, vivas and malariae (excluding Plasmodim falciparum)
Amoebic liver disease if metronidazole insufficient
Occasionally used for RA and lupus as well as mildly immunosuppressive

31
Q

What are the indications for penicillin? (Including benzylpenicillin and phenoxymethylpenicillin)

A

Streptococcal infections, including tonsillitis, endocarditis, skin and soft tissue infections, pneumonia (in combination with a macrolide if severe)
Clostridia infection, e.g. tetanus
Meningococcal infection, e.g. meningitis, septicaemia

32
Q

What is the mechanism of action of flucloxacillin?

A

Activity due to beta lactam ring. Inhibit the enzyme responsible for cell wall synthesis. This prevents cells from maintaining osmotic gradient, so uncontrolled entry of water causes cell swelling, lysis and death.
Acyl side chain protects the active beta lactam ring which is responsible for its antimicrobial activity. This makes flucloxacillin active against beta lactamase producing streptococci as well.

33
Q

Which class of drug do amoxicillin an co-amoxiclav belong to?

A

Broad spectrum penicillins

34
Q

What is the mechanism of action of broad spectrum penicillins?

A

Activity due to beta lactam ring. Inhibit the enzyme responsible for cell wall synthesis. This prevents cells from maintaining osmotic gradient, so uncontrolled entry of water causes cell swelling, lysis and death.

35
Q

What class of medication is flucloxacillin?

A

Penicillin, penicillinase resistant

36
Q

What are the indications for flucloxacillin

A

Skin and soft tissue infections e.g. cellulitis
Osteomyelitis and septic arthritis
Endocarditis

Pharmacology (9 decks)

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