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Principles of Disease BJ > AM revision > Flashcards

AM revision Flashcards

1
Q

What mediates drug allergies?

A

immediate hypersensitivity - IgE mediated

Delayed Hypesensitivity - Cell or immunecomplex mediated

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2
Q

Symptoms of Immediate hypersensitivity?

A
  • LAryngeal Oedema
  • Shock
  • Itching
  • Urticaria (hives)
  • Voming/nausea
  • Wheezing
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3
Q

Symptoms of delayed hypersensitivity:

A
  • Erythema Nodosum
  • Drug Rash
  • Drug fever
  • Serum sickness
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4
Q

What antivirals need constatn blood conc. monitoring?

A

Zidovudine for HIV

Ganciclovir for CMV

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5
Q

What is stevens-johnson syndrome?

A

A form of Delayed hypersensitivity

Not just skin but mucous membranes

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6
Q

What am is associated with stevens-johnson?

A

Sulphonamides

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7
Q

What is thrush & what am causes it?

A

Oral or vaginal candidiasis

Caused by Broad spec. penicillin/cephalosporins

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8
Q

What drugs commonly cause hepatotoxicity?

A

Tetracylcines
Rifampicin
Flucloxicillin
Isonizaid (TB)

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9
Q

What drugs commonly cause convulsions & encephalopathy?

A

PEnicillin
Cephalosporin
Acyclovir

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10
Q

What drugs commonly cause ototoxicity?

A

Aminoglycosides

Vancomycin

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11
Q

What drugs cause peripheral neuropathy?

A

Isoniazid
Metronidazole
Nitrofurantoin

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12
Q

How does isoniazid cause peripheral neuropathy?

A

Competetive inhibition of Vitamin B6 (pyridoxine)

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13
Q

What is pancytopenia?

A

Depression of all marrow produced cell lines (unselective depression)

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14
Q

What causes selective depression of platelets?

A

Linezolid

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15
Q

How does co-trimoxazole produce a haematological side effect?

A

Co-trimoxazole inhibits folic acid synthesis

  • > Folate deficiency
  • > Megaloblastic anaemia
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16
Q

What is co-trimoxazole?

A

Trimethoprim

Sulphamethoxazole

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17
Q

When would you use co-trimoxazole over cephalosporins and why?

A

For chest infections as its less likely to cause a CDI

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18
Q

How do glycopeptides work?

A

Glycopeptides inhibit peptidoglycan precurosor production

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19
Q

How do Beta-lactams work?

A

Bind to PBP

  • > Inhibits carb cross chain linkage
  • > no peptidoglycan formed
  • > cell killed by autolytic enzymes
20
Q

Another name for benzyl penicillin?

A

PEnicillin G

21
Q

What would you use on a gram +ve infection if someone was alleric to penicillin?

A

Macrolides particularly erythromycin & clarythromicin

22
Q

What do you use levofloxacin for?

A

A chest infection

Its much better than older quinalones for gram +ves

23
Q

Why are glycopeptides given parenterally?

A

They arnt absorbed in the gut

24
Q

What do mutagenic drugs do?

A

Mutate foetal chromosomes

25
Q

What do teratogenic drugs do?

A

Theyre associated with congenital abnormilities

26
Q

How are antimicrobials used for prophylaxis?

A
  • Pre-op to prevent infection

- Post-exposure to a highly communicable disese

27
Q

What antibiotics need constand monitoring?

A

Vancomycin

Gentamicin

28
Q

Example of synergy with AMs?

A

Penicillin & gentamicin undergoe snergy when treating Streptococcal infections

29
Q

When would you use combination therapy?

A
  • When theres a mixed infection
  • When the two drugs have a synergistic effect
  • When you want to limit resistance to any one agent
30
Q

What drug causes abnormal cartilage development in kids?

A

Ciprofloxacin

31
Q

Define inherent resistance?

A

All strains of a species are resistant
Usually because the drug cant penetrate the cell wall
E.g. VRE

32
Q

Define acquired resistance?

A

Sometimes by spontatnoues mutation but normally transfer of genes through plasmids or transposons.
Only some of the strains are resistant
E.g. 30% of E.Coli strains are resistant to Ampicillin

33
Q

How do we combat B-lactamases?

A
  • None B-lactams
  • Modify the B-lactam R1 side chain so its not recognised
  • Mix it with a B-lactamase inhibitor
34
Q

What is an R1 modified penicillin?

A

Flucloxacillin

35
Q

What is a mix of a B-Lactam & a B-lactamase inhibiotr?

A

Co-Amoxiclav is amoxicillin & calvulanic acid.

36
Q

What is ESBL?

A

Exteneded spectrum B-lactamases

Resistant to most if not all B-lactams

37
Q

What is CPE?

A

Carbapenemase Producing Enterobacteriacaie
Immune to carbapenems and unfortunately often a lot of other antibiotics too.
Endemic in some countries healthcare

38
Q

VRE?

A

Vancomycin REsistant Enterococci

enterococcus Faecium/Faecalis

39
Q

What is MRSAs method of resistance?

A

Altered PBP binding sites, hence why its still weak to glycopeptides

40
Q

What gram +ve organism is partiall resistant to flucloxacillin?

A

Staph. Aureus

Some strainds are resistant

41
Q

Why wouldnt you use amoxicillin fo blind gram-ve coliform treatment?

A

20-30% of striands are now ressistant to it

42
Q

How would we most accurately determine antibiotic sensitivty?

A

The MIC & MBC

43
Q

Do all antivirals inhibit nucleic acid synthesis?

A

NO,

44
Q

What are the 4 bi Cs broad spectru antibiotics known for leading to a rise in CDI?

A

Cephalosporin
Clindamycin
Co-Amoxiclav
Ciprofloxacin

45
Q

Which cephalosporin generations are best for Gram -ve organisms?

A

The most recent, i.e. 3rd gen

46
Q

Which cephalosporins are best for gram +ve organisms?

A

The oldest, i.e. 1st gen

47
Q

Which generation of cephalosporin is effective against pseudomonas?

A

Third gen specifcally ceftazidime

Principles of Disease BJ (47 decks)

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