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PODT- Microbiology > Anti- microbials > Flashcards

Anti- microbials Flashcards

1
Q

What is the main target of anti-microbials

A

The bacterial cell wall

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2
Q

Two groups of cell wall active agents

A

Beta lactams

Glycopeptides

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3
Q

Examples of Beta lactams

A

Penicillins
Cephalosporins
Monobactams
Carbapenems

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4
Q

Examples of Glycopeptides

A

Vancomycin

Teicoplanin

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5
Q

Anti-microbials that act on nucleoside precursors

A

Trimethorpim

Sulphonamides

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6
Q

Anti-microbials that act on nucleic acid synthesis

A

Metronidoazole
Quinolones
Rifampicin
Nitrofurans

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7
Q

Anti microbials that are protein synthesis inhibitors

A 
Aminoglycosides
Tetracyclines 
Macrolides 
Oxazolidinones 
Fusidic acid
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8
Q

Mode of action of penicillin

A

Interfere with bacterial cell wall peptidoglycan
Attach to penicillin binding proteins
Inhibit transpeptidase enzyme activity
Inactivate inhibitor of autolytic enzyme in the cell wall - causing lysis

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9
Q

Treatement for bacterial meningitis

A

Benzyl penicillin

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10
Q

Penicillin used for resp infections UTI and ottis media

A

Broader spectrum - amoxicillin

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11
Q

what type of penicillin is fluoxacillin and what does it treat

A

Beta-lactamase

cellulitis

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12
Q

Penicillin used to treat severe infections/pseudonomas

A

Piperacillin

Extended spectrum

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13
Q

The pharmokinetics of penicillin’s

A

Oral absorption variable
Widely distributed in body fluids
Mainly renal excretion
short plasma half-life

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14
Q

Adverse affects of penicillin

A

hypersensitivity
anaphylaxis
oral antibiotic associated diarrhoea

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15
Q

Structure of cephalosporins

A

Chemically structurally similar to penicillin

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16
Q

Mode of action of cephlopsorins

A

Similar to penicillins

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17
Q

Why is there a greater resistance to cephalosporins

A

due to them being gram -ve

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18
Q

What excretes cephalosporins

A

Kidney

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19
Q

what cephalosporin should be used for meningitis

A

ceftotaxime

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20
Q

What cephalosporin should be used for bronchiectasis infections

A

ceftazidime

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21
Q

Examples of macrolides

A

Erythromycin
Clarithromycin
Azithromycin

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22
Q

Mode of action of macrolides

A

Inihibit bacterial protein synthesis

Bind to 50S subunit of bacterial ribosome and prevent transolocation of growing peptide chain

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23
Q

How are macrolides administered

A

Usually PO

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24
Q

What are the benefits of macrolides

A

benefits against atypical pneumonia /COPD benefits

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25
Q

Adverse effects of macrolides

A

GI upset
Hypersensitivity
QT prolongation - arrhythmic

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26
Q

Why do macrolides interact with other drugs?

A

Due to their effects on cytochrome P450

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27
Q

Examples of quinolones

A

Ciprofloxacin
Levofloxacin
Moxifloxacin

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28
Q

Mode of action of quinolones

A

Inhibits bacterial DNA gyrase

Prevents DNA double helix being supercoiled - no transcription and replication

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29
Q

Features of quinolones

A

Well absorbed

Good active against Gm -ve coliforms awell as H. influenza and pseudomonas

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30
Q

What do quinolones act poor against

A

strep pneumonia and staph

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31
Q

What are quinolones usually used for

A

UTI and pneumonia and levofloxacin

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32
Q

What are adverse affects of quinolones

A 
GI 
Hypersensitivity 
Caution of QT prolongation 
Inhibits CYP 450 - increase theophylline toxicity 
Rare convulsions
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33
Q

Examples of aminoglycosides

A

Gentamycin

Tobramycin

34
Q

Features of aminoglycosides

A

INihibit bacterial protein synthesis
Require o2 dependent transport to enter bacteria
work synergistically with cell-wall-active antibiotics

35
Q

Mode of action of aminoglycosides

A

Bind to 30s subunits

  • interfere with initiation complex of peptide formation
  • induce misreading’s of RNA
  • cluster for efficiency
36
Q

Uses of aminoglycosides

A

Effective against aerobic Gm -ve and some gm +ve

Gm -ve sepsis in combination with penicillin

37
Q

How to treat pseudamonas infections with aminoglycosides

A

Use tobi plus another anti-pseudomonal antibiotic

38
Q

What are the pharmacokinetics of aminoglycosides

A

Highly polar molecules - IV admin
Kidney elimination
reduce dose and frequency

39
Q

Adverse effects of aminoglycosides

A

irreversible ototoxicity

CNXIII affected

shouldnt be longer than 2 weeks on genti

reversible nehprotoxicity

40
Q

Examples of tetracyclines

A

Tetracycline

Doxycycline

41
Q

Features of tetracyclines

A

inhibits protein synthesis

Broad spectrum

42
Q

Why not to administer tetracycline in pregnancy

A

Chelate calcium -never when pregnant

- weakens the bones and teeth of the child

43
Q

Examples of carbapenems

A

meropenem

Imipenem

44
Q

How do carbapenems act

A

they act the same as other beta lactams

severe resistant infection under infectious disease guidance

45
Q

adverse affects of carbapenems

A

GI upset

46
Q

Example of a monobactam

A

Monobactams

47
Q

How are monobactams administered

A

IV

48
Q

What are monobactams resistant to?

A

Only given IV

49
Q

Adverse effects of monobactams

A

GI upset

50
Q

What are monobacams only effective against?

A

gm -ve aerobic rods ( pseudomonas)

51
Q

What type of antibiotic is vancomycin

A

Glycopeptide bacterial antibiotic

52
Q

How does vancomycin work

A

Inihibits cell wall synthesis

53
Q

Administration for vancomycin

A

C difficile - PO

IV - MRSA

54
Q

Adverse effects of vancomycin

A

rash
ototoxicity
nephrotoxicity

55
Q

What type of antibiotic is metronidazole and what is it good for?

A

Anti-protozoal agent

goof anaerobic cover

56
Q

Adverse effects of metronidazole

A 
reaction with alocohol 
Minor GI disturbance 
Headache 
Dizzy 
Metallic taste
57
Q

What is metronidazole used for as first line

A

C difficile colitis

58
Q

Other use for metronidazole

A

Anaerobic cover in intra-abdominal sepsis

59
Q

What is trimehtroprim and how does it work

A

A bacterial dihydrofolate reducatase inihibitor

efectively stops bacteria making DNA

60
Q

What is trimethroprim used to treat

A

Simple UTI

61
Q

Mode of action of nitrofurantoin

A

Inhibit a no. of different bacterial enzymes for protein synthesis

62
Q

Use of nitrofurantoin

A

UTI

63
Q

When do you not use nitrofurantoin

A

Septicaemia

Renal impairment - less effective and potential -theres a risk of neuropathy

64
Q

Adverse effects of Nitrofurantoin

A 
GI common 
Peripheral neuropathy 
Pulmonary fibrosis 
Hypersensitivity ( skin and bone marrow) 
haemolytic anaemia
65
Q

what should be looked out for when prescribing with nitrofurantoin

A 
Anaemia 
DM 
hepatic/renal impairment 
Vit B12 + folate deficiency 
pulmonary disease
66
Q

What is aciclovir

A

nucleoside analogue

67
Q

What does aciclovir do?

A

Inhibits vira DNA synthesis

68
Q

What enzymes are needed to be active for aciclovir to work?

A

Viral thymidine kinase

Viral DNA polymerase

69
Q

Treatment for varicella zoster/ shingles

A

Higher dose of acicilovir

70
Q

Adverse effects of aciclovir

A

GI
headache
Nephro/neurotoxicity
reduce doses in renal impairment

71
Q

What is famciclovir

A

Guanosine analogue
pro-drug of penciclovir
similar action to anciclovir
higher cell conc. and more prolonged effect

72
Q

What is remdesivir

A

inihbitor of viral RNA polymerase
nucleoside analogue
remdesivir triphosphate taken up by viral RNA polymerase and stalls RNA production

73
Q

Why are antifungal agents not given systemically

A

Toxic

74
Q

When do you give anti fungal agents topically

A

When the patient is immunocompromised

75
Q

when is amphotericin given

A

when life threatening

76
Q

MoA of amphotericin

A

Binds to ergosterol in fungal cell wall
FOrms pre of fungal cells walll
Leakage of ions leads to cell death

77
Q

AE of amphotericin

A

Immediate IV reactions

Gradual toxicity
Hypokalaemic
Abnormal LFT
Anaemia/ thrombocytopenia

78
Q

how is nystatin used

A

Topically for candida infections

79
Q

How do triazoles work

A

Inhibit fungal cytochrome P450 3A enzyme

  • key enzyme in the synthesis of ergosterol
80
Q

how is Fluconazole admin

A

IV

caution with other drugs

81
Q

AE of fluconazole

A

GI

headache

PODT- Microbiology (18 decks)

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