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TAS Infection And Immunity ✅ > Antibiotics ✅ > Flashcards

Antibiotics ✅ Flashcards

(73 cards)

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1
Q

What groups can antibiotics be divided into?

A
  • Beta-lactam agents
  • Macrolides
  • Tetracyclines
  • Aminoglycosides
  • Glycopeptides
  • Fluoroquinolones
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2
Q

What can beta-lactam agents be further divided into?

A
  • Penicillins
  • Cephalosporins
  • Carbapenums
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3
Q

Give 4 examples of penicillins

A
  • Penicillin
  • Flucloxacillin
  • Amoxicillin
  • Piperacillin
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4
Q

Give 2 examples of cephalosporins

A
  • Ceftriaxone

- Cefuroxime

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5
Q

Give 2 examples of carbapenums

A
  • Meropenum

- Imipenum

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6
Q

Give 3 examples of macrolides

A
  • Erythromycin
  • Azithromycin
  • Clarithromycin
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7
Q

Give an example of a tetracycline

A

Doxycycline

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8
Q

Give 2 examples of an aminoglycoside

A
  • Gentamicin

- Amikacin

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9
Q

Give 2 examples of glycopeptides

A
  • Vancomycin

- Teicoplanin

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10
Q

Give an example of a flouroquinolone

A

Ciprofloxacin

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11
Q

What does pharmacokinetics describe?

A

The change in drug and metabolite concentrations in the body over time

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12
Q

What does pharmacodynamics consider?

A

The concentration of a drug at the site of action and the effect it produces on that site, both in terms of clinical effect and adverse effects, at different concentrations

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13
Q

Why is it important to understand pharmacokinetic-pharmacodynamic profiles for antimicrobial drugs?

A

It guides dosage and dose frequency

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14
Q

What factors decide dose frequency of antibiotics?

A
  • Half life

- Mechanism of action of antibiotic

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15
Q

Give an example of an antibiotic with a short half life

A

Penicillins

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16
Q

What is the implication of an antibiotic having a short half life?

A

It needs to be given more frequently

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17
Q

Give an example of an antibiotic with a very long half life?

A

Azithromycin

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18
Q

What aspect of a drugs mechanism of action is important when considering dosing intervals?

A

The way the activity of a drug is affected by it’s concentration

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19
Q

In what ways may the activity of a drug be affected by it’s concentration?

A
  • Activity may be related to time drug exceeds the minimum inhibitory concentration (MIC)
  • Activity may be related to the peak antibiotic concentration reached
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20
Q

Give an example of an antibiotic whose activity is related to the time that the concentration exceeds the minimum inhibitory concentration

A

Penicillin

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21
Q

Give an example of an antibiotic whose activity is related to the peak antibiotic concentration

A

Gentamicin

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22
Q

What does the therapeutic index of a drug describe?

A

How likely the drug is to cause toxicity to the host

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23
Q

How is the therapeutic index of a drug calculated?

A

The maximum tolerated dose divided by the minimum effective dose

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24
Q

What is the minimum effective dose of an antibiotic determined by?

A

The lowest dose that will give the required MIC at the site of infection

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25
Give an example of class of antibiotic with a high therapeutic index
Beta-lactam agents
26
What is required for antibiotics with a low therapeutic index?
Serum level monitoring and dose adjustment
27
Give an example of a class of antibiotics with a low therapeutic index
Aminoglycosides
28
What are the ways that antibiotics can exert their antimicrobial effects?
- Disruption of bacterial cell wall - Inhibition of protein synthesis - Inhibition of DNA replication - Interruption of microbial chemical pathways
29
What classes of antibacterial agents exert their actions by disruption of the bacterial cell wall?
- Beta-lactams | - Glycopeptides
30
How do beta-lactams and glycopeptide agents disrupt the bacterial cell wall?
They prevent cross-linkage of peptidoglycan
31
What is peptidoglycan?
A key component of the bacterial cell wall
32
What kind of infections are beta-lactams used to treat?
Predominantly gram +ve infections caused by Streptococci
33
Which beta-lactam agents have activity against a broader spectrum?
Third-generation cephalosporins
34
Give an example of a third-generation cephalosporin
Ceftriaxone
35
Are third generation cephalosporins active against gram -ve or gram +ve organisms?
Can be either
36
What organisms does ceftriaxone have poor action against?
- Pseudomonas | - Enterococci
37
What kind of bacteria are glycopeptide antibiotics used to treat?
Gram +ve bacteria only
38
Why is the use of glycopeptides limited to use against gram +ve bacteria?
The large molecules are not able to penetrate the outer membrane of gram -ve bacteria
39
What classes of antibiotic exert their actions by inhibiting protein synthesis?
- Macrolides - Tetracyclines - Aminoglycosides - Clindamycin
40
Where do antibiotics act to inhibit protein synthesis?
At the level of the ribosome
41
What is the advantage of antibiotics that inhibit protein synthesis?
As a group, they are active against a wide range of bacteria
42
What organisms are covered by macrolides?
Similar spectrum to penicillin, but also active against Mycoplasma, Mycobacteria, and Chlamydia
43
What kind of organisms do aminoglycosides have very good action against?
Gram -ve
44
Which class of antibiotics inhibit DNA replication?
Fluroquinolones
45
How do fluroquinolone inhibit DNA replication?
They inhibit enzymes involved in coiling and uncoiling of DNA
46
What kind of organisms do fluroquinolones have good activity against?
Gram -ve
47
What kind of organisms do fluroquinolones have poor activity against?
Gram +ve organisms such as Streptococci and Staphylococci
48
Give an example of an antibiotic which works by interrupting microbial chemical pathways
Trimethoprim
49
How does trimethoprim interrupt microbial chemical pathways?
It inhibits the conversion of dihydrofolate to tetrahydrofolate
50
What is the result of trimethoprim inhibiting the conversion of dihydrofolate to tetrahydrofolate?
It prevents purine and pyrimidine metabolism
51
Why do bacteria produce their own folate?
Because they cannot absorb folate from the host
52
What kind of organisms is trimethoprim active against?
Gram +ve and gram -ve
53
Why is trimethoprim most commonly used to treat UTIs?
Due to its excretion and high concentrations in the urine compared to blood
54
What can antibiotics be considered narrow or broad spectrum based on?
The range of bacteria they are active against
55
When should broad spectrum antibiotics be used?
- When a wide range of bacteria may be responsible for an infection - When polymicrobial infection may be present
56
What is meant by bactericidal antibiotics?
Ones that kill the bacteria they are effective against
57
Give two classes of antibiotics that are bactericidal
- Beta lactams | - Aminoglycosides
58
Who should bactericidal antibiotics be used in?
- Serious infections | - Immunosuppressed patients
59
What is meant by bacteriostatic antibiotics?
They inhibit bacterial growth but do not kill them
60
What do bacteriostatic organisms rely on to kill the bacteria?
The immune system
61
Give two bacteriostatic antibiotics or classes of antibiotics
- Tetracycles | - Trimethoprim
62
Where does knowledge of likely sensitivities of bacteria come from?
- Laboratory tests | - Epidemiological data
63
What are the principles of antimicrobial stewardship?
- Only use antibiotics when there is clinical evidence of bacterial infection - Obtain cultures before initiation - Document route, indication, dose, and duration - Review clinical diagnosis and need for antibiotics daily - Decide whether to stop, change routes, change antibiotics, continue, or use OPAT
64
Is bacterial resistance innate or acquired?
Can be either
65
Give an example of a bacterium that has innate resistance
Pseudomonas
66
What is pseudomonas innately resistant to?
Penicillin
67
How can bacteria acquire immunity?
Through a genetic change which results in a survival advantage, which results in the mutated strain of bacteria outgrowing the sensitive population
68
What is the main driver for emergence of resistant bacteria?
Inappropriate and overdose of antibiotics
69
Why is inappropriate and overuse of antibiotics the main driver for antibiotic resistance?
Antibiotics exert a considerable selection pressure on bacterial population, favouring populations that are able to withstand them
70
Why is it important to reduce resistance caused by inappropriate use of antibiotics?
Due to the shortage of new antibiotics, it is essential to maintain the efficacy of current ones
71
How should the inappropriate use of antibiotics be reduced?
Follow principles of selection of antibiotics and antimicrobial stewardship
72
What are the main factors when selecting the most appropriate antibiotic?
- Consideration of most likely organisms causing infection - Knowledge of likely sensitivities of the suspected or isolated organism(s) - Site of infection - Illness severity - Immune status of the host
73
When is a bacterium considered resistant to an antibiotic?
When its growth cannot be inhibited by a concentration of a drug that is achievable in the blood

TAS Infection And Immunity ✅ (14 decks)

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