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Foundations of Medicine JMO > Antibiotics > Flashcards

Antibiotics Flashcards

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1
Q

What 3 classes of antibiotic are ß-lactam antibiotics?

A

Penicillins
Cephalosporins
Carbepanems

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2
Q

What are the 2 types of antibiotic?

A

Bactericidal - kills bacteria
Bacteriostatic - slows bacterial growth

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3
Q

What is the target of a ß-lactam antibiotic?

A

Penicillin Binding Proteins

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4
Q

How are peptidoglycan chains joined?

A

Transpeptidases cleave terminal D-alanine D-alanine, releasing energy for the formation of peptide bonds

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5
Q

How do ß-lactams work?

A

The ß-lactam ring mimics the D-alanine D-alanine cross link. It permanently binds to transpeptidase so prevents formation of more cell wall.

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6
Q

What are some advantages of penicillins?

A

They have very few side effects
They are safe in pregnancy
They are excreted safely by the kidneys

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7
Q

What are some limitations of penicillins?

A

Patients can often be allergic
Rapid excretion means many doses are required
Bacteria can develop resistance to penicillins

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8
Q

What is an example of a gram +ve penicillin?

A

Flucloxicillin

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9
Q

What are examples of gram +ve and -ve penicillins?

A

Amoxicillin
Pipericillin
Phenoxymethylpenicillin

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10
Q

What is Co-amoxiclav?

A

A compound made up of Amoxicillin and Clavulonic acid

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11
Q

What is a ß-lactamase?

A

A compound that breaks down the ß-lactam ring

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12
Q

What is the function of clavulonic acid?

A

It is an inhibitor of ß-lactamase so prevents the degradation of penicillins

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13
Q

What is the function of tazobactam?

A

It is an inhibitor of ß-lactamase so prevents the degradation of penicillins

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14
Q

What is Tazosin?

A

A compound formed from Pipericillin and tazobactam

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15
Q

What is an example of a gram -ve penicillin?

A

Temocillin

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16
Q

What are the 3 principle compounds of penicillin?

A

Benzylpenicillin - Intravenous
Phenxymethylpenicillin - Oral
Benzathine penicillin - Intramuscular

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17
Q

Which 2 species are targeted by flucloxicillin?

A

Streptococci and staphylococci

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18
Q

What is MRSA?

A

Methicillin (Flucloxacillin) Resistant Staphylococcus aureus

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19
Q

What infections can be treated by flucloxacillin?

A

Skin and soft tissue infection
Wound infections
Cellulitis

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20
Q

What is cellulitis?

A

An infection of the soft tissue beneath the skin

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21
Q

What organisms are targeted by Temocillin?

A

Coliforms e.g. E.coli, salmonella, enterobacter
Very useful against ESBLs

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22
Q

What is an ESBL

A

An Extended Spectrum ß-Lactamase

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23
Q

What are the advantages of Cephalosporins?

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A

They have a longer half-life in plasma
Reduced risk of allergy
More resistant to ß-lactamases
Safe in pregnancy

24
Q

What are the disadvantages of cephalosporins?

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A

They kill a large portion of the normal gut flora, which allows the growth of Clostridium difficile infections

25
Does a 1st generation cephalosporin have a broader spectrum than a 4th?
Yes
26
What are examples of 1st generation cephalosporins?
Cefalexin Cefalozin
27
What are examples of 2nd generation cephalosporins?
Cefuroxime Cefaclor
28
What are examples of 3rd generation cephalosporins?
Ceftrioxone Cefixime Cefotaxime Ceftazidime
29
What is an example of a 4th generation cephalosporin?
Cefepime
30
How do Glycopeptide antibiotics work?
They bind to D-alanine-D-alanine terminal ends and block transpeptidase action
31
What are the disadvantages of Glycopeptides?
They are excreted via the kidneys which, in kidney failure, can build up and increase damage They only work on gram +ve cell walls
32
What are some examples of glycopeptides?
Vancomycin (IV) Teicoplanin (IV)
33
What are some examples of antibiotic classes that target protein synthesis?
Aminoglycosides Tetracycline Macrolides Lincosamides
34
What is an example of an aminoglycosides?
Gentamicin
35
What are some examples of Tetracyclines?
Doxycycline Minocycline
36
What is an example of a lincosamide?
Clindamycin
37
How do aminoglycosides (Gentamicin) work?
It binds to the 30S ribosome irreversibly, thus preventing the production of proteins
38
What are the risks of gentamicin use?
It is toxic and can cause damage to kidneys and VIIIth cranial nerve (Vestibulocochlear)
39
How do tetracyclines work?
They are actively transported into the cell and bind to the 30S subunit, preventing attachment of tRNA to acceptor sites
40
What are the risks of tetracycline?
They can destroy the normal gut flora, resulting in increased risk of secondary infection. It also causes staining and impairment of bones and teeth
41
What are examples of macrolides?
Erythromycin Clarythromycin Azithromycin
42
How are macrolides excreted?
They are excreted into the liver, into the biliary tract and then into the gut
43
What are examples of antibiotics that affect nucleic acids?
Metronidazole Trimethoprim Fluoroquinolones
44
What are the uses of metronidazole?
Useful against anaerobes and parasites
45
How does metronidazole work?
It is activated by reduction, requiring intracellular low Eh. This forms a toxic intermediate that induces DNA strand breakage
46
How do Quinolones work?
They bind to the A subunit of DNA gyrase (topoisomerase) and prevent supercoiling of DNA, indirectly inhibiting DNA synthesis
47
What are examples of quinolones?
Ciprofloxacin Nalidixic acid
48
What are examples of fluoroquinolones?
Ciprofloxacin Levofloxacin
49
What antibiotics target folic acid synthesis?
Sulphonamides Trimethoprim
50
What are the uses of trimethoprim?
Useful against some gram +ve and -ve bacteria Commonly used for UTIs e.g. E.coli
51
What are the 3 most common side effects of antibiotics?
Nausea, vomiting and diarrhoea
52
What drugs classes action may be disrupted by antibiotics?
Oral contraceptives
53
What is a side effect of ciprofloxacin?
Tendonitis
54
What substance should not be taken with metronidazole?
Alcohol
55
What are the 4 Cs that can increase risk of Clostridium difficile?
Ciprofloxacin Clindamycin Cephalosporins Co-amoxiclav
56
What disease is caused by the fungus Candida albicans?
Thrush

Foundations of Medicine JMO (56 decks)

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