Antibiotics

Question 0

What does clindamycin target?

Answer 0

Clindamycin Inhibits protein synthesis. It targets the 50s subunit of the ribosome and prevents ribosomal translocation so is only bacteriostatic.

Question 1

What class of antibiotic is clindamycin in?

Answer 1

Clindamycin is a lincosamide.

Question 2

What is clindamycin used for?

Answer 2

Mostly gram positive infections and anaerobic infections.
It cannot penetrate well into gram negative bacteria.
Often used for MRSA/MSSA skin infections and bone and joint infections.
Sometimes used to treat malaria.
May be used in combination with Vancomycin for TSS as it inhibits release of toxins.

Question 3

What adverse effects can clindamycin cause?

Answer 3

It can be hepatotoxic as is excreted by the liver.
Clindamycin is associated with CDAD.

Should not be given in combination with macrolides or chloramphenicol as will antagonise.

Question 4

What class of antibiotic is Erythromycin and what does it target?

Answer 4

Erythromycin is a macrolide antibiotic. It targets the 50s ribosomal subunit preventing ribosomal translocation, inhibiting protein synthesis. It is bacteriostatic.

Question 5

Name four macrolide antibiotics

Answer 5

Erythromycin
Azithromycin
Clarithromycin
Spectromycin

Question 6

What is the spectrum of erythromycin?

Answer 6

Targets gram pos staphs and streps, limited gram negatives (no coliforms) and anaerobes.

Question 7

What is erythromycin used for?

Answer 7

Often used in patients who are allergic to penicillin as has a similar spectrum.
RTIs - targets legionella and mycoplasma/ atypical RTIs as well.

Question 8

What are the adverse effects of erythromycin?

Answer 8

It is excreted by the liver so can be hepatotoxic.

It can also cause nausea and a rash.

Question 9

Name 3 quinolone antibiotics

Answer 9

Ciprofloxacin
Levofloxacin
Nalidixic acid

Question 10

What target does ciprofloxacin have?

Answer 10

It targets DNA gyrate preventing unwinding of DNA strands during replication.

Question 11

What is the spectrum of ciprofloxacin?

Answer 11

Gram neg mostly and some gram positives.

Question 12

What syndromes is ciprofloxacin mostly used for?

Answer 12

Uti’s
Osteomyelitis
CAP
Gastroenteritis

Question 13

What side effects of ciprofloxacin are there?

Answer 13

Nausea
Vomiting
Cartilage erosion in young
CDAD

Question 14

How can ciprofloxacin be administered?

Answer 14

IV or orally

It is the only oral antibiotic effective against pseudomonas

Question 15

Name a sulphonamide

Answer 15

Co-trimoaxazole

Trimethoprim-sulphamethoxazole

Question 16

What is Bactria and what is it used for?

Answer 16

Co-trimoaxazole

Mainly UTI’s

Question 17

What does chloramphenicol target?

Answer 17

It targets the 50s subunit - bacteriostatic

Question 18

What is the spectrum of chloramphenicol?

Answer 18

Broad
G+ve, g-ve and anerobic

Can be give IV, orally or topically
Can enter CSF

Question 19

What side effects does chloramphenicol have?

Answer 19

It can cause bone marrow suppression so has restricted uses.

Question 20

What class is daptomycin in?

Answer 20

It is a lincosamide.

Question 21

What does daptomycin target?

Answer 21

Inhibits DNA/RNA synthesis

Question 22

What is the spectrum of daptomycin

Answer 22

G+ve only

Question 23

What class is linezolid in?

Answer 23

It is an oxazolidinone.

Question 24

What does linezolid target?

Answer 24

It binds the 30s subunit and inhibits protein synthesis.

Question 25

What is the spectrum of linezolid?

Answer 25

Gram positives only | Includes MRSA, VRE, mycobacterium

Question 26

What side effects can linezolid have?

Answer 26

Bone marrow suppression Optic neuropathy Peripheral neuropathy

Question 27

What does fusilier acid target?

Answer 27

It targets protein synthesis. | It targets the G-factor and inhibits ribosomal translocation.

Question 28

What is the spectrum of fusidic acid?

Answer 28

Staphylococci mostly Never used alonE IV, oral, topical

Question 29

What are the side effects of fusidic acid?

Answer 29

Hepatotoxic | Thrombophlebitis

Question 30

What does tetracycline target?

Answer 30

Binds the 30s subunit - inhibits ribosomal translocation | Inhibits protein synthesis.

Question 31

What is the spectrum of tetracycline?

Answer 31

Broad spectrum G+ve, g-ve and anaerobes Give IV/oral

Question 32

What are the side effects of tetracycline?

Answer 32

Causes teeth and bone discolouration in children Don't give to children or pregnant women Can cause photo sensitivity

Question 33

What is the target of Quinupristin/Dalfopristin (Synercid)??

Answer 33

It targets protein synthesis | 50s subunit

Question 34

What is the spectrum of synercid?

Answer 34

G+ve only (MRSA and VRE but not E. faecalis)

Question 35

What side effects does synercid have?

Answer 35

Venous inflammation | Hepatotoxic

Question 36

What does Rifampicin target?

Answer 36

Inhibits RNA polymerase

Question 37

What is the spectrum of Rifampicin?

Answer 37

Broad spectrum G+ve, G-ve, Anaerobes and Mycobacteria DO NOT give alone IV/Oral

Question 38

What are the side effects of Rifampicin?

Answer 38

Hepatotoxic Can cause Type I hypersensitivity reactions Thrombocytopaenia Induction of liver enzymes

Question 39

What does Trimethoprim target?

Answer 39

Dihydrofolate reductase | -inhibits DNA synthesis

Question 40

What is the spectrum of Trimethoprim

Answer 40

Broad spectrum G+ve and G-ve Doesn't reach brain, skin or fat Used for UT

Question 41

What are the side effects of Trimethoprim?

Answer 41

Gastrointesinal upsets Type I hypersensitivity Bone marrow depression can be teratogenic in the first trimester.

Question 42

What does metronidazole target?

Answer 42

it is non-enzymatically reduced by reacting with reduced ferredoxin. Many of the reduced nitroso intermediates will form sulfinamides and thioether linkages with cysteine-bearing enzymes, thereby deactivating these critical enzymes.

Question 43

What is the spectrum of metronidazole?

Answer 43

Anaerobes | Parasites

Question 44

What are the side effects of metronidazole?

Answer 44

``` Nausea Reduced WCC Neurotoxic Rash Reacts with alcohol ```

Question 45

What class of antibiotics is Astreonam in?

Answer 45

Monobactams

Question 46

What is the spectrum of Astreonam?

Answer 46

G-ve mostly

Question 47

What is the target of Astreonam?

Answer 47

Targets PbP3 at low concentrations | Low susceptibility to b-lactamases

Question 48

Name four third generation cephalosporins

Answer 48

Cefotaxime Ceftazidime Cefixime Ceftriaxone

Question 49

Name a fourth generation cephalosporin

Answer 49

Cefipime

Question 50

What is the spectrum of cephalosporins

Answer 50

Broad - more active against g-ve b-lactamases Active against pseudomonas Can cross the BBB Risk of CDAD

Question 51

Name 2 second generation cephalosporins

Answer 51

Cefuroxime | Cefoxitin

Question 52

What spectrum is Tazocin?

Answer 52

Extended spectrum pseudomonas B-lactam G+ve, G-ve, some anaerobes Used to treat pneumonia

Question 53

What is the spectrum of Flucloxacillin?

Answer 53

G+ve Staphylococci/Streptococci | stable to b-lactamases

Question 54

What is the spectrum of ampicillin/amoxicillin?

Answer 54

``` Streptococci Neisseria Haemophilus E. Faecalis Some staphs Some coliforms Used for UTIs, Otitis Media, and in combination with flucloxacillin for cellulitis ```

Question 55

What is the spectrum of benzylpenicillin?

Answer 55

Streptococci Neisseria some staphs - quite narrow spectrum Synergistic with aminoglycosides

Question 56

What class does Imipenem belong to?

Answer 56

Carbapenems

Question 57

What is the spectrum of imipenem?

Answer 57

Very broad spectrum Resistant to beta lactamases Covers pseudomonas NOT active against MRSA

Question 58

What class does Teicoplanin belong to?

Answer 58

Glycopeptides | Cell wall active - bind terminal D-ala-D-ala residues

Question 59

What is the spectrum of Teicoplanin?

Answer 59

Gram positives only - too large for G-ve | Used for MRSA/MRSE

Question 60

What are the side effects of Teicoplanin?

Answer 60

Ototoxic Nephrotoxic Excreted renally

Question 61

What class is vancomycin in?

Answer 61

Glycopeptides

Question 62

what is the spectrum of vancomycin?

Answer 62

Gram positives only - too large for G-ve IV only Use for MRSA/MRSE

Question 63

what are the side effects of vancomycin?

Answer 63

Ototoxic Nephrotoxic excreted renally

Question 64

What class is Tobramycin in?

Answer 64

Aminoglycosides

Question 65

What does Tobramycin target?

Answer 65

The 30s ribsosomal subunit (protein synthesis)

Question 66

What is the spectrum of tobramycin

Answer 66

``` Staphylococci Coliforms Pseudomonas NOT streptococci Use for UTIs and septicaemia as poor tissue penetration ```

Question 67

WHat side effects does tobramycin have?

Answer 67

Ototoxic Nephrotoxic Excreted renally

Question 68

WHat class is gentamicin in?

Answer 68

Aminoglycosides

Question 69

What does gentamicin target in the cell?

Answer 69

30s subunit of ribosome (protein synthesis)

Question 70

What is the spectrum of gentamicin?

Answer 70

Coliforms, Pseudomonas Staphylococci (NOT streps) IV or topical show synergy with b-lactams for enterococci Mainly used for sepsis and UTIs as poor penetration of tissues

Question 71

What side effects does gentamicin have?

Answer 71

Nephrotoxic Ototoxic Excreted renally