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Pharmacology > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Gram +ve Bacteria - main features

A
  • cell wall has single membrane
  • thick peptidoglycan layer
  • stains PURPLE
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2
Q

Gram -ve Bacteria - main features

A
  • cell has 2 layers of lipid membrane (inner, outer)
  • thin peptidoglycan layer
  • stains PINK
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3
Q

Gram +ve cocci (3)

A
  • streptococci
  • staphylococci
  • enterococci
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4
Q

Gram +ve bacilli (4)

A
  • Listeria monocytogenes
  • Clostridium
  • Diphtheroids
  • Bacillus Anthracis
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5
Q

Gram -ve cocci (2)

A
  • Neisseria meningitidis

- Neisseris gonorrhea

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6
Q

Gram -ve bacilli (7)

A
  • Lactose-fermenting coliforms (E. coli, Klebsiella)
  • Pseudomonas
  • Salmonella
  • Haemophilus
  • Helicobacter
  • Campylobacter
  • Bacteroids (anaerobic)
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7
Q

Antibiotics - mechanisms of action (5)

A
  • disruption of cell membrane (phospholipid layer)
  • inhibition of cell wall synthesis
  • inhibition of DNA or RNA synthesis
  • Inhibition of Protein synthesis
  • Inhibition of folic acid metabolism
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8
Q

Disruption of cell membrane - examples

A
  • Lipopeptides (daptomycin)
  • Polymixin B and E
  • Polyene antimycotic (antifungals)
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9
Q

Cell wall synthesis inhibitors - examples

A
  • beta lactams (penicillins, cephalosporins, carbapenems - very broad, monobactams)
  • fosfomycin
  • cycloserine
  • vancomycin (glycopeptide)
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10
Q

Nucleic acid inhibitors - examples

A
  • RNA –> rifamycin (includes rifampicin)

- DNA –> quinolones e.g. ciprofloxacin, nitrofurantoin, metronidazole

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11
Q

Protein synthesis inhibitors - examples

A
  • Target 50s subunit: chloramphenicols, macrolides (clarithromycin, erythromycin), clindamycin
  • Target 30s subunit: aminoglycosides (streptomycin, gentamicin), tetracyclines (tetracyline, doxycycline)
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12
Q

Folic acid metabolism inhibotors - examples

A
  • sulfonamides (sulfa drugs)
  • trimethoprim
target PABA (precursor of folate)
folic acid important for synthesis of adenine and thymine (DNA components)
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13
Q

Penicillins

A
  • Benzylpenicillin sodium (Penicillin G) = streptococcal (including pneumococcal), gonococcal, meningococcal infections and also for anthrax, diphtheria, gas-gangrene, and leptospirosis. Given by IV or IM injection
  • Benzathine benzylpenicillin = early syphilis and late latent syphilis
  • Phenoxymethylpenicillin (Penicillin V) has a similar antibacterial spectrum to benzylpenicillin sodium, but is gastric acid-stable, so is suitable for oral administration
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14
Q

Penicillin subclasses

A
  • fucloxacillin

- broad specturm = tazocin, timentin, amoxicillin

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15
Q

Penicillin allergy - S/E

A
  • 1-10% of people affected
  • usually get skin rash 7-10 days after administration
  • less commonly anaphylactic reaction with/without hypotesion, bronchospasm, angioedema
  • CNS toxicity (convulsions, coma) with high doses
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16
Q

Cephalosporins

A

Broad spectrum Abx

  • first generation = treat gram +ve (eg UTI). Eg. cefalexin, cefradine, and cefadroxil
  • second generation = treat gram -ve. Eg. cefaclor (PO)
  • third generation = broad spectrum, mostly gram -ve. Cefotaxime, ceftazidime and ceftriaxone
  • fourth generation = cefepime
17
Q

Macrolides

A
  • narrow spectrum
  • mycoplasma and chlamydial infections, RTIs, campylobacter and Legionnaire’s disease
  • Erythromycin, Clarithromycin, Azithromycin
18
Q

Resistance Issues

A
  • MRSA = resistant to most agents due to mutation in penicillin-binding protein (transpeptidase). Treated with IV Vancomycin, followed by PO Trimethoprim
  • C Diff = treated with PO Metronidazole or PO Vancomycin
19
Q

Community Acquired Pneumonia - Abx

A
  • CURB 65 (0 or 1) = Amoxicillin PO for 5 days
  • CURB 65 (2) = 7-10 day course of Amoxicillin PO + Clarithromycin PO
  • CURB 65 (3 or more) = Benzylpenicillin IV + Clarithromycin IV

+ve penicillin allergy -> clarithromycin, doxycycline or vancomycin

20
Q

LRTI Abx - known pathogen

A
  • Staphylococcal = Flucloxacillin PO +/- Rifampicin
  • Klebsiella = IV cefotaxime OR Imipenem
  • Pseudomonas = cefepime/ceftazidime + ciprofloxacin
  • Mycoplasma pneumoniae = clarithromycin OR doxycycline
  • Legionella = macrolide OR ciprofloxacin
21
Q

Infective exacerbation of COPD - Abx

A
  • Amoxicillin PO 500mg

- penicillin allergy -> doxycycline

22
Q

Cellulitis - Abx

A
  • Flucloxacillin PO

- penicillin allergy -> clarithromycin

23
Q

Lower UTI - Abx

A

Nitrofurantoin 100mg twice a day for 3 days OR

Trimethoprim 200mg twice a day for 3 days

24
Q

Upper UTI - Abx

A
  • uncomplicated = cefalexin or co-amoxiclav or trimethoprim or ciprofloxacin
  • pregnant = cefalexin
25
Q

Abdominal Sepsis (Liver or biliary infection) - Abx

A

Tazocin IV or Cefalexin PO

penicillin allergy –> Vancomycin IV + Gentamicin IV

26
Q

Meningococcal Septicaemia - Abx

A

Parenteral benzylpenicillin in community settings and IV ceftriaxone in hospital settings

27
Q

Sepsis of unknown source - Abx

A
  • Up to 17 years(except neonates) –> ceftriaxone 80 mg/kg once a day
  • 18 years and over use an intravenous antimicrobial from the agreed local formulary and in line with local (where available) or national guidelines. Eg. Tazocin IV
    penicillin allergy –> Vancomycin IV + Gentamicin IV
28
Q

Meningitis - Abx

A
  • < 1 month age = ampicillin and cefotaxime
  • > 1 month to 50 years = IV ceftriaxone and vancomycin
  • > 50 years = combine vancomycin + ceftriaxone + ampicillin
29
Q

Strep Throat - Abx

A
  • Penicillin V
  • penicillin allergy -> clarithromycin
    erythromycin for a pregnant woman with penicillin allergy
30
Q

Gonorrhea - Abx

A

Ceftriaxone IM or ciprofloxacin if quinolone sensitive gonorrhea
treat both partners

31
Q

Chlamydia - Abx

A

Doxycycline 100 mg twice daily for 7 days

  • If doxycycline is contraindicated -> azithromycin or erythromycin
  • pregnant = azithromycin or erythromycin or amoxicillin

Pharmacology (3 decks)

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