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Antimicrobial Flashcards

1
Q

What are the four major classes of antibacterial meds

A 
Inhibitors of bacterial: 
cell wall synthesis
protein synthesis
DNA replication
metabolic pathways
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2
Q

Antibacterial meds can be administered…

A

Topically or systematically

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3
Q

E.g. of inhibitors of bacterial cell wall synthesis

A

Beta-lactams, cephalosporins, carbapenems

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4
Q

E.g. of beta-lactams

A

Penicillin (amoxicillin, amoxicillin with clavulanic acid, ampicillin, benzathine benzylpenicillin, benzylpenicillin, dicloxacillin, flucloxacillin, phenoxymethylpenicillin)

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5
Q

What do beta-lactams do

A

Beta-lactam ring essential for antibacterial activity and specific enzymes can disrupt the ring and inactivate their mechanism of action

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6
Q

Beta-lactams are

A

Safe, effective and widely used

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7
Q

Extensive use of beta lactams leads to…

A

Resistance in staph

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8
Q

How do beta lactams work

A

Work by inhibiting synthesis of the bacterial cell wall binding with proteins, producing a defective cell wall which destroyed microorganism

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9
Q

What type of bacteria is penicillin primarily used for

A

Gram-positive

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10
Q

Who is penicillin contraindicated for

A

Use in patients with hypersensitivity/allergic reaction to any penicillin preparation and a potential exists for cross-allergenicity with cephalosporins and carbapenems. Penicillin is generally well tolerated

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11
Q

In life-threatening allergic reaction to penicillin…

A

Cephalosporin and carbapenem shouldn’t be used coz similar to penicillin action

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12
Q

Common AEs of beta-lactams

A

Diarrhoea, nausea, pain and inflammation at injection site, superinfection with prolonged treatment, allergy

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13
Q

E.g. of carbapenems

A

Ertapenem, imipenem, meropenem

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14
Q

Mechanism of action of carbapenems

A

Inhibit synthesis of bacterial cell walls by binding with penicillin-binding proteins

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15
Q

Common AEs of carbapenems

A

Nausea, vomiting, diarrhoea, headache

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16
Q

Characteristics of carbapenems

A

Broad-spectrum, bactericidal, beta-lactam

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17
Q

Characteristics of cephalosporins

A

Widely used and derived from a fungus, broad-spectrum.

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18
Q

Cephalosporins against what kind of bacteria?

A

Activity against gram positive and negative but more active against negative than penicillin is

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19
Q

E.g. of cephalosporins

A

Cefaclor, cefalexin, cefalotin, cefazolin, cefepime, cefotaxime, cefoxitin, ceftaroline, ceftazidime, ceftriaxone and cefuroxime.

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20
Q

Clinical uses of cephalosporins

A

Surgical prophylaxis, treatment of infections of resp tract, urinary tract, skin, soft tissues, bones, joints, CNS, septicaemia

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21
Q

Mechanism of action of cephalosporins

A

Damage cell wall by binding to penicillin-binding proteins leading to cell lysis and death

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22
Q

Common AEs of cephalosporins

A

Diarrhoea, nausea, vomiting, rash, headache

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23
Q

Contraindications for cephalosporins:

A

Previous anaphylactic reaction to penicillin or a cephalosporin allergy

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24
Q

Aminoglycosides characteristics

A

Widely used for gram negative, bactericidal, similar to penicillin in pharmacologic, antimicrobial and toxiocologic characteristics

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25
How is aminoglycosides administered
Parentally cos poorly absorbed from GI tract
26
E.g. of aminoglycosides
Amikacin, gentamicin, streptomycin, tobramycin
27
How do aminoglycosides work
Work by penetrating the cell walls of the bacteria and preventing protein synthesis
28
Common AEs of aminoglycosides
Nephrotoxicity, ototoxicity, anaphylaxis, bronchospasm, oliguria, peripheral neuropathy
29
E.g. of inhibitors of bacterial protein synthesis
Aminoglycosides and macrolides
30
Effects of macrolide
Have immunomodulatory and anti-inflammatory effects
31
Macrolides have a similar spectrum of antimicrobial activity to...
Benzylpenicillin, can be used for people with penicillin and cephalosporin allergy
32
E.g. of macrolides
Azithromycin, clarithromycin, erythromycin, roxithromycin
33
Macrolide properties:
Bactericidal or bacteriostatic depending on dose and bacteria
34
Common AEs of macrolides
Nausea, vomiting, diarrhoea, abdo pain, cramps, candida infections
35
E.g. of inhibitors of bacterial metabolic pathways
Sulfonamides
36
Sulfonamides are bacteriostatic against...
Wide range of Gm + and -, however decreasing in efficacy due to AMR
37
When can you use sulfonamides
Should only be used after susceptibility is proven by culture and sensitivity testing
38
E.g. of sulfonamides
Sulfadiazine, sulfisoxazole, trimethoprim-sulfamethoxazole, mafenide, silver sulfadiazine
39
Common AEs of sulfonamides
Burning, itch, rash, transient leucopoenia
40
E.g. of inhibitors of bacterial DNA replication
Quinolones/ fluoroquinolones
41
E.g. of quinolones/ fluoroquinolones
Ciprofloxacin, moxifloxacin, norfloxacin, ofloxacin
42
Properties of quinolones/ fluoroquinolones
Synthetic bactericidal, active against gram + and –, well absorbed orally
43
What are quinolones/ fluoroquinolones used for
Used for infections of resp tract, genitourinary tract, GI tract, bone, joints, skin, soft tissues
44
Mechanism of action of quinolones/ fluoroquinolones?
Interferes with bacterial DNA enzyme synthesis
45
Common AEs of quinolones/ fluoroquinolones?
Rash, itch, nausea, vomiting, diarrhoea, abdo pain, dyspepsia
46
What do most antifungals target
Most target fungal cell membrane and disrupt the structure and function of fungal cell components. Can produce potentially serious toxicities and drug interactions
47
Antifungals can be applied
Superficially or systemically
48
E.g. of antifungals
Azoles, echinocandins, amphotericin B
49
E.g. of azoles
Fluconazole, isavuconazole, itraconazole, ketoconazole, miconazole, Posaconazole, voriconazole
50
How do azoles work
Work by impairing the synthesis of ergosterol in fungal cell membranes causing cell breakdown, cell leakage and cell death
51
E.g. of echinocandins
Anidulafungin, caspofungin, micafungin
52
How do echinocandins work
Inhibit 1,3-beta-D-glucan synthase which inhibits synthesis of 1,3-beta-D-glucan in the fungal cell wall and alters cell membrane permeability
53
Common AEs of echinocandins
Nausea, vomiting, diarrhoea, rash, hypokalaemia
54
How does amphotericin B work
Works by binding irreversibly to ergosterol in fungal cell membranes causing cell death by altering their permeability and allowing leakage of intracellular components
55
Common AEs of amphotericin B
Infusion reactions, thrombophlebitis, anaemia, nephrotoxicity, hypoxia, hyperglycaemia, tachycardia, hyponatraemia
56
What do antiprotozoal drugs do
Either destroy or inhibit protozoa growth and ability to reproduce
57
What are the two main types of antiprotozoals
Antimalarial and antiprotozoal
58
What do antimalarials do
Kill or inhibit growth by affecting different stages of the parasitic lifecycle
59
E.g. of antimalarials
Atovaquone with proguanil (combination is synergistic), clindamycin, doxycycline, hydroxychloroquine
60
What else can antimalarials be used for
Hydroxychloroquine can be used as an anti-inflammatory
61
Most common side effects of antimalarials:
Nausea, vomiting, diarrhoea, anorexia, abdo cramps, rash and itch
62
E.g. of antiprotozoals
Metronidazole and tinidazole
63
What do metronidazole and tinidazole do
Work by interfering with DNA synthesis
64
What are metronidazole and tinidazole often used for
In treating non-protozoal infections
65
Common side effects of metronidazole and tinidazole
Nausea, anorexia, abdo pain, vomiting, diarrhoea
66
What can and can't antivirals do
They inhibit viral replication but can't eliminate virus from host tissue
67
What are neuraminidase inhibitors used for
In the treatment and prevention of influenza A and B
68
What do neuraminidase inhibitors do
Reduce virus replication
69
E.g. of neuraminidase inhibitors
E.g. oseltamivir, peramivir, zanamivir
70
AEs of neuraminidase inhibitors
Bronchospasm, dyspnoea and allergy
71
What are the meds for herpes simplex or cytomegalovirus treatment
Acyclovir, famciclovir, ganciclovir, valaciclovir
72
How do herpes simplex or cytomegalovirus meds work
Work by inhibiting viral DNA polymerase and DNA synthesis
73
Common side effects of herpes simplex or cytomegalovirus meds
Nausea, vomiting, diarrhoea, hallucinations, headache and encephalopathy
74
What are the different types of meds for HIV
Antiretrovirals, nucleoside reverse transcriptase inhibitors (NTRI), non-nucleoside reverse transcriptase inhibitors, HIV protease inhibitors, integrase inhibitors
75
How do antiretrovirals work
Work by stopping the virus replicating in the body to prevent further damage
76
Antiretrovirals usually require a...
Combination of drugs
77
NTRI are used in the treatment of
HIV infection or transmission
78
E.g. of NTRIs
Abacavir, emtricitabine, lamivudine, zidovudine
79
How do NTRIs work
Work by inhibiting viral reverse transcriptase and viral DNA synthesis
80
Side effects of NTRIs
Headache, nausea, vomiting, anorexia, myalgia, asymptomatic hyperlactataemia
81
E.g. of non-NTRIs
Efavirenz, etravirine, nevirapineor, rilpivirine
82
How does rilpivirine work
By inhibiting HIV-1 reverse transcriptase and thus reducing viral DNA synthesis
83
Common side effects of rilpivirine
Rash, malaise, nausea, vomiting, elevated liver enzymes, headache, fever
84
How do HIV protease inhibitors work
By inhibiting HIV-1 and HIV-2 proteases thus preventing virus replication
85
E.g. of HIV protease inhibitors
Atazanavir, darunavir, fosamprenavir, ritonavir, saquinavir, tipranavir
86
Side effects of HIV protease inhibitors
Headache, nausea, vomiting, abdo pain, elevated liver enzymes, weight gain, hyperglycaemia, new-onset of or worsening diabetes, hypertriglyceridemia, hypercholesterolaemia
87
What do integrase inhibitors do
Inhibit HIV integrase and thus stop the insertion of viral DNA into the host DNA
88
E.g. of integrase inhibitors
Bictegravir, dolutegravir, elivetigravir, raltegavir
89
Common side effects of integrase inhibitors
Headache, fatigue, nasopharyngitis, increased liver enzymes, increased creatine kinase, rash, nausea

Medications (10 decks)

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