Antimicrobial agents

Question 1

Gram +ve vs -ve

Answer 1

Gram positive = purple, thick peptigoclycan cell wall, no outer membrane
Gram negative = pink, thin peptidoglycan cell wall, outer membrane with LPS

Question 2

What is MIC and AUC

Answer 2

Question 3

Summarise patterns of Abx activity

Answer 3

Question 4

What do Beta lactams do?

Answer 4

Inhibit cell wall synthesis

Question 5

Types of Beta lactams

Answer 5

Penicillins
Cephalosporins
Carbapenems
Glycopeptides

Question 6

Indications for 3 main penicillins

Answer 6

Penicillin - G+
Amoxicillin - broad spectrum
Flucoxacillin - narrow, skin infections

Question 7

Cross-reactions of penicillins

Answer 7

10% cephalosporins and carbapenems

Question 8

Cephalosporins coverage

Answer 8

Newer gens have more G- coverage and less G+

Question 9

Carbapenems indication

Answer 9

ESBLs

Question 10

Carbapenem resistant bugs

Answer 10

Acenitobacter
Klebsiella

Question 11

Glycopeptide indication

Answer 11

G+ only
oral - C diff
IV - MRSA

Question 12

Glycopeptide side effect

Answer 12

Nephrotoxic

Question 13

Abx that inhibit protein synthesis and which part of the ribosome do they each work on

Answer 13

TA(50S)
MC(30S)
O(23S component of 50S)

Question 14

Tetracycline Indication and contraindication

Answer 14

Indication - G+, intracellular
CI - pregnancy, children(Tetra=teratogenic)

Question 15

Aminoglycoside examples and indication

Answer 15

TAG - tobramycin, amikacin, gentamicin
Indication - G- sepsis (Ami-NO-glycosides)

Question 16

Aminoglycoside SEs

Answer 16

Ototoxic, nephrotoxic

Question 17

Macrolides examples and indication

Answer 17

ACE - Azithromycin, Clarithromycin, Erythromycin
Indication - G+ atypical pneumonia
Good for penicillin allergy

Question 18

Chloramphenicol indication

Answer 18

Eye drops for bacterial conjunctivitis

Question 19

Chloramphenicol SEs

Answer 19

Aplastic anaemia
Grey baby risk

Question 20

Oxazolidinone example and indication

Answer 20

Linezolid
G+s, MRSA, VRE

Question 21

Which Abx inhibit DNA synthesis?

Answer 21

Fluoroquinolones - -floxacins
Nitroimidazoles - -dazoles

Question 22

Fluoroquinolones example and indication

Answer 22

Ciprofloxacin
Broad spec G-ves
Anti-pseudomonas (fluoroquinolones anti-pseudomonas, q and p are oppposites)

Question 23

Nitroimidazole example and indication

Answer 23

Metronidazole
Anaerobes and protozoa

Question 24

RNA synthesis inhibitor

Answer 24

Rifamycins - e.g. Rifampicin

Question 25

Cell membrane toxins, examples and indication

Answer 25

Polymyxins - Colistin - G-ves Cyclic lipopeptides - Daptomycin - same as linezolid

Question 26

Drugs that inhibit folate metabolism with examples

Answer 26

Sulfonamides - sulphamethoxazole (co-trimox for PCP) Diaminopyrimidines - trimethoprim (UTI)

Question 27

Broad spectrum Abx

Answer 27

Cures All Types of Microbes Ciprofloxacin Co-Amoxiclav Tazocin Meropenem

Question 28

Narrow spectrum Abx

Answer 28

Greatly Fine Margins Gentamicin Flucloxacillin Metronidazole

Question 29

Anti-pseudomonas Abx

Answer 29

Chefs Take Care Grilling Meat Ceftazadime Tazocin Ciprofloxacin Gentamicin Meropenem

Question 30

4 Mechanisms of Antibiotic resistance

Answer 30

BEAT

Question 31

Likely organism and Abx choice for skin infection

Answer 31

S. aureus Fluclox

Question 32

Likely organism and Abx choice for Pharyngitis

Answer 32

Beta haemolytic strep Phenoxymethylpenicillin

Question 33

Abx choice for nosocomial UTI

Answer 33

Co-amoxiclav or Cephalexin

Question 34

Abx choice for severe sepsis

Answer 34

Tazocin / ceftriaxone Metronidazole +- Gentamicin

Question 35

Abx choice for neutropenic sepsis

Answer 35

Tazocin + Gentamicin

Question 36

Likely organism and Abx for colitis

Answer 36

C diff Oral vancomycin