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ME2019 PART 2 > Antimicrobial Chemotherapy 2 > Flashcards

Antimicrobial Chemotherapy 2 Flashcards

1
Q

What are some commonly used B-lactams (penicillins)?

A

Benzyl penicillin

Amoxicillin, ampicillin

Co-amoxicaly

Flucloxacillin

Piperacillin

Imipenem, meropenum

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2
Q

What does benzyl penicillin act against?

A

Gram positive bacteria

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3
Q

What does amoxicillin and ampicillin act against?

A

Gram negative bacteria

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4
Q

What does co-amoxicaly act against?

A

B-lactamase producing coliforms

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5
Q

What is flucloxacillin the best treatment for?

A

Staphyloccocal infection

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6
Q

What does piperacillin treat?

A

Extended gram negative coverage

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7
Q

What does imipenem and meropenem treat?

A

Most bacteria, including anaerobes

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8
Q

What is a class of B-lactams other than penicillin?

A

Cephalosporins

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9
Q

How does the activity of cephalosporins change against gram negative and positve bacteria through the generations?

A

Activity against gram negative bacteria increases

Activity against gram positive bacteria decreases

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10
Q

What are the 3 generations of cephalosporins?

A

1) Cephradine
2) Cefluoxime
3) Ceftrixone

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11
Q

What are some commonly used agents other than B-lactams?

A

Aminoglycosides

Glycopeptides

Macrolides

Quinolones

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12
Q

How are aminoglycosides administered?

A

Only parenterally

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13
Q

What are aminoglycosides useful against?

A

Gram negative bacteria

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14
Q

What gram positive bacteria is sensitive to aminoglycosides?

A

Only staphylococci

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15
Q

What is an example of an aminoglycoside?

A

Gentamicin

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16
Q

How are glycopeptides administered?

A

Parenteral use only

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17
Q

What are glycopeptides active against?

A

Gram positive bacteria (anaerobic and aerobic)

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18
Q

What are examples of glycopeptides?

A

Vancomycin

Teicoplanin

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19
Q

What are macrolides mainly active against?

A

Gram positive bacteria

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20
Q

When are macrolides often used?

A

As an alternative to penicillin for people who are allergic

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21
Q

What are examples of macrolides?

A

Clarithromycin

Erythromycin

Azithromycin

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22
Q

What are quinolones active against?

A

Nearly all gram negative bacteria

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23
Q

What are some miscellaneous commonly used agents?

A

Metranidazole

Fusidic acid

Co-trimoxazole

Tetracyclines

Clindamycin

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24
Q

What is metronidazole used against?

A

Anaerobes, both gram positive and negative

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25
Q

What is fusidic acid used against?

A

Staphyloccocus

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26
Q

What is co-trimoxazole?

A

A combination of trimethoprim and sulphamethoxazole

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27
Q

What kinds of infection are tetracyclines useful for?

A

Some genetial tract and respiratory tract infections

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28
Q

What is clindamycin useful against?

A

Gram positive and anaerobes

29
Q

What are some commonly used new agents?

A

Linezolid

Daptomycin

30
Q

What is linezolid used against?

A

MRSA

31
Q

What is daptomycin active against?

A

Only gram positive bacteria

32
Q

What is daptomycin useful for the treatment of?

A

Serious MRSA infections

33
Q

What is a positive of linezolid compaired to glycopeptides?

A

It can be given orally

34
Q

What are some agents that are only used for urinary tract infections?

A

Nalidixic acid

Nitrofurantoin

35
Q

What is nalidixic acid active against?

A

Only against gram negative aerobes (coliform) bacteria

36
Q

What is nitrofurantoin effective against?

A

Most gram negative bacteria

Some gram positive bacteria

37
Q

What are most antimicrobials associated with?

A

Adverse reactions

38
Q

What does the incidences of adverse reactions depend on?

A

Dose of therapy

Duration of therapy

39
Q

What are some different kinds of adverse reactions?

A

Allergic reaction

Immediate hypersensitivity

Delayed hypersensitivity

Gastrointestinal side effects

Thrush

Liver toxicity

Renal toxicity

Neurological toxicity

Haematological toxicity

40
Q

What is an example of immediate hypersensitivity?

A

Anaphylactic shock

41
Q

What are some common gastrointestinal side effects?

A

Nausea

Vomiting

Diarrhoea

42
Q

What is thrush?

A

Surpress normal flora in parts of the body resulting in overgrowth of resistant organisms

43
Q

What are examples of liver toxicity?

A

Transient elevators of liver enzymes

Severe hepatitis

44
Q

What is haematological toxicity?

A

Toxic effects on the bone marrow resulting in selective depression of one cell line (neutropenia) or unselective depression of all bone marrow elements (pancytopenia)

45
Q

What is neutropenia?

A

Selective depression of one cell line of bone marrow

46
Q

What is pancytopenia?

A

Unselective depression of all bone marrow elements

47
Q

How can adverse side reactions be minimised?

A

Antimicrobials should only be used when indicated and in the minimum dose and duration to achieve efficacy

48
Q

Who should adverse reactions be reported to?

A

Commitee on safety of medicines

49
Q

What has been set up on each health board to monitor antimicrobial prescribing and develop policy?

A

Antimicrobial management teams

50
Q

What are factors that should be considered when deciding which antimicrobial agents to use are?

A

Age

Renal function

Liver function

Pregnancy

51
Q

What is prophylaxis?

A

Administration of antimicrobials to prevent the future occurence of infection

52
Q

What should happen when the organism causing infection is unknown?

A

Empirical antimicrobial therapy (broad spectrum) should be commenced if urgent treatment is required

53
Q

What should we consider when deciding which drug to use?

A

Spectrum of antimicrobial agent

Monotherapy v combination

Penetration to site of infection

Monitoring

Dose and duration of therapy

54
Q

What can mixing drugs do?

A

Cover mixed infections by more than one organism

Could have enhanced effect together

Minimise the development of resistant strains

55
Q

Why is monitoring done?

A

Difference between a therapeutic and toxic dose is small in a drug with a low therapeutic index

56
Q

What are the 3 possible outcomes when we use antimicrobials in combination?

A

Anatagonistic and combined effect is less than the sum of their individual contribution

Synergistic and their combined effect is greater than the sum of their individial contribution

Their effects are addictive

57
Q

What is a cidal antibiotic (bactericidal)?

A

One that kills bacteria without reliance on the patient’s immune system to help

58
Q

What is a static antibiotic (bacteriostatic)?

A

One that prevents the organism multiplying but it is the patient’s immune system which kills off the bacteria

59
Q

What is the combination of two cidal or two static drugs?

A

Synergistic or addictive

60
Q

What is the combination of one static and one cidal drug?

A

Antagonistic

61
Q

What is the role of the laboratory, and of medical microbiologists?

A

Give advice on the choice of antimicrobial

62
Q

What are the 2 reasons for monitoring the serum levels of an antimicrobial?

A

Ensure that therapeutic levels have been achieved

Ensure that levels are not so high to be toxic

63
Q

What does the serum levels being the same as the tissue depend on?

A

Antimicrobial’s ability to penetrate

64
Q

What is serum levels?

A

Amount of medication in your blood

65
Q

What is the simplest way to measure the minimum inhibitory concentration (MIC) of an antibiotic agent?

A

E-test

66
Q

What is an E-test?

A

Commercially available paper strip which has a gradient of antibiotic concentration from the point where the organism intersects the strip

67
Q

What are methods of measuring the minimum inhibitory concentration (MIC) an an antibiotic agent other than an E-test?

A

Automated, which labs use, where growth of individual isolates are measured in the presence of different concentrations of each antibiotic and MIC is calculated

68
Q

What does in vitro laboratory test give?

A

A prediction whether the infection is likely to be cured by the antibiotic in question

69
Q

What are factors that influence the outcome of using antibiotics?

A

Route of administration

Dosing schedule

Penetration of antibiotic to target site

Interaction with other drugs

ME2019 PART 2 (45 decks)

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