Antimicrobial Chemotherapy Flashcards
(135 cards)
1
Q
An antimicrobial that kills bacteria
A
Bactericidal (e.g.Penicillin)
2
Q
An antimicrobial that inhibits growth of bacteria
A
Bacteriostatic (e.g. erythromycin)
3
Q
An organism is considered this is it is inhibited or killed by levels of antimicrobial that are available at the site of infection
A
Sensitive
4
Q
An organism is considered this if it is not killed or inhibited by levels of antimicrobial that are available at the site of infection
A
Resistant
5
Q
Minimum concentration of antimicrobial needed to inhibit visible growth of a given organism
A
Minimum Inhibitory Concentration (MIC)
6
Q
Minimum concentration of antimicrobial needed to kill a given organism
A
Minimum Bacterialcidal Concentration (MBC)
7
Q
Applied to a surface, usually skin or mucous membranes
A
Topical e.g. conjunctiva
8
Q
Taken internally, either orally or parenterally
A
Systemic
9
Q
Administered either intra-venously (IV) or intra-muscular (IM), occaisonally subcutaneously
A
Parental
10
Q
Sites of antibiotic action
A
Inhibition of cell wall
Inhibition of protein synthesis
Inhibition of nucleic acid synthesis
11
Q
Antibiotics that inhibit cell wall synthesis
A
B lactams
Glycopeptides
12
Q
B lactam antibiotics
A
Penicillin and Cephalosporin
13
Q
Mode of action of Penicillin and Cephalosporin
A
Disrupt peptidoglycan synthesis by inhibiting enzymes responsible for crosslinking
14
Q
Original naturally occurring B-lactam discovered by Fleming
A
Benzyl Penicillin (Penicillin G)
15
Q
Glycopeptide Antibiotics
A
Vancomycin
Teicoplanin
16
Q
Mode of action of Vancomycin and Teicoplanin
A
Inhibit assembly of a peptidoglycan precursor.
Only act on Gram positive- cannot penetrate gram negative cell wall
17
Q
Route of administration for Glycopeptide
A
Parentally
18
Q
Toxic Glycopeptide
A
Vancomycin
19
Q
Antibiotics that inhibit protein synthesis
A
Aminoglycosides
Macrolides and Tetracyclines
Oxazolidinones
Cyclic Lipopeptide
20
Q
Aminoglycosides antibiotic
A
Gentamicin
21
Q
Aminoglycosides mechanism
A
Inhibit protein synthesis
22
Q
Toxic Aminoglycosides
A
Gentamicin
23
Q
Macrolides and Tetracyclines
A
Erythromycin, Clarythromycin and Tetracyclines
24
Q
Glycopeptides act on _________ organism
A
Gram positive
25
Aminoglycosides used for treatment of Gram ______ organism
Negative
26
Macroslides and Tetracyclines are useful for treatment in Gram ____ infection and for people allergic to
Positive and Penicillin
27
Oxazolidinones antibiotic
Linezolid
28
Linezolid is useful for ____ infection and given ____
MRSA and orally
29
Cyclic Lipopeptide
Daptomycin
30
Antibiotics that inhibit nucleic acid synthesis
Trimethoprim & sulphamethoxazole
| Fluoroquinolones
31
Mechanism of Trimethoprim & sulphamethoxazole
Inhibit different steps in purine synthesis and combined form in the drug co-trimoxazole
32
Mechanism of Fluoroquinolones
Inhibit DNA synthesis directly in gram negative organism
33
Fluoroquinolones Antibiotics
Ciprofloxacin (orally) and Levofloxacin
34
Types of Resistance
Inherent or intrinsic
| Acquired resistance
35
All strains of a given species are naturally resistance
Inherent or intrinsic
36
Resistance present in some strains of the species but not in others
Acquired
37
Acquired resistance can be acquired through_____ and _____
A spontaneous mutation during DNA multiplication and genes that code for resistance are spread via plasmids or on transposons due to selective pressure
38
Two mechanisms for B-lactam resistance
B-lactamase production and alteration of penicillin binding protein (PBP) target site
39
Co-amoxixlav (Penicillin)
Amoxicillin +Clavulanic acid
40
Clavulanic acid
B-lactamase inhibitor
41
Flucloxacillin (Penicillin)
Modification of antibiotc side chain to produce an antibiotic which is resistant to B-lactamase
42
Microbial that can break down third generation cephalosporin and penicillins
ESBL (Extended spectrum B-lactamases)
43
A group of extremely resistant Gram negative organism resistant to carbapenems
Carbapenemase Producing Enetrobacteriaceae
44
Organism that alters PBP
MRSA
45
Vancomycin resistance is unusual in ________
Gram positive organism
46
Two mechanisms of antibiotic resistance
Inactivation of antibiotic and alteration of target site of antibiotic
47
Penicillins
```
Penicillin G
Amoxicillin
Ampicillin
Co-amoxiclav
Flucloxacillin
Piperacillin
Imipenem
Meropenum
```
48
IV treatment for pneumococcal, meningococcal and strep pyogenes (Group A) infection
Benzyl penicillin (Penicillin G) oral
49
Amoxicillin and Ampicillin
Streptococci and coliforms infection
50
Flucloxacillin
Staphylococcal infection
51
Has extended spectrum and is active against Pseudomonas species
Piperacillin (used with tazobactam)
52
Carbapenems with widest spectrum
Imipenem, meropenem
53
Encourage Clostridium difficile
Cephalosporins
54
Only third generation that has action against a pseudomonas species
Ceftriaxone (cephalosporins)
55
Used against gram negative organisms such as pseudomonas
Gentamicin
56
Used against gram positive, both aerobic and anaerobic
Vancomycin and Teicoplanin
57
Mainly against gram positive organism and used as an alternative to penicillin
Clarithromycin and Erythromycin
58
Used against atypical pneumonia (chlamydia psittacci, coxiella burnetti, mycoplasma pneumonia and legionella pneumophilia)
Clarithromycin and Erythromycin
59
Chlamydia treatment
Azithroymycin
60
Pseudomonas infection (ciprofloxacin) and pneumococci (levofloxacin)
Quinolones
61
Metronidazole
effective against anaerobes
62
Fusidic acid
anti-staphylococcal drug
63
Trimethoprim
Urinary infection and chest infections
64
Tetracyclines
Genital tract (chlamydia) and respiratory tract infection. Not given to pregnant women and children under 12 as it is deposited in teeth and bone
65
Clindamycin
Good at tissue penetration, taken orally and used against gram positive organism (staph and strept)
66
Linezolid
MRSA
67
Daptomycin
Gram positive orgamism (serious MRSA)
68
Fidaxomicin
bactericidal against C.difficle
69
Urinary tract agents (gram negative aerobes)
Nalidixic acid
70
Urinary tract agents with exception of proteus and psuedomonas
Nitrofurantoin
71
Allergic Reaction
Immediate
Delayed
Gastrointestinal
72
Immediate Hypersensitivity allergic reaction
IgE mediated within minutes of administration
73
Delayed Hypersensitivity allergic reaction
Can take hours or days e.g. Steven's-Johnson syndrome
74
Gastrointestinal Side effects
C. difficile:
Diarrhoea
Pseudomonas colitis
75
CDI treatment from overuse of broad spectrum antibiotics
oral metranidazole or oral vancomycin
76
Therapy with broad spectrum penicillins and cephalosporins lead to overgrowth of the yeast Candida albicans
Thrush
77
Tetracycline and anti-tuberculosis drugs isoniazid and rifampicin
Liver toxicity
78
Aminoglycoside (gentamicin) or vancomycin side effect
Renal Toxicity
79
Ototoxicity (side effect)
Aminoglycoside or vancomycin use
80
Optic Neuropathy (side effect)
Ethambutol (anti-tuberculosis drug)
81
Encephalopathy and convulsions (side effect)
High dose of penicillin and cephalosporin
82
Peripheral Neuropathy (side effect)
Metronidazole and nitrofurantoin
83
Haematological toxicity (side effect)
```
Co-trimoxazole
Anti-virals:
Zidovudine (HIV)
Ganciclovir (CMV)
Linezoilid
```
84
Prevention of Adverse Reactions
Used only when indicated and in the minimum dose to achieve efficacy
85
Patient characteristics
Age, Renal, Liver function and pregnancy
86
Indications for Antimicrobials
Prophylaxis and Therapy
87
Combination Therapy
Cover mixed infection
Synergy
Minimise the development of resistance strains
88
Outcomes of combination therapy
Additive
Antagonistic
Synergistic
89
Combination of two cidal drugs
additive or synergistic
90
Combination of two static drugs
additive or synergistic
91
Combination of one static and one cidal
anatagonism
92
Macolides are Bacterio______
static
93
Standard course of treatment
7 days
94
Course for IV therapy for staph.aureus infection
14 days
95
Two main reasons for monitoring serum levels
Ensure therapeutic levels are being achieved
| Ensure levels are not so high to be toxic
96
Antibiotics most commonly measured
Gentamicin and Vancomycin
97
How is Vancomycin measured
Measure trough level
98
Types of susceptibility testing
Automated methods
| E test
99
Automated susceptibility methods
MIC that determine whether an organism is sensitive or resistant
100
Simplest way to measure MIC using a paper test strip with gradient of antibiotic concentration
E test
101
Anti-Fungal Drugs
Polyenes
Azoles
Allylamines
Echinocandins
102
Antifungal drugs that bind to ergosterol in fungal cell wall and increase permeability
Polyenes
103
Polyenes
```
Amphotericin B (IV)
Nyastatin
```
104
Fungal skin infections, pessaries for vaginal thrush and oesophageal candidiasis
Nyastatin
105
Inhibit ergosterol synthesis
Azoles
106
Azoles
Fluconazole
Voriconazole
Itraconazole
107
Used to treat yeast (not filamentous) infection
Fluconazole
108
Not all yeast are sensitive to ______
Fluconazole
109
Aspergillosis
Voriconazole and itraconazole
110
Supress ergosterol synthesis, but act at a different stage of the synthetic pathway of azoles
Allylamines
111
Allylamines
Terbinafine
112
Fungal infection of skin and nails
Terbinafine
113
Inhibit synthesis of glucan polysaccharide in several types of fungi
Echinocandins
114
Used for seriious candida and Aspergillus infections
Echinocandins
115
Echinocandins
Caspofungin, myafungin and Anidulafungin
116
Types of Anti-Viral Drugs
Anti-Herpes
Anti-HIV
Drugs for Chronic Hep B and C
117
Active against Herepes Simplex and Varicella zoster virus
Aciclovir
118
Nucleoside analogue
Aciclovir
119
used for HSV and shingles with better bioavailability than Aciclovir
Famciclovir
120
Nucloside analogue used to treat CMV
Ganciclovir
121
Highly nephrotoxic, given IV and is used to treat HSV, VZV and CMV
Foscarnet
122
Types of anti-HIV drugs
Zidovudine (AZT, ZDV)
Nevirapine, Efavirenz
Saquinavir, Darunavir
123
Nucleoside analogue that interferes with the action of reverse transcriptase
Zidovudine (AZT, ZDV)
124
Non-nucleoside reverse transcriptase inhibitors
Nevirapine, Efavirenz
125
Protease Inhibitor that inhibits viral protease enzymes
Saquinavir, Darunavir
126
Used to treat selected chronic Hep B and C infection
IFN-alpha
127
Subcutaneous injection of IFN-alpha and _____ is a common treatment for
Ribavarin and Hep C
128
Mainly used for HIV treatment but can be used for Hep B. Given orally
Lamivudine
129
Treatment for influenza A and B within 48 hours of symptoms of post exposure prophylaxis
Zanamavir and Oseltamivir
130
Nucleoside analogue Used for treatment of Respiratory Synctial Virus infections
Ribavarin (inhaled in fine spray)
131
Pseudomembranous colitis usually results from Vancomycin (True/False)
False - caused by antibiotic therapy and treated with oral vancomycin or metronidazole
132
Thrush is due to overgrowth of anaerobic bacteria during broad spectrum antibiotic therapy (True/False)
False- broad spectrum antibiotic causes the overgrowth of the yeast Candida albicans
133
Vancomycin and Tecoplanin are Glycopeptides suitable to treat gram positive organisms such as _____
MRSA
134
Penicillin allergic patients may also be allergic to cephalosporins (True or False)
True
135
What type and names are the drugs combines to make co-trimaxazole
Trimethoprim and Sulphamethoxazole
| Inhibition of DNA synthesis
