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Yr3 CSP > Antimicrobial Drugs, September 7th > Flashcards

Antimicrobial Drugs, September 7th Flashcards

1
Q

What are the main Classes of Cephalosporins and how do we distinguish them by name?

A 
Class 1 have PHA/FA in their names
Class 2 are random
Class 3 contain ONE/TEN/IME at the ends
Class 4 contain PI in it
Class 5 contain ROL in it

The classes become more capable of dealing with Gram Negative Bacteria as they develop

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2
Q

Which agent that inhibits Protein Synthesis is Bactericidal?

A

Aminoglycosides

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3
Q

Give two examples of Aminoglycosides

A

Gentamicin and Amikacin

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4
Q

Give three examples of Macrolides

A

Azithromycin, Clarithromycin, Erythromycin

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5
Q

What is the Mechanism of Action of Aminoglycosides

A

Acts upon the 30S subunit on the ribosomes

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6
Q

What bacteria can Aminoglycosides affect?

A

Gram (+) (Staph) and Gram (-); Anti-pseudomonal

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7
Q

How are Aminoglycosides administered and what is the dosage?

A

IV Once a Day or TDS/BD (2/3)

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8
Q

What are the main side effects of Aminoglycosides

A
  1. Nephrotoxicity (Reversible)
  2. Ototoxicity (Vestibular is Reversible, Auditory not)
  3. NMJ Blockage at high dose
  4. Damages Eighth Nerve in Pregnancy
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9
Q

What are the main interactions of Aminoglycosides

A

Increased Nephrotoxicity with:

  1. Vancomycin
  2. Colistin (Polymyxin)
  3. Ambisome (Antifungal)
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10
Q

What is the Mechanism of Action of Macrolides

A

Acts upon the 50S subunit on the ribosomes

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11
Q

What bacteria can Macrolides affect?

A

Gram (+) and usually H.influenzae

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12
Q

How are Macrolides administered and what is the dosage

A

Oral and IV (Can cause Thromboplebitis)

Once or Twice a Day

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13
Q

Which Macrolide has shown excellent intracellular penetration

A

Azithromycin

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14
Q

What are the main side effects in Macrolides

A

Though safe in Children, it can:

  1. Erythromycin Inhibits P450
  2. Prolong QT
  3. Nausea and Vomiting
  4. Abdominal Pain
  5. Liver toxicity
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15
Q

Which bacteria are known to cause resistance in Aminoglycosides

A

Gram Negative Organisms (Acquired)

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16
Q

Which bacteria are known to cause resistance in Macrolides

A

Both Staphs and Streps

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17
Q

What drugs can affect Nucleic Acid Metabolism

A
  1. Quinolones (Ciprofloxacin Moxifloxacin, Levofloxacin)
  2. Rifampicin
  3. Metronidazole (Good against most Anaerobes)
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18
Q

What is the Mechanism of Quinolones

A

Inhibits DNA Gyrase and kills Bacteria

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19
Q

What types of Bacteria do Quinolones affect?

A

Gram + : Staph, not Streps

Gram - : Anti-pseudomonal too

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20
Q

How are Quinolones administered and what is the dosage?

A

Oral and IV

Twice a Day

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21
Q

What are the main side effects of Quinolones?

A
  1. Ruptures Tendons
  2. Photosensitivity
  3. Seizures and Prolonged QT
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22
Q

Human cells are known to not synthesise _____ and will lack _____?

A

Folic Acid

Lack Dihydropteroate Synthase

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23
Q

What are examples of Antifolates?

A

Sulphonamides

Trimethoprim

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24
Q

What is the mechanism of action of Sulphonamides?

A

Inhibiting Dihydropteroate Synthase

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25
Q

What is the mechanism of action of Trimethoprim?

A

Inhibiting Dihydrofolate Reductase

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26
Q

What types of drugs can affect the Membranes of Bacteria?

A
  1. Colistin (Polymyxin)
  2. Amphotericin (Antifungals)
  3. Daptomycin
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27
Q

What are qualities required for the IDEAL antibiotic?

A
  1. Magic Bullet (Selectively kills MO without harming body/microbiome)
  2. Reach and Concentrates within the Target Organ
  3. Reach good levels in Infected Body Fluids
  4. Non-Toxic
  5. Cheap
  6. No selection of resistance
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28
Q

Which antibiotics have the greatest influence throughout the Antimicrobial Spectrum?

A

Meropenem and Imipenem have the greatest, affecting both Gram Positive and Negative Bacteria

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29
Q

Which Antibiotics in the Antimicrobial Spectrum can only affect Gram Positive Bacteria?

A

Benzyl Penicillin
Flucloxacillin
Vancomycin/Teicoplanin (Glycopeptides)

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30
Q

What are the main infection issues with Antimicrobial Resistance?

A
  1. UTI
  2. RTI
  3. N. gonorrhoea
  4. M. tuberculosis
  5. Diarrhoea
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31
Q

What are the main reasons for Antimicrobial resistance in regards to specific drugs and bacteria?

A
  1. Multidrug Resistance
  2. Penicillin Resistance
  3. Beta-lactamase producing Coliforms
  4. Resistant Pneumococci and H.influenzae
  5. Resistant Salmonella and Shingles
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32
Q

What are some of the most dangerous resistant bacteria in Hospitals?

A
  1. MRSA
  2. Coagulase-Negative Staph
  3. Multi-resistant Enterococci
  4. Multi-resistant Gram Negative Rods
    a. Pseudomonas, Klebsiella, Enterobacter, Acinetobacter
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33
Q

What is the difference between Synergistic and Antagonistic Combinations?

A

Synergistic: Combined activity > Sum of individual (Beta Lactam + Aminoglycoside)

Antagonistic: Activity of 1 drug is compromised by the other (Tetracylcine/Chloramphenicol with Beta-Lactam or Aminoglycoside, or Two Beta Lactams)

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34
Q

Which types of Drugs are mostly ANTI-GRAM Positive?

A
  1. Penicillins
  2. Fusidic Acid
  3. Macrolides
  4. Clindamycin
  5. Glycopeptides
  6. Oxazolidinones
  7. Daptomycin
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35
Q

Which types of Drugs are mostly ANTI-GRAM Negative?

A
  1. Trimethoprim
  2. Polymyxin (Colistin)
  3. Monobactams (Aztreonam)
  4. Aminoglycosides (Good against Strep, Staph, Enterococci too)
  5. Temocillin
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36
Q

What Drugs are Broad Spectrum Antimicrobials?

A

Beta Lactams

  1. Carbapenems
  2. Amoxicillin/Clavulanate
  3. Piperacilin/Tazobactam
  4. Cephalosporins
  5. Chloramphenicol
  6. Tetracycline (Spirochaetes)

(These two can deal with +/-/Atypicals/Anaerobes)

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37
Q

Which Drugs act upon the Cell Wall?

A

Beta Lactams

  1. Penicillin
  2. Cephalosporins
  3. Carbapenems
  4. Aztreonam

Glycopeptides

  1. Vancomycin
  2. Teicoplanin
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38
Q

Which Drugs act upon the Cell Membrane?

A

Polymyxin

39
Q

Which drugs affect Nucleic Acid Synthesis?

A
  1. Quinolones (DNA Gyrase)
  2. Rifampin (RNAP)
  3. Metronidazole (Anaerobic DNA inhibitors)
  4. Antifolates (Trimethoprim, Sulfonamides)
40
Q

What bacteria can Penicillin affect?

A

Gram +

41
Q

What is the route and dosage of Penicillin?

A

Oral/IV

4-6 Times a Day

42
Q

What is the Mechanism of Action of Penicillin?

A

Inhibits CW Synthesis

43
Q

What the main side effects of Penicillin?

A

Allergies
Resistance (Beta Lactamases)
Cross Hyper-sensitivity

44
Q

How do bacteria gain resistance from Penicillin?

A

Alteration of PBPs

Production of Beta Lactamases

45
Q

What Drugs can Penicillin interact with?

A

Allopurinol

Methotrexate

46
Q

What bacteria can Amoxicillin affect?

A

Gram + and -

47
Q

What is the route and dosage of Amoxicillin?

A

Oral/IV

3 Times a day

48
Q

When do we administer Penicillin?

A

Streptococcal and Meningococcal Disease

49
Q

When do we administer Amoxicillin?

A

Streptococcal except sore throat

Listeria

50
Q

What drugs can Amoxicillin interact with?

A

Allopurinol (Rash)

Can cause Antibiotic-Associated Diarrhoea

51
Q

What is the MOA of Flucloxacillin?

A

Inhibition of the Cell Wall synthesis

52
Q

What bacteria can Flucloxacillin kill?

A

Gram + only

53
Q

What is the dosage and route of administration of Flucloxacillin?

A

Oral/IV

4 times a day

54
Q

When do we give Flucloxacillin?

A

All S.aureus infections except MRSA

55
Q

What drugs can Flucloxacillin interact with?

A

Not many

56
Q

What is Co-Amoxiclav’s MOA and what are the Two drugs?

A

Inhibition of CW Synthesis and Beta-Lactamase Inhibitor

Amoxicillin and Clavulanic Acid

57
Q

What bacteria can Co-Amoxiclav kill?

A

Gram +
Gram -
Anti-Anaerobic

58
Q

What is the dosage and route of administration of Co-amoxiclav?

A

Oral/IV

3 times a day

59
Q

What resists Co-amoxiclav?

A

MRSA

Hospital Acquired Gram - (Pseudomonas)

60
Q

When do we administer Co-amoxiclav?

A

Polymicrobial infections

B-lactamase producing Gram +/- infections

61
Q

What is the Mechanism of Action of Piptazobactam and what are the two drugs that make it up?

A

Inhibition of CW Synthesis and Beta-Lactamase Inhibitor

Piperacillin and Tazobactam

62
Q

What types of drugs do Piptazobactam kill?

A

Gram +
Gram -
Anti-anaerobes
Anti-PSEUDOMONAL

63
Q

What is the route of Administration and Dosage of Piptazobactam?

A

IV

3-4 times a day

64
Q

What is Piptazobactam resistant to?

A

MRSA

Hospital Acquired Gram - (Pseudomonas)

65
Q

When do we administer Piptazobactam

A

Polymicrobial infections
B-lactamase producing Gram +/- infections
PSEUDOMONAS

66
Q

What is the MOA of Cefuroxime and what Class is it?

A

Inhibits CW synthesis

Class 3

67
Q

What types of bacteria does Cefuroxime kill?

A

Gram +
Gram -
NOT PSEUDOMONAS

68
Q

What is the route of administration and dosage of Cefuroxime

A

IV

3 times a day

69
Q

What is Cefuroxime resistant against?

A

MRSA

Gram -

70
Q

When would we give Cefuroxime?

A

Pneumonia

Intra-abdominal and UT infections (Add Metronidazole for ab)

71
Q

Why do bacteria resist Cefuroxime?

A

Production of ESBL
Impermeability
Altered PBPs
Efflux

72
Q

What is the MOA of Ceftriaxone and what Class is it?

A

Inhibits CW synthesis

Class 3

73
Q

What types of bacteria does Ceftriaxone kill?

A

Gram +
Gram -
NOT PSEUDOMONAS

74
Q

What is the route of administration and dosage of Ceftriaxone

A

IV

1 or 2 times a day

75
Q

What are the side effects of Cefuroxime?

A

C.diff

Diarrhoea

76
Q

What are the side effects of Ceftriaxone?

A

C.diff
Diarrhoea
Pseudocholelithiasis (Drug complexes with calcium and mimics gallstones)

77
Q

Which drug can cause Pseudocholelithiasis

A

Ceftriaxone

78
Q

When would we give Ceftriaxone?

A

Meningitis
Pneumonia
Sometimes Gonorrhea

79
Q

Which Cephalosporin is capable of dealing with Pseudomonas aeruginosa?

A

Ceftazidime

80
Q

What types of bacteria does Ceftazidime kill?

A

Gram +
Gram -
YES PSEUDOMONAS

81
Q

What is the route of administration and dosage of Ceftazidime?

A

IV

3 times a day

82
Q

What is the MOA of Meropenem?

A

Inhibits CWS

Beta Lactamase Inhibitor AND ESBLs

83
Q

What bacteria can Meropenem kill?

A

Gram +
Gram -
Anti-anaerobic actions
Anti-pseudomonal

84
Q

What is the route of administration and dosage of Meropenem?

A

IV

3 times a day

85
Q

When would we prescribe Meropenem?

A

Polymicrobial infections

ESBL producing Gram - infections

86
Q

What is the difference between Antibiotics and Antimicrobials?

A

Antibiotics: Naturally made by MOs

  • Fungal (Penicillin/Cephalosporins)
  • Actinomycetes (Streptomycin)

Antimicrobials: Semi-synthetic to stop MO growth

  • Sulphonamides
  • Ampicillin
  • Quinolones
87
Q

Why do bacteria resist Meropenem?

A

Metallo-B-Lactamase
Impermeability
Efflux
Altered PBP

88
Q

What is the Mechanism of action of Glycopeptides?

A

Acts on the Cell Wall?

89
Q

Give Two Examples of Glycopeptides

A

Vancomycin and Teicoplanin

90
Q

What bacteria do glycopeptides kill?

A

Gram +

Anaerobic C.diff

91
Q

What is the dosage and route of Glycopeptides?

A

IV

1-2 times a day

92
Q

What are the side effects of Vancomycin?

A

Nephrotoxicity

Red Man Syndrome

93
Q

What types of Bacteria can Cephalosporins NOT deal with?

A

Enterococci

Yr3 CSP (4 decks)

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