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Pharmacology > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

What is selective toxicity

A

Ability of a drug to target cell or organism without injuring other cells

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2
Q

What do medications target in bacteria?

A

The bacterial cell wall

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3
Q

Narrow spectrum

A

Active against only a few species of microorganisms-preferred

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4
Q

Broad spectrum

A

Active against a wide variety of microorganisms species

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5
Q

What is resistance to antimicrobial drugs?

A

Reduction of drug concentration at its site of action

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6
Q

What does NDM1 gene do?

A

Gene code for powerful beta lactamase
Adds resistance
Gives drugs efflux pumps

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7
Q

How does bacteria gain resistance?

A

Spontaneous mutation
Genetic material is transferred through conjugation

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8
Q

What happens when you take too many antibiotics?

A

Antibiotics promote the emergence of drug resistant microbes

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9
Q

Characteristics of microbes

A

Secrete compounds that are toxic to other microbes
Compete with each other for nutrients
Some will gain drug resistance

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10
Q

Which promotes higher chance of resistance? broad or narrow

A

Broad

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11
Q

What is a superinfection

A

Infection that appears during course of treatment

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12
Q

Why get a culture?

A

To identify organism and its sensitivity?

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13
Q

What happens if antibiotics are discontinued prematurely?

A

Recurring infection and might become resistant

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14
Q

Reasons for combining Antimicrobials

A

Advantages
For severe infection.
Enhanced antibacterial action
Disadvantages
Increase risk of toxicity
Increased risk of superinfection
Increased risk of resistance

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15
Q

Prophylactic antibiotics

A

Should be given before surgery or dental procedures

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16
Q

Improper dosage

A

Too low
Adverse effects without killing bacteria
Too high
Increased risk of superinfection and adverse effects

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17
Q

Omission of surgical drainage

A

Foreign material, necrotic tissue, exudate/abscess is surgically removed for optimal antimicrobial effect

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18
Q

Penicillin

A

MOA- weaken the cell wall, cause bacteria wall to swell and rupture
Target pbp when cell is growing or dividing

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19
Q

Bacterial resistance

A

Inability of penicillins to reach target
Inactivation of penicillins by bacterial enzymes
Production pbps that have low affinity for penicillins

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20
Q

Penicillinase

A

Cleave beta lactam ring
In gram positive and negative bacteria
Negative secrete more in surrounding area
Positive in periplasmic area

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21
Q

MRSA colonists what?

A

Skin and nostrils of most people

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22
Q

What is MRSA resistant to?

A

All penicillins and cephalosporins

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23
Q

What are the two strains of MRSA

A

Health care associated
Community associated

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24
Q

Mechanism of MRSA

A

Mrsa makes low affinity pbps to beta lactam antibiotics

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25
Q

Chemistry of antibiotics

A

All abx have beta lactam ring
Affinity
Penetrate negative cell
Resistance to stomach acid

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26
Q

Penicillin G

A

Narrow spectrum
Effective form most gram positive and some gram negative(most are resistant)
AE: allergy or anaphylaxis
IM and IV
High risk of toxicity

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27
Q

Penicillinase resistant penicillin’s

A

Resistant to beta lactamase
Nafcillin, oxacillin, dicloxacillin
Narrow spectrum

28
Q

Broad spectrum penicillins (aminopenicillins)

A

Ampicillin and amoxicillin
Same spectrum as penicillin G, increased against gram negative bacilli
SE; diarrhea, rash

29
Q

Extended spectrum penicillins (antipseudomonal penicillins)

A

Ticarcillin and piperacillin
Same as aminopenicillins plus pseudomonas aeruginosa
Ineffective against beta lactamase producing staph

30
Q

Beta lactamase inhibitors

A

Inhibit beta lactamase
Combines with penicillins can extend spectrum

31
Q

Unasyn

A

Ampicillin and sulbactam

32
Q

Augmentin

A

Amoxicillin and clavulanate

33
Q

Timentin

A

Ticarcillin and clavulanate

34
Q

Zosyn

A

Piperacillin and tazobactam

35
Q

Penicillin allergy

A

Previous exposure required
Cross allergy
Don’t take cephalosporins if anaphylaxis reaction occurred

36
Q

Cephalosporins

A

Like penicillins contains beta lactam ring, bactericidal
Also has inactivation by beta lactamase of cephalosporins

37
Q

First to fifth generation

A

Increased against negative gram
Can reach csf
Increased resistance to destruction

38
Q

Fifth generation cephalosporin

A

Ceftaroline only active against mrsa
Gen 3 and up get into csf

39
Q

Cephalosporins adverse effect

A

Mild reactions like rashes
Anaphylaxis
Bleeding
Hemolytic anemia
Don’t take with alcohol or calcium

40
Q

Carbapenems

A

Beta lactam abx with the largest spectrum
Good for mixed but not effective Against MRSA

41
Q

Imepenem (primaxin)

A

Combined with cilastatin- inhibits inactivation
Resistant to nearly all beta lactamases
Can penetrate gram negative
Given IV
Adverse effects GI diarrhea N/V superinfection in 4%

42
Q

Vancomycin

A

Used for c diff, mrsa serious infections in those with pcn allergies
Inhibits cell wall synthesis
Adverse effects renal toxicity peaks and trough

43
Q

Tetracyclines

A

Broad spectrum
MOA- binds 30s ribosomal subunit, inhibits transfer of RNA, preventing protein synthesis
Uses-chlamydia, cholera, mycoplasma pneumoniae
Adverse effects- irritation to GI tract, cramping diarrhea, givings meals decreases adverse and absorption
Causes bone suppression and teeth discoloration

44
Q

Tetracyclines- tigecycline (tygacil)

A

Effective against bacteria with NDM 1
Broad spectrum, little drug resistance but not as effective
Adverse effects- irritation to GI

45
Q

Macrolides

A

Broad spectrum; large molecules

46
Q

Erythromycin

A

MOA- binds to 50s ribosomal subunit and blocks amino acids from chain
Resistance mechanisms- production of pump that excretes drug out
Spectrum same as pcn but more effective against gram positive and negative
Adverse effects GI, give with meals to reduce AE
Qt prolongation

47
Q

Clindamycin (cleocin)

A

Used for c diff

48
Q

Linezolid (zyvox)

A

MOA binds to 23s portion of ribosomes subunit and blocks formation of initiation
Uses active against VRE and MRSA
Adverse effects HA N/V
CBC weekly rare neuropathy

49
Q

Aminoglycosides

A

MOA bind to 30s ribosomal subunit causing
Blockade of initiation
Premature termination
Misread of RNA

50
Q

Gentamycin

A

Preferred Aminoglycosides
Resistance- bacteria makes enzymes that inhibit Aminoglycosides
Spectrum-limited to aerobic gram negative bacilli Ecoli
Adverse effects- ototoxicity, can lead to hearing impairment

51
Q

Sulfonamides

A

MOA suppress bacterial growth by inhibiting folic acid
Uses for UTI
Adverse effects- hypersensitivity, Steven Johnson, hemolytic anemia
Kernicterus- deposition of billirubin in brain
Renal damage via crystalluria

52
Q

Trimethoprim

A

MOA- suppress bacterial growth by inhibiting folic acid
Uses- UTI
Adverse effects- rare hematologic effects, hyperkalemia, birth defects

53
Q

Bactrim

A

Trimethoprim/sulfamethoxazole
MOA, inhibits folic acid synthesis
Uses - uti, pneumocystis pneumonia
Adverse effects hematologic, hyperkalemia, kernicterus, crystalluria hypersensitive
Patients with aids susceptible

54
Q

Polymixins- colistin

A

Being used for NMD 1
MOA- binds to lipopolysaccharides and phospholipids in outer cell membrane
Side effects- nephrotoxicity, neurotoxicity, dizziness paresthesias, vertigo, confusion

55
Q

Fluoroquinolones- ciprofloxacin(cipro)

A

MOA-inhibits two bacterial enzymes needed for DNA replication an cell division
Uses- infection in respiratory, urinary, GI tracts
Adverse effects- mostly mild GI, CNS, Candida infection of a vaginal
Long term neurologic deficits
Risk of photo toxicity

56
Q

Metronidazole (flagyl)

A

MOA causes DNA breakdown and cell death
Uses: obligate anaerobes and protocol infection, C. difficile
Cannot have with alcohol

57
Q

Amikacin

A

Reserved for infections that don’t respond to Aminoglycosides

58
Q

Amphotericin B (abelcet, amphotec)

A

MOA- binds to fungal cell wall, increasing permeability, Bacterial cells not affected, can weakly bind to mammalian cells
Uses- systemic mycoses,
Adverse effect- infusion reaction, fever chills
Nephrotoxicity- observe k
Hematologic- bone marrow suppression

59
Q

Azoles

A

Less toxic but inhibit drug interactions

60
Q

Itraconazole(sporanox)

A

Less toxic than Amphotericin
MOA- inhibits synthesis of ergosterol, fungal growth cancelled
Adverse effects, GI, cardiac suppression
Increases levels of other drugs

61
Q

Superficial mycoses

A

Candida and dermatophytes
Ring worm
Vaginal or oral

62
Q

Onychomycosis

A

Fungal infection of nail
Treatment topical

63
Q

Clotrimazole(gyne-lotrimin)

A

Uses- skin mouth vagina
Adverse effects, stinging, erythema, edema, urticaria, pruritus

64
Q

Influenza

A

Respiratory tract infection
Influenza A(96) and B(4)
Spread by aerosolized droplets
Symptoms begins 2-4 days after exposure, lasts 5-6 days. Fever cough sore throat

65
Q

Influenza vaccine

A

IM and intradermal
Lasts 6 months
Febrile; those allergic to eggs

66
Q

Oseltamivir(tamiflu)

A

Prevention and treatment of influenza
Can reduce complications
MOA- inhibit neuramidase
Adverse effects, take with food to minimize GI symptoms
Rare, hypersensitive

67
Q

Ivermectin

A

Treats onchocerciasis and intestinal strongyloidiasis
Side effects N/V, allegic

Pharmacology (4 decks)

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