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YEAR 2 > Antimicrobials > Flashcards

Antimicrobials Flashcards

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1
Q

Which 4 drug groups belong to the class of beta lactams?

A

Penicillins
Cephalosporins
Carbapenems
Monobactam

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2
Q

Are drugs that target the cell wall bactericidal or bacteriostatic?

A

Bactericidal

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3
Q

Name drug groups that target the cell wall?

A

Penicillins
Cephalosporins
Carbapenems
Monobactam

Glycopeptides
Fosfomycin
Bacitracin

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4
Q

How do beta-lactams work?

A

Beta lactams bind to PBP (protein binding penicillin), a transpeptidase

PBP inhibited from cross-linking the pentapeptides = instability

Activation of autolytic pathways to cleave crosslinking

Water leaks in = cell death

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5
Q

Which drug class would cause a rash in somebody with glandular fever?

A

Penicillins
Notably ampicillin and amoxicillin

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6
Q

Which beta-lactams are not sensitive to beta-lactamases?

A

Carbapenems
Monobactams
Co-amoxiclav
Tazocin

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7
Q

What are 4 mechanisms of resistance against beta-lactams

A

Hyperproduction of existing PBP (induce saturation of abx)

Mutation of PBP to produce a new PBP with a different active site

Production of beta-lactamases to inactivate beta-lactams

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8
Q

What are 2 beta-lactamase inhibitors?

A

Clavulanic avid
(added to amoxicillin = co-amoxiclav)
(added to ticarcillin = timentin)

Tazobactam
(added to piperacillin = tazocin)

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9
Q

What is a notable side effect of carbapenems?

A

Reduces seizure threshold

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10
Q

What are side effects of vancomycin?

A

Nephrotoxic
Ototoxic
Red man syndrome
Neutropenia
Hypotension
Steven-Johnson Syndrome

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11
Q

What other drugs should not be given in a severe penicillin allergy?

A

Cephalosporins
Carbapenems

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12
Q

How do glycopeptides destroy the cell wall?

A

Binds to 2-d-alanine in the pentapeptide
This blocks the formation of cross-linking between the amino acids and peptide bonds between the peptidoglycan chains

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13
Q

How does fosfomycin destroy the cell wall?

A

Irrevseribly inhibits an enzyme that is required in the first step of cell wall synthesis

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14
Q

How does bacitracin destroy the cell wall?

A

Prevents dephosphorylation of transport proteins which inhibits cell wall synthesis

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15
Q

How did MRSA come about?

A

Mutation in cell wall genes of bacteria = new PBP produced - different active site - penicillins no longer fit in the target

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16
Q

What are 2 enzymes beta-lactamases can produce?

A

ESBL
CPE

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17
Q

How do bacteria mediate resistance against glycopeptides?

A

Mediated by transposons = alterations in peptide chains = reduced affinity to glycopeptides

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18
Q

Which penicillin has activity against pseudomonas?

A

Piperacillin
(+Tazobactam = tazocin)

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19
Q

What is vancomycin against?

A

MRSA
C.diff
Gram + -> staph, strep, bacillus

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20
Q

How do polymyxins work and what is it active against?

A

Active against gram negative bacteria - outer membrane

Bind to LPS in the membrane - act as a detergent to disrupt the membrane = cellular permeability and demise

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21
Q

What antibiotics are used against the cell membrane and are they bactericidal or static?

A

Polymyxins - gram negative
Daptomycin - gram positive

Bactericidal

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22
Q

How does daptomycin disrupt the cell membrane and what is it active against?

A

Combines with calcium to form complex
Complex inserts in to cell membrane
Forms pore like structures
Allows potassium to leak out = cell death

Active against gram positive - inner membrane

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23
Q

Which drugs work against the cell membranes?

A

Polymyxins
Daptomycin

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24
Q

How does polymyxin work?

Study These Flashcards
A

Binds to LPS in the membrane acting as a detergent to cause structural changes = cellular permeability

25
What is polymyxin active against?
Gram negative - outer membrane
26
What is daptomycin active against?
Gram positive - inner membrane
27
How does daptomycin work?
Forms complex with calcium which facilitates the insertion into cell membrane - pore like structures in the membrane - potassium leaks out = cell death
28
What is a side effect of daptomycin?
Skeletal muscle toxicity - rhabdomyolysis
29
Which drugs inhibit enzymes in the folate synthesis pathway?
Sulphonamides Trimethoprim Reduced production of purines and pyrimidines - reduce growth - bacteriostatic
30
What are side effects of fluoroquinoloes?
Tendon damage or rupture Reduce seizure threshold Aortic aneurysm and dissection
31
What is the action of fluoroquinolones?
Stimulate the cutting part of DNA gyrase(relaxes the supercoil) but inhibits the ligase domain that repairs it together
32
What is the action of metronidazole and nitrofurantoin?
Bind to nitroreductase which produces active metabolites of the drug and free radicals - this damages helical structure of DNA, RNA, the cell = cell death
33
Which antibiotics work against the 50S subunit of ribosomes?
Macrolides Chloramphenicol Bacteriostatic
34
Which antibiotics work against the 30S subunit of ribosomes?
Aminoglycosides Tetracyclines
35
Are aminoglycosides bacteriostatic or cidal?
Bactericidal
36
Are tetracyclines bacteriostatic or cidal?
bacteriostatic
37
Which abx are nephrotoxic and ototoxic?
Aminoglycosides Vancomycin
38
What are side effects of tetracyclines?
Photosensitivity GI disturbance Discolouration of teeth and bone deformation (high affinity for calcium so accumulate in the bone)
39
What are side effects of chloramphenicol?
Grey baby syndrome Aplastic anaemia
40
What are side effects of macrolides?
QT prolongation Cholestatic hepatitis Eosinophilia Rash GI dysfunction
41
Which abx can affect QT prolongation?
Macrolides Fluoroquinolones
42
Which abx can give a false Coombs test?
Penicillin Cephalosporin
43
Which abx can cause haemolytic anaemia in those with G6PD deficiency?
Nitrofurantoin Fluoroquinolones
44
Which abx should be avoided in pregnancy?
Fluoroquinolones Sulphonamides Tetracycles Trimethoprim Chloramphenicol
45
Which abx after bactericidal?
Beta Lactams Aminoglycosides Glycopeptides Polymyxin Daptomycin Fluoroquinolones Nitrofurantoin Metronidazole
46
Which abx after bacteriostatic?
Chloramphenicol Macrolides Sulphonamides Tetracyclines Trimethoprim
47
Which abx can cross the BBB?
IV ceftriaxone IV vancomycin IV meropenem IV Penicillin G
48
Which abx are used in respiratory?
Clarithromycin Levofloxacin Amoxicillin Vancomycin Ceftriaxone Tazocin Co-trimoxazole
49
What bacteria dominates skin?
Gram positive Staph, strep
50
Which bacteria dominates UTIs?
Gram negative E coli
51
Which bacteria dominates intra-abdominal infections?
Gram negative E.coli
52
Which drug is used to fight against pseudomonas and neutropenic sepsis?
Tazocin
53
What abx is used against MRSA
Glycopeptides - teicoplanin or vancomycin
54
Which abx target ribosomes to disrupt protein synthesis?
Tetracyclines Aminoglycosides Chloramphenicol Macrolides
55
Examples of gram positive aerobic bacilli...
Listeria Bacillus
56
Examples of gram positive anaerobic bacilli...
Clostridium
57
Examples of gram positive cocci ...
Staph Strep
58
Examples of gram negative bacilli...
Pseudomonas Shigella Salmonella E.coli Klebsiella Enterobacter Haemophilus
59
Examples of gram negative cocci...
Neisseria - gonorrhoeae/meningitidis Moraxella

YEAR 2 (8 decks)

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