Antimicrobials Flashcards

(27 cards)

1
Q

How can antimicrobials be classified

A

Antibacterial

Antifungal

Antiprotozoal

Antiviral

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2
Q

How are antibacterial agents classified

A

Bactericidal or bacteriostatic

Spectrum - broad or narrow

Target site

Chemical structure

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3
Q

What are the idea features of antimicrobial agents

A

Selectively toxic

Few adverse affects

Reach site of infection

Oral/IV formulation (preferentially both)

Long half-life

No interference with other drugs

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4
Q

Name the mechanisms of action of antibacterials

A

Cell wall synthesis

Protein synthesis

Cell membrane function

Nucleic acid synthesis

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5
Q

Which antibacterials affect cell wall synthesis

A

Beta-lactams

Glycopeptides

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6
Q

Which antibacterials affect protein synthesis

A

Tetracyclines

Aminoglycosides

Macrolides

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7
Q

Which antibacterials affects cell membrane function

A

Polymixins

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8
Q

Which antibacterials affect nucleic acid synthesis

A

Quinolones

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9
Q

What are the types of resistance and are they permanent

A

Intrinsic - permanent

Aquired - permanent

Adaptive - usually reversible

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10
Q

What are the mechanisms of resistance

A

Drug inactivating enzyme

Altered target - target enzyme has lower affinity for drug

Altered uptake - decreased permeability or increased efflux

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11
Q

How does a bacteria develop antibiotic resistance

A

Chromosomal gene mutation

Horizontal gene transfer - conjunction, transduction or transformation

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12
Q

What is minimum inhbitory concentration (MIC)

A

Minimum concentration of antibiotic needed for no bacterial growth

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13
Q

What are the catalgories of beta-lactam antibacterials

A

Penicillins

Cephalosporins

Carbapenems

Monobactams

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14
Q

What does penicillin affect and name some penicillins

A

Affects cell wall synthesis

Penicillin

Amoxicillin

Flucloxacillin

Co-amoxiclav

Piperacillin

Tazobactam

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15
Q

What do cephalosporins affect and give examples

A

Affects cell wall synthesis

Affects Gram -ve but not Gram +ve

Is a good broad spectrum but no anaerobe activity

Cetriaxone

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16
Q

What do carbapenems affect and give an example

A

Affects wall synthesis

Meropenem - very broad (incl anaerobes), active against most Gram -ves

17
Q

What do glycopeptides affect and give an example

A

Affects cell wall synthesis

Vancomycin - against most gram +ve, given as IV as not absorbed, must be monitored

18
Q

What do tetracyclines affect and give examples

A

Affect protein synthesis

Tetracycline and doxycycline - broad spectrum, oral only

19
Q

What do aminoglycosides affect and give an example

A

Affect protein synthesis

Gentamicin - gram -ve, good activity in blood/urine (bacteraemia), usually reserved for severe gram -ve sepsis

20
Q

What do macrolides affect and give an example

A

Affect protein synthesis

Erythromycin

21
Q

What do quinolones affect and give an example

A

Affect nucleic acid synthesis

Ciprofloxacin

22
Q

Name some antifungals and how they function

A

Azoles (against yeasts +/- molds) - inhibt cell membrane synthesis. Fluconazole (Candida)

Polyenes - inhibit cell membrane function

23
Q

Name some antivirals and their mechanism of action and what they can be used to treat

A

Aciclovir - when phosphorylated inhibits viral DNA polymerase. Used for herpes simplex and varicella zoster

Oseltamivir (tamiflu) - inhibits viral neuraminidase. Influenza A and B

24
Q

What is metronidazole

A

Antimicrobial and antiprotozoal agent

Active against anaerobic bacteria and protozoa

25
What are the consequences of antibacterial resistance
Treatment failure Prophylaxis failure Economic costs
26
Define the types of antimicrobial resistance
MDR (multi-drug resistant) - non-susceptibility to at least one agent in three or more antimicrobial categories XDR (extensively drug resistant) - non-susceptibility to at least one agent in all but two or fewer antimicrobial categories PDR (pan-drug resistant) - non-susceptibility to all agents in all antimicrobial categories
27
What are the IDSA's antimicrobial stewardship objectives
Appropriate use of antimicrobials Optimal clinical outcomes Minimise toxicity and other adverse events Reduce cost of health care for infections Limit selection for antimicrobial resistant strains