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POM Exam 1 > Antimicrobials > Flashcards

Antimicrobials Flashcards

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1
Q

What had biggest effect on human life expectancy?
A. Public health measures, sanitation, and immunization
B. Antimicrobials

A

A. Public health measures

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2
Q

% of death worldwide due to infectious disease?

A

10%

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3
Q

How are antibacterials classified?

A

By MOA

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4
Q

MIC definition?

A

Lowest concentration of drug that inhibits visible growth

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5
Q

MBC definition?

A

Lowest concentration of drug that kills bacteria

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6
Q

Define bacteriostatic in terms of MBC and MIC

A

MBC&raquo_space; MIC

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7
Q

Define bactericidal in terms of MBC and MIC

A

MBC roughly equals MIC

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8
Q

The lower the MBC/MIC of an organism/drug combo, the ____ the organism.

A

more susceptible

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9
Q

Methods for determining microbial susceptibility/resistance?

A

Culture based (disk diffusion and E-test) or molecular detection of resistance mutations (i.e. PCR)

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10
Q

What is a hospital antibiogram?

A

Summary of antibiotic susceptibilities in your own site to track resistance trends

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11
Q

Pharmacodynamics is…

A

the biological effects of the drug on the body (i.e. time course and intensity of therapeutic and adverse effects)

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12
Q

Pharmacokinetics is…

A

the body’s effect on the drug (i.e. time course of absorption, distribution, metabolism, and excretion)

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13
Q

Cmax is?

A

Peak concentration of drug in body

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14
Q

AUC is?

A

Area under the curve

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15
Q

Time dependent killing goal?

A

Maximize time above the MIC; you want serum [drug] above MIC for at least 50% of dosing interval

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16
Q

Beta lactam MOA?

A

bind PBP and inhibit peptidoglycan synthesis

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17
Q

Name the 5 beta lactam subclasses

A

penicillins, carbapenems, monobactams, clavulanic acid, cephalosporins

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18
Q

Glycopeptides MOA?

A

inhibit transglycosylase activity in peptidoglycan synthesis

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19
Q

Function of PBPs?

A

make peptidoglycan

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20
Q

PBPs must have ____ function, and may also have ____ function.

A

peptidyltransferase; transglycosylase

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21
Q

Penicillin resembles…

A

D-Ala D-Ala moiety

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22
Q

Concentration-dependent killing goal?

A

Maximize Cmax and therefore AUC

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23
Q

Drugs with TDK MOA?

A

Penicillins, Cephalosporins, Macrolides, Clindamycin

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24
Q

Drugs with CDK MOA?

A

Fluoroquinolones, Aminoglycosides

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25
Post antibiotic effect is...
time it takes bacteria to return to log phase growth after removal of abx
26
Bacteria with longer PAEs require need ___ frequencies of dosing.
lower
27
Which generally needs longer PAE? CDK or TDK?
CDK
28
Which generally needs longer PAE? Gram + or -?
Gram +
29
What are the three main antibiotic resistance mechanisms?
Enzymatically inactivate drug, alter drug target, alter drug exposure
30
What does beta-lactamase do?
Enzymatically inactivate beta-lactams
31
What does clavulanic acid do?
Inhibits beta-lactamase, overcome abx resistance
32
2 beta-lactamases to know?
ESBL (extended spectrum beta lactamases) and Metal-dependent/New Delhi
33
What is the "nuclear option" for beta-lactam resistance?
PBP mutation that alters affinity for beta-lactams, but still retain transpeptidase activity
34
Prioritize choosing abx with ____ fitness cost for resistance
higher
35
Gram ___ bacteria alter their membrane permeability to pump out abx
negative
36
2 ways to alter drug exposure?
decrease membrane permeability; increase efflux of drug to shoot out of cell
37
Main abx resistance mechanism for vancomycin?
Alter D-Ala D-Ala slightly with lac so that vancomycin cannot bind precursor.
38
Lipopeptides MOA?
disrupt cell membrane of G+ by binding phosphatidyl-glycerol forming pores
39
Why are lipopeptides specific?
Phosphatidyl-glycerol is abundant in bac cells but not human cells
40
What part of body should lipopeptides not be used to treat?
Lungs (surfactant)
41
Main lipopeptide to know?
Daptomycin
42
Main class of folate synthesis inhibitors?
Sulfonamides
43
Main sulfonamide to know?
Sulfamethoxazole
44
Are sulfonamides bacteriostatic or bactericidal?
Bacteriostatic, combine with trimethoprim to make bactericidal
45
Are fluoroquinolones bacteriostatic or bactericidal?
Bactericidal
46
Fluoroquinolone resistance is usually via ____ and/or ___
altering the drug target (mutations in topoisomerase genes); altering the drug exposure by decreasing uptake
47
Rifamycins MOA?
inhibit mRNA synthesis by binding DNA dep RNA Pol
48
Rifamycins bacteriostatic or bactericidal?
Either! Depends on concentration
49
Rifamycin to know?
Rifampin
50
Rifamycin is rarely used alone because it quickly develops abx resistance by ____
mutations in RNA polymerase gene (altered drug target)
51
2 main classes of drugs that damage DNA?
fluoroquinolones and nitroimidazoles
52
Main nitroimidazole to know?
metronidazole
53
Nitroimidazole MOA?
forms free radicals that damage DNA
54
Which class of abx is a prodrug? What does this mean?
nitroimidazoles - must be activated by microbial enzymes
55
Most likely cause of abx resistance in nitroimidazoles?
mutations in microbial enzymes that convert prodrug to active compound
56
Name all the classes of 30S ribosome antibiotics.
tetracyclines, aminoglycosides
57
Name the 2 important tetracyclines to know.
Tetracycline, doxycycline
58
Name the 2 important aminoglycosides to know.
gentamycin, streptomycin
59
Name the 2 classes of abx used for anaerobic microbes exclusively. Which one is bacteriostatic and which one is bactericidal?
Lincosamides, nitroimidazoles; lincosamides = static, nitroimidazoles = cidal
60
Aminoglycosides should not be used in what part of the body and why?
the GI tract; will be ineffective because anaerobes are intrinsically resistant
61
Tetracycline is bacteriostatic or bactericidal?
Bacteriostatic
62
Bacteriostatic drugs + bactericidal drugs = ?
Antagonistic effect
63
5 classes of abx that bind 50S subunit?
oxazolidenones, streptomycins, lincosamides, macrolides, chloramphenicol
64
Clindamycin falls under what class of antibiotic?
Lincosamide
65
2 main types of macrolides to know?
erythromycin, azithromycin
66
MLSb resistance is associated with which abx? Why does it happen?
macrolides, lincosamides, and streptogramins; similar MOA
67
What does the D test detect?
inducible clindamycin resistance
68
Main oxazolidinone to know?
linezolid

POM Exam 1 (14 decks)

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