Chapter 20: Antimicrobial Medications Flashcards
(156 cards)
1
Q
Resistantance that develops due to genetic changes, including mutations and horizontal transfers.
A
Acquired resistance
2
Q
A compound naturally produced by molds and bacteria that inhibits growth or kills other organisms
A
Antibiotic
3
Q
An antibiotic or other chemical that is used to treat an infectious disease and acts by inhibiting or killing microbes; aka antimicrobial drug
A
Antimicrobial medication
4
Q
A chemical that is used to treat a viral infection and acts by interfering with the infection cycle of the virus; also called an antiviral drug
A
Antiviral medication
5
Q
Describes a chemical that kills a bacteria
A
Bactericidal
6
Q
Describes a chemical that inhibits grow of bacteria
A
Bacteriostatic
7
Q
An antibiotic that is effective against a wide range of bacteria, generally including both gram-negative and gram-positive
A
Broad-spectrum antibiotic
8
Q
A chemical used to treat disease
A
Chemotherapeutic agent
9
Q
Resistantance due to inherent characteristics of the organism
A
Intrinsic (innate) resistance
10
Q
An antibiotic that is effective against a limited range of bacteria
A
Narrow-spectrum antibiotic
11
Q
A plasmid that encodes resistance to one or more antimicrobial medications
A
R plasmid
12
Q
Medication used to treat syphilis a long time ago
A
Salvarsan (arsenic)
13
Q
Salvarsan and Prontosil are examples of these kinds of drugs
A
Chemotherapeutic agents
Chemicals that treat disease
14
Q
Who discovered that Penicillium contained substances that killed bacteria
A
Alexander Fleming
15
Q
Most antibiotics come from microorganisms that live where?
A
In soil
16
Q
Penicillin G is mainly active against
A
Gram-positive
17
Q
Ampicillin kills
A
Gram-positive & Gram-negative
18
Q
Causing greater harm to a pathogen than to its host
A
Selective toxicity
19
Q
The measure of the relative toxicity of a medication, defined as a ratio of minimum toxic dose to minimum effective dose
A
Therapeutic index
20
Q
Antimicrobial that have a (high or low) therapeutic index are safer for humans.
A
High
21
Q
The range between the dose used therapeutically and the dose that is toxic
A
Therapeutic window
22
Q
A medication that has a high therapeutic index has a (narrow or wide) therapeutic window
A
Wide
23
Q
Medications with a low therapeutic index are most used how in humans
A
Topically
24
Q
Sulfa drugs prescribed for urinary tract infections don’t kill bacteria but stop them from multiplying, hence they have this kind of antimicrobial action
A
Bacteriostatic
25
A disadvantage of broad spectrum antibiotics
They disrupt the natural biome of microflora leaving the paitent at risk for new infections
26
Combinations of antimicrobials that are neither synergistic nor antagonistic are called
Additive
27
The rate of elimation of a drug is called
Half life
28
The time it takes serum concentration of a chemical to reach 50% is called
Half life
29
___ species lack a cell wall and cannot be treated with penicillin
Mycoplasma
30
Therapeutic index
Antimicrobial action
Spectrum of activities
Combination effects
Tissue distribution
Half life
Adverse effects
Are all what factors
What one must consider when prescribing an antimicrobial
31
Cell wall peptidoglycan synthesis
Nucleic acid synthesis
Cell membrane integrity
Metabolic pathways
Protein synthesis
Are all what
Targets of antibacterial medications
32
B-lactam, glycopeptide, and bacitracin all attack bacteria how
The peptidoglycan during reproduction
33
A group of antimicrobial medications that inhibit peptidoglycan synthesis have a shared structure called a ______ ring
They group shares the name with this ring also
B-lactam
34
Penicillin, cephalosporins, carbapenems, and monobactams are this group that interfer with the peptidoglycan synthesis
High therapeutic index
B-lactam
35
This type of narrow spectrum penicillins are affective against ____ and Penicillin V is more stable in Acid than Penicillin G thus is better taken orally
Natural penicillin
Gram-positive and a few gram-negative
36
The chemical structure of these antimicrobial drugs protects them from destruction by certain B-lactamases.
Generally more effective against gram-negative
Examples include: CEPHALEXIN & CEFAZOLIN(first generation)
Cephalosporins
37
Effective against a wide variety of gram bacteria.
Not inactivated by Extended Spectrum B-lactamases
Last resort due to toxicity
B-lactam
Includes: IMIPENEM, ERTAPENEM, MEROPENEM, DORIPENEM
Carbapenems
38
Vancomycin is this type of antibiotic?
Meaning it affects what
B lactam
Peptidoglycan synthesis
Also, it is a glycopeptide
39
____ inhibits cell wall synthesis with transport of peptidoglycan precursors across the cytoplasm membrane.
Class of B lactam
Bacitracin
40
Bactin, glycopeptide antibiotics, monobactam, carbapenems, cephalosporins.
All disrubt bacteria how
The peptidoglycan cell wall
41
Bacterial ribosome is made of subunits 30S and 50S and is called
70S
42
Macrolides, Chloramphenicol,
All interfer with bacteria how
Tetracycline , Aminoglycosides
Interfer how
Top: Disruption of 50S of Ribosome
Bottle: Disruption of 30S Ribosome
43
Streptomycin, gentamicin, neomycin all are examples of a microbial drug that interfere with the 30S Ribosome subunit
Name this group
Aminoglycosides
44
Bacteriostatic against some Gram-positive and Gram-negative bacteria
bind to the 30S Ribosome, blocking attachments of tRNA, prevents translation.
Tetracyclines
45
These are used against walking pneumonia and bind the to 50S Ribosome
Preventing transition from occurring
ERYTHROMYCIN, AZITHROMYCIN
Macrolides
46
Paitents with kidney disease must take medications (more or less) frequently
Less
47
Chloramphenicol may cause _____ loss of ability to produce blood cells
Aplastic anemia
48
How is horizontal gene transfer made possible, which action
Conjugation
49
Penicillins and derivatives
Cephalosporins and derivatives
Carbapenems and derivatives
Glycopeptide antibiotics
Bacitracin
$$$$ total list $$$$
Are all this type of antibiotic that interfere with the peptidoglycan layer
B-lactamas
50
Aminoglycosides (streptomycin and -mycin derivatives
Tetracycline
Macrolides (erythromycin and -mycin derivatives)
Chloramphenicol
Antibiotics with this function
Interfer with protien synthesis
51
Fluoroquinolones
(Ciprofloxacin and -floxcin drugs)
Rifamycins
(Rifampin)
Fidaxomicin
Metronidazole
All affect bacteria how
Nucleic acid synthesis
52
Daptomycin
Polymyxins
All affect bacteria how
Cell membrane integrity
53
Ethambutol
Isoniazid
Pyrazinamide
Affect which type of bacteria
Mycobacterium tuberculosis
54
Penicillinase- Resistant Penicillins developed in response to penicillinase from _____ strains
S. Aureus
55
B-lactam antibiotics completely inhibit ________ enzymes needed to form peptide bridge between adjacent glycine strands
Disrupt cell wall synthesis in reproducing cells
Only effective against actively growing cells
Penicillin-binding proteins
56
Penicillinase (B-lactamase enzyme) inactive members of the Penicillin family.
_______ produced by more resistant bacteria offer wider variety of resistance of B-lactam medications
Extended-spectrum B-lactamases
(ESBLs)
57
Gram _____ produce more extensive array of B-lactamases
Negative
58
Natural penicillins are from Penicillium chrysogenum aka Penicillin __
(Narrow or broad) spectrum
Act against gram-positive and few gram-negative
G
Narrow
59
MRSA comes from this bacteria
S. aureus
60
Ampicillin & amoxicillin are (broad or narrow) spectrum
That are inactivated by many B-lactamases
Broad
61
______ Penicillins have greater activity against Enterobacter & Pseudomonas
But reduced activity against Gram-positive
Destroyed by B-lactamases
Extended-spectrum
62
This B-lactam antibiotic
Structure makes it resistant to some B-lactamases
Some have low affinity for PBPs of gram positive
5th generation is effective against MRSA
Cephalosporins
63
B-lactam antibiotics harm bacteria how
Inhibit the cell wall synthesis
64
B-lactam antibiotic
Effective against a wide rage of Gram-negative and gram-positive
Not inactivated by extended spectrum B-lactamases
Last resort for ESBL-producing organisms
Carbapenems
65
This type of B-lactam
Bind to the amino acid side chain of NAM molecules and prevents peptidoglycan synthesis
Gram-positive only
Low in therapeutic index
glycopeptide antibiotic
Vancomycin
66
_____ is the most widely used Glycopeptide usually administered via IV except in intestinal infections
Last resort to treat gram-positive resistant to B-lacam
Used against MRSA
Vancomycin
67
This B-lactam
Toxicity limits to topical applications
Bacitracin
68
This group of antibiotics is used against a wide variety of bacteria
Interfer with peptidoglycan synthesis by inhibiting _________ that help form cross links between glycine chains
B-lactam
Penicillin-binding proteins
69
The later generations of this class of antibiotics are usually more effective against Gram-negative bacteria
Less susceptible to destruction from certain B-lactamases
Cephalosporins
70
Ampicillin & amoxicillin are examples of (broad or narrow) spectrum B-lactam antibiotics
Broad
71
Narrow spectrum
1st penicillinase-resistant penicillin
Used to treat gram-positive S. Aureus
Methicillin
72
Inhibition of protein synthesis is generally (bacteriostatic or bacterialcide)
Static
73
____ are a ribosome binding; generally the 1st choice for penicillin alergic people
Macrolides
74
Average RN salary in MI is
80,000$ per year
75
Streptomycin, gentamicin, and neomycin are represented in this group
Aminoglycosides
76
Bacterialcidal against aerobic and facultative Bacteria
Bind to 30S blocks translation and misreading of mRNA
Aminoglycosides
77
This Aminoglycosides is toxic and used only topically
Neomycin
78
Bacterialstatic against some Gram-positive and negative
Bind to 30S and stops tRNA
Tetracycline
79
Bacteriostatic against many Gram-positive & Atypical Pneumonia
Prevents the continuation of protein synthesis
Macrolides
Erythromycin & azithromycin
80
Erythromycin & azithromycin are represented in this group
Where they bind to the 50S Ribosome Preventing continuation of protein synthesis
Used against pneumonia
Macrolides
81
Clindamycin is a 50S Ribosome bacteriostatic
From this group
Lincosamides
82
Clindamycin a (lincosamide-binds to 50S) used to treat lungs, skin, blood, female reproductive
It is a bacterial (static or cide)
Static
83
Fluoroquinolones (ciprofloxacin)
Rifamycins(Rifampim)
Fidaxomicin
All attack this part of the bacterial cell
Nucleic acid
84
_____ belongs to a class called Fluoroquinolones ( which target Nucleic Acid) and inhibits topoisomerases
Ciprofloxacin
85
____ belongs to a class called Rifamycins ( nucleic acid targeting)
Bacterialcidal both grams
Bind RNA polymerase stopping RNA synthesis
Rifampin
86
Sulfonamides and trimethoprim affect bacteria how
Folate biosynthsis
87
Polymixin B (toxic internally) g-nega
Daptomycin gram-positive
Damage bacteria how
Cell membrane integrity
88
Ethambutol
Isoniazid
Pyrazinmide
Affect this type of bacteria
Mycobacterium tuberculosis
89
_____ is routinely used to determine susceptibility of bacteria to antibiotics
Kirby-bauer disc diffusion test
90
____ is the lowest concentration that prevents growth in vitro
Minimum Inhibitory Concentration
(MIC)
91
Minimum Inhibition Concentration
Microbes that are susceptible (treatable/ untreatable)
Microbes that are resistant (treatable/ untreatable)
Susceptible = treatable
Resistant = untreatable
92
____ is the lowest concentration that kills 99.9% of cells in vitro
Minimum Bacterial Concentration
93
Antibiotic-inacvating enzymes
(Penicillanse, extended spectrum B-lactamases, chloramphenicol acetylase)
Alteration in target molecule
PBPs (B-lactam antibiotics)
Ribosomal RNA (macrolides, lincosamides, streptogramins)
Decreased uptake in medicine
(Change in Porin Protiens Gram-negative)
Increased elimination of medicine
(Efflux pumps)
Are all examples of ....
Acquired Resistance
94
Spontaneous mutation & Conjugation (gene transfer of R plasmid)
Are examples of...
Acquisition of resistance
95
Enterococci
Enterobacter
Mycobacterium tuberculosis
Neisseria gonorrhea
Staphylococcus aurus
Staphylococcus pneumonia
Examples of emerging resistance
96
This emerging resistance strain
Large number of cells
Combination therapy
6 months of treatment
Mycobacterium tuberculosis
97
This strain makes MRSA
S. aureus
98
Why are viruses hard to target
Because they use the host cells to multiply
Lack cell wall & ribosomes
99
Prevent viral entry
Interfer with viral uncoating
Interfer with Nucleic Acid Synthesis
(Nucleoside & Nucleotide analogs)
Prevent Genome Entry
Protease Inhibition
Neuramindiase Inhibition
Are all what
Methods to prevent viral infections
100
Funsion inhibition
Prevent viral particles from fusing with the host
Used in HIV
Is this type of target for stopping viral disease
Viral entry
101
Prevent the release of viral nucleic acid from the protein coat.
Used in the past to reduce severity and duration of influenza A
Is this type of target for stopping viral disease
Vital uncoating
102
Incorporate error-prone virally encoded polymerase, resulting in defective viral nucleic acid.
Treats shingles, chickenpox, cold scores, herpes
HCV
HIV & hep B
Is this type of target for stopping viral disease
Nucleic Acid Synthesis
103
Inhibit the activity of viral polymerase by binding to a site other than the nucleotide-binding site.
Is this type of target for stopping viral disease
Nucleic Acid synthesis
Non-nucleoside polymerase inhibition
104
Inhibit the activity of reverse transcriptase by binding to a site other than the nucleotide-binding site.
Used HIV infections
Is this type of target for stopping viral disease
Non-nucleotide reverse transcriptase inhibition
105
Interfere with the HIV encoded enzyme integrase
Is this type of target for stopping viral disease
Genome integration
106
Inhibits virally encoded protease, which cleave viral polyproteins to release individual proteins
Used to treat HIV and hep C.
Is this type of target for stopping viral disease
Assembly and release of viral particles
107
Action of antifungal medication
Azoles
Interfer with the cytoplasmic membrane by targeting a steroid called ____
Ergosterol
108
Action of antifungal medication
Echinocandins
Interfer with B13 glucagon synthesis
Treats Candida yeast infections
This is the target
Cell wall synthesis
109
Action of antifungal medication
Griseofulvin
Used to treat skin and nail infections
Active only against fungi that invades keratinized cells
Targets this part of fungal infections
Cell division
110
Action of antifungal medication
Flucytosine
Used to treat systemic yeast infections
Targets this part of fungal infections
Nucleic Acid synthesis
111
Action of antifungal medication
Tavaborole
Used to topically treat nail infections
Targets this part of fungal infections
Protein synthesis
112
Medication that interferes with Protozoan parasites targets this
Biosynthic pathways
113
Medications that target worms(helmiths) target this
Neuromuscular function
114
First antibiotic produced
Penicillin G
115
Any chemical used to treat any disease
Chemotherapeutic agents
116
What was used to treat syphilis
Arsenic
117
Chemical naturally produced by one microbe that affects different types of bacteria
Antibiotic
118
How does penicillin become ampicillin & methicillin
Altering structure
119
Causes greater harm to microbes than to human host
Selective toxicity
120
Extended spectrum penicillins have a greater activity against these 2 species
But less active against gram positive
Enterobacteriaceae
Pseudomonas
121
Inhibits protein synthesis
Bacterocide/ static
Bacteriostatic
122
Bactericidal against aerobic and facultative bacteria, bind to the 30S subunit, blocking initation of translation and causing misreading of mRNA. Toxicity limits use.
Are this class. With these examples (3)
_____ this specific antibiotic from this class is used in non prescription antibiotic ointments
$$$$$$$
Aminoglycoside
Streptomycin, Gentamicin, Neomycin
Neomycin
123
Bacteriostatic against many Gram-positive bacteria ad well as the most common causes of atypical pneumonia; bind to the 50S Ribosome subunit, preventing the continuation of protein synthesis.
Name is class and examples
$$$$$$$$
Macrolides
Erythromycin
Azithromycin
124
Bacterioatatic against a variety of Gram-positive and Gram-negative bacteria. Bind to the 50S preventing protein synthesis
Last resort
Is a lincosamide (class)
name the antibiotic
Clindamycin
125
Clindamycin a (lincosamide)
Azithromycin & erythromycin (Macrolides)
Interfer with bacteria how
Binding to the 50S Ribosome subunit
126
Tetracycline (end in -line) & Aminoglycosides ( gentamicin, neomycin, and streptomycin)
Interfere with bacteria how?
Bind to the 30S Ribosome subunit
127
Augmentum
Penicillin combined with "B-lactamases inhibitor"
128
Cephalosporins are resistant to B lactamase but are less effective against...
Gram positive
129
Vancomycin works only against gram (+ or -)
+
130
Aminoglycosides work against (Aerobic or Anaerobic)
Aerobic
131
Tetracycline works against gram (+ or -)
Both
132
Macorlides work well against gram (+ or -)
+
133
Chloramphenicol works against gram (+ or -)
Both
134
Fluoroquinolones (Ciprofloxacin) works well against gram (+ or -)
Both
135
Sulfonamides
inhibit folic acid production
136
Polymixin B is the first skin antibiotic binds to gram (+ or -) and damages cell membrane
-
137
Do antiviral drugs work against latent infections
No
138
Penicillin V is taken 4x daily; azithromycin is taken 1x daily
Which has the longer half life
Azithromycin
139
Dysbiosis is...
Imbalance of normal flora
140
The ____ of Gram-negative blocks penicillin
Outer membrane
141
B-lactam have a high therapeutic index
They inhibit _____ enzymes needed to form peptide bridges between adjacent glycan strands
Only effective against (Growing / Non Growing) bacteria
Penicillin-binding proteins
Growing
142
Bacterialcidal against gram-positive
Interfere with transport of peptidoglycan precursors across the cytoplasmic membrane
Common ingredient in nonprescription antibiotic creams
Bacitracin
143
These bacterial statics bind to the 30S and block Initation and translation
Also, cause misreading of mRNA by ribosome past Initation
Aminoglycosides
144
These 30S Block tRNA attachment and prevent translation
Tetracycline and Glycyclines
145
Macrolides bind to the 50S and prevent the continuation of...
Translation
146
Bacteriostatic against a variety of gram-positive and gram-negative bacteria. Bind to the 50S Ribosome, preventing the continuation of protein synthesis
Family (lincosamide)
Clindamycin
147
____ inhibits DNA or RNA nucleic acid synthesis
Block prokaryotic RNA polymerase; prevent initation of transcription
Bacterialcidal against Gram-positive, some gram-negatives, MYCOBACTERIUM TUBERCULOSIS
Rifamycins
148
Inhibit DNA or RNA nucleic acid synthesis
Inhibit topoisomerase enzymes that maintain supercoiling of DNA
Fluoroquinolones
149
Bacterialcidal against a wide variety of gram-positive and gram-negative
Inhibit topoisomerase (enzyme that maintains super coiling of DNA)
Fluoroquinolones (Ciprofloxacin)
150
Bacterialcidal against Gram-positive and some gram-negatives
Bind RNA polymerase, blocking the initation of RNA synthesis
Rifamycins (Rifampin)
151
This is the lowest concentration that prevents growth in vitro
Minimum inhibitory concentration MIC
152
Which is a method of acquired resistance that eliminates medication from within bacterial cell
Efflux pump
153
Bacteria mutate and select for resistant stains
What is a method Dr's. use to combat this resistance
Combination therapy
Multiple antibiotics
154
Clostridium difícil
Carbapenem-resistant Enterobacteria (CRE)
Drug resistant Neisseria gonorrhea
Are all labeled this threat level
Urgent
155
MRSA
Drug resistant Streptococcus pneumonia
Drug resistant TB
Vancomycin resistant S. aureus
Are all this threat level by CDC
Concerning
156
Decreased uptake in medicine,
Gram-negative, is by this method
Porin Protiens
