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Leila's Yr 5 Pathology > Micro - Antimicrobials 1 + 2 > Flashcards

Micro - Antimicrobials 1 + 2 Flashcards

1
Q

Name 2 antimicrobials causing renal dysfunction

A

Vacnomycin (glycopeptide) + gentamicin (amino glycoside)

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2
Q

3 patterns of Abx activity

A

type 1 : concentration dependent killing
type 2 : time dependent killing
type 3: both

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3
Q

Concentration-dependent Abx?

A

Aminoglycosides e.g. gentamicin, amikacin

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4
Q

time dependent Abx

A

penicillin

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5
Q

time + concentration dependent Abx

A

VANCOMYCIN

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6
Q

Length of abx course for bacterial endocarditis? for acute osteomyelitis?

A

IE 4-6 weeks

Osteomyelitis 6 weeks

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7
Q

Group A strep pharyngitis length of treatmnet

A

10 days

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8
Q

Typical Abx for pharyngitis? how long for?

A

BenPen 10 days

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9
Q

mx of CAP mlid and severe

A

mild: amoxicillin
severe: Co-amoxiclav + clarithromycin

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10
Q

mx of HAP

A

Amoxicillin + gent or taz

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11
Q

management of Neisseria meningitidis

A

Benpen or ceftriaxone +/- amoxicillin (old or neonate)

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12
Q

typical Abx for UTI - community? hospital?

A

community - trimethoprim/nitro

nosocomial = cefalexin or co-amox

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13
Q

Typical Abx for Sepsis - severe?

A

tazocin/ceftriaxone, metro +/- gentamicin

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14
Q

typical abx for neutropaenic

A

tazocin + gentamicin

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15
Q

6 main MOA of antibiotics

A
  1. inhibit cell wall synthesis
  2. inhibit protein synthesis
  3. inhibit DNA syntehsis
  4. Inhibit RNA synthesis
  5. Cell membrane toxine
  6. Inhibit folate synthesis
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16
Q

3 types of beta lactam

A

penicillins
cephalosporins
carbapenems

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17
Q

How do the cephalosporins change from 1st –> 3rd gen?

A

increased gram -ve activity

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18
Q

name 3 cephalosporins

A

cefuroxime, cefotaxime, ceftriaxone

19
Q

Why were carbapenems developed?

A

bacteria developed extended spectrum beta lactamases, therefore resistant to cephalosporins but nOT carbapenems e.g. meropenem

20
Q

Which cell wall synthesis inhibitors cannot be used against Gram-ves?

A

glycopeptides e.g. vancomycin and teicoplanin as they cannot cross the gram -ve cell wall

21
Q

What type of Abx is gentamicin?

MOA?

A

Aminoglycoside

Inhibits protein synthesis by binding to 30S ribosome subunit

22
Q

What are aminoglycosides particularly useful vs?

A

neutropenic gram -ve sepsis, particularly pseudomonas

23
Q

Doxycycline - which Abx class is it in? What is it useful against?

A

tetracycline - intracellular organisms e.g. chlamydia

24
Q

doxy MOA

A

Targets 30S subunit of ribosome/ protein synthesis inhibitor

25
Q

considerations with doxy

A

do not give to pregnant women or children

SE: photosensitivity rash

26
Q

Name 3 macrolides.

A

azithromycin, clindamycin, erythromycin

27
Q

MOA of macrolides

A

bind to 50S ribosomal subunit

28
Q

Usefulness of macrolides vs?

A

Against staph or strep in penicillin allergy, atypical pneumonia

29
Q

Chloramphenicol - why isn’t it used much?

MOA

A

Binds to 50S subunit

Risk of aplastic anaemia and grey baby syndrome in neonates

30
Q

linezolid class of antibiotic and MOA?

A

Inhibits protein synthesis (oxazolidinone) - prevents formation of 70s complex by binding to 23S component of 50S subunit

31
Q

Linezolid - USE?

A

Gram +VE ONLY - MRSA, VRE

32
Q

Quinolone - eg? MOA?

A

Ciprofloxacin, moxifloxacin (new)

Bind to alpha unit of DNA gyrase and inhibit DNA synthesis

33
Q

Eg of nitroimidazoles?

A

metronidazole

34
Q

2 useful groups which metronidazole is used against? give eg of each?

A

Anaerobes e.g. C.diff and protozoa e.g. Giardia

35
Q

Name an RNA synthesis inhibitor?

A

Rifampicin

36
Q

Orange secretions, impaired LFTs, DDI with COCP

A

Rifampicin

37
Q

name 2 cell membrane toxins

A

Daptomycin and colistin

38
Q

lipopeptide

A

daptomycin

39
Q

polymyxin

A

colistin

40
Q

When is colistin used? SE?

A

Last resort in MDR gram -ve bacteria

last resort as highly nephrotoxic

41
Q

when is daptomycin used?

A

GRAM +VES ONLY, WHEN RESISTANT

42
Q

4 mechanisms of Abx resistance (beat)

A

Bypass antibiotic sensitive step
Enzyme chemical modification/ inactivation of antibiotic
Accumulation reduced of antibiotic
Target altered or replaced

43
Q

2 main modes of resistance against beta lactams?

A

Enzyme mediated inactivation - beta lactamases

Altered target - MecA gene in MRSA encodes novel Penicillin binding proteins, PBP mutations in S.pneumonia

44
Q

2 main SEs of aminoglycosides

A

ototoxicity and nephrotoxicity

Leila's Yr 5 Pathology (100 decks)

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