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2060 Pharmacology > Module 16 Antibiotics > Flashcards

Module 16 Antibiotics Flashcards

(64 cards)

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1
Q

Bacteria

A
  • Single cell organisms
  • Rod, sphere, spiral shaped
  • Majority harmless to immune system
  • Some beneficial types
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2
Q

Virulence Factors

A
  • Fimbriae & pilli
  • Flagella
  • Secretion of toxins/enzymes
  • Invasion
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3
Q

Fimbriae & Pilli

A
  • Hair like structures
  • Project from surface of bacterial cells
  • Allow bacteria attachment within body
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4
Q

Flagella

A
  • Aqueous environment
  • Swim through body (flagellum)
  • Find site to survive
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5
Q

Toxins & Enzymes

A
  • Cause nausea/vomit, diarrhea, cramps
  • Mediate toxic reactions with body entry
  • Enzymes effect tissue, antibodies
  • Degrade defense against infection
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6
Q

Gram Straining

A
  • Used to classify as positive/negative
  • Cell wall structure of bacteria
  • Amount of peptidoglycan
  • Determine antibiotic choice
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7
Q

Gram Positive Cells

A
  • Thick peptidoglycan wall
  • Purple stains
  • No LPS or outer membrane
  • No porins
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8
Q

Gram Negative Cells

A
  • Thin peptidoglycan layer
  • Pink stains
  • No techoic acid
  • LPS on outer membrane
  • Outer membrane protects againts bile salt/detergents
  • Porins on outer membrane (sugars/ions into bacteria)
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9
Q

Signs of Infection

A
  • Fever
  • Malaise
  • Local redness
  • Swelling
  • Increased respiratory rate
  • Tachycardia
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10
Q

Selective Toxicity

A
  • Treatment of bacterial infection
  • Therapy to destroy bacteria without harming human cells
  • Differences between cellular chemistry of humans/bacteria
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11
Q

Mechanisms of Selective Toxicity

A
  • Disrupting bacterial cell wall
  • Targeting bacteria unique enzymes
  • Disrupting bacterial protein synthesis
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12
Q

Antibiotic Selection

A
  • Identification of bacteria
  • Bacterial sensitivity to antibiotic
  • Antibiotic access to infection site
  • Ability of patient to battle infection
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13
Q

Bacteria Identification

A
  • Prior to treatment selection
  • Gram stain rapid test (structural features)
  • Culturing
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14
Q

Bacteriostatic Antibiotics

A
  • Stops growth & replication of bacteria
  • Stops infection spread
  • Immune system attack & remove cells
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15
Q

Bactericidal Antibiotics

A
  • Kill bacteria directly
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16
Q

Determining Bacterial Sensitivity

A
  • Culture bacteria
  • Determine minimum inhibitory concentration (MIC)
  • Determine minimum bactericidal concentration (MBC) of drug
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17
Q

Difficult Penetration to Site of Action

A
  • Meningitis
  • UTI
  • Osteomyelitis
  • Abscesses
  • Otitis media
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18
Q

Meningitis

A
  • Infection of meninges
  • Membranes cover brain/spinal cord
  • Viral more common than bacterial
  • Antibiotic must penetrate meninges
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19
Q

UTI

A
  • Bacteria enters urinary system
  • Bladder most common (catheterization)
  • Antibiotic must enter urinary system
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20
Q

Osteomyelitis

A
  • Infection of bone
  • Limited treatment options, antibiotic must enter bone
  • 4-6 week antibiotic period
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21
Q

Abscesses

A
  • Pus/infected material collect under skin
  • Difficult to treat, low blood perfusion
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22
Q

Otitis Media

A
  • Infection of middle ear
  • Common in children
  • Antibiotics do not penetrate inner ear
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23
Q

Ability to Battle Infection

A
  • Immunological state of patient determines antibiotic choice
  • Bactericidal used with compromised immune function
  • Bacteriostatic compromised immune function may not respond
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24
Q

Impaired Response to Bacteriostatic Antibiotics

A
  • AIDS
  • Organ transplant
  • Cancer chemotherapy
  • Elderly
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25
Complications of Antibiotic Therapy
- Resistance - Allergy - Serum sickness - Superinfection - Destruction of normal bacterial flora - Bone marrow toxicity
26
Resistance
- Bacteria doesn't respond to antibiotic - Sensitivity loss
27
Acquiring Antibiotic Resistance
- Reduction of drug at site of target - Increased drug inactivation - Alteration of bacterial target
28
Drug Reduction at Target Site
- Bacteria decreases antibiotic uptake - Bacteria increase expression of efflux pumps (extrude antibiotics)
29
Increased Drug Inactivation
- Bacteria evolution to produce enzymes to inactivate antibiotics
30
Alteration of Bacterial Target
- Bacteria evolves to contain mutations - Within antibiotic target - Making antibiotic ineffective
31
Resistance Prevention
- Infection prevention - Diagnosis & effective infection treatment - Use antibiotics wisely - Prevent transmission
32
Allergy Signs
- Urticaria (hives) - Anxiety - Swelling (hands, feet, throat) - Difficulty breathing - Hypotension
33
Antibiotic Allergy
- Penicillin most common - Within 20 mins of dosing - Stop treatment immediately - Monitor vitals - Treatment with epipen & antihistamine
34
Serum Sickness
- Develops 7-21 days after antibiotic exposure - Immune system improperly identifies drug as harmful - Producing immune reaction
35
Immune Reaction Symptoms
- Fever - Hives - Rash - Joint pain - Itching - Angioedema - Enlarged lymph nodes
36
Serum Sickness Treatment
- Antihistamine (itching) - Analgesics (pain) - Corticosteroids (inflammation)
37
Superinfection
- New infection develops during antibiotic therapy - Antibiotics kill pathogenic & normal bacterial flora - Destruction of bacterial flora allows new bacteria - Caused by drug-resistant bacteria - Difficult to treat
38
Destruction of Normal Bacteria Flora
- Decreased vit K levels (warfarin) - Increase blood drug levels, toxicity - Decrease enterohepatic recycling
39
Bone Marrow Toxicity
- Rare complication, serious - Aplastic anemia - Thrombocytopenia - Agranulocytosis - Leukopenia - Watch for bruising/fatigue/sore throat
40
Penicillin
- Bactericidal - Effective against active growing/dividing bacteria - No outer membrane
41
Penicillin Mechanism of Action
- Inhibit transpeptidases - Activate autolysins - Disrupt synthesis of cell wall/promote destruction - Bacteria take up excess H2O & die
42
Bacterial Cell Wall
- Composed of peptidoglycan layer - Transpeptidases & autolysins form Penicillin binding proteins - Transpeptidases form crossbridge with peptidoglycan - Autolysins degrade peptidoglycan wall - Primary target of antibiotics
43
Penicillin Resistance
- Inability to reach target - Inactivation - Mutation to PBPs (low affinity)
44
Mechanisms of Penicillin Resistance
- Inactivation by beta lactamases enzyme - Target beta lactam ring of penicillin - Beta lactase inhibitors block enzyme
45
Penicillin Classes
- Narrow spectrum penicillins - Narrow spectrum penicillins resistant penicillins - Broad spectrum penicillins - Extended spectrum penicillins
46
Narrow Spectrum
- Treatment of gram positive bacteria - Destroyed by gastric acid - Intravenous/intramuscular administration - Pneumonia/meningitis treatment - Considered safe
47
Narrow Spectrum Penicillins Resistant Penicillins
- Altered side chain - Not effected by beta lactamase enzymes - Penicillinase treatment (produce staphylococci) - Less effective compared to non-penicillinase - MRSA resistant to this class
48
Broad Spectrum
- Effective against gram positive & negative bacteria - Pseudomonas aeruginosa treatment - Degradation by beta lactase enzymes
49
Cephalosporins
- Same mechanism of action as penicillin - Inhibit transpeptidases - Activate autolysins - Increase in activity against gram negative bacteria - Increase resistance to beta lactamases - Increase ability to penetrate cerebrospinal fluid - Alternative for penicillin allergies
50
Vancomycin
- Potentially toxic - Treatment for serious infections caused by MRSA - Osteomyelitis, meningitis, pneumonia - Cause ototoxicity & rapid infusion (red skin)
51
Vancomycin Mechanism of Action
- Inhibits cell wall synthesis - Binds to precursors of cell wall synthesis - Block transglycosylation in cross bridge formation
52
Tetracyclines
- Protein synthesis inhibitors - Act on ribosomes - Prevent addition of amino acids to peptide chain - Bacteriostatic - Typhus fever, chlamydia, cholera
53
Adverse Effects of Tetracyclines
- GI irritation - Photosensitivity (UV) - Susceptible to superinfection
54
Macrolid Antibiotics
- Protein synthesis inhibitors - Block ribosomes Block addition of amino acids to peptide chain
55
Adverse Effects of Macrolide Antibiotics
- GI upset - QT interval prolongation
56
Oxazolidinones
- Bacteriostatic (narrow spectrum) - Protein synthesis inhibitors - Bind to ribosomes - Gram positive bacteria - MRSA & VRE treatment
57
Adverse Effects of Oxazolidinones
- Reversible myelosuppression
58
Aminoglycosides
- Bactericidal (narrow spectrum) - Protein synthesis inhibitors - Effective versus gram negative bacteria - Bind to ribosomes - Rapid & lethal
59
Adverse Effects of Aminoglycosides
- Ototoxicity - Reversible nephrotoxicity
60
Sulfonamides & Trimethoprim
- Block folic acid synthesis - Bacteria dependant on synthesis of folic acid into DNA - Administered together to create bactericidal action - UTI treatment
61
Adverse Effects of Sulfonamides & Trimethoprim
- Hypersensitivity - Fever - Photosensitivity (UV) - Stevens-johnson syndrome
62
Fluoroquinolones
- Inhibit DNA replication - DNA gyrase & topoisomerase IV enzymes - Bactericidal, broad spectrum - UTI, soft tissue, osteomyelitis treatment
63
Isoniazid
- Tuberculosis treatment ONLY - Inhibit mycolic acid synthesis (cell wall component)
64
Adverse Effects of Isoniazid
- Peripheral neuropathy - Hepatotoxicity

2060 Pharmacology (18 decks)

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