Treatments

Question 1

Subcategorise CLASS I - prevent cell wall synthesis

Answer 1

B-lactams

Glycopeptides

Question 2

B-lactams subcategorise

Answer 2

Penicillins (Penicillin, Amoxicillin, Flucloxacillin) - Mainly G+
(Co-amoxiclav, above including anaerobes + inc G-)

Cephalosporins (Ceftriaxone, Cefotaxime) inc Gneg & dec Gpos through generations - no anaerobe activity

Carabapenems (Meropenem) - Most gram negatives + anaerobes, generally safe in penicillin allergy

Monobactams (Aztreonam)

Question 3

Subcategorise CLASS II - disrupt cell membrane function

Answer 3

Polymixins eg. Colistin

Disrupts cell membrane function

Question 4

Subcategorise CLASS III - prevent protein synthesis

Answer 4

Tetracyclines

Aminoglycosides

Macrolides

Question 5

Tetracyclines subcategorise

Answer 5

Class III - prevent protein synthesis

Tetracycline

Doxycycline (not for use on patients <12 = stains teeth yellow)

• Usually used for Gpos bacteria
• Broad spectrum, so often used if patient has a penicillin allergy
• ORAL administration only

Question 6

Aminoglycosides subcategorise

Answer 6

Class III (prevent protein synthesis)

Gentamicin
Used for Gneg
Therapeutic drug monitoring required- nephrotoxic / ototoxic
Good activity in the blood/ urine
Generally reserved for severe Gneg sepsis

Question 7

Macrolides subcategorise

Answer 7

Class III - prevent protein synthesis

Erythromycin & Clarithromycin
Used against Gpos bacteria
Mild treatment
Used as an alternative to penicillin

Question 8

Subcategorise CLASS IV - inhibits nucleic acid synthesis

Answer 8

Quinolones

Trimethoprim & sulphonamides

Question 9

Quinolones subcategorise

Answer 9

Class IV- prevent nucleic acid synthesis

Ciprofloxacin

Very powerful against Gneg bacteria
People on ciprofloxacin are predisposed to tendonitis and tendon ruptures.

Question 10

Trimethoprim and sulphonamides subcategorise.

Answer 10

Trimethoprim used to treat UTIs (Ecoli)

Combined with sulphamethoxazole = ‘Co-triamoxazole’ to treat PCP & MRSA

Question 11

Subcategorise antifungals

Answer 11

Azores

Polyenes

Question 12

Azores subcategorise

Answer 12

Antifungal
Used to treat yeasts and moulds

Fluconazole - candida

Posaconazole - aspergillus

Question 13

Polyenes subcategorise

Answer 13

Anti-fungal
Inhibit cell membrane function

Nystatin = topical treatment for Candida

Amphotericin (IV) = systemic fungal infection (aspergillus)

Question 14

Antivirals subcategorise

Answer 14

Acyclovir- used to treat herpes, VZV infections (chicken pox / shingles)

Oseltamivir ‘Tamiflu’ - used to treat influenza A and B

Specialist agents are used for HIV, HBV, HCV and CMV.

Question 15

Glycopeptides

Answer 15

Vancomycin:
Cell wall active agent, mostly gram positive (not -)
Not absorbed in gut, oral = C.diff only,
Therapeutic drug monitor required
VRE = Vancomycin resistant enterococci

Teicoplanin similar to Vancomycin

Question 16

Metronidazole

Answer 16

Antibacterial & Antiprotozal

Active against anaerobic bacteria

Active against protozoa:

1. Trichomonas (vaginitis)
2. Amoebae (dysentery & systemic)
3. Giardia (diarrhoea)