Vaccines and Antimicrobial Drugs (#2) Flashcards
(196 cards)
1
Q
any molecule or substance that stimulates the immune system to make antibodies against it and activate immune memory (response)
A
antigen
2
Q
the substance given to a host (usually by injection) that induces artificial active immunity
A
vaccine
3
Q
vaccines act as ______, but do not cause disease
A
antigens
4
Q
what kind of immunity do vaccines induce?
A
artificial active (stimulate B cells to make antibodies + T cells)
5
Q
inoculation of a host with a vaccine to stimulate protective active immunity; booster may be required to enhance or restore protection
A
vaccination (immunization)
6
Q
first vaccine given ever was by who?
A
Jenner (gave James Smith cowpox for his smallpox)
7
Q
immune responses after exposure to antigen (2):
A
- primary immune response
- secondary immune response
8
Q
immune response that is slow to start; smaller antibody concentration
A
primary immune response
9
Q
immune response that is FASTER and is larger; antibody concentration is higher
A
secondary immune response
10
Q
vaccines get you through your _____ immune response level
A
primary (so when you get exposed again, your body responds with the more effective secondary response)
11
Q
T/F: during your second exposure to the antigen, your immune system is already activated so you should not get sick (or less sick if there’s been mutation changes to antigen = partial protection)
A
true
12
Q
T/F: you will always have antibodies leftover after your primary immune response
A
false (may have none)
13
Q
what type of immunity includes your body’s first line of defense?
A
innate immunity
14
Q
what type of immunity is built up as we are exposed to diseases or get vaccinated?
A
adaptive
15
Q
what type of immunity occurs when an individual produces antibodies to a disease through his or her own immune system?
A
active
16
Q
what type of immunity occurs when a person is GIVEN antibodies?
A
passive
17
Q
purpose of vaccine development =
A
get antigen into your body to stim. an immune reponse
18
Q
3 main approaches to making a vaccine:
A
1) whole-microbe approach
2) subunit approach
3) genetic approach (nucleic acid vaccine)
19
Q
type of whole-microbe approach vaccines (3):
A
1 inactivated vaccine
#2 live-attenuated vaccine
#3 viral vector vaccine
20
Q
type of whole-microbe approach vaccine: flu virus; attenuation; DEAD viruses; can cause you to get sick
A
inactivated vaccine
21
Q
type of whole-microbe approach vaccine: still ALIVE but weakened; MMR (measles)
A
live-attenuated vaccine
22
Q
type of whole-microbe vaccine: whole microbe approach but taken DNA out (ex: Johnson-and-Johnson vaccine)
A
viral vector vaccine
23
Q
type of vaccine: Flu =
A
inactivated virus (whole-microbe)
24
Q
type of vaccine: MMR (measles) =
A
live-attenuated vaccine (whole-microbe)
25
type of vaccine: Johnson-&-Johnson
viral vector vector
26
type of APPROACH of vaccine development: only uses the very specific parts of a virus or bacterium that the immune system needs to recognize
subunit approach
27
type of APPROACH of vaccine development: uses the genetic material for specific proteins -- the DNA or RNA; sends in pieces; novavax for covid
genetic approach (nucleic acid vaccine)
28
type of approach: novavax for COVID
genetic approach
29
an effective vaccine should do all of the following EXCEPT:
a) cause a primary immune response in the host
b) present antigen to the immune system
c) replace the host's previous immune memory to the pathogen
d) cause the production of antibodies that will bind to the pathogen
c) replace the host's previous immune memory to the pathogen
30
virus that causes COVID-19 =
SARS-CoV-2
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the ____ protein on SARS-CoV-2 is an ANTIGEN.
spike
32
what does the covid vaccine target on the virus?
spike protein (antigen)
33
what does the spike protein do for the COVID virus?
helps it attach to cells to cause infection
34
usually viruses mutate and become more transmissible, but not more ______
sever (wouldn't be advantageous to kill host; no longer could spread)
35
we look at the _____ of vaccines, not effectiveness bc effectiveness looks at real world impacts (which is too far ahead for us to tell)
efficacy
36
what kind of genome does SARS-CoV-2 have?
RNA
37
what kind of vaccine is Pfizer and Moderna (for covid)?
mRNA vaccine
38
steps of the develop. of mRNA vaccine (Pfizer + Moderna - 6 steps)
1) mRNA with instructions for making the spike protein is developed in a lab
2) put mRNA in a lipid particle
3) mRNA enters the human cell and antigen presents itself (flag)
4) COVID-19 virus spike protein created (B cell recognizes it and then differentiates)
5) spike proteins are recognized by the immune system (prod. specific antibodies + memory cells)
6) if infected, antibodies bind to virus and stop it from replicating
39
when antigens are presented on the surface of the virus; FLAG; says "hey this cell is infected!"
antigen presentation
40
what kind of vaccine is the Johnson-and-Johnson vaccine?
viral vector vaccine
41
steps of the development of a viral vector vaccine (Johnson-&-Johnson - 6):
1) genetic material (of spike protein) inserted into inactive (harmless) virus
2) viral vector vaccine (genetic material put in lipid-molecule)
3) phagocytic cell engulfs harmless virus
4) COVID spike protein created on surface
5) spike proteins recognized by the immune system, which produces specific antibodies against the virus
6) if infected with virus, antibodies bind to virus and stop it from replicating
42
resistance in a population to a pathogen (disease) as a result of the immunity of a large portion of the population
herd immunity
43
herd immunity breaks the chain of ______ ______ from one susceptible host to another
pathogen transmission
44
in herd immunity, the more highly infectious a pathogen, the _____ the proportion of immune individuals needed to prevent disease spread
greater
45
measles, which is very contagious, requires a ____% herd immunity
95%
46
you want ___% herd immunity but this rarely happens
80%
47
compounds used to treat disease by destroying or inhibiting the growth of pathogenic microbes within a host (in vivo)
antimicrobial drugs
48
types of antimicrobial drugs (3):
- synthetics
- antibiotics
- semi-synthetics
49
type of antimicrobial drug: CHEMICAL (ex: sulfur drug)
synthetic
50
type of antimicrobial drug: naturally produced antimicrobial agents (microbial products); produced by bacteria + fungi;
antibiotic
51
less than __% of antibiotics have clinical significance
1%
52
antibiotics are _______ into pills or a liquid --- NOT _______
purified; NOT modified
53
type of antimicrobial drug: chemically modified antibiotics (ex: amoxicillin)
semi-synthetic
54
example of semi-synthetic =
amoxicillin (chem. modified from penicillen)
55
antimicrobial drugs are classified based on what 3 things?
- molecular structure
- mechanism of action
- spectrum of antimicrobial activity
56
1st antibiotic ever used; still the most frequently used antibiotic (40% freq)
penicillins
57
general characteristics of antimicrobial drugs (4):
- selective toxicity
- therapeutic (effective dose)
- toxic dose
- therapeutic index
58
characteristic of antimicrobial drugs: ability of a drug to kill or inhibit a pathogen while damaging the host as LITTLE as possible
selective toxicity
59
penicillin targeting peptidoglycan and amino acid linking in the cell wall demonstrates the its high ______ _______
selective toxicity
60
characteristic of antimicrobial drugs: drug level required for clinical treatment; get to the MIC
therapeutic (effective) dose
61
ED =
effective/therapeutic dose
62
T/F: ED50 means 50% of the trial subjects will be successfully effected with this dose
true
63
characteristic of antimicrobial drugs: drug level at which drug becomes too toxic for patient (produces side effects)
toxic dose
64
TD =
toxic dose
65
T/F: TD50 means 50% of the trial subjects will have toxic side effects
true
66
characteristic of antimicrobial drugs: ratio of toxic dose to therapeutic dose
therapeutic index
67
the _____ the therapeutic index, the better
larger
68
for therapeutic index, we want ED to be _______ TD
greater than (ex: morphine is 70:1)
69
T/F: morphines therapeutic index is 70:1, meaning you have to take 70x more morphine than needed to get toxic side effects
true
70
usually highly ______ _____ drugs have a higher therapeutic index (good!!)
selectively toxic
71
who came up with the general characteristics of antimicrobial drugs (selectively toxic, ED, TD, and therap. index)
Paul Irwin
72
OTHER general characteristics of antimicrobial drugs (5):
- narrow-spectrum drugs
- broad-spectrum drugs
- cidal agent
- static agent
- side effects
73
general characteristics of antimicrobial drugs cont: drugs attacks only a FEW different pathogens (ex: only goes after gram-pos pathogens)
narrow-spectrum drugs
74
example of narrow-spectrum drug =
penicillin (but some semi-synthetic forms are consid. broad)
75
general characteristics of antimicrobial drugs cont: drugs attacks MANY different pathogens (ex: gram-pos + neg or bacteria, fungi, AND other microbes)
broad-spectrum drugs
76
general characteristics of antimicrobial drugs cont: KILLS microbes
cidal agent
77
general characteristics of antimicrobial drugs cont: inhibits growth of microbes
static agent
78
general characteristics of antimicrobial drugs cont: undesirable effects of drugs on host cells
side effects
79
types of antimicrobial targets (5):
- cell wall synthesis
- DNA gyrase
- protein synthesis (50S inhibitors)
- protein synthesis (30S inhibitors)
- lipid biosynthesis
80
type of antimicrobial TARGET by: penicillins
cell wall synthesis
81
type of antimicrobial TARGET by: Quinolones (ciprofloxacin)
DNA gyrase
82
what type of Quinolone (antimicrobial) targets DNA gyrase ?
ciprofloxacin
83
type of antimicrobial TARGET: packages DNA; agent inhibits cell to replicate DNA; works against actively growing cells
DNA gyrase
84
you have probably taken ciprofloxacin for ______
UTI's
85
ciprofloxacin goes again't what type of bacteria?
gram-NEGATIVE
86
type of antimicrobial TARGET by: Erythromycin (macrolides)
protein synthesis (50S inhibitor)
87
classification type of Erythromycin =
macrolides
88
type of antimicrobial TARGET: large ribosome subunit; selectively toxic bc agents go after a ribosome subunit
protein synthesis (50S inhibitor)
89
large HUMAN ribosomal subunit =
60S
90
_________ is a semi-synthetic erythromycin
Z-pack
91
type of antimicrobial TARGET by: Tetracyclines
protein synthesis (30S)
92
type of antimicrobial TARGET: commonly used for ACNE; small ribosome subunit; long-term use (for now); use a lot for animals
protein synthesis (30S)
93
human small ribosomal subunit =
40S
94
type of antimicrobial TARGET by: Platensimycin
lipid biosynthesis
95
type of antimicrobial TARGET: newly discovered; agents don't allow for formation of things such as the cell membrane
lipid biosynthesis
96
T/F: antimicrobials go after cells, whether they're dead or alive
false (only ACTIVE cells)
97
antimicrobials go after bacterial _______
components (ex: cell wall synthesis)
98
gram-_______ are more susceptible to antimicrobial agents
gram-POSITIVE *
99
types of SYNTHETIC (chemical) antimicrobial drugs (2):
- growth factor analogs
- quinolones
100
type of SYNTHETIC antimicrobial drug: structurally similar to an essential growth factor; disrupt cell metabolism
growth factor analogs
101
example of growth factor analog =
isoniazid
102
growth factor analog; NARROW spectrum; cidal if actively growing + static if dormant
isoniazid
103
isoniazid resembles ______ (similar structure) which is needed to produce mycolic acid; cell acidently puts isoniazid in place and build mycolic acid WONG (kills TB cells)
nictimomide
104
isoniazid has a ______ spectrum
narrow
105
when the cell puts isoniazid instead of nictimomide, it kills ______ cells bc _____ _____ is built wrong
TB cells; mycolic acid
106
type of SYNTHETIC antimicrobial drugs: interfere with bacterial DNA gyrase; prevents DNA packaging
quinolones
107
example of quinolone; NARROW spectrum (against gram-negative bacteria); cidal
ciprofloxacin
108
example of quinolones =
ciprofloxacin
109
antibiotics from bacteria re _____ products
natural
110
ciprofloxacin has a ______ spectrum against what?
narrow; gram-negative (like UTI bacteria)
111
ciprofloxacin is always ____ against cells
cidal (KILLS!)
112
types of ANTIBIOTICS from bacteria (3):
- macrolides
- tetracyclines
- lipid biosynthesis disruptor
113
type of antibiotic from bacteria: targets the 50S ribosomal subunit
macrolides
114
example of macrolides =
erythromycin
115
example of macrolide; BROAD spectrum -- attacks 50S subunit in a LOT of bacteria; static (only prevents growth)
erythromycin
116
erythromycin has a ______ spectrum and is ______
broad; static
117
semi-synthetic macrolide
azithromycin (Z-pack)
118
type of antibiotic from bacteria; targets the 30S ribosomal subunit
tetracyclines
119
tetracyclines have a ______ spectrum and are ______
broad; static
120
type of antibiotic from bacteria; targets FATTY ACID biosynthesis
lipid biosynthesis disruptor
121
example of lipid biosynthesis disruptor =
platensimycin
122
platensimycin has a ______ spectrum and is _____
broad; static
123
platensimycin is effective against what 2 very resistant bacteria?
MRS and VRE
124
trend of antibiotics from bacteria: have a _____ spectrum and are ______ (at least the examples)
broad; static (only prevents growth)
125
Beta-Lactam antibiotics from fungi (2):
- penicillins
- cephalosporins
126
who discovered penicillin?
Alexander Fleming
127
what do Beta-Lactam antibiotics target?
cell wall synthesis (prevent amino acids from linking up = transpeptidation)
128
beta-lactam antibiotics are effective primarily against what type of bacterium?
gram-positive bacteria (bc gram-neg have outer membrane)
129
beta-lactam antibiotics are _____ against actively growing cells
cidal
130
beta-lactam antibiotics have a ______ ring
Beta-lactam
131
have a different chemical group than normal penicillins; make it BROAD spectrum or less resistant to bacteria
semisynthetic penicillins
132
types of semisynthetic penicillins (4):
- methicillin
- oxacillin
- ampicillin
- carbenicillin
133
type of semisynthetic penicillins: TWO; acid-stable (so it can survive stomach acid and still be active after digestion); beta-lactamase RESISTANT
methicillin + oxacillin
134
enzyme that some resistant bacteria can make to break the beta-lactam ring
beta-lacatamase
135
type of semisynthetic penicillin: broadened spectrum of activity (especially against gram-negative bacteria); acid-stable; Betal-lacatamase SENSITIVE
ampicillin
136
type of semisynthetic penicillin: broadened spectrum of activity (especially against Pseudomonas aeruginsoa); acid-stable but ineffective ORALLY; Betal-lacatamase SENSITIVE
carbenicillin
137
you're allergic to penicillin if you produce this PROTEIN; binds to penicillin and makes it into an antigen, causing an allergic rxn
Haptin
138
natural penicillin =
penicillin G
139
isoniazid is used to treat what?
TB
140
the acquired ability of a microorganism to resist the effects of a chemotherapeutic agent to which it is normally sensitive
antimicrobial drug resistance
141
T/F: synthetic and semi-synthetic antimicrobials can be drug resistant as well
true
142
once resistance originates in a bacterial population, it can be _____ to other bacteria
transmitted
143
T/F: resistance mechanisms are NOT confined to a single class of drugs; could be a whole class of drugs
true!
144
erroneous practices ______ for the growth of resistant bacteria; makes problems worse (ex: take antibiotics for a virus-causing disease)
selects
145
MRSA was transformed to _____
VRSA
146
when scientists were trying to determine the "super bug," they isolated a bacterium from a diabetes patient's foot and realized it was _____
MRSA
147
bacteria conjugated (type of horiz. gene transfer) _________________ to MRSA to become VRSA
vancomyosin-resistant interocoxide
148
we can use vancomyosin-resistant interocoxide anymore to treat MRSA anymore so we have to use ______
plantosomyosin
149
T/F: drug resistance always occurs very slowly
false (can be very quick)
150
penicillin became resistant to ______ bc bacteria of this disease now produce a beta-lactamase enzyme (which breaks down penicillin)
gonorrhea
151
T/F: it's not the antimicrobial that causes the resistance -- it SELECTS for those bacteria that are resistant and then they can go on and take over the population (SELECTIVE MECHANISM)
true
152
resistance mechanisms (how bacteria make themselves resistant to antibiotics - 5):
- reduced permeability
- inactivation of antibiotics
- alteration of target
- development of resistant biochemical pathway
- efflux (pumping out of cell)
153
genetic basis of bacterial resistance that is very STABLE
chromosomal
154
genetic basis of bacterial resistance that is not very stable but can easily be transformed to other bacteria
plasmid
155
if an antimicrobial drug has a high selective toxicity, it means that it will:
a) cause noticeable side effects in the host
b) be bacteriocidal
c) be more active against the pathogen than the host tissues
d) have a narrow spectrum of activity
c) be more active against the pathogen than the host tissues
156
mechanisms of bacterial resistance (6):
1) target modification
2) preventing entrance
3) inactivation (of antibiotics)
4) efflux pumps
5) alternate pathway
6) impermeability
157
mechanism of bacterial resistance: changes target of drug/antibiotic (ex: mutation ot ribosome; antimicrobial can no longer find it); get a LOT of resistance from this; can be a small mutation (spontaneous usually)
target modification
158
target modification usually results from what?
small spontaneous mutation
159
mechanism of bacterial resistance: produce an antibiotic degrading enzyme; can never come into the cell; EXOENZYME (outside of the cell)
preventing entrance
160
preventing entrance mechanism of bacterial resistance involves what kind of enzyme?
exoenzyme
161
mechanism of bacterial resistance: antimicrobial gets INSIDE the cell, but then enzymes inside inactivate it
inactivation
162
mechanism of bacterial resistance: revolving door; pumps antimicrobials back outside
efflux pumps
163
mechanism of bacterial resistance: antimicrobials can't get in (ex: outer membrane or peptidoglycan layer doesn't let it thru)
impermeability
164
ORIGINS of drug resistance (3):
- natural immunity genes
- spontaneous mutations
- location of resistance genes
165
origin of drug resistance: resistance to certain antibiotics so it won't kill them
natural immunity genes
166
origin of drug resistance: MOST of resistance
spontaneous mutations
167
3 locations of resistance genes:
- chromosome
- plasmids (R factors)
- mobile genetic elements such as TRANSPOSONS
168
location of resistance genes: via horizontal gene transfer; more stable bc plasmids can be lost
chromosome
169
location of resistance genes: can carry more than one resistance; can be lost
plasmids (R factors)
170
why are plasmids called "R factors"?
R for resistance
171
location of resistance genes: copy genes; gene hops from one chromosome to another
mobile genetic elements such as transposons
172
copy genes =
transposons
173
made by bacteria and fungi to kill other bacteria and fungi
antibiotics
174
why would bacteria want to kill other bacteria?
to steal it's food + outcompete it; great advantage for survival (some even take their DNA)
175
transmission of drug resistance is thru what process?
horizontal gene transfer
176
types of drug resistance TRANSMISSION (horiz. gene transfer - 3):
- transformation
- conjugation
- transduction
177
T/F: resistance comes from using antimicrobials
false (comes from us "selecting" these bacteria that are resistant to drugs)
178
Suppose you have been suffering from a terrible cold for 10 days and it's getting worse. What would the doctor say to assure you that you have found a Dr. who is concerned about antibiotic resistance?
"I will call you tomorrow, after I have looked at the bacterial culture results."
179
type of horizontal gene transfer/transmission: transfer of free DNA; occurs when a cell dies and another cell takes up their DNA; comes thru cell wall + membrane; "competent cells" do this
transformation
180
cells able to take up "naked" DNA up from their environment
competent cells
181
type of horizontal gene transfer/transmission: plasmid transfer; use a pilus to send a plasmid over to another cell; pilus can also carry resistance genes as well
conjugation
182
type of horizontal gene transfer/transmission: transfer by viral delivery; occurs via a bacteriophage (virus that infects bacteria); mistake for virus -- injects resistance bacterial genes instead of viral DNA; gene has to be transferred thru plasmid or chromosomes
transduction
183
virus that infects bacteria
bacteriophage
184
sources of antibiotic resistance (5):
- inappropriate prescribing practices
- unregulated sale of antibiotics
- failure to complete courses of antibiotics
- use of suboptimal antibiotic dosages
- use of antibiotics as animal growth enhancers
185
source of antibiotic resistance: can get antibiotics online
unregulated sale of antibiotics
186
source of antibiotic resistance: mutant survivors begin to multiply and propagate bc you didn't kill them ALL
failure to complete courses of antibiotics + suboptimal antibiotic dose
187
source of antibiotic resistance: most times when you first get sick, it's a viral infection; ppl take antibiotics for viral infections and don't take them long enough
inappropriate prescribing practices
188
____% of sinus infections start as viral
98%
189
source of antibiotic resistance: giving livestock antibiotics "proactively" to prevent them from getting sick; causes them to get bigger; started to give them antibiotics all the time; resistant bacteria get into the environment when handling raw meat and contaminating veggies (no illegal to treat them proactively)
use of antibiotics as animal growth enhancers
190
___ out of 1 or 2 million sources of antibiotic resistance will be a spontaneous mutant
1
191
preventing emergence of drug resistance: give drug in ______ concentrations to destroy susceptible; takes away wall of protection and gets rid of mutants
high
192
preventing emergence of drug resistance: use antimicrobials only when ________; make sure it's not viral
necessary
193
preventing emergence of drug resistance: take full ______ of antimicrobial; not taking suboptimal dose
course
194
preventing emergence of drug resistance: use ____ spectrum antimicrobials; doesn't occur as often bc Dr's don't culture it; prevents natural flora from becoming resistant to drugs
narrow
195
preventing emergence of drug resistance: give a _____ of unrelated drugs (controversal)
combination
196
possible future solutions to preventing drug resistance (2):
1) continued development of new antimicrobials
2) use of BACTERIOPHAGES to treat bacterial disease (attacks bacterial cells, not human cells)
