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PA1: Pharmacology > Week 2 Antibiotics: DNA + Protein Synthesis ✅ > Flashcards

Week 2 Antibiotics: DNA + Protein Synthesis ✅ Flashcards

(72 cards)

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1
Q

What are the 4 targets for DNA antibiotics?

A

DNA base synthesis
DNA strand breaking
DNA supercoiling
RNA polymerase

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2
Q

Which group of antibiotics work on DNA base synthesis?

A

Sulfonamides

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3
Q

Which antibiotics work on DNA strand breaking?

A

Metronidazole

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4
Q

Which group of antibiotics work on DNA supercoiling?

A

Quinolones

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5
Q

Which group of antibiotics work on RNA polymerase?

A

Rifampicin

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6
Q

Which are the 2 most important Sulfonomides to remember?

A

Trimethoprim and Nitrofurantoin

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7
Q

How does Trimethoprim work?

A

Inhibits dihydrofolate reductase

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8
Q

What kind of bacteria is Trimethoprim used for?

A

Broad spec (not Pseudomonas A)
Aerobic +ve staphylococcus, aerobic -ve E. coli, enterobacter, Klebsiella pneumoniae

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9
Q

What conditions can Trimethoprim be used for?

A

Uncomplicated UTIs e.g. cystitis

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10
Q

Why is Trimethoprim good for UTIs?

A

Excreted mainly unchanged

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11
Q

What are the adverse effects of Trimethoprim?

A

GI upset, rash, hyperkalaemia, haematological disorders

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12
Q

How does Nitrofurantoin work?

A

Damages RNA, DNA and proteins - free radical generated

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13
Q

Why is Nitrofurantoin good for resistance?

A

Multiple mechanism of action

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14
Q

What condition can Nitrofurantoin be used to treat?

A

UTIs - broad spec

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15
Q

Which UTI treating antibiotic is a pro drug?

A

Nitrofurantoin

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16
Q

Which drug is important to remember for DNA strand breaking?

A

Metronidazole

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17
Q

How does Metronidazole work?

A

Generates free radical which breaks down DNA

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18
Q

What type of bacteria does Metronidazole treat?

A

Anaerobic bacteria

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19
Q

What conditions can Metronidazole be used to treat?

A

GI tract infections, duodenal ulcers, C. diff

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20
Q

Which drug can be used to treat C Diff?

A

Metronidazole

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21
Q

Which antibiotic can cause C Diff?

A

Amoxicillin

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22
Q

Why is Metronidazole contraindicated with alcohol?

A

Metronidazole inhibits acetaldehyde dehydrogenase involved in alcohol metabolism

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23
Q

What symptoms can you get with alcohol and Metronidazole?

A

Flushing, headache, vomitting
Due to increase of acetaldehyde in body

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24
Q

Which important antibiotics are important to remember for inhibition of unwinding DNA supercoils?

A

Ciprofloxacin
Levofloxacin
Moxifloxacin

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25
What are fluoroquinolones?
Active against -ve pseudomonas and anthrax
26
How do Fluoroquinolones work?
Helicase enzymes break H bonds in double helix Gyrase and topoisomerase enzymes cut DNA strand during replication - INHIBITED
27
Why are Fluoroquinolones used as 2nd line antibiotics?
Resistance is easier
28
What bacteria are Fluoroquinolones used for?
Aerobic -ve
29
Which conditions are Fluoroquinolones used for?
UTI/severe GI
30
What is the only oral antibiotic for Pseudomonas A
Fluoroquinolones (Ciprofloxacin)
31
What is the important Fluoroquinolone antibiotic to remember?
Ciprofloxacin
32
What are respiratory quinolones?
Active against strep. pneumoniae
33
What are the 2 respiratory quinolones to remember?
Levofloxacin Moxifloxacin
34
What are the differences between Levofloxacin and Moxifloxacin?
They are both active against MRSA (Levofloxain less so) Both have enhanced gram +ve activity - Strep pseudomonae
35
What are the adverse effects of Fluoroquinolones?
Promote C Diff, colitis, nausea and diarrhoea Increase arrhythmias (prolong QT interval) Lower seizure threshold Tendinitis -> rupture muscle tendons
36
What are the interactions of Fluoroquinolones?
Drugs/conditions that prolong the QT interval NSAIDS - increases seizures
37
How are proteins made by bacteria?
RNA polymerase in nucleus Transcription - makes mRNA from DNA using bases mRNA goes to ribosome and binds Ribosome reads mRNA and makes amino acid chain tRNA carries amino acids to ribosome mRNA read 3 bases at a time (codon) Once finished, amino acids fold into 3D protein
38
What is Rafampicin?
Inhibits RNA polymerase
39
What is Rafampicin used to treat?
TB - 6-12m treatment as slow growing! Also effective against leprosy
40
What is adverse effect of Rafampicin?
Induces CYP enzymes which decrease effect of liver metabolised drugs
41
What kind of bacteria is TB?
Mycobacteria
42
What are the symptoms of TB?
Cough, haemoptysis, fever, night sweats, weight loss
43
How does Isoniazid work?
Inhibits fatty acid synthase 2 (FAS-2) which polymerases fatty acids
44
What are the adverse effects of Isoniazid?
Causes hepatitis, peripheral neuropathy, increase plasma concentration of anti-epileptic drugs
45
How does Ethambutol work?
Inhibits arabinosyl transferase which prevents chains from attaching
46
What are the adverse effects of Ethambutol?
Optic neuritis, haemorrhaging, blue-yellow abnormalities, loss of visual field Reversible
47
What is Pyrazinamide used for?
TB persisters - reduces treatment from 12m to 6m
48
How do tetracyclines work?
Block tRNA binding
49
What are examples of tetracyclines?
Aminoglycosides Macrolides Chloramphenicol Doxycycline
50
What is Doxycycline used to treat?
Acne vulgaris, COPD, pneumonia, chlamydia, malaria, anthrax, lyme disease
51
What are the adverse effects of Doxycycline?
Nausea, vomitting, diarrhoea, oesophageal irritation/ulceration, photosensitivity
52
What is adverse effect of Doxycycline?
Binds to calcium (teeth and bones) - avoid in children
53
Which antibiotic is least likely to cause C diff/colitis?
Doxycycline
54
How are aminoglycosides adminstered?
IV/IM, narrow therapeutic index
55
How do aminoglycosides get into bacteria?
Water soluble so enter cells via O2-dependent pathway (absent in anaerobic bacteria)
56
What is an example of aminoglycosides?
Gentamicin
57
What is Gentamicin used for?
Severe sepsis, complicated UTI, endocarditis
58
What other antibiotics does Gentamicin work well with?
Penicillins as they weaken the cell wall to enhance aminoglycoside uptake
59
What bacteria is Gentamicin ineffective at treating?
Anaerobic
60
What are the adverse effects of Gentamicin?
Ototoxicity (permanent - auditory hair cells) Nephrotoxicity
61
What bacteria can Chloramphenicol not be used to treat?
Pseudomonas
62
What is an adverse effect of Chloramphenicol?
Suppresses bone marrow (panocytopenia)
63
How is Chloramphenicol adminstered?
Topically e.g. eye ointment
64
Can Chloramphenicol penetrate CNS? How?
Yes - lipid soluble
65
How do Macrolides work?
Uptake by phagocytes to infection site
66
What is an example of a Macrolide?
Erythromycin Clarithromycin
67
How do Macrolides work?
CYP3A4 inhibitor
68
What bacteria can Erythromycin treat?
Broad spec gram +ve and some -ve (similar to Penicillin)
69
What conditions can Erythromycin be used to treat?
Respiratory, skin and soft tissue infections Penicillin allergies H. Pylori and severe pneumonia (Legionaire's)
70
What is the adverse effects of macrolides?
Oral irritation, colitis, QT interval prolong, increases drugs that are metabolised by liverH
71
How does Linezoid work?
Prevents tRNA initiating transcription
72
Which is the last new antibiotic?
Linezoid

PA1: Pharmacology (8 decks)

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