Flashcards
Antibiotics
Cards in this deck (29)
- 1Which two classes of antibiotics target the bacterial cell wall?beta-lactams and glycopeptides
- 2Which antibiotics target gram +tive bacteria?Penicillins (E,S,S,L)
Fusidic acid
Macrolides (Strep only)
Clindamycin (Strep, some staph)
Glycopeptides (strep, staph, some e)
Oxazolidinones (SSE)
Daptomycin (SSE) - 3Which three classes of antibiotics can be used to treat MRSA? (methicillin-resistant)Oxazolidinones (linezolid), lipopeptide (daptomycin) and glycopeptide (vancomycin)
- 4Which antibiotics target gram negative bacteria?Polymixin
Trimethoprim
Monobactams
Temocillin - 5Which antibiotics are broad spectrum?B-lactams:
Carbapenams
Amoxicillin/clavulanate
Piperacillin/tazobactam
Cephalosporins
Aminoglycosides
Chloramphenicol
Tetracycline - 6For the following AB, describe their use, MOA, spectrum, mechanism of resistance , interactions and SE.X
- 7Penicillin1) Meningitis, pneumonia and resp. infections, syphilis
2) Inhibits transpeptidation of cell wall (-cidal)
3) Gram positive
4) Production of B-lactamase and alteration of PBPs: >80% of staphylococci resistant; S. Pneumoniae resistance in USA & S Europe; gonococcal resistance worldwide.
5) Interactions with allopurinol and methotrexate
6) Rule out penicillin allergy (IgE), safe in pregnancy and childbirth, Jarisch Herxheimer reaction, coombs positive haemolytic anaemia, interstitial nephritis, serum sickness, hepatitis, drug fever. - 8Amoxicillin1) Used in streptococcal disease, empirically for a sore throat, and listeria bacteria
2) Inhibits transpeptidation
3) Gram +tive and -tive
4) Production B lactamase and alteration PBPs
5) Interaction with allopurinol
6) Similar to penicillin, neutropenia, eosinophilia, antibiotic associated diarrhoea (AAD), RASH WITH MONONUCLEOSIS, increased PT and Kounis syndrome - 9Flucloxacillin1) All S. aureus infections except for MRSA
2) Inhibits transpeptidation
3) Gram positive (only)
4) Alteration of PBPs (B-lactamase resistant)
5) No significant interactions
6) Cholestasis, hepatitis, rash, leukopenia, anaemia, and thrombocytopenia - 10Co-amoxiclav/Augmentin (amoxicillin + clavulanic acid)1) Polymicrobial infections and B-lactamase producing infections
2) Transpeptidation inhibitor + B-lactamase inhibitor
3) Gram +tive, -tive and anaerobes
4) ESBLs, impermeability, efflux, altered PBPs: MRSA, hospital acquired gram +/- organism (including pseudomonas)
5) No interactions
6) See amoxicillin + DRUG INDUCED LIVER INJURY - 11Piptazobactam (piperacillin + tazobactam)1) Polymicrobial infections, b-lactamase producing gram +/- infections and pseudomonas
2) Transpeptidase inhibitor + B lactamase inhibitor
3) Gram +/-. anaerobes, pseudomonas
4) ESBLs, impermeability, efflux, altered PBPs: MRSA, gram - acquired hospital infections including pseudomonas
5) Methotrexate
6) Candida, insomnia, hypotension, thrombophlebitis, epistaxis, constipation, hypokalaemia - 12Which class of gram positive bacteria are cephalosporins not active against? Which organism can cephalosporin lead to the proliferation of?Enterococci
C. dif - 13CefuroximeCephalosporin
1) Pneumonia, serious intra-abdominal infections and UTIs
2) Inhibits cell wall synthesis
3) Gram +/-, not active against pseudomonas spp
4) ESBLs, impermeability, efflux, altered PBPs: MRSA, hospital acquired gram -tive organisms
5) No interactions
6) Rule out pen al (10% cross R), diarrhoea and c. dif
6) - 14Ceftriaxone1) Meningitis and pneumonia
2) Inhibits cell wall synthesis
3) Gram +/-, not active against pseudomonas SPP
4) ESBLs, impermeability, efflux, altered PBPs: MRSA and hospital acquired gram - infections
5) RULE OUT PEN AL. Diarrhoea, C. dif, pseudocholelithiasis
6) No major interaction - 15Ceftazidime1) Serious intra-abdominal infections and UTIs (especially if pseudomonas involved). Cannot be used in CAP (little action against S. pneumoniae)
2) Inhibits cell wall synthesis
3) Gram +/- bacteria and PSEUDOMONAS SPP
4) ESBLs, impermeability, efflux, altered PBPs: MRSA and hospital acquired gram -tive infections
5) Photosensitive rash, C diff, diarrhoea
6) No major interaction - 16MeropenemCarbapenem
1) Polymicrobial infections, ESBL producing gram -tive infections (ICU, haem-onc)
2) Inhibit cell wall synthesis + B-lactamase inhibitor (including ESBLs)
3) Gram +/-, pseudomonas and anaerobes
4) Metallo-B-lactamase, impermeability, efflux, altered PBPs
5) Rule out pen/ceph al. Rash and seizures
6) No major interactions - 17Vancomycin/TeicoplaninGlycopeptides
1) Problem gram + infections (e.g. MRSA)
2) Inhibits cell wall synthesis
3) Gram + C. diff
4) Alteration of binding site: vancomycin resistant enterococcus
5) Vancomycin is nephrotoxic (red man syndrome)
6) No significant interactions - 18What are the protein synthesis inhibitors?Aminoglycosides, tetracyclines, chloramphenicol, macrolides, clindamycin, fusidic acid
- 19Gentamicin and amikacin Bactericidal (only one of the protein synthesis inhibitors)Aminoglycosides
1) Adjunct to systemic sepsis including pseudomonas. Bacterial synergy with B lactam for IE and group B enterococcal sepsis. MRSA and others.
2) Irreversible inhib. of protein synthesis (30S) - O2 dependent (i.e. aerobes only)
3) Gram +/- and not pseudomonas spp
4) Impermeability, efflux - acquired resistance in gram -tive
5) Nephrotoxicity and ototoxicity
6) Increase nephrotoxicity with vancomycin, colistin and ambisome - 20Erythromycin, clarithromycin, azithromycinMacrolides
1) Used in atypical agents; penicillin allergy, H. pylori infections, STIs etc.
2) Bacteriostatic inhibition of protein synthesis (50S)
3) Gram + and H influenzae
4) Mutation of binding site - staphylococcus and streptococcus
5) Inhibits P450 and causes QT prolongation
6) No major interactions - 21Quinolones (ciprofloxacin, moxifloxacin, levofloxacin) Rifampicin MetronidazoleInhibit nucleic acid metabolism. Metronidazole is not active against most aerobes. Quinolones are the only oral anti-pseudomonas agent.
Poor selective toxicity - 22Cipro/levo/moxifloxacinQuinolones
1) Serious intra-abdominal and urinary tract infections, especially if pseudomonas are involved. Not used for pneumonia. Can be used in TB.
2) Inhibits DNA gyrase
3) Gram -/+, can't be used in pseudomonas
4) Impermeability and efflux: high rates of resistance
5) NOT LICENSED IN PREGNANCY. AAD, lowers seizure threshold, tendon rupture.
6) No major interaction - 23Sulphonamide and trimethoprimAntifolates
S - inhibits dihydropteroate synthase
T - inhibits dihydrofolate reductase (50,000 X more active than bacterial enzyme)
We lack dihydropteroate synthase but do have dihydrofolate reductase - 24Amphotericin Colistin DaptomycinMembrane disorgansing agents - poor selective toxicity
Amphotericin - antifungal agent
Colistin - polymixin
Daptomycin (lipopeptide which can be used to treat MRSA) - 25Which antibiotics show true synergy?B-lactams and aminoglycoside in endocarditis and group B enterococcus
- 26Which antibiotic classes show antagonism?Tetracycline or chloramphenicol with B-lactam or aminoglycoside.
Two beta-lactams together - 27Which antibiotics are used for ESBLs?Meropenem
Tazobactam, clavulanic acid
Non-beta lactamases
Colistin if all others have failed - 28Which antibiotics are used in penicillin allergies?Tetracyclines, aminoglycosides, quinolones, glycopeptides
- 29Which antibiotics are used to treat pseudomonas? Which is the only oral option?Ceftazidime (cephalosporin), quinolones, carbapenems, gentamicin
Quinolones
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- CSP lectures Flashcards on Antibiotics, created by Anna Hogarth on 30/10/2019.
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- Anna Hogarth
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