Flashcards
Antimicrobials
Cards in this deck (50)
- 1Antimicrobials are different toevery other type of medication. we must think and act differently when using them
- 2What proportion of in patients reveive antibiotics1/3
- 3what can overuse of antimicrobials result inantimicrobial resistence
- 4what is antimicrobial resistence (AMR)ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals and antimalarials) from working against it.
- 5What are some results of AMRstandard treatments become ineffective, infections persist and may spread to others
- 6What is antimicrobial stewardshipsystematic approach to optimising antimicrobial therapy
Optimise selection dose and duration
Avoid overprescribing - 7Antimicrobials have activity against?fungi,
viruses,
protozoa(malarial parasite)
bacteria - 8How do antimicrobials work 3 pointsdestroy microbes
prevent microbe multiplication and growth
prevent microbe pathogenic action - 9what is selective toxicitydrugs that are toxic to the microbe but not to the human cells
- 10Two types of bacteriagram positive
gram negative - 11what is MICminimum inhibitory concentration
- 12What does MIC meanlowest concentration of an antimicrobial that will inhibit visible growth of a micro-organism after overnight incubation
- 13what is concentration dependantthe higher the concentration above the MIC the more bacteria dies
- 14time dependentconcentration increase does not affect but duration of time at MIC is important
- 15what is empirical therapy?clinical educated guess - could be broad spectrum to cover a number of possibilities
- 16Mechanisms of antimicrobials*inhibit bacterial wall synthesis
*inhibit bacterial protein synthesis
*inhibit bacterial folate metabolism
*alter bacterial nucleic acid metabolism
*produce free radicals that damage bacterial DNA - 17Bacterial Wall synthesis inhibitorsBeta-Lactams like penicillin's, cephalosporins, monobactams and carbapenems
Glycopepetides like vancomycin and teicoplanin
Cyclic Lipopeptides like daptomycin
Polypeptides like colistin and polymyxin - 18Inhibitors of bacterial protein synthesismacrolides like erythromycin, clarithromycin, azithromycin
Tetracyclines
Aminoglycosides like gentamicin
Tigecycline, linezolid, clindamycin, chloramphenecol - 19alters nucleic acid metabolismquinolones like ciprofloxacin, levofloxacin
sulphonamides
rifampicin - 20inhibit folate metabolismtrimethoprim
- 21Anti TB therapyRifampicin sometimes with streptomycin
Isoniazid
Pyrazinamide
Ethambutol - 22How does resistence to beta lactams happen?bacteria develops a beta lactamase enzyme that breaks down beta lactam ring
- 23Problems with penicillinAllergy
diahorrea and nausea
severe colitis - 24Narrow spectrum penicillins and routepenicillin v-strep tonsillitis (po not with food)
benzylpenicillin-group b strep (IV poor po absorption) - 25Flucloxacillin (4 points)staphylococci
choleatic jaundice
oral or IV
30min before or 2hrs after food - 26Amoxycillinwith clavulanic acid = a beta lactamase inhibitor
Co-Amoxiclav - 27PipericillinTazobactam is a beta lactmase inhibitor
nosocomial infections
pseudomonas cover(Gram-negative bacillus resistant to many antibiotics) - 28Cephalosporins are categorized ingenerations. four and five are restricted use
- 29CephlosporinsHypersensitivity reactions
cross sensitivity for penicillin reactions
excreted via the kidney nb renal function
indications vary depending on generation and antibiotic - 30Other beta lactamsMonobactam like aztreonam
Carbepenems like metropenem (these are protected - best used in consult with microbiologist) - 31Aminoglycosides likegentamicin, tobramycin, amikacin
- 32Aminoglycosides considerationsmust be given IV (No GI tract-inhaled tobramycin)
narrow therapeutic index
renally excreted
ototoxic
nephrotoxic
nb infusion rate
blood levels for dose and dose interval - 33Tetracyclines likeTetracycline, doxycycline, minocycline, oxytetracycline
- 34Tetracycline considerationsphotosensitivity, nausea, diarrhoea
plenty of fluid
upright position better-oesophageal irritation and ulceration
same reason for daytime administration-not lying down soon afterwards - 35Macrolides likeerythromycin, clarithromycin, azithromycin
- 36Macrolides considerationsGI upset
altered taste
QT interval prolongation (heart ecg)
Inhibits CYP450-interaction with statins like simvastatin, digoxin, warfarin - 37Metronidazoleproduces free radicals that are toxic to bacterial cell
- 38metronidazole considerationsorally, pr, IV
narrow spectrum
usually used in combination with other antibiotics
active against anaerobic and protozoa
used in dental practice
used for CDIFF - 39metronidazole-interactionsalcohol - nausea vomiting headache flushing
significant drug interactions - 40What antibiotic is used for C DiffMetronidazole
- 41Quinolones likeciproflaxin, oxoflaxin, moxiflaxin, levoflaxin
- 42quinolones considerationsOral vs IV bioavailability is similar so limit IV use
significant drug interactions
tendonitis
use is a risk factor for cdiff - 43Glycopeptides likevancomycin and teicoplanin
- 44glycopeptides considerationsnarrow therapeutic window
renal function monitor
slow infusion rate/long infusion time or Red Man Syndrome
Oral vancomycin for CDIFF only
Teicoplanin for MRSA - 45what is oral vancomycin used forCDiff
- 46wnot absorbed and can pass into small intestine
- 47SulphonamidesSeptrin
man made synthetic medicine
rash reaction
prevention of opportunistic infection in immunocompromised - 48TrimethoprimUTI
antifolate activity - 49antfungalsfluconazole
nystatin
clotrimazole - 50AntiviralsAciclovir
Antiretrovirals for HIV