MD2 Foundation > Antibiotics > Flashcards

Antibiotics Flashcards

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1
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Staphylococcus

A

Gram positive
Coccus
Aerobic

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2
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Streptococcus

A

Gram positive
Coccus
Aerobic

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3
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Enterococcus

A

Gram positive
Coccus
Aerobic

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4
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Peptostreptococcus

A

Gram positive
Coccus
Anaerobic

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5
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Propionibacterium

A

Gram positive
Coccus
Anaerobic

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6
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Listeria

A

Gram positive
Bacillus
Aerobic

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7
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Clostridium

A

Gram positive
Bacilllus
Anaerobic

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8
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Bacillus

A

Gram positive
Bacillus
Aerobic

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9
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Corynebacterium

A

Gram positive
Bacillus
Aerobic

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10
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Neisseria

A

Gram negative
Coccus
Aerobic

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11
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Coliforms

A

Gram negative
Bacillus
Aerobic

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12
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Haemophilus

A

Gram negative
Coccobacillus
Aerobic

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13
Q

For the following bacteria, describe

  • Gram stain
  • Shape
  • Air requirement

Bordetella

A

Gram negative
Coccobacillus
Aerobic

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14
Q

What antibiotic classes are inhibitors of cell wall synthesis?

A

Beta-lactams

Glycopeptides

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15
Q

What antibiotic classes are inhibitors of the 30S ribosomal subunit?

A

Aminoglycosides

Tetracyclines

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16
Q

What antibiotic classes are inhibitors of the 50S ribosomal subunit?

A

Lincosamides
Macrolides
Fusidic acid
Linezolid

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17
Q

What antibiotic classes are inhibitors of folic acid synthesis?

A

Trimethoprim

Sulphonamides

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18
Q

What antibiotic classes are inhibitors of DNA gyrase?

A

Fluoroquinolones

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19
Q

What antibiotic classes are inhibitors of RNA polymerase?

A

Rifamycins

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20
Q

What antibiotic classes are disrupts of DNA strands?

A

Nitroimidazoles

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21
Q

What antibiotic classes are inhibitors of cell membrane function?

A

Colistin

Daptomycin

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22
Q

What antibiotic classes are bactericidal?

A 
Penicillins
Cephalosporins
Carbapenams
Glycopeptides
Fluoroquinolones
Rifamycins
Aminoglycosides
Metronidazole
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23
Q

What antibiotic classes are bacteriostatic?

A 
Macrolides
Lincosamides
Tetracyclines
Trimethoprim
Sulphonamides
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24
Q

What sort of infection does discoloured sputum suggest?

A

Bacterial, rather than viral

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25
What are the typical causes of community acquired pneumonia?
``` Streptococcus pneumoniae Haemophilus influenzae type b Staphylococcus aureus Streptococcus pyogenes Moraxella catarrhalis Anaerobes Aerobic and facultative Gram negative rods ```
26
What are the atypical causes of community acquired pneumonia?
``` Mycoplasma pneumoniae Legionella Chlamydophila pneumoniae C psittaci Chlamydia trachomatis Coxiella burnetii ```
27
What are examples of narrow spectrum penicillins?
``` Penicillin G Penicillin V Procaine penicillin - Procaine slows absorption rate Benzathine pencillin ```
28
What are examples of moderate spectrum penicillins?
Amoxycillin | Ampicillin
29
What are examples of broad spectrum penicillins?
Piperacillin | Ticarcillin
30
Against which bacteria do broad spectrum penicillins have?
Pseudomonas aeruginosa
31
When would you use broad spectrum penicillins?
If complicating factors present
32
What do beta-lactamase inhibitors do?
Inhibit most beta-lactamases produced by bacteria
33
What are examples of beta-lactamase inhibitors?
Clavulanic acid | Tazobactam
34
What are examples of beta-lactam/beta-lactamase inhibitor combinations?
Amoxycillin-clavulanate Piperacillin-tazobactam Ticarcillin-clavulanate
35
If a patient develops a rash within 24 hours of commencing penicillin, which antibiotics would you use?
Cephalosporins
36
What should you keep in mind when using cephalosporins as an alternative antibiotic in people with penicillin allergies?
Some cross-reactivity between true penicillin allergy and some cephalosporins Rare
37
What are examples of first generation cephalosporins?
``` Oral - Cephalexin IV - Cephazolin - Cephalothin ```
38
What is the spectrum of first generation cephalosporins?
Gram positives | Some common Gram negatives; eg: E coli
39
What are examples of second generation cephalosporins?
Oral - Cefuroxime - Cefaclor
40
What is the spectrum of second generation cephalosporins?
Same as 1st generation | Slightly enhanced activity against Gram negatives; eg: H influenzae
41
What are examples of third generation cephalosporins?
IV - Ceftriaxone - Cefotaxime
42
What is the spectrum of third generation cephalosporins?
Enhanced Gram negative activity | Less Gram positive activity, especially against S aureus
43
What are examples of fourth generation cephalosporins?
IV - Ceftazidime - Cefepime
44
What is the spectrum of ceftazidime?
Gram negatives, including Pseudomonas aeruginosa | Poor against Gram positives, especially S aureus
45
What is the spectrum of cefepime?
Gram negatives, including P aeruginosa | Some Gram positive activity, including against Streptococcus and S aureus
46
When are fourth generation cephalosporins used a lot?
Febrile neutropaenia
47
What are examples of fifth generation cephalosporins?
IV - Ceftaroline - Ceftolozane
48
What is the spectrum of ceftaroline?
Gram positives, including MRSA | Gram negatives except Pseudomonas
49
What is the spectrum of ceftolazane?
Pseudomonas | Gram negative activity
50
Which antibiotic classes have intracellular activity?
Tetracyclines Macrolides Fluoroquinolones
51
What differential diagnoses should you consider when considering community acquired pneumonia?
``` Upper respiratory tract infections Acute exacerbation of chronic bronchitis Cardiac failure Pulmonary embolus Endocarditis Liver abscess ```
52
What antibiotic classes have Gram negative activity?
``` Minimal/some - Moderate spectrum penicillins - 1st and 2nd generation cephalosporins Penicillin/beta-lactamase inhibitor combinations 3rd and 4th generation cephalosporins Gentamicin Fluoroquinolones ```
53
What antibiotic classes have anaerobic activity?
``` Penicillin Metronidazole Beta-lactam/beta-lactamase inhibitor combinations Carbapenems Clindamycin Moxifloxacin ```
54
Why is vancomycin given orally in the treatment of Clostridium difficile?
Oral vancomycin not absorbed very well > stays in gut - where you need it Also undergoes 1st pass hepatic metabolism, so not much enters systemically
55
What cause true rigors?
Influenza | Bacteria
56
Is there a clinical benefit in treating asymptomatic bacteriuria?
No Exceptions - Pregnancy - Patients undergoing urology procedures
57
Why is asymptomatic bacteriuria usually not treated?
Exposes patient to complications | Promotes antibiotic resistance
58
Signs of splinter haemorrhages and Janeway lesions suggest what?
Infective endocarditis
59
What is MRSA resistant to?
All beta-lactams
60
Describe penicillin G
Beta-lactam Also called benzylpenicillin Narrow spectrum Mainly active against Gram positive bacteria Inactivated by beta-lactamases IV administration Treatment of choice for susceptible infections; eg: pneumococcal pneumonia
61
Describe flucloxacillin
``` Beta-lactamase Food impairs absorption Dosed at 6-hourly intervals Usually well tolerated Rarely associated with - Cholestatic jaundice, especially in older patients on prolonged therapy IV/oral ```
62
Describe ceftriaxone
3rd generation cephalosporin Broad spectrum - Including majority of community-associated enteric Gram negative rods - Less active against Staphylococcus Inactive against MRSA Anti-staphylococcal activity dose dependent Not useful against enterococci Effective in meningitis Risk-benefit ratio in neonates Shouldn't be mixed with Ca-containing IV solutions
63
Describe gentamicin
Aminoglycoside Broad spectrum activity against Gram negative bacteria - Including P aeruginosa
64
Describe ciprofloxacin
``` Quinolone Reserved for - Infections resistant to other drugs - Oral therapy when alternative antibiotics not available Broad spectrum activity against Gram negative bacteria - Haemophilus influenzae - Enteric Gram negative rods - P aeruginosa - Gram negative cocci - Some Gram positive cocci - Legionella - Several mycobacteria Not active against anaerobes Poor activity against streptococci ```
65
Describe vancomycin
Glycopeptide Broad spectrum activity against Gram positive bacteria Primary indication: treatment for - MRSA - Methicillin-resistant coagulase negative staphylococci; eg: S epidermidis - Enterococcus faecium Used in people with penicillin hypersensitivity Oral vancomycin reserved for severe cases/those not responding to metronidazole when treating C difficile - To avoid development of VRE
66
Describe metronidazole
``` Nitroimidazole Broad spectrum activity against - Gram negative anaerobic bacteria - Gram positive anaerobic bacteria - Helicobacter pylori - Protozoa Can cause disulfiram-like reaction when used with alcohol - Abstain during treatment for up to 72 hours after completing course ```
67
Describe doxycycline
Tetracycline Broad spectrum - Gram positive and negative bacteria - Chlamydia - Rickettsia - Mycoplasma - Spirochetes - Some non-TB mycobacteria - Some protozoa; eg: malaria-causing Plasmodium Can cause oesophagitis Should be taken with food and full glass of water Can cause photosensitivity Tooth discolouration and enamel dysplasia in children - Reactions minimal if single short courses used
68
Describe acyclovir
``` Nucleic acid analogue Primarily used for treatment of - HSV - Chickenpox (VZV) - Shingles (VZV) Other uses - Prevention of CMV infections after transplant - Severe complications of EBV IV/oral ```
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