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80 Cards in this Set
- Front
- Back
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What are the classification of antimicrobial agents based on their mechanism of action?
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Cell destruction, increasing cell wall permeability, protein synthesis inhibitors, DNA/RNA disruption, antimetabolites, and antiviral agents
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what are the major mechanisms of antimicrobial resistance?
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Production of inactivating enzymes, changing the target site, decreased uptake into bacterial cells, and synthesis of antagonizing compounds.
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True or False
All antimicrobials promote drug resistance |
True
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what is empirical therapy?
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Treatment of high-risk hosts who may exhibit signs and symptoms of disease in the absence of positive culture.
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what is definitive therapy?
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Targeting therapy directed at a specific pathogen
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What is prophylactic therapy?
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Administration of drug to prevent disease
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Which of the following is not a mechanism for which bacteria can develop resistance?
a) Presence of efflux pumps b) Production of antagonizing coumpounds c) Production of activating enzymes d) Changes in the target site |
C) Production of activating enzymes
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What is colonization?
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positive presence of bacteria at site but not actively causing infection, symbiotic coexistence between host and pathogen
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What is contamination?
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False positive presence of bacteria
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What is infection?
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Positive presence of pathogenic bacteria requiring antimicrobial therapy
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What choice of treatment depends on?
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Identity of the infecting organism, drug susceptibility, drug factors, host factors(immune system status, site of infection other- age, pregnancy status, allergy history, and genetics)
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Which of the following statement is correct?
a) Contamination is defined as the presence of false negative bacteria b) Definitive therapy is when a particular antibiotic is used to target a known pathogen c) Colonization is the positive presence of both infection and bacteria at a particular site d) Infection is defined as the positive presence of bacteria without need of antimicrobial therapy |
b) Definitive therapy is when a particular antibiotic is used to target a known pathogen
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What is minimum inhibitory concentration (MIC)?
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Lowest concentration of antibiotic that suppresses growth of an organism (macrobroth or microboth dilution, agar dilution, kirby-bauer disk diffusion, epsilometer strip, automated systems)
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what are the gram positive aerobic cocci?
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staphylococcus, streptococcus, and enterococcus
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what are the gram positive anaerobic cocci?
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peptococcus, peptostreptpcoccus
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what are the gram positive aerobic bacilli?
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Listeria, Corynebacterium, nocardia
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What are the gram positive anaerobic bacilli?
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Clostridium, lactobacillus
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what are the gram negative aerobic cocci?
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Neisseria, Mirabella
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What are the gram negative aerobic bacilli?
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Enterobacter, E coli, klebsiella, proteus, shigella, salmonella, enterobacteriace, citrobacter, acinetobacter, yersinia, pseudomonas, hemophilus influenza
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What are the gram negative anaerobic bacilli?
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Bacteroides
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what atypical organisms?
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Mycobacteria, chlamydia,legionella, mycoplasma, rickettsia, and borelia
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what are the anti-infective classifications?
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Penicillins, cephalosporins, monobactams, carbapenems, macrolides, tetracyclines, clindamycin, fluroquinolones, sulfonamides, glycopeptides, and aminoglycosides
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what are the mechanism of action of penicillins?
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Inhibits bacterial cell wall synthesis. Bind penicillin binding proteins, inhibits the final transpeptidation step of peptidoglycan synthesis
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what are the penicillin classes ?
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Penicillins, aminopenicillins, anti-staphylococcal penicillins, extended spectrum penicillins including the anti-pseudomonal penicillins, and beta-lactamase inhibitor combinations
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what is the drug of choice for syphilis and strptococcus?
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Penicillin G
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what are the agents of aminopenicillins?
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Amoxixillin and ampicillin
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What is the drug of choice for Listeria and enterococcus species?
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Ampicillin
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What is the dug of choice for MSSA?
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Oxacillin
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what classes of penicillin do Oxacillin and methicillin are?
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Anti-staphylococcal penicillins
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What are the agents of extended spectrum penicillins?
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Piperacillin and ticarcillin
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What are the agents of beta-lactamase inhibitor combinations?
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Augmentin, Unasyn, zosyn and timentin
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what is the drug of choice for bacteroides fragilis activity?
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Piperacillin
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What are the penicillin class adverse effects?
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Allergy reactions, GI upset, Neurotoxicity (seizure, confusion, irritability)
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what is the percentage of penicillin cross reactivity with cephalosporins?
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5-10%
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what is the percentage of penicillin cross reactivity with carbapenems?
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40%
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what are the agents of 1st generations Cephalosporins?
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Cefazolin, Cephalexin and cefadroxil
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What are the spectrum activity of the 1 st generation of cephalosporins?
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Staphylococcus (good MSSA, no MRSA coverage), streptococcus no enteroccus. Gram negative: PEK
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what are the agents of 2nd generations Cephalosporins?
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Cefuroxime, cefotetan, cefmetazole,cefoxitin (covered more gram negative HMN PEK)
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what are the agents of 3rd generations Cephalosporins?
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Ceftriaxone, ceftazidime, cefoperazone, cefixime.
(ceftazidime & cefoperazone have pseudomonas coverage) |
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what are the agents of 4th generations Cephalosporins?
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Cefepime (good for patients who have weak immunity)
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what are the agents of 5th generations Cephalosporins?
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Ceftaroline
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what is the only agents of cephalosporin that covers staphylococcus including MRSA?
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ceftaroline
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what are the agents manobactams?
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Aztreonam
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what drug can be ised for patients who have allergy with penicillin?
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Aztreonam
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what are the agents carbapenems?
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Meropenem and ertapenem
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Which of the following antibiotic does not have cross reactivity with PCN?
a) Meropenem b)Aztreonam c) Cefazolin d) Zosyn |
b) Aztreonam
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What are the three bugs that Ertapenem does not cover?
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Acinetobacter, pseudomonas, enterococcus
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What is the mechanism of action p macrolides?
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Inhibit proteins synthesis, binds to the 50 s ribosomal subunit
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What are the agents of macrolides?
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Erythromycin, Clarithromycin, Azithromycin
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what is the mechanism of action of tretracyclines?
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inhibit protein synthesis, binds to the 30s ribosomal subunit
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What are the agent of tetracyclines?
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tetracyclines, minocyclines, doxycyclines
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what are the spectrum of activity of tetracyclines?
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broad gram positive and negative coverage including MSSA & MRSA, atypical coverage
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What are the adverse effect of tetracycline class?
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GI irritation, tooth discoloration in kids less than 8 & pregnant women, photosensitivity and vertigo
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what is the mechanism of action of clindamycin?
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Inhibits protein synthesis, binds to the 50s ribosomal subunit
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what is the mechanism of action of fluroquinolones?
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inhibits DNA synthesis, interferes with DNA-gyrase, prevents relaxation of supercoiled DNA & promotes breakage of DNA strands.
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what is the mechanism of action of sulfonamides?
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Sulfamethoxazole (SMX) inhibits bacterial folic acid synthesis & growth, prevents the formation of dihydrofolic acid from paraaminobenzoic acid (PABA)
Trimethroprim (TMP) inhibits dihydrofolate reductase (DHF) inhibiton |
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what are the adverse effect of fluoriquinolones?
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GI upset, impaired bone/cartilage development, phototoxicity, QT prolongation
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What are the agent of fluoroquinolones?
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Levofloxacin, ciprofloxacin (pseudomonas)
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what are the adverse effects of sulfonamides?
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Hypersensitivity reaction (rash), Stevens johnson syndrome, hyperkalemia, GI upset, photosensitivity
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what is the treatment of choice for oneumocystis jiroveci pneumonias (PCP) & nocardia infections?
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Bactrim (sulfamethoxazole/trimethoprim) good stapf coverage (MRSA) good enterobacteriacea coverage
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what is the mechanism of action of aminoglycosides?
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Inhibits bacterial protein synthesis
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what are the adverse effects of aminoglycosides?
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Nephrotoxicity (reversible)
Ototoxicity (irreversible) Vestibular toxicity (reversible) |
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What are the agent of aminoglycosides?
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amikacin, tobramycin, gentamicin
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What are the agent of glycopeptide?
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Vancomycin
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what is the mechanism of action of glycopeptide?
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inhibits bacterial cell wall synthesis
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what are the adverse effects of glycopeptide?
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Redman syndrome, nephrotoxicity, and ototoxicity
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what are the mechanism of action of oxazolidinone?
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protein synthesis inhibor, binds to the 23s subunit of the 50s ribosomal unit
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what are the adverse effects of oxazolidinone?
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GI, headache, myelosuppression (related to length of use & reversible), peripheral neuropathy and serotonin syndrome
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what is the agent that is active against VRE?
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Linezolid (oxazolidinone)
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What are the adverse effect of daptomycin?
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Mucle breakdown (need to monitor cretinine kinase weekly)
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Which of the following antibiotic class is not bacteriocidal?
a) Penicillins b)Clindamycin c)Bactrim d)Cephalosporins e)Vancomycin |
b) Clindamycin
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which of the following antibiotics adverse effects not match?
a) ertapenem w/ seizure b) amoxicillin w/ Gi upset c) clindamycin w/ constipation d) gentamicin w/ ototoxicity e) levaquin w/ bone impairment f) doxycycline w/ tooth discoloration |
c) clindamycin w/ constipation
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what is antiseptic?
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agents applied to living tissue
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what is disinfectant?
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agents too harsh to be applied to inanimate objects
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what is sterilization?
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eradication of all microorganisms
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what is sanitization?
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decreased organism burden to a level which meets health standards
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what are the bactericidal antibiotics
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Penicillins, cephalosporins, monobactams, carbapenems, fluoroquinolones, sulfonamides, aminoglycosides, glycopeptide, and doptomycin
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what are the bacteriostatic antibiotics?
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macrolides, tetracyclines, clindamycin, oxazolidinone, and tigecycline
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what are the spectrum of activity of tigecycline?
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broad gram positive & negative & anaerobes (no pseudomonas activity)
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what are the spectrum of activity of daptomycin?
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broad gram positive coverage, no gram negative coverage, useful for multi-drug resistant organisms (VRE & MRSA)
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