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Flashcards in antibiotics and bugs Deck (35)
1

treat ESCAPPM organisms?

ESCHAPPM is a mnemonic for the organisms with inducible beta-lactamase activity that is chromosomally mediated

carbapenems
fourth gen cephalosporins
ciprofloxacin or aminogycosides

Enterobacter
Serratia
Citrobacter
Hafnia
Aeromonas
Proteus
Providencia
Morganella Morganii

2

Mechanism of rifampicin

inhibits bacterial DNA dependent RNA polymerase preventing transcription of DNA into mRNA

3

Mechanism of isoniazid

mechanism of action: inhibits mycolic acid synthesis

4

Pyrazinamide MOA

mechanism of action: converted by pyrazinamidase into pyrazinoic acid which in turn inhibits fatty acid synthase (FAS) I

Causes gout!!

5

MOA of ethambutol

inhibits the enzyme arabinosyl transferase which polymerizes arabinose into arabinan

6

MOA beta lactam (penicillins, cephalosporins, carbapenems, monobactams)

inhibit cell wall synthesis

7

MOA glycopeptides eg vanc, teicoplanin

inhibit cell wall synthesis

8

aminoglycoside MOA

inhibit protein synthesis (30S ribosomal subunit)

9

tetracycline MOA
eg doxy

inhibit protein synthesis (30S ribosomal subunit)

10

MOA chloramphenicol

inhibit protein synthesis (50S ribosomal subunit)

11

MOA clindamycin

inhibit protein synthesis (50S ribosomal subunit)

12

MOA macrolides
eg eryth, azith, roxith

inhibit protein synthesis (50S ribosomal subunit)

13

MOA linezolid

inhibit protein synthesis (50S ribosomal subunit)

14

MOA trimethoprim and sulphonamides

block folic acid synthesis

15

MOA fluoroquinolones

DNA gyrase inhibition

16

MOA Daptomycin

inhibit cell membrane function

17

What is the main drawback of cephalosporins?

Do not cover enterococcus

18

Which antibiotics are bactericidal? (5)

Beta lactams
Glycopeptides
Aminoglycosides
Fluoroquinolones
Colistin

19

How are ESBLs encoded and transmitted?

Plasmids

20

What are three examples of altered binding sites as a mechanism of resistance?

Rifampicin binding RNA polymerase
S pneumoniae and penicillin resistance
Methicillin resistance in S aureus and coag negative staph
Fluoroquinolone resistance by alteration of DNA gyrase

21

Cephalosporins do not cover LAME organisms...

Listeria
Atypicals
MRSA (except ceftaroline 5th gen)
Enterococci

22

Four notorious for C diff?

Amox
Amp
Clinda
Linco

23

Indications for infection VZV in immunocompetent person?

Age over 50
severe rash
mod-sev pain
eye involvement or face

should initiate within 72 hours of the rash

24

Melioid treatment?

First line is either ceftazidime or meropenem followed by BACTRIM

Imipinem second line

25

Get actual tetnus?

IM tetanus immunoglobulin
vent support
muscle relaxants
METRO NOT BENPEN

26

Who gets a tetanus booster?

Uncertain history of immunisation three or more times? minor wounds- tetanus vax only
all other- vax and Immunglob

History of three or more doses of vax?
less than 5 years ago- no worries
5-10 years ago and a minor wound- no worries
5-10 and a nasty wound or more than 10- vax

27

Ertapenem is the carbapenem that does not cover///

pseudomonas

28

What do carbapenems not cover

MRSA
burkholderia cepacia
not atypicals
not stenotrophomonas maltophilia

only ok for enterococcus

causes SEIZURES

29

WHy is nitrofurantoin creepy?

hepatitis
haemolysis
pulmonary toxicity
polyneuropathy

30

side effects linezolid

lactic acidosis!!
serotonin syndrome
bone marrow supression
peripheral neuropathy
optic neuropathy

31

Which NNRTI avoid in suicidal history?

Efavirenz

32

What will cover enterobacter and bacteroides for HITH?

Ertapenem

Remember mero covers pseudo- erta does not
Erta does not cover nocardia

33

Why is there a rash in Dengue?

Immune complex formation

34

If skin prick to penicillin positive, what is the chance you are also ceph positive sens?

2%

35

What proportion of Pneumococcal meningitis patients have pneumonia

1/3