Antimicrobials
41 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Which adverse effect is most closely associated with cumulative aminoglycoside exposure rather than peak serum concentrations?

  • Neuromuscular blockade
  • Ototoxicity (correct)
  • Hypersensitivity reactions
  • Nephrotoxicity
  • What is an important consideration when administering aminoglycosides to different patients?

  • Aminoglycoside doses always need to be adjusted based on the patient's weight.
  • Aminoglycoside doses have the same plasma levels in different patients.
  • The peak levels do not need to be high enough to kill bacteria.
  • The same aminoglycoside dose can produce very different plasma levels in different patients. (correct)
  • Which of the following adverse effects is specifically associated with macrolide use but not aminoglycoside use?

  • Superinfection
  • QT interval prolongation (correct)
  • Gastrointestinal distress
  • Blood dyscrasias
  • What is the rationale behind monitoring both peak and trough serum levels of aminoglycosides?

    <p>Ensuring peak levels are high enough to kill bacteria and trough levels are low enough to minimize toxicity. (C)</p> Signup and view all the answers

    A patient is prescribed an antimicrobial medication that inhibits tetrahydrofolic acid production. Which of the following drug classes fits this description?

    <p>Sulfonamides and Trimethoprim (D)</p> Signup and view all the answers

    Which mechanism of action is associated with selective toxicity in antimicrobial drugs?

    <p>Disruption of the bacterial cell wall. (A)</p> Signup and view all the answers

    What is the most accurate definition of an antibiotic, according to the provided text?

    <p>A chemical produced by a microbe that can harm other microbes. (D)</p> Signup and view all the answers

    An antimicrobial drug that inhibits the synthesis of nucleic acids would directly interfere with which bacterial process?

    <p>Genetic replication and repair. (C)</p> Signup and view all the answers

    Which of the following best explains how bacteria develop acquired resistance to antimicrobial drugs?

    <p>Genetic mutations and selection processes over time. (B)</p> Signup and view all the answers

    How does classifying antimicrobial drugs by susceptible organism aid in treatment strategies?

    <p>It enables selection of the most effective drug for a specific pathogen. (B)</p> Signup and view all the answers

    Which of the following is a noted mechanism of action for antibiotics?

    <p>Disrupting cell wall synthesis (C)</p> Signup and view all the answers

    Which of the following exemplifies selective toxicity?

    <p>A drug highly toxic to microbes but harmless to the host. (C)</p> Signup and view all the answers

    According to the classification of antimicrobial drugs, which of the following is NOT a typical target?

    <p>Synthesis of lipids. (A)</p> Signup and view all the answers

    What is the primary mechanism by which microbes develop resistance to drugs?

    <p>Decreasing the concentration of a drug at its site of action. (B)</p> Signup and view all the answers

    Which of the following is an example of a mechanism for acquired resistance in microbes?

    <p>Spontaneous mutation (C)</p> Signup and view all the answers

    Which strategy is LEAST likely to delay the emergence of drug resistance in a clinical setting?

    <p>Administering broad-spectrum antibiotics for every suspected infection. (A)</p> Signup and view all the answers

    According to the guidelines for antibiotic selection, what information is most critical for a clinician to consider when choosing an appropriate antibiotic?

    <p>The identity and drug sensitivity of the infecting organism. (C)</p> Signup and view all the answers

    Which host factor is least important to consider when selecting an antimicrobial drug?

    <p>Patient's favorite color (D)</p> Signup and view all the answers

    Why is it crucial for patients to complete the full course of an antibiotic prescription?

    <p>To maintain a high concentration of the drug at the site of infection for a sufficient time. (D)</p> Signup and view all the answers

    Which of the following is generally considered an appropriate indication for prophylactic antibiotic use?

    <p>Prevention of infection following surgery. (D)</p> Signup and view all the answers

    What distinguishes contamination from infection in the context of antimicrobial use?

    <p>Infection involves microbial invasion and multiplication causing clinical harm, contamination does not. (C)</p> Signup and view all the answers

    Which of the following adverse effects is primarily associated with trough levels when administering aminoglycosides?

    <p>Ototoxicity (D)</p> Signup and view all the answers

    What is a significant consideration when administering aminoglycosides, based on the text?

    <p>The fact that the same dose can produce very different plasma levels in different patients. (C)</p> Signup and view all the answers

    Which of the following is a potential adverse effect associated with macrolide antibiotics such as erythromycin?

    <p>QT prolongation (C)</p> Signup and view all the answers

    What is the primary mechanism of action for sulfonamides and trimethoprim?

    <p>Inhibiting tetrahydrofolic acid synthesis (A)</p> Signup and view all the answers

    Why are aminoglycosides typically administered in a single large dose each day, or in 2-3 smaller doses?

    <p>To optimize peak levels for bactericidal effect and minimize toxicity related to trough levels. (B)</p> Signup and view all the answers

    Which of the following mechanisms enables bacteria to become resistant to a drug by reducing the amount of drug that reaches its target site?

    <p>Increasing the expression of efflux pumps. (A)</p> Signup and view all the answers

    What is the primary role of bacterial enzymes in drug resistance?

    <p>To chemically modify or degrade the drug. (B)</p> Signup and view all the answers

    Which of the following modifications to a bacterial target site is a mechanism of antibiotic resistance?

    <p>Mutation in the gene encoding the target protein. (B)</p> Signup and view all the answers

    How does the production of a drug antagonist contribute to microbial resistance?

    <p>By directly neutralizing the drug's effects. (D)</p> Signup and view all the answers

    Which mechanism is responsible for the transfer of resistance genes between bacteria?

    <p>Conjugation, which involves plasmid transfer. (C)</p> Signup and view all the answers

    In what way does proper catheter management help delay the emergence of drug resistance?

    <p>By preventing biofilm formation and associated infections. (B)</p> Signup and view all the answers

    Why is it important to target the pathogen with a narrow-spectrum antibiotic whenever possible?

    <p>To minimize disruption of the normal microbiota and reduce the risk of superinfection. (B)</p> Signup and view all the answers

    What is the most significant reason to avoid unnecessary vancomycin use in hospitals?

    <p>Vancomycin use promotes the emergence of vancomycin-resistant bacteria. (B)</p> Signup and view all the answers

    What is the most accurate definition of an antimicrobial agent?

    <p>Any agent that can kill or suppress microorganisms. (B)</p> Signup and view all the answers

    According to the information, antimicrobial drugs can be classified based on:

    <p>The susceptible organism and mechanism of action. (A)</p> Signup and view all the answers

    An antimicrobial drug that inhibits cell wall synthesis would directly interfere with which bacterial process?

    <p>Formation of the protective outer layer. (C)</p> Signup and view all the answers

    Which of the following is an accurate description of how some organisms develop resistance to antimicrobial drugs?

    <p>By altering their metabolic pathways to bypass the drug's effect or reducing cell permeability. (C)</p> Signup and view all the answers

    Which bacterial structure or function is LEAST likely to be a target for antimicrobial drugs, based on the information?

    <p>Mitochondrial function. (A)</p> Signup and view all the answers

    For an antimicrobial drug to exhibit selective toxicity, it should:

    <p>Be toxic to the microbe but harmless to the host. (D)</p> Signup and view all the answers

    Which of the following organisms is identified as having microbial drug resistance?

    <p>Enterococcus faecium. (A)</p> Signup and view all the answers

    Flashcards

    Chemotherapy

    Use of chemicals against invading organisms.

    Antibiotic

    A chemical produced by one microbe that harms other microbes.

    Antimicrobial agent

    Any substance that kills or suppresses microorganisms.

    Selective Toxicity

    Toxic to microbes but harmless to the host.

    Signup and view all the flashcards

    Classification by Mechanism of Action

    Grouping antimicrobials based on how they work.

    Signup and view all the flashcards

    Acquired Resistance

    When organisms develop resistance to antimicrobial drugs over time.

    Signup and view all the flashcards

    Examples of Drug-Resistant Organisms

    Microbes like Enterococcus faecium and Staphylococcus aureus that resist drugs.

    Signup and view all the flashcards

    Mechanisms of Antibiotics

    How antibiotics work, like disrupting cell walls or protein synthesis.

    Signup and view all the flashcards

    Macrolides

    A class of antibiotics including erythromycin, clarithromycin, and azithromycin, used for various infections.

    Signup and view all the flashcards

    Aminoglycosides

    Narrow-spectrum, bactericidal antibiotics effective against aerobic gram-negative bacilli, such as gentamicin.

    Signup and view all the flashcards

    Nephrotoxicity

    Kidney damage caused by certain drugs, particularly aminoglycosides.

    Signup and view all the flashcards

    Serum Levels Monitoring

    Observing drug concentration in blood to ensure effective dosing and avoid toxicity.

    Signup and view all the flashcards

    Sulfonamides

    Broad-spectrum antibiotics that inhibit bacterial growth by interfering with folate synthesis.

    Signup and view all the flashcards

    Drug Resistance Actions

    Four main ways microbes resist drugs: decrease drug concentration, inactivate drugs, alter target molecules, or produce antagonists.

    Signup and view all the flashcards

    Conjugation

    A process where bacteria transfer genetic material to gain drug resistance.

    Signup and view all the flashcards

    Delaying Drug Resistance

    Strategies to slow down the development of drug resistance, such as vaccination and proper catheter use.

    Signup and view all the flashcards

    Treating Infections Correctly

    Treat actual infections instead of contamination or colonization to prevent resistance.

    Signup and view all the flashcards

    Identifying Organisms

    Selection of antibiotics involves identifying the organism causing the infection and its sensitivity to drugs.

    Signup and view all the flashcards

    Host Factors

    Factors that affect treatment, including host defenses, infection site, age, and previous allergies.

    Signup and view all the flashcards

    Prophylactic Antimicrobials

    Agents used to prevent infection instead of treating established infections, like before surgery.

    Signup and view all the flashcards

    Classification by Susceptible Organism

    Grouping antimicrobial drugs based on the types of organisms they target.

    Signup and view all the flashcards

    Disruption of Bacterial Cell Wall

    A mechanism where antibiotics break down the protective layer of bacteria.

    Signup and view all the flashcards

    Inhibition of Protein Synthesis

    Stopping bacteria from making proteins essential for their survival.

    Signup and view all the flashcards

    Nucleic Acids Synthesis Inhibitors

    Drugs that prevent bacteria from replicating their DNA or RNA.

    Signup and view all the flashcards

    Antimetabolites

    Substances that interfere with microbial metabolism, preventing growth.

    Signup and view all the flashcards

    Viral Enzyme Inhibitors

    Drugs that specifically target enzymes viruses need to replicate.

    Signup and view all the flashcards

    Acquired Resistance Development

    The process where microbes become less vulnerable to drugs over time.

    Signup and view all the flashcards

    Selective Toxicity Mechanism

    The ability of a drug to target microbes without harming the host.

    Signup and view all the flashcards

    Therapeutic uses of Macrolides

    Used for whooping cough, diphtheria, and chlamydial infections.

    Signup and view all the flashcards

    Adverse effects of Aminoglycosides

    Can cause nephrotoxicity, ototoxicity, and hypersensitivity reactions.

    Signup and view all the flashcards

    Monitoring Serum Levels

    Monitoring drug concentration to ensure effectiveness and avoid toxicity.

    Signup and view all the flashcards

    Sulfonamides and Trimethoprim

    Broad-spectrum antibiotics that inhibit bacterial growth by blocking folate synthesis.

    Signup and view all the flashcards

    Decrease drug concentration

    Reducing the amount of a drug at its action site to prevent effectiveness.

    Signup and view all the flashcards

    Inactivate a drug

    Bacteria can neutralize or disable a drug's effectiveness.

    Signup and view all the flashcards

    Alter drug target molecules

    Changing the structure of molecules that drugs target, making them ineffective.

    Signup and view all the flashcards

    Produce a drug antagonist

    Microbes can create substances that counteract drug effects.

    Signup and view all the flashcards

    Spontaneous mutation

    Random genetic changes in microbes that can lead to drug resistance.

    Signup and view all the flashcards

    Vaccination to delay resistance

    Using vaccines to prevent infections and the emergence of resistance.

    Signup and view all the flashcards

    Complete prescription

    Ensuring patients finish their entire antibiotic course to prevent resistance.

    Signup and view all the flashcards

    Study Notes

    Basic Principles of Antimicrobial Therapy

    • Chemotherapy is the use of chemicals to target invading organisms.
    • An antibiotic is a chemical produced by one microbe that harms other microbes.
    • An antimicrobial agent is any substance that kills or suppresses microorganisms.

    Selective Toxicity

    • Antimicrobials are toxic to microbes but harmless to the host.
    • Mechanisms include disrupting bacterial cell walls, inhibiting unique bacterial enzymes, or disrupting bacterial protein synthesis.

    Classification of Antimicrobial Drugs

    • Classifying antimicrobials is done in various ways.
    • The textbook uses classification by susceptible organism and mechanism of action.

    Classification of Antibiotics

    • Antibiotics work on various cellular processes.
    • These processes include cell wall synthesis, cell membrane permeability, protein synthesis (lethal and non-lethal inhibition), nucleic acid synthesis, antimetabolites, and viral enzyme inhibitors.

    Antibiotic Mechanisms of Action (Diagram)

    • The diagram displays the various mechanisms of antibiotic action.
    • These include inhibition of bacterial protein synthesis, inhibition of cell membrane synthesis, and inhibition of nucleic acid synthesis.
    • Specific examples of antibiotics that target each mechanism are shown in the diagram.

    Acquired Resistance to Antimicrobial Drugs

    • Over time, organisms develop resistance.
    • Resistance can occur even if the organism was highly susceptible previously.

    Organisms with Microbial Drug Resistance

    • Specific examples include Enterococcus faecium, Staphylococcus aureus, Enterobacter species, Klebsiella species, Pseudomonas aeruginosa, Acinetobacter baumannii, and Clostridium difficile.

    Microbial Mechanisms of Drug Resistance

    • Microbes can resist drugs by decreasing the drug's concentration, inactivating the drug, modifying drug targets, or producing drug antagonists.

    Mechanisms for Acquired Resistance

    • Resistance occurs through spontaneous mutation and conjugation.

    Delaying Emergence of Drug Resistance

    • Strategies to prevent drug resistance include vaccination, removing catheters, targeting the pathogen, preventing nosocomial infections, and preventing superinfections.

    Delaying Emergence of Drug Resistance

    • Effective strategies include treating the infection, not just the contamination, recognizing when to stop using a drug, isolating the pathogen, and breaking the chain of contagion.

    Selection of Antibiotics

    • Selecting antibiotics involves identifying the organism, evaluating drug sensitivity, and considering clinical factors and the likely infectious agent.

    Host Factors

    • Factors affecting antibiotic selection include host defenses, site of infection, patient age, pregnancy/lactation, and any previous allergic reactions.

    Dosage Size and Duration

    • Antibiotics must be present at the site of infection for a sufficient duration.
    • Complete the full prescription.

    Prophylactic Use of Antimicrobials

    • Antibiotics are used to prevent infections, not treat them.
    • Prophylactic use can occur in surgeries, bacterial endocarditis, and neutropenia.

    Penicillins

    • Active against many bacteria.
    • Low direct toxicity.
    • Principal adverse effect is an allergic reaction.
    • Beta-lactam ring structural component.
    • Other beta-lactam drugs include cephalosporins, aztreonam, imipenem, meropenem, and ertapenem.

    Penicillins: Mechanism of Action and Resistance

    • Weaken bacteria cell walls to allow water uptake, leading to rupture.
    • Primarily active against growing and dividing bacteria.
    • Bacterial resistance due to inability of penicillins to reach targets, bacterial enzymes inactivating penicillins, and production of low affinity penicillin-binding proteins.

    Mechanisms of Bacterial Resistance- Additional Factors

    • Bacteria resist penicillins by preventing their entry, inactivating them via bacterial enzymes, or creating low-affinity penicillin-binding proteins.

    Staphylococcus Aureus

    • S. aureus became resistant to penicillin during the 1960s.
    • MRSA (methicillin resistant Staphylococcus aureus) has a unique mechanism of resistance; producing penicillin-binding proteins with low affinity.
    • Mechanisms develop by acquiring genes that code for low-affinity PBPs from other bacteria.

    Penicillinases

    • Beta-lactamases are enzymes that inactivate penicillins.
    • Bacteria produce a variety of these enzymes that target penicillins and other beta-lactam antibiotics.

    Classification of Penicillins

    • Narrow-spectrum vs broad-spectrum penicillin, sensitive or resistant to penicillinase, and extended-spectrum.

    Gram-Negative vs Gram-Positive Cell Envelopes

    • Gram-negative bacteria have a thin cell wall, and an additional outer membrane. This outer membrane makes gram-negative bacteria harder to penetrate with antibiotics.
    • Gram-positive bacteria have only two layers, and usually a thicker cell wall. The thicker cell wall in gram-positive bacteria makes them more permeable and easier to treat with some antibiotics.

    Penicillinase-Resistant Penicillins

    • Nafcillin, oxacillin, and dicloxacillin are examples, available in the United States.
    • Used to treat infections by methicillin-resistant Staphylococcus aureus.

    Broad-Spectrum Penicillins

    • Aminopenicillins, such as ampicillin and amoxicillin (Amoxil, DisperMox), are broad-spectrum, meaning they can combat many bacteria.
    • Possible adverse effects include rashes or diarrhea.

    Extended-Spectrum Penicillins

    • Piperacillin is an example; it's broad-spectrum but sensitive to penicillinase.

    Drugs That Weaken Bacterial Cell Walls

    • Cephalosporins, carbapenems, and others, combat bacteria by weakening their cell walls.

    Cephalosporins

    • Widely used beta-lactam antibiotics.
    • Similar to penicillin in structure.
    • Usually given intravenously.
    • Low toxicity
    • Mechanisms include binding to penicillin-binding proteins, disrupting cell wall synthesis, and causing cell lysis.
    • Beta-lactamases destroy first-generation but affect later generations less.

    Classification of Cephalosporins

    • Categorized into generations (first, second, third, fourth, and fifth), each with varying levels of resistance to beta-lactamases and spectrum of activity.

    Cephalosporins: Therapeutic Uses

    • First generation often used prophylactically in surgical procedures.
    • Second generation is rarely used for active infections.
    • Third generation are often the first choice when active infections are occurring.
    • Fourth generation are most often used to treat healthcare and hospital-associated pneumonia.
    • Fifth generation are most often used to treat infections associated with MRSA.

    Carbapenems

    • Broad-spectrum beta-lactam antibiotics with low toxicity.
    • Not active against MRSA.
    • Examples include imipenem, meropenem, ertapenem, and doripenem.

    Carbapenems [Imipenem]

    • Active against many pathogens, including those resistant to other antibiotics.
    • Effective against gram-positive cocci, gram-negative cocci/bacilli, and anaerobic bacteria.
    • Administered intravenously.
    • Potential adverse effects and interactions.

    Vancomycin

    • Inhibits bacterial cell wall synthesis.
    • Primarily used for severe infections caused by MRSA, Staphylococcus epidermidis, and Clostridium difficile.
    • Intravenous administration necessary.
    • Potential adverse effects, including ototoxicity (reversible or permanent), "red man" syndrome, thrombophlebitis, rare cases of thrombocytopenia, allergic reactions.
    • Vancomycin is a last resort antibiotic due to rare toxicity.

    Tetracyclines

    • Broad-spectrum antibiotics that inhibit protein synthesis.
    • Resistance is rising.
    • Commonly used for rickettsial diseases, chlamydia, brucellosis, cholera, and other conditions.

    Tetracyclines: Specific Drugs

    • Tetracycline, demeclocycline, doxycycline, and minocycline are available systemically.
    • Treatment for various infections and conditions, including mycoplasma pneumonia, Lyme disease, anthrax, Helicobacter pylori infections, acne, peptic ulcers, and periodontal disease.

    Macrolides (Erythromycin)

    • Broad-spectrum antibiotics that inhibit protein synthesis (often bacteriostatic, but potentially bactericidal in some circumstances).
    • Usually used when patients are allergic to penicillin.
    • Effective against most gram-positive and some gram-negative bacteria.
    • Treats whooping cough, diphtheria, chlamydia, M. pneumoniae, and group A strep.

    Macrolides (Erythromycin): Uses and Adverse Effects

    • Treating whooping cough, acute diphtheria, chlamydial infections, certain bacterial infections, and potentially helpful when penicillin is contraindicated.
    • Potential adverse effects including gastrointestinal problems, QT prolongation, and potentially rare life-threatening side effects.

    Aminoglycosides

    • Narrow-spectrum antibiotics, typically bactericidal.
    • Commonly used to treat infections from aerobic gram-negative bacilli, including gentamicin, tobramycin, and amikacin.
    • Can cause significant damage to the inner ear and kidneys.
    • Not well-absorbed from the gastrointestinal tract and usually administered intravenously.

    Aminoglycosides: Adverse Effects and Interactions

    • Potential adverse effects include ototoxicity (hearing damage), nephrotoxicity (kidney damage), hypersensitivity reactions, neuromuscular blockade, and blood dyscrasias..
    • Interactions with other medications possible.

    Serum Levels of Aminoglycosides

    • Monitoring serum levels is crucial for effective aminoglycoside use.
    • Dosage is typically adjusted according to these levels.
    • Peaks need to be high enough to appropriately treat bacterial infections, but troughs must be low enough to prevent toxic effects.

    Sulfonamides and Trimethoprim

    • Broad-spectrum antibiotics that inhibit tetrahydrofolic acid synthesis.
    • Frequently used to combat bacterial infections, especially urinary tract infections (UTIs).

    Sulfonamides: Primary Uses and Microbial Resistance

    • Historically among the first drugs used, they primarily treat urinary tract infections.
    • Resistance has been developed by many bacteria, and can be more significant in certain types.

    General antibiotic principles

    • Understanding the different classes of antibiotics and their mechanisms of action.
    • Knowing the conditions for which antibiotics are appropriate and when they are contraindicated.
    • Understanding how to choose or optimize the antibiotic protocol to minimize patient risk.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Intro To AntiMicrobials PDF

    More Like This

    Unit 4 Antimicrobial Drugs and Immunizations
    10 questions
    Classification of Antimicrobial Drugs
    15 questions
    Antimicrobial Drugs Overview
    20 questions
    Use Quizgecko on...
    Browser
    Browser