Introduction to Antimicrobials

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Questions and Answers

What is the primary function of antimicrobials?

  • To kill or suppress microorganisms (correct)
  • To relieve symptoms of infections
  • To promote bacterial growth
  • To enhance the immune response

Which type of drug resistance mechanism involves the alteration of drug-binding sites?

  • Compounds that antagonize drug actions
  • Active uptake cessation
  • Drug-metabolizing enzymes production
  • Alteration of target sites (correct)

Which of the following antibiotics is classified as a broad-spectrum penicillin?

  • Penicillin G
  • Ampicillin (correct)
  • Methicillin
  • Nafcillin

What does selective toxicity refer to in the context of antimicrobials?

<p>The ability to affect only infecting microorganisms without harming the host (C)</p> Signup and view all the answers

Which of the following is NOT a misuse of antimicrobials?

<p>Treating confirmed bacterial infections (B)</p> Signup and view all the answers

Which class of antibiotics inhibits bacterial cell wall synthesis?

<p>Penicillins (B)</p> Signup and view all the answers

What is the primary mechanism of action for Penicillin G?

<p>Weakening bacterial cell wall by binding to penicillin-binding proteins (B)</p> Signup and view all the answers

Which drug combination acts as a beta-lactamase inhibitor?

<p>Ampicillin + sulbactam (B)</p> Signup and view all the answers

What is a key contraindication for the use of CI in patients?

<p>Patients with renal disease (C)</p> Signup and view all the answers

Which combination of medications is used to treat serious infections with gram-positive bacteria?

<p>CI and Vancomycin (C)</p> Signup and view all the answers

What is one of the adverse effects of Sulfonamides?

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

Which of the following types of bacteria are treated with Ciprofloxacin?

<p>Aerobic gram-negative and gram-positive bacteria (A)</p> Signup and view all the answers

What is a major concern regarding the use of Metronidazole?

<p>Interactions with warfarin (C)</p> Signup and view all the answers

Which adverse effect is associated with Fluoroquinolones?

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

What is the mechanism of action of Daptomycin?

<p>Causes loss of potassium from the cell membrane (D)</p> Signup and view all the answers

What should be monitored in patients taking CI?

<p>Signs of nephrotoxicity (A)</p> Signup and view all the answers

What type of infections are predominantly treated by 1st generation cephalosporins?

<p>Gram positive infections (C)</p> Signup and view all the answers

Which of the following is an adverse effect associated with vancomycin?

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

What is the mechanism of action for cephalosporins?

<p>Inhibit cell wall synthesis (D)</p> Signup and view all the answers

Which generation of cephalosporins is known for reaching the central nervous system (CSF) more easily?

<p>4th Generation (B)</p> Signup and view all the answers

What are aminoglycosides contraindicated from mixing with?

<p>Cephalosporins (A)</p> Signup and view all the answers

Which type of antibiotic is effective against methicillin-resistant Staphylococcus aureus (MRSA)?

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

The use of tetracyclines can lead to which of the following adverse effects?

<p>GI irritation (B)</p> Signup and view all the answers

Which is a common drug interaction that must be avoided when using tetracyclines?

<p>Antacids containing aluminum (B)</p> Signup and view all the answers

Flashcards

Antimicrobial

A substance that kills or slows the growth of microorganisms.

Selective Toxicity

A drug's ability to harm a microorganism without harming the host.

Antibiotic

A chemical produced by a microorganism that can harm other microorganisms.

Penicillin

A type of antibiotic that inhibits bacterial cell wall synthesis.

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Drug Resistance

The ability of microorganisms to survive exposure to a drug.

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Cell Wall Synthesis Inhibitors

Antibiotics that block the formation of bacterial cell walls.

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Narrow-spectrum antibiotic

An antibiotic effective against a limited range of microorganisms.

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Beta-lactamase

An enzyme that breaks down some antibiotics like penicillin.

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Cephalosporins: 1st Generation

Effective against gram-positive bacteria like Streptococcus and Staphylococcus. Used for infections and surgical prophylaxis.

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Cephalosporins: 2nd Generation

Broader spectrum than 1st generation. Effective against gram-negative bacteria, certain gram-positive bacteria, and respiratory infections.

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Cephalosporins: 3rd Generation

Wide spectrum, effective against gram-negative bacteria and can reach the cerebrospinal fluid (CSF). Used for serious infections.

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Cephalosporins: 4th Generation

The strongest and most effective, easily reaching the CSF. Used for serious, resistant infections.

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Carbapenems: Imipenem

A powerful antibiotic often used in combination with cilastatin. Effective against a wide range of bacteria, including resistant ones.

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Vancomycin

A potent antibiotic used for serious gram-positive infections, including those resistant to other antibiotics.

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Tetracyclines

They work by suppressing bacterial growth by inhibiting protein synthesis. Used for a variety of infections, including acne and periodontal disease.

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Tetracyclines: Side Effects

They can cause gastrointestinal irritation, discoloration of teeth and bones, and photosensitivity.

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Aminoglycoside MOA

Aminoglycosides bind to the 30S ribosomal subunit, preventing protein synthesis in bacteria.

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Aminoglycoside AE

Aminoglycosides can cause ototoxicity (hearing loss) and nephrotoxicity (kidney damage).

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Aminoglycoside CI

Aminoglycosides are contraindicated in patients with renal disease, the elderly, and those with pre-existing hearing loss.

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TMP/SMZ MOA

Trimethoprim/Sulfamethoxazole (TMP/SMZ) inhibits bacterial synthesis of folic acid, a crucial nutrient for bacterial growth.

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TMP/SMZ Uses

TMP/SMZ is effective against various bacterial infections, including UTIs, ear infections, bronchitis, and pneumocystis pneumonia.

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Ciprofloxacin MOA

Ciprofloxacin inhibits bacterial DNA gyrase, an enzyme essential for DNA replication.

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Ciprofloxacin Uses

Ciprofloxacin is used for a wide range of infections, including those affecting the respiratory tract, GI tract, urinary tract, bones, skin, and joints.

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Metronidazole MOA

Metronidazole targets and damages the DNA of anaerobic bacteria and protozoa.

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Study Notes

Introduction to Antimicrobials

  • Antimicrobial agents kill or suppress microorganisms.
  • Antibiotics are chemicals produced by microorganisms with the ability to harm others.
  • Selective toxicity is a drug's ability to kill or suppress infecting microorganisms without harming the host.
  • Antimicrobials are used to treat infections and prophylactically (e.g., surgery, bacterial endocarditis, neutropenia).

Misuses of Antimicrobials

  • Misuse includes attempting to treat untreatable infections, using the wrong dosage, using the wrong drug for a specific microorganism, or omitting proper cleaning procedures.

Drug Resistance

  • Microorganisms can alter their function or structure, leading to changes in their DNA.
  • They can develop enzymes to metabolize drugs, stop taking up certain drugs, or alter binding sites, or produce compounds that counteract drug actions.

Types of Antibiotics

  • Antibiotics are classified based on susceptible organisms (gram-positive or gram-negative, anaerobic or aerobic).
  • They are also categorized by narrow-spectrum or broad-spectrum activity.
  • Mechanisms of antimicrobial action include inhibiting cell wall synthesis (e.g. penicillins, cephalosporins, carbapenems, vancomycin), inhibiting protein synthesis (e.g. tetracyclines, macrolides), other mechanisms

Inhibitors of Cell Wall Synthesis

  • Penicillins have a beta-lactam ring; some bacteria develop resistance by producing beta-lactamases. Subtypes include narrow and broad spectrum, penicillin-sensitive or penicillin-resistant types.
  • Cephalosporins are classified by generations (1st to 4th generation), with varying spectra of activity.
  • Carbapenems are broad-spectrum and are used in serious infections.
  • Vancomycin is used against specific resistant organisms.

Inhibitors of Protein Synthesis

  • Tetracyclines are broad-spectrum inhibitors of protein synthesis.
  • Macrolides include erythromycin, azithromycin, and clarithromycin, and are bacteriostatic or bacteriocidal.

Other Antimicrobials

  • Sulfonamides interfere with folic acid synthesis.

  • Fluoroquinolones inhibit DNA replication, including ciprofloxacin and levofloxacin.

  • Metronidazole causes DNA damage in anaerobic organisms and protozoal infections.

  • Daptomycin disrupts cell membranes, affecting Gram-positive bacteria, including drug-resistant strains.

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