Antimicrobial agents

Card Set Information

Author:
trincam2008
ID:
275850
Filename:
Antimicrobial agents
Updated:
2014-06-01 17:51:07
Tags:
path microbio abx
Folders:
Microbio
Description:
- Classification on targets, each with class, eg and indication - Broad and narrow spectru - Mec of Abx resistance
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  1. Classification - target
    1. Cell membrane toxin 

    (từ ngoài, đục lỗ)
    • 1. Polymycin e.g. colistin
    • -> Gram -ve

    • 2. Cyclic lipopeptide  e.g. daptomycin
    • -> G+ve, MRSA + VRE
  2. Classification - target
    2. Inhibit cell wall synthesis
    • 1. beta lactam: penicillin, cephalosporins, carbapenems
    • e.g benxylpenicillin, ceftriaxone, meropenem
    • -> - G+ve
    •     - G-ve: 3rd gen ceph's, carbapenems

    • 2. glycopeptides e.g. vancomycin, teicoplanin
    • -> MRSA, C.diff
  3. Classification - target
    3. Inhibit protein systhesis
    • 1. Aminoglycosides e.g. gentamicin
    • -> G-ve sepsis

    • 2. Tetrecyclines e.g. Doxycycline
    • -> Intracellular - chlamydia

    • 3. Macrolides e.g. Erythromycin, clarithromycin
    • -> G+ve (PCN) allergy

    • 4. Chloramphenicol e.g. eye drops
    • -> Bacterial conjunctivitis

    • 5. Oxaolidionones  e.g. linezolid
    • -> G+ve, MRSA + VRE
  4. Classification - target
    4. Inhibit DNA synthesis
    • 1. Fluroquinolones e.g. ciprofloxacin 
    • -> G-ve

    • 2. Nitroimidazoles e.g. metronidazole
    • -> Anaerobes + protozoa
  5. Classification - target
    5. Inhibit RNA synthesis
    • Rifamycin e.g Rifampicin
    • -> Mycobacteria - used in TB
  6. Classification - target
    6. Inhibit folate mechanism
    • 1. Sulfonamides e.g. sulphamethoxazole
    • -> PCP (with trimethoprim - co-trimoxazole)

    • 2. Diaminopyrimidines e.g. trimethroprim
    • -> UTI
  7. Broad spectrums 4x e.g
    (both G+ve and -ve)
    • - Co-amoxiclav
    • - Tazocin
    • - Ciprofloxacin 
    • - Meropenem
  8. Narrow spectrum x3
    • - Flucoxacillin
    • - Trimethoprim
    • - Gentamicin
  9. 4 mechanisms of antibiotic resistance
    BEAT drug action

    • 1. Bypass abx-sensitive step in pathway 
    • e.g. MRSA

    • 2. Enzyme-mediated drug inactivation
    • e.g B-lactamases

    • 3. Impairment of Accumulation of the drug
    • e.g. tetracycline resistance

    • 4. Modification of the drug's Target in the microbe
    • e.g. Quinolone resistance
  10. Typical abx
    against various focal and systemic infections

    (Site, organism/severity/circumstances, Abx)
    (skin, pharyngitis, pneumonia community & hosp)
    • 1. Skin  - S.aureus
    • -> Flucoxacillin (unless allergy, MR-)

    • 2. Pharyngitis  - b-haemolytic Streptococcus
    • -> Benzylpenicillin

    • 3. Community - acquired pneumonia 
    • a) mild -> amoxicillin
    • b) severe -> cefuroxime + clarithromycin

    • 4. Hospital - acq pneumonia
    • -> cefuroxime
  11. Typical abxagainst various focal and systemic infections

    (Site, organism/severity/circumstances, Abx)
    ( Bacterial meningitis, Sepsis)
    • 5. Bacterial meningitis - meningococcus/streptococcus
    • -> Ceftriaxone (amox if listeria likely, young/old/IC)

    • 6. Sepsis
    • a) severe-> cefuroxime, metronidazole +- Gent
    • b) neutropenic -> tazocin + gentamicin
  12. Typical abx
    against various focal and systemic infections

    (Site, organism/severity/circumstances, Abx)
    (UTI, colitis)
    • 7. UTI 
    • a) community -> trimethoprim (3 days)
    • b) nosocomial -> augmentin or cephalexin

    • 8. Colitis - Clostridium difficile 
    • => Metronidazole PO (stop ceph!)

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