Term
| 3 Kinds of antibiotics that have been increasing in use since 1922 (all others are decreasing) |
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Definition
Azithromycin/clarithromycin
Amox/Clav (<15 yo)
Fluroquinolones (>15 yo) |
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Term
| Give the MOA for β-Lactam antibiotics |
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Definition
1. They diffuse through the peptidoglycan of gram + bacteria and bind to penicillin binding proteins, inhibiting cell wall synthesis.
2. They also activate autolytic enzymes |
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Term
3 ways bacteria resist B-Lactam antibiotics |
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Definition
1. Inactivate it with B-Lactamase (destroys the B-Lactam ring)
2. Alter peptidoglycan binding proteins so they don't bind well
3. Reduce their outer membrane permeability so antibiotic can't get in (mostly in gram negative bacteria, loss of outer membrane porin) |
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Term
| 4 antibiotics that are desroyed by B-Lactamases |
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Definition
1. Penicillins
2. Cephalosporins
3. Monobactams
3. Carbapenems |
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Term
| All B-Lactam antibiotics are ___ dependent in order to work. |
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Definition
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Term
| MIC means _______ when referring to antimicrobial drugs. |
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Definition
| Minimum amount needed to inhibit microbial growth. |
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Term
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Definition
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Term
| Natural Penicillins (like penicillin g) are effective at killing ________, ______, and ________ (be specific) |
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Definition
1. Non B-Lactamase producing gram + cocci
2. Neisseria meningiditis (gram - cocci)
3. Non-penicillinase-producing Neisseria gonorrhoeae (gram - cocci) |
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Term
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Definition
| Penicillinase-resistant penicillin |
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Term
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Definition
| Penicillinase-resistant penicillin |
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Term
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Definition
| Penicillinase-resistant penicillin |
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Term
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Definition
| Penicillinase-resistant penicillin |
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Term
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Definition
| Penicillinase-resistant penicillin |
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Term
| Phenoxymethyl penicillin is a ___ |
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Definition
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Term
Penicillinase-resistant penicillin is resistant because ___.
+ What microbe produces penicillinases? |
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Definition
- has a side chain that protects the B-lactam ring
- Staphylococcus make penicillinases |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Aminopenicillins are effective against ___, ___, & ___. |
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Definition
1. gram +s
2. enterococcus (better than natural penicillins)
3. Listeria |
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Term
| ___ and ___ are resistant to aminopenicillins and why. |
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Definition
1. Staphylococcus (make penicillinases)
2. Gram negative B-lactamase producers |
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Term
| Give the difference between aminopenicillins and natural penicillins. |
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Definition
| Aminopenicillins are acid stable and work better against g- bacteria. |
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Term
| 3 adverse effects from aminopenicillins. |
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Definition
Ampicillin-specific rash
Diarrhea
Pseudomembranous colitis |
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Term
| Carbenicillin is a ___ + what they're effective against (5) |
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Definition
Carboxypenicillin
For: g- bacteria including Pseudomonas aeruginosa, enterobacter, morganella, indole-positive proteus, + all those of ampicillin |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| Ureidopenicillins are effective against ______(6) |
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Definition
1. all those of carboxypenicillins
2. Klebsiella
3. Serratia
4. Enterobacter
5. Enterococcus
6. Better anaerobic activity |
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Term
| 2 penicillins that are acid stable |
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Definition
| Phenoxymethyl penicillin and amoxicillin |
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Term
| Describe the chemical structure of cephalosporins |
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Definition
| B-Lactam ring fused to a dihydrothiazine ring & has a "cephem nucleus" |
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Term
| Describe the MOA of cephalosporins |
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Definition
| They bind to Penicillin-binding proteins (PBP's) in bacterial membranes to prevent them from creating the peptidoglycan cell wall |
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Term
| What are first generation cephalosporins effective against? (4) |
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Definition
Affective against:
1. Gram + cocci (except enterococci and methicillin-resistant staphylococci)
2. most E. Coli
3. most Proteus mirabilis
4. most Klebsiella. |
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Term
| Cefazolin is a ___ for ___ (2) |
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Definition
| a cephalosporin for perioperioperative prophylaxis for joint protheses or parenteral therapy for simple skin and soft tissue infections |
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Term
| Cefadroxil is a ___ for ___ |
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Definition
a cephalosporin for oral therapy for skin infections or uti's
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Term
| All second generation cephalosporins are more effective (than first generations) against ___ (3), but are less effective against ___ |
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Definition
Effective against:
1. E. coli
2. Klebsiella
3. Proteus
Less effective against:
Gram + bacteria |
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Term
| Cefamandole, Cefuroxime, and Cefonicid are ___ with activity against ___ |
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Definition
second generation cephalosporins
additional activity against Haemophilus influenzae |
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Term
| Cefoxitin, Cefotetan, and Cefmetazole are ___ with activity against ___ |
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Definition
Are cephamycins (a type of second generation cephalosporins)
Additional activity against Bacteroides fragilis |
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Term
| 2 Main uses of second generation cephalosporins |
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Definition
1. Abdominal and pelvic surgery antibiotic
prophylaxis
2. Treatment of mild intra-abdominal
infections (e.g. cholecystitis) |
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Term
Third generation cephalosporins are most effective against ___ (specific type of microbes)
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Definition
| Best against aerobic gram- bacilli (including H. influenza) |
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Term
| Describe the effectiveness of third generation cephalosporins against gram + microbes. |
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Definition
poor
Except for Ceftriaxone and Cefotaxime against strep. pneumo. |
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Term
| Describe the effectiveness of third generation cephalosporins against anaerobes. |
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Definition
| Variable, includes bacteroides fragilis |
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Term
| Ceftriaxone is a ___ with activity against ___ |
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Definition
A third generation cephalosporin
Activity against Streptococcus Pneumoniae ***Penetrates into CSF*** |
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Term
| Cefotaxime is a ___ with activity against ___ |
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Definition
Third generation cephalosporin
Against streptococcus pneumoniae ***Penetrates into CSF*** |
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Term
| Ceftazidime is a ___ with activity against ___ |
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Definition
Third generation cephalosporin
Against Pseudomonas aeruginosa ***Penetrates into CSF*** |
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Term
| Cefepime is a ___ with activity against ___ (5) |
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Definition
The only available fourth generation cephalosporin
Against:
1. gram +
2. gram - (including pseudomonas aeruginosa)
3. anaerobes
4. multi-resistant gram- bacilli
5. bacteria with B-lactamases |
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Term
| What Cefepime (a fourth generation cephalosporin) is NOT active against |
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Definition
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Term
| Ceftobiprole is a ___ with activity against ___ |
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Definition
A fourth generation cephalosporin
Against MRSA
**Not available is United States, but is in some other countries including Canada** |
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Term
Ceftaroline is a ___ with activity against ___
+ it's MOA |
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Definition
A fifth generation cephalosporin
Against MRSA
Binds to penicillin-binding protein 2a, in MRSA |
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Term
| Cefamandole is a ___ with activity against ___ |
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Definition
second generation cephalosporin
additional activity against Haemophilus influenzae |
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Term
| Cefuroxime is a ___ with activity against ___ |
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Definition
second generation cephalosporin
additional activity against Haemophilus influenzae ***Penetrates into CSF*** |
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Term
| Cefonicid is a ___ with activity against ___ |
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Definition
second generation cephalosporin
additional activity against Haemophilus influenzae |
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Term
| Cefoxitin is a ___ with activity against ___ |
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Definition
A cephamycin (a type of second generation cephalosporins)
Additional activity against Bacteroides fragilis |
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Term
| Cefotetan is a ___ with activity against ___ |
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Definition
A cephamycin (a type of second generation cephalosporin)
Additional activity against Bacteroides fragilis |
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Term
| Cefmetazole is a ___ with activity against ___ |
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Definition
A cephamycin (a type of second generation cephalosporin)
Additional activity against Bacteroides fragilis |
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Term
| Most cephalosporins are excreted by ___. Ceftriaxone, Cefoperazone, and Cefotaxime and excreted by ___. |
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Definition
Most by kidneys
Other 3 by Hepatobiliary |
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Term
| The 2 cephalosporins that have the longest halflives and are therefore good for once a day home IV therapy. |
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Definition
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Term
| Safety & most common side effect of cephalosporins. |
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Definition
Very safe
Most common adverse effect is hypersensitivity: Maculopapular rash after several days of therapy |
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Term
| 5 Possible toxicities from cephalosporins and which ones cause which toxicities |
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Definition
- Nephrotoxicity- interstitial nephritis
- Diarrhea (from hepatobiliary excereted ones)
- Disulfiram-like reaction (can't metabolise alcohol, for ones with a MTT side chain)
- Hypoprothrombinemia (for Cephalosporins with a MTT side chain, competetive inhibition of the MTT group)
- Biliary sludge formation (by Ceftriaxone, because it's excreted in bile and can preicipitate out as crystals in high doses)
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Term
| What are first generation cephalosporins not effective against? (3) |
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Definition
Not effective against:
1. anaerobes.
2. enterococci (gram + cocci)
3. methicillin-resistant staphylococci (gram + cocci) |
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