Term
| Which classes of antibiotics prevent bacterial cell wall synthesis by binding to and and inhibiting cell wall transpeptidases? |
|
Definition
| penicillins, cephalosporins, carbapenems, monobactams |
|
|
Term
| Which drugs inhibit cell wall synthesis by binding to the D-ala D-ala terminus of nascent peptidoglycan? |
|
Definition
|
|
Term
| Which drugs bind to cell membrane, causing depolarization and rapid cell death? |
|
Definition
|
|
Term
|
Definition
| prevent bacterial cell wall synthesis by binding to and and inhibiting cell wall transpeptidases |
|
|
Term
| What are the effects of penicillins, cephalosporins, carbapenems and monobactams? |
|
Definition
| rapid bactericidal activity against susceptible bacteria |
|
|
Term
| What are the clinical applications of Pcn G? |
|
Definition
| streptococcal infections, meningococcal infections, neurosyphilis |
|
|
Term
| What drug can be used for streptococcal infections, meningococcal infections, and neurosyphilis? |
|
Definition
|
|
Term
| Name the drug: IV, rapid renal clearance (half life 30min) so requires frequent dosing every 4 hr, Tox: immediate hypersensitivity, rash seizures |
|
Definition
|
|
Term
| Which drug can cause immediate hypersensitivity, rash and seizures? |
|
Definition
|
|
Term
| How does PCN V compare to PCN G? |
|
Definition
| oral, low systemic levels limit widespread use |
|
|
Term
| which penicillin is taken orally and reaches low systemic levels which limit widespread use? |
|
Definition
|
|
Term
| How do benzathine PCN and procaine PCN compare to PCN G? |
|
Definition
| intramuscular, long-acting formulations |
|
|
Term
| which PCNs can be given intramuscularly and have long-acting formulations? |
|
Definition
| benzathine and procaine PCN |
|
|
Term
| How do nafcillin and oxacillin compare to PCN G? |
|
Definition
| IV, added stability to staphylococcal B lactamase, biliary clearance |
|
|
Term
| Which PCNs are given IV, have added stability to staphylococcal B lactamase and biliary clearance? |
|
Definition
|
|
Term
| How do ampicillin, amoxicillin, ticaricillin and piperacillin compare to PCN G? |
|
Definition
| greater activity against gram-negative bacteria, addition of B-lactamase inhibitor restores activity against many B-lactamase-producing bacteria |
|
|
Term
| Which PCNs have greater activity against gram-negative bacteria, addition of B-lactamase inhibitor restores activity against many B-lactamase-producing bacteria |
|
Definition
| ampicillin, amoxicillin, ticarcillin, piperacillin |
|
|
Term
| What are the 1st gen cephalosporins? |
|
Definition
| cefazolin, cephalexin, etc |
|
|
Term
| cefazolin, cephalexin are which generation? |
|
Definition
|
|
Term
| Which cephalosporins are 2nd gen? |
|
Definition
| Cefuroxime, cefotetan, cefoxitin |
|
|
Term
| Cefuroxime, cefoxitin, cefotetan are which generation? |
|
Definition
|
|
Term
| Ceftriaxone, cefotaxime, ceftazidime are which generation? |
|
Definition
|
|
Term
| Name the 3rd gen cephalosporins |
|
Definition
| Ceftriaxone, cefotaxime, ceftazidime |
|
|
Term
|
Definition
| prevents bacterial cell wall synthesis by binding to and inhibiting cell wall transpeptidases |
|
|
Term
| What are the clinical applications for cefazolin? |
|
Definition
| skin and soft tissue infections, urinary tract infections, surgical prophylaxis |
|
|
Term
| Which drug is used for skin and soft tissue infections, urinary tract infections, surgical prophylaxis |
|
Definition
|
|
Term
| name the drug: IV admin, renal clearance (half life 1.5 hr), dosed every 8h, poor penetration into CNS, tox: rash, drug fever |
|
Definition
|
|
Term
| Which drug can cause rash and drug fever? |
|
Definition
|
|
Term
| How does cephalexin compare to cefazolin? |
|
Definition
| oral, 1st gen, skin and soft tissue infections and UTI |
|
|
Term
| name the cephalosporin: oral, 1st gen, skin and soft tissue infections and UTI |
|
Definition
|
|
Term
|
Definition
| oral and IV, 2nd gen, improved activity for pneumococcus and H flu |
|
|
Term
| Name the cephalosporin: oral and IV, 2nd gen, improved activity for pneumococcus and H flu |
|
Definition
|
|
Term
| Describe cefotetan / cefoxitin |
|
Definition
| IV, 2nd gen, activity against Bacteroides fragilis allows for use in abdominal/pelvic infections |
|
|
Term
| Name the cephalosporin: IV, 2nd gen, activity against Bacteroides fragilis allows for use in abdominal/pelvic infections |
|
Definition
|
|
Term
|
Definition
| IV, 3rd gen, mixed clearance with long half life (6hrs), good CNS penetration, many uses including pneumonia, meningitis, pyelonephritis, and gonorrhea |
|
|
Term
| name the cephalosporin: IV, 3rd gen, mixed clearance with long half life (6hrs), good CNS penetration, many uses including pneumonia, meningitis, pyelonephritis, and gonorrhea |
|
Definition
|
|
Term
|
Definition
| IV, 3rd gen, similar to ceftriaxone but clearance is renal and half life is one hour |
|
|
Term
| name the cephalosporin: IV, 3rd gen, similar to ceftriaxone but clearance is renal and half life is one hour |
|
Definition
|
|
Term
|
Definition
| IV, 3rd gen, poor gram-positive activity, good activity against pseudomonas |
|
|
Term
| name the cephalosporin: IV, 3rd gen, poor gram-positive activity, good activity against pseudomonas |
|
Definition
|
|
Term
| Name a 4th gen cephalosporin |
|
Definition
|
|
Term
|
Definition
| IV, 4th gen, broad activity with improved stability to chromosomal B-lactamase |
|
|
Term
| name the cephalosporin: IV, 4th gen, broad activity with improved stability to chromosomal B-lactamase |
|
Definition
|
|
Term
| What are the investigational cephalosporins that are administered IV, are active against methicillin resistant staphylococci, and have broad gram-negative activity? |
|
Definition
| ceftobiprole, ceftaroline |
|
|
Term
| What type of drug is imipenem-cilastatin? |
|
Definition
|
|
Term
| imipenem-cilastatin: MOA? |
|
Definition
| prevents cell wall synthesis by binding and inhibiting transpeptidases |
|
|
Term
| What are the applications for imipenem-cilastatin? |
|
Definition
| serious infections such as pneumonia and sepsis |
|
|
Term
| Name the drug: IV, renal clearance (half life 1 hr), dosed every 6-8hr, component of drug prevents hydrolysis by renal dehydropeptidase, tox: seizures especially in renal failure or with high doses |
|
Definition
|
|
Term
| Why is cilastatin added to imipenem-cilastatin? |
|
Definition
| to prevent hydrolysis by renal dehydropeptidase |
|
|
Term
| which drug can cause seizures especially in high doses? |
|
Definition
|
|
Term
| What drug is used for serious infections such as pneumonia and sepsis? |
|
Definition
|
|
Term
| Describe meropenem / doripenem |
|
Definition
| IV, similar activity to imipenem, stable to renal dehydropeptidase, lower incidence of seizures |
|
|
Term
| name the drug: IV, similar activity to imipenem, stable to renal dehydropeptidase, lower incidence of seizures |
|
Definition
|
|
Term
|
Definition
| IV, longer half life allows for once-daily dosing, lacks activity versus pseudomonas and acinetobacter |
|
|
Term
| name the drug: IV, longer half life allows for once-daily dosing, lacks activity versus pseudomonas and acinetobacter |
|
Definition
|
|
Term
| What type of drug is aztreonam? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| binds and inhibits cell wall transpeptidases |
|
|
Term
| What are the clinical applications for aztreonam? |
|
Definition
| infections caused by aerobic, gram negative bacteria in pts with immediate hypersensitivity to PCNs |
|
|
Term
| Which drug is used for infections caused by aerobic, gram negative bacteria in pts with immediate hypersensitivity to PCNs |
|
Definition
|
|
Term
| How is aztreonam given? How is it cleared? Is there cross allergenicity with PCNs? |
|
Definition
|
|
Term
|
Definition
| inhibits cell wall synthesis by binding D-ala D-ala terminus of nascent peptidoglycan |
|
|
Term
| How do the effects of vancomycin compare to B-lactam abx? |
|
Definition
|
|
Term
| What are the clinical applications for vancomycin? |
|
Definition
| infections caused by gram positive bacteria including sepsis, endocarditis and meningitis, C difficile colitis (oral formulation) |
|
|
Term
| which drug is used for infections caused by gram positive bacteria including sepsis, endocarditis and meningitis, C difficile colitis (oral formulation) |
|
Definition
|
|
Term
| Name the drug: Oral and IV, renal clearance (6 hr half life), tox: red man syndrome, nephrotoxicity uncommon |
|
Definition
|
|
Term
|
Definition
| IV, similar to vanco except long half life permits once daily dosing |
|
|
Term
| Name the drug: IV, similar to vanco except long half life permits once daily dosing |
|
Definition
|
|
Term
|
Definition
| IV, very long half life 6-11d, once weekly dosing, more active than vanco |
|
|
Term
| name the drug: IV, very long half life 6-11d, once weekly dosing, more active than vanco |
|
Definition
|
|
Term
|
Definition
| IV, dual MOA results in improved activity against bacteria with reduced susceptibility to vancomycin |
|
|
Term
| name the drug: IV, dual MOA results in improved activity against bacteria with reduced susceptibility to vancomycin |
|
Definition
|
|
Term
| What type of drug is daptomycin? |
|
Definition
|
|
Term
|
Definition
| binds cell membrane, causing depolarization and rapid cell death |
|
|
Term
| what are the effects of daptomycin compared to vanco |
|
Definition
| more rapidly bactericidal |
|
|
Term
| What are the clinical applications for daptomycin? |
|
Definition
| infections caused by gram positive bacteria including sepsis and endocarditis |
|
|
Term
| Name the drug: IV, renal clearance (half life 8hr), once daily dosing, inactivated by pulmonary surfactant so cannot be used to treat pneumonia, tox: myopathy, should monitor CK levels |
|
Definition
|
|
Term
| which drug is inactivated by pulmonary surfactant? |
|
Definition
|
|
Term
| which drug causes myopathy? |
|
Definition
|
|
Term
| Aminopenicillins offer better coverage of... |
|
Definition
|
|
Term
| penicillinase-resistant PCNs are also called... |
|
Definition
|
|
Term
| Anti-pseudomonal PCNs include which groups? |
|
Definition
| carboxy and ureidopenicillins and monobactams |
|
|
Term
| describe the coverage for cephalosporins |
|
Definition
| Resistant to beta-lactamase, broad spectrum of G+ and G- |
|
|
Term
| PCN G is acid ____, so it can be given ____. |
|
Definition
|
|
Term
| PCN V is the oral form of ... |
|
Definition
|
|
Term
| Name the aminopenicillins. How does their spectrum compare to PCN G? Why? Are they sensitive to b-lactamases? |
|
Definition
| ampicillin and amoxicillin, broader spectrum with better killing of G-, they can penetrate the outer membrane better and bind transpeptidases better, yes they are still sensitive to b-lactamase |
|
|
Term
| The G- bacteria killed by aminoPCNs include ______ and other enterics. However, resistance has developed and many enteric G- bacteria have acquired _____ and are resistant. |
|
Definition
|
|
Term
| Both ampicillin and amoxacillin can be taken ____, but amoxicillin better absorbed this way. |
|
Definition
|
|
Term
| IV ampicillin is commonly used with other ABX like aminoglycosides (gentamicin) for broad gram-_____ coverage |
|
Definition
|
|
Term
| What are the penicillinase-resistant penicillins? What do they kill? How are they given? |
|
Definition
| methicillin, nafcillin, oxacillin, Staph aureus, only IV |
|
|
Term
| Naficillin is the DOC for... |
|
Definition
| serious staph aureus infections, like cellulitis, endocarditis, sepsis |
|
|
Term
| The clocks were ticking. It was only a matter of time before the ORAL beta-lactamase resistant PCNs were discovered. They are... |
|
Definition
| cloxacillin, dicloxacillin, flucloxacillin |
|
|
Term
| cloxacillin, dicloxacillin and flucoxacillin are not good against gram-_____ bacteria, they are used for gram-____ bacteria, especially those that produce _______, like _______ |
|
Definition
| negative, positive, penicillinase, staph aureus |
|
|
Term
| Pt has infected skin wound. He most likely has _____ or _______. Would treating with PCN G, V or ampicillin work? Why or why not? |
|
Definition
| staph aureus or group A beta-hemolytic strep, those would not cover penicillinase-producing Staph. Treating with a penicillinase-resistant agent (meth, ox, naf) would, and if you give an oral abx (clox, diclox, fluclox) you can send him home with an Rx and don't have to care for him around the clock |
|
|
Term
| CarboxyPCNs and ureidoPCNs are what type of PCN? What are they good for? |
|
Definition
| anti-pseudomonal PCN, expanded G- rod coverage especially against pseudomonas, also active against anaerobes and G+ bacteria |
|
|
Term
| Pseudomonas was so tricky we needed James Bond to help. His tools include a special CAR, a trained TICK, and a PIPE bomb. What are the anti-pseudomonal PCNs? |
|
Definition
| carbenicillin and ticaricillin (carboxyPCNs), piperacillin, mezlocillin, azlocillin (ureidoPCNs) |
|
|
Term
| Like ampicillin, the anti-pseudomonal penicillins are frequently combined with ______ to double up the pseudomonas killing |
|
Definition
|
|
Term
| anti-pseudomonal ABX are sensitive to ________, and thus most _______ infections are resistant |
|
Definition
|
|
Term
| What are the b-lactamase inhibitors? |
|
Definition
| clavulonic acid, sulbactam, tazobactam |
|
|
Term
| The generations of cephalosporins are based on... |
|
Definition
| activity against gram+ and gram- |
|
|
Term
| With each generation of cephalosporins, the drugs get better in which ways? |
|
Definition
| Increasingly able to kill G-, increasingly resistant to b-lactamases, increasingly potent |
|
|
Term
| The newer (3rd gen) cephalosporins are less effective against... |
|
Definition
| gram + organisms like staph and strep |
|
|
Term
| MRSA is resistant to all cephalosprorins because it has changed... |
|
Definition
| the structure of its PBP (transpeptidase). The enterococci are also resistant to cephalosporins |
|
|
Term
| FA, FAM, FUR, FOX, TEA - what is this? |
|
Definition
| 2nd gen cephs - cefamandole, cefaclor, cefuroxime, cefoxitin, cefotetan |
|
|
Term
| around 10% of pts with allergy to PCN will also have allergy to... |
|
Definition
|
|
Term
| How are first gen cephs used? |
|
Definition
| Excellent G+ coverage, so used as alternative to PCN for staph and strep infections. Surgeons love to use them before surgery to prevent infection from skin |
|
|
Term
| 2nd gen cephalosporins cover more gram-____ rods. Cefuroxime is a good agent for CAP because it has good coverage against ____ and ____. |
|
Definition
|
|
Term
| 3 second gen cephalosporins have good coverage against anaerobes, making them good for abd/pelvic infections, aspiration pneumonia, and colorectal surgery prophylaxis. Which are they? |
|
Definition
| cefotetan, cefoxitin, cefmetazole - the fox met the anaerobic bug for tea |
|
|
Term
| In general, what are 3rd gen cephalosporins good for? |
|
Definition
| Multi-drug resistant aerobic G- organisms that cause nosocomial pneumonia, meningitis, sepsis and UTIs |
|
|
Term
| Which is the only cephalosporin that's good against pseudomonas? |
|
Definition
|
|
Term
| What is special about ceftriaxone? |
|
Definition
| best CSF penetration, first line drug for meningitis in neonates, kids and adults. Also given IM for gonorrhea as more of these bugs have been resistant to tetracycline and PCN, pneumonia and pyelonephritis |
|
|
Term
| What bugs are still resistant to imipenem? |
|
Definition
| MRSA, some pseudomonas, mycoplasma |
|
|
Term
| Imipenem is ____ to beta-lactamases. It is very small and can pass through porin channels to the _____ space. There, it can interact with _____. |
|
Definition
| stable, periplasmic, transpeptidase |
|
|
Term
| inipenem can cause what types of reactions? It also lowers the threshold for what? |
|
Definition
|
|
Term
| Aztreonam - what's it good for? |
|
Definition
| it is a monobactam, good for AEROBIC GRAM NEGATIVE only, kills the tough ones like Pseudomonas |
|
|
Term
| can you use aztreoname in PCN-allergic pts? |
|
Definition
|
|
