Test 2 Part 1: Antimicrobials

Front 1

bacterioCIDAL

Back 1

Kills bacteria

Front 2

bacterioSTATIC

Back 2

stops bacterial reproduction

Front 3

MOA of Sulfonamides

Back 3

- PBA analogs

-inhibit DHPS which is required for folic acid synth

-bacterioSTATIC

Front 4

Reasons for SULFA resistanance

Back 4

-altered DHPS

-^ synth of PABA

-^ NAT

-alt pathways for syth

8 all can occur via point mutation or plasmid transfer

Front 5

Sulfa absorption

Back 5

rapidly absorbed from GI tract

in urine in 30mins

Front 6

sulfa DIstriubution

Back 6

- well distribution including CSF

***may displace bilirubin => can cause kernicterus (neuro condition r/t high bilirubin) in neonates

Front 7

how is SULFONAMIDES metabolized?

Back 7

ACETYLATION

@ N4

* think fast acetylators(Asians)

Front 8

SULFONAMIDE drug interactions

Back 8

- may be antagonized by ester L.A. (PABA)

-may potentiate warfarin

-contra w/ methenamines =forms parcipitate

Front 9

name the adverse effects of SULFONAMIDES

Back 9

-hypersensitivity

-crystalluria ( increase fluid intake)

-hemolytic anemia

-GI : N&V

-hepatic necrosis

-blood dyscrasias

Front 10

SULFONAMIDE clinical use

Back 10

Clamydia

some UTIs

Front 11

how are SULFONAMIDES classified?

Back 11

by DOA

Front 12

name the rapidly absorbed SULFONAMIDES

Back 12

- sulfisoxazole

-sulfamethoxazole

-sulfadiazine

Front 13

poorly absorbed SULFONAMIDE

Back 13

sulfasaiazine (AZULFIDINE)

Front 14

name the topical SULFONAMIDES

Back 14

-sulfacetamide

-mafenide

-Silver sulfadiane (silvadene)

Front 15

what is the combo SULFONAMIDE

Back 15

trimethoprim-sulfamethoxazole (BACTRIM, SEPTRA)

can cause CNS tox in AIDS pts

Front 16

PCN MOA

Back 16

-inhibits final stage (3) of cell wall synth

-analog of D-ala-D-ala

-bacterioCIDAL

Front 17

resistance mechs for PCN

Back 17

- Beta lactamase

-altered PBPs (PCCN binding proteins)

-porin mutation

-failure to activate autolytic enzyme

-

Front 18

Name the 5 classes of PCN

Back 18

1. natural

2. penicillinase-resistanant

3. aminopenicillins

4. extended spectrum

5. combo w/ b-lactamase inhibitors

Front 19

what are the natural PCN?

Back 19

Pen G (prototype)

Pen V

Front 20

natural PCNs are HIGHLY active vs ???

Back 20

Gram + cocci

Front 21

natural PCNs are POORLY active vs?????

Back 21

gram neg bacilli

Front 22

which natural PCN is better absorbed?

Back 22

Pen V- more acid stable

Front 23

name the penicillinase-resistant PCN

Back 23

- nafcillin

-isoxazolyl

-methicillin (D/c)

Front 24

what do PRPs not work against?????

Back 24

no gram negative spectrum

Front 25

PRPs are active vs?????

Back 25

- staph. aureus

-gram positive cocci

Front 26

name the AMinopencillins

Back 26

-AMpicillin

-AMoxicillin

*ampicillin> PEN G vs Enterococcus

Front 27

which aminoPCN is better absorbed????

Back 27

AMOXICILLIN

Front 28

name the extended spectrum (antipseudomonal) PCNS

Back 28

- carboxyPCNs

high NA content can cause CHF

-ureidoencillins

pipercillin

Front 29

NAME combo PCN w/ b-lactamase

Back 29

-clavulanic acid

-sulbactam

-tazobactam

Front 30

talk about PCN oral absorption

Back 30

-rapid but incomplete

-Pen V & amoxicillin best absorbed

-destroyed by gastric juice

elderly aborb better b/c they produce less gastric acid

-food interfers w/ aborption (except amoxillin)

best on empty stomach

Front 31

discuss parenteral absorption

Back 31

can have higher plasma conc. after IM

-procaine or benathine suspensions slowly

Front 32

PCN distribbution

Back 32

-widely distributed in most body fluid

-do not freely enter CSF

Front 33

PCN excretion

Back 33

-renal

-blocked by proenecid

-^ t 1/2 in neonates

- nafcillin has high biiary excretion

Front 34

adverse PCN effects

Back 34

- hypersensitivity

cross sensitivity w/ cephalosporins, most severe reactions happen 30 mins post

-ampicillin rash

-diarrhea

-SZ

-phebiltis

-Na+ loading (ticarcillin)

-Jarisch-Herxheimer (reaction to endotoxins released by death of microbes, resembles sepsis) if used in pts w/ 2ndary syphillis

Front 35

Prophylactic use of PCN

Back 35

- Rheumatic fever recurrance

-endocarditis

Front 36

how many cephalosporins generations are there

Back 36

4

Front 37

name the only 4th generation cephalosporin

Back 37

cefepime (MAxipime)

Front 38

name the first generation cephalsporins

Back 38

oral: cephalexin (Keflex)

cefeadroxil

parental: cefazolin (Ancef, Kefzol)

Front 39

name the 2nd generation cephalsporins

Back 39

oral: cefaclor

cefuroxime

cefprozil

parenteral: cefoxitin (Mefoxin)

cefuroxime sodium

cefotetan(can laed to blleding dis

orders)

Front 40

name the third generation cephalosporins

Back 40

oral: cefixime

cefpodoxime proxetil

ceftibuten

parenteral: cefotaxime

ceftriaxone (rocephin)

ceftazidime ( fortaz)

Front 41

cephalosporin cns penetration

Back 41

3>2>1

Front 42

what is generation one good against?

Back 42

staph

gram neg - e. coli, klebsiella

Front 43

what is gen 2 good for?

Back 43

gram neg

e coli

enterobacter

nesseria

Front 44

gen 3???

Back 44

gram neg

not reliable vs anaerobes

Front 45

cephalosporin resistance to b-lactamases

Back 45

1= gram + b-lac

2. ^ resistance to gram neg b-lac

3. more resistant to gram neg b-lac

Front 46

what class of cephalosporin is used for surgical prophylaxis

Back 46

class one

Front 47

which generation of cephalosporin is useful against meningitis?

Back 47

3

Front 48

special toxicity

Back 48

1: irritant

2: disulfiram-like tox

3:more superinfection

Front 49

name the 2nd generation cephalosporins that are used for mixed aerobic-anaerobic infection

Back 49

cefoxitin

cefotetan

Front 50

what is the drug of choice for typhoid fever and gonorrhea??

Back 50

3 cefotaxime

Front 51

how is cephalosporin absorbed from GI tract

Back 51

poorly absorbed from GI tract

Front 52

which generatiosn do not penetrate CSF

Back 52

1st & 2nd

Front 53

which generation is well distributed to most body fluids?/

Back 53

3rd

Front 54

how are cephalosporins primarily excreted ??

Back 54

renal

Front 55

adverse side affects of cephalosporins???

Back 55

-hypersensitivity (cross sen w/ PCN)

-thrombophlebitis

-N-methylthiotetrazole containing cephs (cefotetan) cause disulfiram reaction with etoh and bleeding

Front 56

CARBAPENEMS end in

Back 56

-penems

Front 57

inhibits most beta- lactamaese

Back 57

CARBAPENEMS

Front 58

indications for carbapenems

Back 58

-enterobacter

-citrobacter freundi

-acinetobacter,

-c. fetus

Front 59

adverse effects of Imipenem

Back 59

-hypersensitivity

-superinfection

-sz (elderly)

Front 60

what inhibits the inactivation of imipenem and is in Primax?

Back 60

cilastatin

Front 61

all carbapenems are given in what route

Back 61

parenteral

Front 62

what oraganisms are carbapenem resistant enterobacteriaceae???

Back 62

e. coli & Klebsiella

Front 63

CRE (carbapenem-resistent enterobacteriaceae) are sometimes known as

Back 63

KPC & NDM

Front 64

- a monobactam

-only cover gram neg.

-effective for PNA, septicemia, PID

-Cayston is a brand for inhalation for cystic fibrosis

Back 64

Aztreonam(AZACTAM)

Front 65

AZtreonam SFX

Back 65

gram + superinfections

*safe with PCN

Front 66

Aztreonam Pharmacokinetics

Back 66

-IV or IM

-rapid distribution

-pred excreted in urine