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24 Cards in this Set
- Front
- Back
What are the two major categories of cell wall synthesis inhibitors?
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Beta lactams
Non beta lactams |
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What are the major categories of beta lactams?
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Penicillins
Cephalosporins Carbapenems Monobactams |
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What categories are penicillins broken into, and list the drugs of each category.
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1) Standard (Penicillin G, Penicillin V, Procaine Penicillin, Benzathine Penicillin)
2) Anti-staph (Methicillin, Nafcillin, Dicloxicillin) 3) Amino (Ampicillin, Amoxicillin) 4) Anti-pseudomonas (Pipercillin (givin with beta-lactamase inhibitor and aminoglycoside)) |
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What is the MOA of beta lactams?
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Bind PBP
Inhibit transpeptidation Inhibit crosslinking |
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What is the MOA of resistance of penicillins?
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1) Beta lactamase/Penicillinase
2) Structural change in PBP 3) Change in porin structure |
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What's the major use(s) of standard penicillins?
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Syphillis (Treponema pallidum)
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Uses of anti-staph drugs?
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Tx staph aureus (methicillin is not used anymore, but nafcillin and dicloxacillin are, UNLESS resistant).
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Use(s) of amino/broad spectrum penicillins?
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Listeria, and Gram + cocci (not staph)
Gram - , E.coli, H. influenza, H. pylori Borrellia (Lyme disease) |
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Anti-pseudomonas/extended spectrum use(s)?
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Pseudomonas
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Adverse effect of ampicillin/amoxicillin?
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Pseudomembranous collitis
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Two general Adverse effects for beta lactams?
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GI upset
Hypersensitivity/Allergic reactions |
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If a pt is allergic to a cephalosporin, what would be the adjustments you'd make to his/her tx and why? Do this for both gram + bacteria, along with gram - rods.
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1) Pt allergic to cephalosporin
2) Skip using penicillin because of partial cross-reactivity. 3a) If gram (+), use macrolides. 3b) If gram (-) ROD, use Aztreonam. |
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Name two 1st gen cephalosporins.
Bonus question: What bacteria are they good against, and what's use? |
Cephalexin
Cefazolin Bonus: 1) Gram+, some gram- (not LAME) 2) Surgical prophylaxis, 24 hr half life |
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Name some important 2nd gen cephalosporins.
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Cefuroxime (first ceph to cross BBB/tx meningitis)
Cefoxitin Cefotetan (AE = disulfiram) (Fox + Tetan tx B.fragilis) |
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Name some important 3rd gen cephalosporins (5 of them, think of mnemonic)
Bonus question: Uses/AE for each. |
Ceftriaxone
Cefixime Cefotaxime Cefoperazone (AE: disulfiram) Ceftazidime (tx pseudomonal inf, AE = neutropenia) Use: Empirical Sepsis and Meningitis (not opera) TRI and FIX = gonorrhea NOT USEFUL AGAINST LAME (e = enterococcus) (Mnemonic, TRI and FIX the TAXes, so we can go to the OPERA and watch TAZ) |
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If cephalosporins are weak against LAME (listeria, atypicals, MRSA, and enterococcus), what are the appropriate treatments for each?
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Listera = Ampicillin/Amoxicillin (in combination with aminoglycosides, and probably beta-lactamase inhibitor)
Atypicals = Macrolides/Tetracyclines MRSA = Vancomycin Enterococcus = Ampicillin/Amoxicillin (in combination with aminoglycosides, and probably beta-lactamase inhibitor) |
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Imipenem must be givin with what (but not in the same formula, just seperate injections)
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Cilastin (it inhibits renal dehydropeptidase, preventing breakdown of imipenem)
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Adverse effect of imipenem, seen in about half the pts that take it?
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Seizures
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Aztreonam is typically used when?
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When pt is allergic to cephalosporins/penicillins but needs to tx Gram (-) RODS.
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What's the MOA of vancomycin?
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1) Binds to D-ala-D-ala muramyl pentapeptide, which
2) prevents TransGLYCOSYLation, thus preventing 3) ELONGATION of peptidogylcan chains (Has nothing to do with PBPs, that's beta-lactam MOA) |
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Uses of Vancomycin include?
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1) MRSA
2) Enterococci 3) C.difficile (NOT Drug of choice) |
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If MRSA's mecanism of resistance is to change PBP, what's VRSA's mecanism of resistance?
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Change D-ala-D-ala to D-ala-D-lac
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Adverse effects of vancomycin include?
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Red-man syndrome (hypersensitivity type 1), Nephrotoxicity, Ototoxicity, Neuomuscular junction blockade
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Does vancomycin cross BBB?
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No
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