Y2B3 Do15 Pharm Antibiotic Cell Wall Agents

Front 1

what is the definition of an abx?

Back 1

substsances produced by other psecies which prevent the growth of other microorganisms

Front 2

what are some things to consider when choosing an abx?

Back 2

reaches the target
binds to the target
interferes with fxnl capacity of target
reaches appro concentration
maintains adequate contact time
avoids toxicity to the host

Front 3

what are some reasons for treatment failure

Back 3

wrong dose
factors like abscess or foreign body at site of infec
poor delivery
immunocompromised host
superinfection
inappropriate PD/PK

Front 4

antimicrobial activity depends on what 2 thigns

Back 4

drug concentration and duration of exposure

Front 5

cell walls are made up of ____________ and are joined by _________

Back 5

peptidoglycan
glycosidic bonds and peptide cross bridges

Front 6

what is the MOA of b- lactams?

Back 6

it binds the transpeptidase which typically joins the monomers. in doing so, peptide cross links don't occur and causes a weak cell wall and lyses

Front 7

beta lactams are highly selective with low toxicity T OR F

Back 7

true

Front 8

natural PCN are usu good for what organisms?

Back 8

g+
some g-
anaerobes

Front 9

which natural PCN is given IM and what is given IV and PO?

Back 9

IM = aq procaine PCN G, benzathine PCN G
IV= aq crystalline PCN G
po = PCN V

Front 10

Which is used for endocarditis? syphylllis? strep throat?

Back 10

IV= endocarditis
IM= syphyllis
PO= strep throat

Front 11

why is PCN G given IV or IM?

Back 11

it is unstable in stomach acid

Front 12

what is the drug inactivation that can occur?

Back 12

b-lactamase can open up the b-lactam ring.

altered target site so abx can't bind

Front 13

what are some anti staph PCN

Back 13

nafcillin
oxacillin
dicloxacillin

Front 14

what does anti staph PCN NOT protect against?

Back 14

enterococci

Front 15

which ones are IV and which ones are PO?

Back 15

IV= nafcillin and oxacillin
PO= dicloxacillin

Front 16

which ones need renal adjustment and which need hepatic adjustment?

Back 16

renal = dicloxacillin
hepatic= nafcillin

Front 17

what is antistaph pcn used to treat?

Back 17

cellulitis, osteomyelitis, bacteremia, endocarditis

Front 18

what aminoPCN is used for otitis media and endocarditis prophylaxis?

Back 18

amoxicillin

Front 19

what route is amoxicillin administered?

Back 19

PO

excreted renally so you need renal adjustment

Front 20

which is for listeria meningitis and enterococcus?

Back 20

ampicillin (IV)

Front 21

what is added as an adjunct to amoxicillins and ampicillins to increase their coverage of organisms?

Back 21

b lactamase inhibitors

clavulanic acid
sulbactam
tazobactam

Front 22

what are the 2 combos with b lactamase inhibitors + aminopcn?

Back 22

ampicillin+ sulbactam (PO)

amoxicillin + clavulanic acid (IV)

Front 23

what do you give when you're switching from Unasyn (IV)

Back 23

you give amoxicillin + clavulanic acid (augmentin) po

Front 24

what are the combo drugs used for?

Back 24

HEENT, bacetermia, cellulitis, osteomyelitis, pneumonia

Front 25

what are some antipseudomonal PCNs?

Back 25

piperacillin
ticarcillin

Front 26

what are the combos of antipseudomonals?

Back 26

pip + tazobactam = zosyn (IV)

tic + clavulanic acid = timentin (IV)

Front 27

what are some SE of antipseudomonals?

Back 27

allergy, rash, pancytopenia, hepatotoxicity

Front 28

what do anti pseudomonal pcns cover?

Back 28

pseudomonas, anaerobes, g+, lesser g-, NOT atypicals

Front 29

what is a highly potent broad spectrum abx against g + g- anaerobes enterococcus and has the acronym DIME

Back 29

doripenem
imipenem
meropenem
ertapenem

Front 30

which is th eonly one not given IV?

Back 30

eratpenem (IM)

Front 31

which one is always given with cilastin?

Back 31

imipenem

Front 32

what is the point of cilastin?

Back 32

it inhibits dihydropeptidase I (enzyme that destroys the drug)

Front 33

what are some thigns that carbapenems protect against

Back 33

intra-ab infec
bacteremia
soft tissue infection
bone/joint infection
nosocomial pnuemonia

Front 34

which one of the carbapenems is a niche drugs and what is it used for?

Back 34

ertapenem, specifically for cSSSI, intraab infections and for outpatient therapy

Front 35

T OR F: carbapenems, because they work so well, should be used as a first line tx

Back 35

false

they should always be reserved for last line therapy

Front 36

what is another niche medicine good against pseudomonas and for pts with b lactam allergy

Back 36

azitreonam

IV/IM

Front 37

what are some SE with azitreonam

Back 37

hepatotoxicity
hypersensitivity rxn

Front 38

what do cephalosporins NOT protect against EVER?

Back 38

enterococci

Front 39

T OR F : a 4th generation cephalosporin is the best tx for a g+ bacteria

Back 39

FALSE

4th generation has the least potency against g+

it has the best against g- though

Front 40

how are cephalosporins different than PCN?

Back 40

2 r groups and a 6 membered ring

Front 41

what are some major SE of cephalosporins?

Back 41

allergies, hepatoxicity, sludging of gall bladder with ceftriaxone,

Front 42

what is the drug to give when switching from IV cefazolin?

Back 42

PO cephalexin

Front 43

what is a first gen cephalosporin only good for?

Back 43

g+

Front 44

what is a 1st gen ceph used for?

Back 44

puncture wound, cellulitis, cystitis, sx prophylaxis

Front 45

what are the 2nd generation cephs and what are they used for?

Back 45

cefoxitin
cefotetan"
cefuroxime

used for HNM PEK
h flu, n meningitis, m catarrhalis, proteus, e coli, kleb

Front 46

which ones are IV and which ones are PO

Back 46

cefturoxime is the only IV and PO, all others are IV

Front 47

what are 2nd gen cephs good for?

Back 47

anaerobe AND gram- coverage

Front 48

what are 2nd gen used for in treatment settings?

Back 48

pulm, HEENT, infections

decreases otitis media, pnuemonia, pharyngitis, tonsillitis, bronchitis

Front 49

for a 3rd gen cep, which one has biliary excretion?

Back 49

ceftriaxone

Front 50

which 3rd gen is used to switch from IV cefotaximeor ceftriaxone?

Back 50

PO cefpodoxime

Front 51

which one is similar to 4th gen? why?

Back 51

ceftazidime because it has pseudomonas coverage

Front 52

what do 4th gen cephs protect against?

Back 52

acinetobacter and pseudomonas

Front 53

when do you use 4th gens?

Back 53

when there are resistant infections

bacteremia, pneumonia, febrile neutropenia, intraab infection, meninigitis

IV only

Front 54

this drug is used for g+ pts with b lactam allergy and can also be used for MRSA infections. does NOT protect against VRE enterococcus

Back 54

vancomycin

Front 55

T or F, vancomycin is preferred over b lactams

Back 55

false. vanco is inferior to b lactams

Front 56

PO vanco is used only for what org?

Back 56

c. difficile

Front 57

vanco is used via IV in all sites except where?

Back 57

GI

Front 58

what are some major se of vanco?

Back 58

ototoxcity
nephrotoxicity
red man syndrome

Front 59

what do you give for HA MRSA if all the other drugs are failing and it irreversibly binds to membranes and causes an efflux of k+, destroying the [] gradient

Back 59

daptomycin

Front 60

daptomycin is good only against what type of bacteria?

Back 60

g+

Front 61

how is daptomycin administered?

Back 61

iv only, adjust dose for renally impaired pts

Front 62

what lab tests do you have to check for weekly if you're on dapto?

Back 62

cpk elevations.

Front 63

what disease is daptomycin NEVER used for?

Back 63

pneumonia

Front 64

what disease does daptomycin protect against that vancomycin does NOT?

Back 64

VRE