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68 Cards in this Set
- Front
- Back
What are the 6 bactericidal cell wall lysers?
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"BIC PEN VANQUISHES" - Bacitracin, Isoniazid, Cycloserine, PENicillins and cephalosporins VANcomycin
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What are the 2 bacteriostatic anti-folic acid synthesis drugs?
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"TRIM PRIM SULFA" - TRIMethoPRIM SULFAmethoxadole
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What are the 3 classes of drugs?
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replacement therapy, magic bullets/cruise missiles, poisons & stimulants
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What are the 2 penicillinase fighters?
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clavulanic acid and sulbactam
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What are the drugs augmentin and timentin?
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augmentin=amoxicillin + clavanulate; timentin=ticarcillin + clavulanate
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What is unasyn?
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"USA": Unasyn=Sulbactam + Ampicillin
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What are the 2 cocci that produce penicillinase?
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staphylococcus and gonococcus
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What is cilastatin
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used in combination with imipenem; inhibits renal dihydropeptidase to reduce renal excretion and renal damage
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What is probenecid?
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blocks renal ampicillin loss; rarely used, competes with penicillin and cephalosporin for organic ion transport system
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What are the 3 "generations" of penicillins according to Youel?
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1. basic penicillins; 2. penicillinase resistant penicillins; 3. broad spectrum penicillins
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What are the characteristics of the basic penicillins?
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1. beta lactamase sensitive; 2. relatively narrow spectrum; 3. inexpensive
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Basic penicillins are the DOC for what bugs?
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streptococcus pyogenes, s. pneumoniae, spirochetes
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What makes aminopenicillins different?
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They can slip through the outer membrane of some gram - bacilli such as E. coli and Proteus
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What is the DOC for beta-hemolytic streptococcal pharyngitis?
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penicillin VK
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What is the DOC for subacute bacterial endocarditis caused by s. viridans?
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penicillin G aqueous
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What is the DOC to prevent the recurrence of rheumatic fever?
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penicillin G benzathine
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What are the characteristics of the penicillinase resistant drugs?
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1. extremely narrow spectrum; 2. work well primarily against penicillinase-secreting staphylococci; 3. expensive
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What toxicity is caused by methicillin?
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allergic nephritis
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How do the penicillinase-resistant drugs work?
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attachment of bulky group to block beta-lactamase grip
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List the penicillinase-resistant drugs.
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methicillin, nafcillin, oxacillin, cloxacillin, dicloxacillin
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How is Methicillin administered?
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intraMuscular
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How is DiclOxicillin given?
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Definitely Oral
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What are the characteristics of the broad spectrum penicillins?
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1. extended spectrum; 2. beta-lactamase sensitive; 3. expensive; 4. work against most gram - rods, including the slime monster pseudomonas.
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What are the broad spectrum penicillins?
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CAMP TIC: Carbenicillin, Azlocillin, Mezlocillin, Piperacillin, TICarcillin
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What is the problem with carbenicillin?
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leads to renal potassium loss, causing hypokalemic alkalosis
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Which valve does streptococcus viridans like to vegetate?
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mitral valve
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What can you get from penicillin allergies?
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"SNEAR": Serum sickness, Nephrotoxicity, Exfoliative dermatitis, hemolytic Anemia, maculopapular Rash
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How are penicillins and cephalosporins different?
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cephalosporins are more likely to kill staphylococci
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How are cephalosporins and penicillins similar?
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bacteriocidal, attack a microscopic part of cells that mammalian cells lack
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What do 1st generation cephalosporins cover?
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most effective against strep, gram +
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What do 2nd generation cephalosporins cover?
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G+ and some G- rods
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What do 3rd generation cephalosporins cover?
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most gram - rods, less effective against staph aureus and streptococcus than 1st and 2nd generation cephalosporins
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What generation cephalosporins is good for bacteroides?
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2nd generation cephalosporins
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How do you treat pelvic inflammatory disease?
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ceftriaxone to kill neisseria gonorrhea and doxycycline for chlamydia
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What are the 6 first generation cephalosporins?
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"unFAZed, the RAD sLOTH reads, rights, and takes aspirin": cefazolin, cephradine, cephalothin, cephalexin, cephadroxil, cephapirin.
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What are the 7 2nd generation cephalosporins?
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"I MET a MAN FOND of FOX FUR with a TEA TAN FACE": cefmetazole, cefamandole, cefonicid, cefoxitin, cefuroxime, cefotetan, cefaclor
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What are the 7 3rd generation cephalosporins?
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"TRY to pay your TAX, TAZ. TIZ not PERsonal or a MOCKery": ceftriaxone, cefotaxime, ceftazidime, ceftizoxime, cefperazone, moxalactam, imipenem-cilastin
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What are the 3 2nd generation cephalosporins good against anaerobes like bacteroides fragilis?
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"the FOX MET the anaerobe for TEA": cefotetan, cefoxitin, cefmetazole
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What is the disulfiram reaction and what drugs can cause it?
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nausea, vomiting, death when taken with alcohol; can occur with sulfas and cephalosporins
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When are sulfas contraindicated?
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pregnancy, newborns, and nursing mother
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What is the main action of the sulfa drugs?
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block folic acid synthetase; good because mammalian cells don't have or need folic acid synthetase
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What are bactrim and septra?
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1-2 combo of folic acid synthesis blockers: sulfamethoxazole+trimethoprim
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How do sulfas cause kernicterus in newborns?
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sulfa displaces unconjugated bilirubin from serum albumin, the bilirubin can pass through the perinatal meninges and cause lasting damage to the development of the basal ganglia
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What are potential urinary complications with taking sulfas?
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crystaluria can occur if sulfa is given with acidic urine (pH<5.0)
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Which antibiotics inhibit protein synthesis by anti-ribosomal action?
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"I SAT (30S) on a big MACC! (50S)": Spectinomycin, Aminoglycosides, Tetracyclines, Macrolides, Azalides, Clindamycin/Lincomycin, Chloramphenicol
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What are the 8 aminoglycosides?
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gentamycin, tobramycin, streptomycin, amikacin, netilmicin, kanamycin, neomycin, paromycin
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What's the most widely used aminoglycoside?
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gentamycin
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Which aminoglycoside is used to fight pseudomonas?
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tobramycin
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Which aminoglycoside is a primary anti-TB drug?
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streptomycin
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Which aminoglycoside is least likely to induce resistance?
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amikacin
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Which aminoglycoside is most nephrotoxic?
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neomycin
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Which of the 30s anti-ribosomals are bacteriocidal, bacteriostatic?
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spectinomycin, tetracycline: bacterioSTatic
aminoglycoside: bacteriocidal |
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What's the best use for aminoglycosides?
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gram negative bacilli, used in conjunction with cell wall lysers
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What are the main side effects of the aminoglycosides?
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ototoxicity, nephrotoxicity, neuromuscular block
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What are 4 key characteristics of aminoglycosides?
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Aerobes only
Absorption is poor Access to CNS is poor Activity prolonged due to poor absorption ie. use with aerobic bacteria, infection outside of CNS, good renal function |
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When should tetracyclines be used?
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"tetra" = 4: BORes CRaM
BRUCe VIBrates (Borrelia, Brucella, Vibrio cholerae, CRaM creatures) |
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When is spectinomycin used?
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used only against Neisseria gonorrhea
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Is there ototoxicity or nephrotoxicity associated with spectinomycin?
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NO!
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What is vancomycin?
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analogue of aminoglycoside, ototoxic, nephrotoxic, not absorbed, bacteriocidal
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When should vancomycin be used?
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Rarely!
1. gram + septicemia, especially in penicillin resistant bug or penicillin allergic patient 2. pseudomembranous colitis |
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What toxicity is associated with vancomycin?
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red man syndrome: prostaglandin outpouring, profound flushing, pruritis, not dangerous
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What is the major macrolide? When is it used and what is the toxicity?
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1. erythromycin
2. group A strep pharyngitis, non-enteric gram - rods except H. influenza 3. GI intolerance |
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What are the 2 azalides?
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azithromycin, clarithromycin
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The azalides are the DOC for what bugs?
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azithromycin: same as erythromycin and includes anaerobes
clarithromycin: Helicobacter pylori, Mycobacterium avium |
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What is clindamycin/lincomycin used for?
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same as erythromycin (group A strep pharyngitis) AND bacteroides
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When is chloramphenicol used?
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kills most clinically important bacteria: gram +, gram -, anaerobes (incl. bacteroides)
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What are the toxic effects of chloramphenicol?
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bone marrow suppression, aplastic anemia, Gray Baby Syndrome
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Which antibiotics can be used to kill Pseudomonas aeruginosa?
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"PIC The FOX": piperacillin, imipenem, ciprofloxacin, tobramycin + piperacillin/ceftazidine, cefoxitin
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