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71 Cards in this Set
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Penicillin
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Cidal
- Gram + -- strep, enterococci, meningococci, treponema palladium (syphilis) -most anaerobes |
-hapten mediated toxicity
-beta lactamases --> resistance --efflux pumps -porins in gram - |
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Ampicillin
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Same as penicillin (gram+ cocci)
-also Gram-: hemophilus, e.coli, salmonella, shigella |
-rash is common
-same resistance problems as penicillin -Gram- plasmid mediated resx |
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Semisynthetic Penicillinase-resistant penicillins (Methicillin, Oxacillin)
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Cidal used primarily for STAPH
- Gram+: pneumococci, streptococci, NOT enterococci |
-bulk prevents entry thru (-) porins
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Beta Lactamase Inhibitors
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Tazobactam
Sulbactam Clavulanic acid |
-high affinity for plasmid mediated beta lactamases
-given with Piperacillin |
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Piperacillin and Tazobactam
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PSEUDOMONAS! (-)
-also broad spectrum cidal for Gram+ and Gram- |
-Gram- porins give resistance
-efflux pumps -Gram+ alter PBPs |
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Carbapenems
-Imipenem -Menopenem |
Anaerobes
-e. coli, enterobacter, klebs -pseudomonas |
NOT for
-MRSA, enterococcus, c. diff |
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Monobactams
-Aztreonam |
only aerobic Gram- rods
-enterobacter -not often used |
-can use in place of aminoglycoside
- little cross-reactivity w/ penicillins |
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1st gen Cephalosporins
-Cefazolin -Cepha-whatever |
Bind PBPs to inhibit cell wall synthesis
Gram+ cocci except enterococc Gram- rods: klebs, e. coli, proteus |
not really used anymore
all generations can have nasty side effects: rash, fever, leukopenia, superinfection, phlebitis |
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2nd gen Cephalosporins
-Cefuroxime -Cefoxitin -Cefotetan |
Gram+ cocci except enterococc
Gram- rods (better than 1st gen): klebs, e. coli, proteus |
side effects:
rash, fever, leukopenia, superinfection, phlebitis -resistance due to permeability issues, beta lactamases |
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3rd gen Cephalosporins
-Cefotaxime -Ceftriaxone -Ceftazidime |
-Cefotaxime- MENINGITIS, E. COLI, KLEBS, ENTEROBACTER s. pneumoniae,
-Ceftriaxone- strep pneum, gonorrhea -- long lasting -Ceftazidime - pseudomonas |
side effects:
rash, fever, leukopenia, superinfection, phlebitis -resistance due to permeability issues; STABLE to beta lactamases |
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Vancomycin
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MRSA!
-S. pneum w/ resist to penicillin and 3rd gen cephalosporins -Pen/Amp resistant enterococcus -binds D-ala to prevent cell wall synth (cidal) |
-IV only
-risk of red man syndrome if given too quickly -nephrotoxicity If anything is Vanco resistant, Linezolid is the answer |
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Chloramhenicol
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Protein synth inhibitor
- Rx meningitis in penicillin allergic patients -Rickettsial infections |
Not used in 1st world anymore
-aplastic anemia |
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Quinolones
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prevent DNA unwinding
1st gen - complicated UTIs 2nd gen (Cipro) - broad, anthrax 3rd - backup for pseudomonas resistant TB, STDs |
well tolerated
-photosensitivity generally saved for serious infections |
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Tetracyclines
-doxycycline |
-Protein synth Inhibitor
Rickettsia (RMSF) Ehlerichia (WBC infection) Borrelia burgdorferi (Lyme) |
2nd line to azithromycin for chlamydia
-bone/teeth staining -photosensitivity -not used in kids |
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Macrolides
-mycins -not dapto |
PSI
-1st line CHLAMYDIA -Gram+ replacement for pts w/ penicillin allergy (GAS!) |
-inhibit CYP450 system
-QT prolongation |
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Linezolid
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only used for serious resistant Gram+
-MRSA -Strep -Enterococcus (VRE) |
always given after Vanco resistance determined
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Daptomycin
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Only for VRE, MRSA, resistant pneumococci
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-can't get into lung to treat pneumonias
-side effect - myopathy |
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TMP-SMZ
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Folic acid synth inhibitor (cidal)
-broad spectrum but not 1st choice for anything |
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Anaerobes
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Metronidazole
-c. diff |
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E. coli
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3rd Gen Cephalosporin
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all enterobacteriaceae get 3rd gen ceph
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Chlamydia
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Azithromycin
Doxycycline |
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Gonorrhea
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Penicillin if sensitive
3rd generation Cephalosporin --cetriaxone |
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Syphilis
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Penicillin G
-Treptonema Palladium |
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Atypical Pneumonias (mycoplasm, legionella, chlamydia, bordetella)
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Macrolides (azithromycin, erythromycin)
-Quinolones if resistant |
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Group B Strep
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Penicillin or Ampicillin
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Strep Pneumo (Group D)
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Pen or Amp
-3rd Gen Cephalosporin if resistant -Vancomycin 3rd |
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GAS
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Penicillin
if allergic, macrolide (azithro, erythromycin) |
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Enterobacteriaceae (E.coli, Klebs, Enterobacter)
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3rd gen cephalosporins
Quinolones Extended Penicillins |
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Staph Aureus
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Pen if sensitive
Semi synthetic - oxacillin, diclox MRSA - Vanco Dapto or Linezolid last line |
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Rickettsia/ehrlichia/borrelia burgdorferi
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Tetracycline
(Doxy) |
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Aminoglycosides
(Gentamicin) |
Gram- specialist
Usually given with a Gram+ specialist to provide broad spectrum |
PSI via 30S
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What causes VAP?
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Gram- Enterics
-Enterobacter -Pseudomonas |
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Leading cause of UTI
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E. coli
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treatment for UTI
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Bactrim (TMP-SMZ)
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Most common US cause of diarrhea
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Norovirus
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Site of infection of watery diarrhea
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Small intestine
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Site of infection of bloody diarrhea
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Colon
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Causes of watery diarrhea
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Vibrio cholera, ETEC, C. profringens, B. cerius, S aureus
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Causes of bloody diarrhea
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Shigella, Salmonella (non-typhoid), Campylobacter, EHEC, C. diff
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Person to person diarrhea
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Salmonella typhi
Shigella |
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Lowest inoculum diarrheal causes
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Shigella
EHEC |
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Low inoculum diarrheal <1000
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Salmonella typhi
Campylobacter |
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Rice water stool
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Vibrio cholera
-gram- facultative bacillus |
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Vibrio cholera
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-gram- facultative bacillus
-suscept to stomach acid, so must ingest large inoculum |
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Vibrio cholera treatment
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Oral rehydration
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Shigella
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Invasion of epithelial cells and macs
-entero and cytotoxins -watery then bloody |
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EHEC
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low inoculum
HUS more likely if abx given |
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Non-typhoidal Salmonella
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animal eggs
3-7 days cramping, diarrhea -bacteremia --cholecyst, septic arthritis, |
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Typhoidal Salmonella
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fecal-oral (humans only)
enteric fever for weeks -rose spots, splenomegaly -can be fatal |
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Dental procedure leads to this cervicofacial infx
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Actinomyces
-Gram+ rod |
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Gas gangrene/nectrotizing fascitis
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C. perfringens
-gram positive rod |
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Gastritis after cephalosporin/clindamycin
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C. diff
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Intra abdominal infx
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Bacteroides fragilis
-gram negative bacillus -increased adhesion to peritoneum |
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leading causes of bacterial meningitis in neonates
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S. agalactiae (GBS)
E. coli K1 Listeria Enterococci |
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leading causes of bacterial meningitis in children
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S. pneumo
N. meningitidis H. Influenza --all 3 encapsaulated |
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leading causes of bacterial meningitis in adults
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S. pneumo
N. meningitidis (vaccine) |
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N. meningiditis
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gram negative diplococci
-2nd leading cause of meningitis |
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How does mycobacteria TB evade immune killing?
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Inhibits phagosome - lysosome fusion
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This bacteria aided by hardy spores
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C. Diff
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Aminoglycoside toxicity
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Oto, nephro
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Aminoglycoside targets
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gram negatives aerobes
-pseudomonas aer |
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Hyper/hypo pigment
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Pityriasis versicolor
(massezia furfur) |
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trx for ringworm
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topical azole
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cryptococcus
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huge capsule
comes from pigeon shit meningitis Ampho B |
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sporotrichiosis
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soil in mexico, SA
ulcerating nodules spread via lymph -Ampho B |
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Candida
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gram + pseudohyphae
common in AIDS |
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Aspergillus
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acute angle hyphae
aspergilloma - looks like cancer treat w caspofungin if serious |
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Mucormycosis
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right angle hyphae
necrosis of sinuses ampho, surgery |
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histoplasma
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(Poopy) caves - birds and bats
TB like w/ granulomas GI issues Ampho |
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Coccidioides
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(DRY) Amer SW
caseating necrosis, nodules |
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Blastomyces
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(HUMID) midwest
similar sx to histo -urogenital ulcers -beavers |
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