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102 Cards in this Set

  • Front
  • Back
Penicillin mechanism of action
inhibits cell wall synthesis by binding to PBPs on cell surface
3 antibiotics to consider first
Penicillin G, V and Amoxicillin
Advantages of Pen G, V, Amoxicillin
selective toxicity, bactericidal, potent, wide toxic-theraputic ratio, active over broad pH, not inactivated by pus, can be "forced" into inaccessible areas, many routes, inexpensive
T or F Penicillin is inactivated by pus and a low pH
T or F Penicillin is bacteristatic
FALSE bacteriocidal
T or F Pen G and ampicillin are absorbed well from the GI
T or F Pen V and amoxicillin are the of choice PO
Where are penicillins not easily distributed systemically
CNS, and humors of the eye
____ to ____ % protein binding occurs with Pen
25-45 % = good, greater affinity would inhibit distribution
Pen is excreted by the _______
Why do Procain Pen G and Benzathine Pen G maintain high concentrations
crystaline formation = extended release others use Na+/K+ salts
List in arder from highest to lowest transient concentration after administration - Pen G (PO) - Pen G (IM) - Pen V (PO)
Pen G (IM), Pen V (PO), Pen G (PO)
Pen V (PO) and Pen G (PO) are in for about 4 days T or F
Pen G (IM) is excreted fastest T or F
Pen G and V aerobic spectrum
G+, beta-lactamase negative
Pen G, V anaerobic spectrum
G+ and G -, b-lac neg (cocci, spirochetes, Clostridium) *B fragilis is resistant
Pen __ is used for mild infections while Pen __ is used for severe infections
Pen V = mild, Pen G = serious
How do beta-lactamase resistant Pen.'s work
bulky side chains hinder beta-lac
Methicilin, nafcilin, oxacilin, cloxacilin, dicloxacilin are all __________ Pen.s
Beta-lactamase-resistant spectrum
G+ cocci and bacilli
Aminopenicillins have better penetration of the _______ _______ which enhances _______ activity
outer membrane, G -
List two common aminopenicillins
ampicillin (PO/IV), amoxicillin (PO)
Amoxicillin (PO) is better absorbed in the GI than Ampicillin T or F
True (only 40% of ampicilin is absorbed --> resistance of intestinal flora)
Aminopen spectrum
G+, G-, beta-lac negetive anaerobes
Amoxicillin is commonly used for prophylaxis T or F
True kills both G+,-, in 1 office dose
Carboxypen.s have greater G- spectrum including pseudomonas, are parenteral and used in hospital name two
Carbenicillin and Ticarcillin both IM/IV
Augmentin is a common Pen+beta-lac combination of which two
Amoxicillin + claulanate (kills B fragilis)
Pen adverse effects
Allergy (IgE 1% pop), superinfections, Rare - seizures (don't inject on nerve), hepatic and hematologic (bleeding/neutropenia) probs
Cephalosporins are bactericidal T or F
Cef.s spectrum (1st gen. Cefazolin, Cefadroxil, Cephalexin)
aerobic G +
Which 1st generation Cef is used for surgical prophy
Which 1st generation Cef is commonly used PO
Most Cef's are semi-synthetic, not easily hydrolyzed by staph penicillinase and very expensive T or F
Older Pen.s are less potent than Cef.s to bacteria which are susceptible to both T/F
False Pen.s are more potent
Most studies show __ to __ % of Cef.s cross-allergy w/ Pen
Bleeding may be a side effect of Cef.s due to interference with _________ or prevention of _______ __________
prothrombin (due to NMTT side chain, tx = VitK) or platelet aggregation
Pen is the most over-used Rx T or F
FALSE Cephalosporins are most used and abused
Side effects of Cef.s
Allergy, bleeeding, disulfiram rxn (antabuse-like), rash
List 3 indications for systemic antibiotics
cure established inf., localize (prevent spread) of inf., prophy
List settings for prophy (4)
major oral surgery, trauma, minor surgery on immunocomp, risk of SBE
Which macroglides are indicated for SBE prophy if allergic to Pen
Azithromycin or Clarythromycin
Which Cef.s indicated for SBE prophy if allergic to Pen
Cephalexin or Cephadroxil
Clindamycin, cephalexin, cefadroxil, azithromycin and clarithromycin are all alternitives to Pen used for SBE prophy T or F
Settings for parenteral SBE prophy (4)
patient unable to take oral, past SBE, artificial valves, previous RF (latter 3 = high risk)
Drugs for parenteral prophy include _________(IM/IV) or for Pen allergies _____ (IV) or _________(IM/IV)
ampicillin, clindamycin, cefazolin
Timing of prophy oral ______ before, IV ______ before, IM ______ before procedure
oral = 1 hr, IV = just before, IM = 30 min
T or F macroglides can be administered parenterally
A combination bactericidal and bacteristatic antibiotics will cause a positive synergistic effect T or F
FASLE they will hinder each other
Vitamins containing PABA will ________ the effect of sulfonamides
Topical neomycin supplemented with gentimycin will cause aminoglycoside ________.
Taking Fe supplements will _________ the effect of tetracylclines
Kidney problems facilitate the removal of from the T or F
Fasle concentrations will
Checklist: What (3)
what organism (G+,- aerobe ect), penetration/distribution, patient modifiers
If does not work one should recheck patients HX, and look for ______, _______ _____and ______ __ _____
abscess, foreign bodies, obstruction to drainage
Clindamycin must be used to treat chronic osteomyelitis because it is bectericidal. T or F 2 statements
1st true, 2nd false Clindamycin is bacteristatic (it is used for its penetrating properties)
Chronic osteomyleitis is caused by
Imipenem, Meropenem and Ertapenem are part of which family
beta-lactam (carbopenems)
Vancomycin and Gentimicin are toxic to what (2)
nephrotoxic and ototoxic
Vancomycin is bactericidal and is used for treating highly resistant G+ including MRSA T or F
Other than Vanc what other are used to treat MRSA
Clindamycin, Tigecycline
Vancomycin routes of administration
Pen.s, Cef.s, beta lactams and Vancomycin are bactericidal how?
inhibit cell wall biosynthesis
Aminoglycosides are bacteristatic T or F
False Aminoglycosides are bactericidal
Aminoglycosides are bactericidal, how?
Inhibit protein synthesis by atttaching to ribosomes
Chloramphenicol is bacteriostatic against G+ and G- but may cause serious side effects which include ___ and ____
bone marrow supression and 1:40K
Gentimicin and Neomycin are both classified as
Aminoglycoside spectrum
G - bacilli, primary choice for nosocomial G- inf
What is wrong with prescribing gentimycin if a patient is using neomycin (topical)
Aminoglycoside toxicity (neomycin is extremely potent and diffuses into system)
Tetracyclines are bactericidal and inhibit protein synthesis T/F 2 statements
F (tetracyclines are bacteristatic is correct), True
Tetracycline spectrum
G+,-, effective against bacteria w/o cell wall
Tetracylcine side effects
dysgenesis (skeletal dev.), tooth staining, photosensitivity, nausea, expired Rx = nephrotoxic
Tige-, Mino-, Doxy-, and Tetracylcine are all ______
Macroglides are bacteriostatic T or F
List 3 Macroglides
Erythromycin, Clarithromycin, Azithromycin
Erythromycin, Clarithromycin and Azithromycin can all be taken orally T/F
Macroglide spectrum
G+ staph and resp inf
Macroglides often cause liver damage and/or gastric disturbances T/F
Clindamycin is bacteriostatic and inhibits cell wall synthesis T/F 2 statements
T, F (Clindamycin = inhibits protein synth)
Clindamycin spectrum
G+, anaerobes
Clidamycin is effective against B fragilis, MRSA and staph induced chronic osteomyelitis T/F
TRUE (3 reasons to use clidamycin vs macroglides)
Clindamycin may cause __________ ______ due to the proliferation of C difficile
pseudomembranous colitis
________ are bactericidal inhibitors or membrane function (neurotoxic).
Polymixins are used _____ in combination with neomycin.
Polymixin spectrum
CHX used for perio is a ________
Fluoroquinolones suffix _______
How are fluoroquinolones bactericidal
intefere with DNA gyrase/topoisomerase
Why are fluoroquinolones not indicated for children
may interfere with collagen formation in joints
fluoroquinolone spectrum
_____ is bactericidal and used to treat aggressive (juvenile) perio = anaerobic bacteria
List used to treat TB (4)
Rifampin, Isoniazid, Ethambutol, Paraaminosalicylic acid
Rifampin is bacteriostatic by inhibiting ________
DNA dependant RNA polymerase
Aminoglycosides and Polymixin are effect against G__ inf
Pen.s, Cef.s, Vancomycin, Macroglides, Clindamycin and Rifampin are effective against G__
Drugs effective against both G+ and - include Carbopenems, fluoroquinolones, beta-lactams, ________ and _______
Amoxicillin , Tetracyclines
Pen.s, Cef.s, beta-lactlms, Vancomycin, Aminoglycosides, Polymyxixns, Fluoroquilinones and Metronidazole are all _______
Tetracylcines, Chloramphenicol, Macroglides, Clindamycin and Rifampin are all _________
List inhibitors or cell wall synthesis
Pen.s, Cef.s, beta-lactams and Vancomycin
Aminoglycosides, Tetracycline, Chloramphenicol, Macroglides and Clindamycin all inhibit ______ ________
protein synthesis
Polymixins inhibit _______ ________
membrane synthesis
________ interfere with w/ DNA
Rifampin inhibits ________
RNA polymerase