Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
42 Cards in this Set
- Front
- Back
|
Penicillin
|
G = IV form; V = oral form
Prototype Beta-lactam antibiotics 1. Bind penicillin-binding proteins 2. Block transpeptidase cross-linking of peptidoglycan (block Cell wall synthesis) 3. Activate autolytic enzymes G+, syphilis Bactericidal for g+ cocci, g+ rods, g- cocci and spirochetes Toxi: Hypersensitivity reactions, hemolytic anemia Res: beta lactamases cleave beta-lactam ring |
|
|
penicillinase-resistent penicillins
|
Methicillin, nafcillin, dicloxacillin
Mechanism same as penicillin -> narrow spectrum penicillinase resistant because of bulkier R group Staph. aureus ! Toxi: Hypersensitivity reactions, methicillin -> interstitial nephritis |
|
|
Ampicillin, amoxicillin
|
Mechanism same as penicillin -> wider spectrum
also combine with clavulanic acid to protect beta-lactamase AmOxicillin has greater Oral bioavailability than ampicillin extendend - spectrum penicillins: HIb, E.coli, listeria monoc., Proteus m, Salmonella, Shigella Toxi: Hypersensitivity reactions, ampicillin rash, pseudomembranous colitis Res: beta lactamases cleave beta-lactam ring |
|
|
Antipseudomonals
|
Ticarcillin, carbenicillin, piperacillin
same as penicillin -> extended Spectrum use with clavulanic acid Pseudomonas + g- rods Toxi: Hypersensitivity reaction |
|
|
Beta-lactamase inhibitors
|
CAST
Clavulanic Acid Sulbactam Tazobactam |
|
|
Mechanism of action
Drugs? Block cell wall synthesis by inhibitiona of peptidoglycan cross-linking |
penicillin, methicillin, ampicillin, piperacillin, cephalosporin, azotreonam, imipenem
|
|
|
Mechanism of action
Drugs? Block peptidoglycan synthesis |
Bacitracin, Vancomycin
|
|
|
Mechanism of action
Drugs? Block nucleotide synthesis |
Sulfonamides, trimethoprim
|
|
|
Mechanism of action
Drugs? Block DNA topoisomerases |
Fluoroquinolones
|
|
|
Mechanism of action
Drugs? Block mRNA synthesis |
Rifampin
|
|
|
Mechanism of action
Drugs? Damage DNA |
Metronidazole
|
|
|
Mechanism of action
Drugs? Block protein synthesis at 50s ribosomal subunit |
Chloramphenicol, macrolides, clindamycin, Streptogramins C, linezolid
|
|
|
Mechanism of action
Drugs? Block protein synthesis at 30s ribosomal subunit |
Aminoglycosides, tetracyclines, streptogramins (quinupristin/dalfopristin)
|
|
|
Treatmentof highly resistant bacteria
MRSA - ? VRE - ? |
MRSA - vancomycin
VRE - linezolid and streptogramins (quinupristin/dalfopristin) |
|
|
Empiric therapy for community acquired pneumonia ?
|
outpatient setting - Macrolides
inpatient setting - Fluoroquinoles ICU setting - Beta-lactam + (fluoroquinolone OR azithromycin) |
|
|
Antimicrobial Prophylaxis
Meningococcal infection ? Gonorrhea ? Syphilis ? History of recurrent UTI's ? Endocarditis with surgical or dental procedures ? |
Meningococcal infection - !Ciprofloxacin! or Rifampin
Gonorrhea - Ceftriaxone Syphilis - Benzathine penicillin G Endocarditis with surgical or dental procedures - Penicillins History of recurrent UTI's ? Endocarditis with surgical or dental procedures ? |
|
|
Bug hints...
Pus, empyema, abscess |
S.aureus
|
|
|
Bug hints...
Pediatric infection |
Hemophilus influenzae (including epiglottits)
|
|
|
Bug hints
Pneumonia in cystic fibrosis |
Pseudomonas aeruginosa
|
|
|
Bug hints...
Branching rods in oral infection, sulfur granules |
Actinomyces israelii
|
|
|
Bug hints...
Traumatic open wound |
Clostridium perfringens
|
|
|
Bug hints...
Surgical wound |
S.aureus
|
|
|
Bug hints...
dog or cat bite |
Pasteurella multicida
|
|
|
Bug hints...
Currant jelly sputum |
Klebsiella
|
|
|
Bug hints...
Positive PAS stain |
Tropheryma whippelii (whipples`s disease)
|
|
|
Bug hints...
Sepsis/meningitis in newborn |
Group B Strep
|
|
|
Bug hints...
Health care provider |
HBV (from needle stick)
|
|
|
Bug hints...
Fungal infection in diabetic/leukemic |
mucor or rhizopus spp.
|
|
|
Bug hints...
asplenic patient |
Encapsulated microbes, especially SHiN
(S.pneumoniae, H.influenzae type B, N.meningitidis) |
|
|
Bug hints...
Chronic granulomatous disease |
Catalase positive microbes
|
|
|
Bug hints...
Neutropenic patients |
Candida albicans (systemic), Aspergillus
|
|
|
Bug hints...
Bilateral Bell`s palsy |
Borrelia burgdorferi (Lyme disease)
|
|
|
Agent?
Rash begins at head and moves down; fine truncal rash, postauricular lymphadenopathy |
Rubella virus -> Rubella, German measles
Togavirus, RNA, enveloped, ss-linear, icosahedral |
|
|
Agent?
rash beginns at head moving down, rash is proceeded by cough, conjunctivitis and coryza |
Measules virus -> Koplikspots (blue-white) on buccal mucosa
Paramyxovirus, enveloped, ss-linear, nonsegmented |
|
|
Agent?
Vesicular rash begins on trunk, spreads to face and extremities with lesions of different age. |
VZV -> Chickenpox
encephalitis, Pneumonia Herpesvirus, enveloped, DS-linear also shingles |
|
|
Agent?
"slapped cheek" rash on face |
Parvovirus B19 -> Erythema infectiosa
can cause hydrops fetalis in pregnant woman due to RBC destruction) Parvovirus, not enveloped, SS-linear, smallest DNA virus, can cause aplastic crisis in sickle cell anemia |
|
|
HIV prophylaxis
CD4 < 200 - ? CD4 < 100 - ? CD4 < 50 - ? |
CD4 < 200 - TMP-SMX - Pneumocystis pneumonia
CD4 < 100 - TMP-SMX - Pneumocystis pneumonia and toxoplasmosis CD4 < 50 - Azithromycin -Mycobacterium avium complex |
|
|
Cephalosporins
1st generation |
Cefazolin, cephalexin
Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases. Bactericidal g+ cocci, Proteus mirabilis, E.coli, Klebsiella (PEcK) Toxi: Hypersensitivity reactions, vit. K deficiency. Cross-hypersensitivity with penicillins occurs in 5-10% of patients. higher risk of nephrotoxicity of aminoglycosides; disulfiram-like reaction with ethanol( in cephalosporins with a methylthiotetrazole group, e.g. cefamandole |
|
|
Cephalosporins
2nd generation |
Cefoxitin, cefaclor, cefuroxime
Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases. Bactericidal g+ cocci, HiB, Enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E.coli, Klebsiella, Serratia (HEN PEcKS) Toxi: Hypersensitivity reactions, vit. K deficiency. Cross-hypersensitivity with penicillins occurs in 5-10% of patients. higher risk of nephrotoxicity of aminoglycosides; disulfiram-like reaction with ethanol( in cephalosporins with a methylthiotetrazole group, e.g. cefamandole |
|
|
Cephalosporins
3rd generation |
Ceftriaxone (meningitis/gonorrhea), Cefotaxine, ceftazidime (Pseudomonas)
Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases. Bactericidal serious g - infections resistant to other Beta-lactams Toxi: Hypersensitivity reactions, vit. K deficiency. Cross-hypersensitivity with penicillins occurs in 5-10% of patients. higher risk of nephrotoxicity of aminoglycosides; disulfiram-like reaction with ethanol( in cephalosporins with a methylthiotetrazole group, e.g. cefamandole |
|
|
Cephalosporins
4rd generation |
Cefepime
Beta-lactam drugs that inhibit cell wall synthesis but are less susceptible to penicillinases. Bactericidal higher activity against Pseudomonas and g+ organisms Toxi: Hypersensitivity reactions, vit. K deficiency. Cross-hypersensitivity with penicillins occurs in 5-10% of patients. higher risk of nephrotoxicity of aminoglycosides; disulfiram-like reaction with ethanol( in cephalosporins with a methylthiotetrazole group, e.g. cefamandole |
|
|
Aztreonam
|
Monobactam resistant to Beta-lactamases
inhibits cell wall synthesis (binds to PBP3). synergistic with aminoglycosides. No cross-allergenicity with penicillins g- rods only ! For penicillin-allergic patients or renal insufficiency who cannot tolerate aminoglycosides Toxi: Usually nontoxic, GI upset |
