Antimicrobial Antibiotics

Front 1

Sites that require high levels of abx

Back 1

bone, brain, heart, orbits, testis

Front 2

Sites that are easy to reach with abx

Back 2

skin, lungs

Front 3

Do not use these antibiotics for abscesses

Back 3

Aminoglycosides

Front 4

po = IV for these drugs (6)

Back 4

clindamycin, fluoroquinolones, septra, tetracyclines, metronidazole, linezolid

(can't fkn see the movie lenny)

Front 5

How can we achieve a constant time above MIC (time-dependent)?

Back 5

continuous drip

Front 6

Classic type of abx using time-dependent killing?

Back 6

beta-lactams

Front 7

Classic type of abx using concentration-dependent killing?

Back 7

aminoglycosides

Front 8

Describe the post antibiotic effect

Back 8

the delayed regrowth of bacteria following exposure to an antibiotic

Front 9

Name 3 types of abx in the beta-lactam group

Back 9

penicillins, cephalosporins, carbapenems

Front 10

Penicillins use what kind of killing?

Back 10

time-dependent

Front 11

Mechanism of action of penicillin?

Back 11

inhibition of cell wall synthesis by binding to penicillin binding proteins

Front 12

There are 3 mechanisms of resistance to penicillins. Name them

Back 12

1) inactivation of abx via penicillinase or beta-lactamase, 2) mutated PBP, 3) decreased penetration of abx

Front 13

How did gram negative enterobacteriaceae start to become resistant to penicillins?

Back 13

beta-lactamases

Front 14

Name a penicillin specifically designed for staph aureus

Back 14

cloxacillin

Front 15

Name 2 penicillins specifically designed for pseudomonas aeruginosa

Back 15

ticarcillin, piperacillin

Front 16

Name 2 penicillins specifically designed to expand gram negative coverage, including E. Coli

Back 16

ampicillin IV, amoxicillin po (these are aminopenicillins)

Front 17

Name a common side effect of beta-lactamase inhibitors

Back 17

Diarrhea

Front 18

How many generations of cephalosporins exist?

Back 18

5

Front 19

Timentin

Piperacillin-tazobactam

--> what kind of drugs are these?

Back 19

penicillins + beta-lactamase inhibitors

Front 20

T or F:

timentin and piperacillin-tazobactam are active against pseudomonas spp.

Back 20

true

Front 21

T or F:

timentin and piperacillin-tazobactam are active against enterococcus and listeria spp (gram + organisms)

Back 21

true

Front 22

T or F:

4th generation and 5th generation cephalosporins have activity against MRSA

Back 22

false - ONLY 5TH GEN

Front 23

Do 5th gen cephalosporins work against pseudomonas?

Back 23

no!!

Front 24

which generation cephalosporins have the greatest activity against gram positives (MSSA)?

Back 24

1st

Front 25

Would you use a cephalosporin against enterococcus sp or listeria sp? why or why not?

Back 25

NO. They have beta-lactamases, cephalosporinases

Front 26

Which specific gram negative bacterial species can you NOT use cephalosporins for?

Back 26

campylobacter sp

Front 27

Which 3rd generation cephalosporin would you use against pseudomonas?

Back 27

ceftazidine

Front 28

Which generation of cephalosporins has activity against pseudomonas:

1st

2nd

4th

5th

Back 28

4th gen

Front 29

the 2 most serious adverse reactions of beta-lactams are....

Back 29

seizures, anaphylaxis

Front 30

T or F: if a patient is anaphylactic to amoxicillin, it is highly unlikely that they will react to ticarcillin

Back 30

false - if anaphylaxis occurs with 1 penicillin, high risk of reacting to another penicillin (less risk with cephalosporins)

Front 31

What do these beta-lactams have in common?

- penicillin IV (high dose)

- ampicillin IV (high dose)

- 3rd gen cephalosporins IV (high dose)

- cefepime (4th gen cephalosporin)

- carbapenems

Back 31

All of those beta-lactams cross the BBB!

Front 32

Fill in the blank: the following beta-lactams have activity against _________________ (specific microbe)

- ticarcillin + piperacillin

- timentin and pip/tazo

- ceftazidime

-cefepime

-carbapenems

Back 32

pseudomonas spp

Front 33

Fill in the blank: the following beta-lactams have activity against _________________

- penicillin

- all beta-lactams/beta-lactamase combos

- carbapenems

Back 33

anaerobes

Front 34

Vancomycin belong to which class of abx?

Back 34

Glycopeptides

Front 35

The mechanism of action of this drug is inhibition of the chain formation AND cross-linking of peptidoglycan

Back 35

vancomycin

Front 36

Has good activity against C diff

Back 36

vancomycin, metronidazole

Front 37

Does vancomycin penetrate the BBB?

Back 37

yes

Front 38

Which drug can cause red-man syndrome if administered over a short period of time?

Back 38

vancomycin

Front 39

Macrolides and ketolides make use of what type of killing?

Back 39

Time dependent

Front 40

Erythromycin, clarithromycin, azithromycin belong to what group of drugs?

(remember these don't cross the BBB)

Back 40

macrolides

Front 41

Which gram negative bacteria are covered by macrolides/ketolides?

Back 41

campylobacter spp, bordetella pertussis

Front 42

Which gram positive bacteria are covered by macrolides/ketolides?

Back 42

S pneumoniae (if S), Group A strep (if S)

Front 43

T or F

Macrolides/ketolides do not work against atypical bacteria like chlamydia spp

Back 43

false- Macrolides/ketolides work against atypicals: mycoplasma spp, chlamydia spp and clamydophila spp

Front 44

Antibacterial spectrum of aminoglycosides?

Back 44

GRAM NEGATIVE

Front 45

Name 2 gram negative bacteria which cannot be covered with aminoglycosides

Back 45

salmonella spp, neisseria spp

Front 46

Which aminoglycoside has anti-parasitic activity (giardia lamblia)?

Back 46

paromomycin

Front 47

Which 2 adverse reactions to aminoglycosides require therapeutic drug level monitoring?

Back 47

renal toxicity, vestibular and cochlear toxicity

Front 48

Ciprofloxacin po/IV

Levofloxacin po/IV

Moxifloxacin po

what are these?

Back 48

fluoroquinolones

Front 49

How many generations of fluoroquinolones exist?

Back 49

4

Front 50

The only bacteria that 1st generation fluoroquinolones might work against?

Back 50

enteric gram negative rods

Front 51

Enterococcus is intrinsically resistant to...? (hint - it's a sulfonamide)

Back 51

trimethoprim-sulfametoxazole

Front 52

The antibacterial spectrum of the drug is:

- gram negative enteric rods

- anaerobes

- atypical bacteria

Back 52

tetracyclines

Front 53

Can use broad spectrum of this abx for all bacteria which require endogenous folic acid synthesis

Back 53

trimethoprim-sulfametoxazole

Front 54

Has activity against shigella, chlamydia, nocardia, pneumocystis jeroveci, toxoplasma, and much more

Back 54

trimethoprim-sulfametoxazole

Front 55

Has gram positive coverage, and anaerobe coverage.

Back 55

Clindamycin

Front 56

Clindamycin is a _______________(class)

Back 56

Lincosamide

Front 57

Associated with C diff colitis

Back 57

clindamycin

Front 58

The antibacterial spectrum of this antibiotic includes:

- anaerobes (+ and -)

- C diff

- antiparasitic activity

Back 58

metronidazole

Front 59

You can have alcohol while on abx, as long as you're not taking ________(Drug)

Back 59

flagyl (metronidazole)

Front 60

Which drug is NEVER used alone to treat an infection because of rapid resistance?

Back 60

Rifamycins

Front 61

In what case can rifamycins be used alone?

Back 61

prophylaxis against development of meningitis from H influenzae or N meningitides

Front 62

The treatment of rifamycins includes.... (2 things)

Back 62

-TB, Non-TB mycobacteria

Front 63

Which drug causes orange-red discolouration of body fluids?

Back 63

rifampin

Front 64

Which drug causes bronze discolouration of skin + violet-red discolouration of urine?

Back 64

rifabutin

Front 65

Does ceftaroline work against VRE?

Back 65

No - only MRSA, not VRE

Front 66

The only beta lactam that works against MRSA is?

Back 66

ceftaroline

Front 67

Linezolid is a ______________ (class) and was specifically produced for _________ (bacteria)

Back 67

oxazolidinones, MRSA

Front 68

Which cephalosporins cover MSSA?

Back 68

1st and 2nd gen and cefepime. 3rd gen is not that good.