Ch. 8 - Principles Of Antimicrobial Therapy

Front 1

First isolated in 1928, this antibiotic was used successfully to treat streptococcal and staphylococcal infections.

Back 1

Penicillin

Front 2

Unstable in the acid environment of the stomach, and must be administered parenterally

Back 2

Penicillin

Front 3

Penicillins are widely distributed in the body, and penetrate the what in the presence of inflammation?

Back 3

CSF (cerebrospinal fluid)

Front 4

Penicillin is excreted by the what?

Back 4

Kidneys

Front 5

Syphilis is a what?

Back 5

Spirochete

Front 6

Antibiotic associated with Jarisch-Herxheimer reaction

Back 6

Penicillin

Front 7

Reaction to penicillin that includes fever, chills, sweating, and flushing

Back 7

Jarisch-Herheimer reaction

Front 8

Amino glycosides can be inactivated by what type of penicillin?

Back 8

Carboxypenicillin

Front 9

Don't mix amino glycosides with what an IV bag?

Back 9

Penicillin

Front 10

The half-life of the penicillins in adults is __ to __ minutes

Back 10

30 to 90

Front 11

What does hemodialysis do to penicillins? Are all penicillins affected by hemodialysis?

Back 11

Removes it. No, nafcillin and oxacillin aren't removed

Front 12

Penicillins work against gram-__ organisms

Back 12

Positive

Front 13

The mechanism of action of penicillin is the inhibition of bacterial cell growth by interference of cell __ synthesis

Back 13

Wall

Front 14

Penicillins are effective in many infections, including __ and __ respiratory tract infections, __ tract infections, and __ nervous system.

Back 14

Upper and lower
Urinary
Central

Front 15

They are the agents of choice against gram-positive infections such as endocarditis

Back 15

Penicillins

Front 16

There is a (low/high) incidence of adverse reactions with penicillin

Back 16

Low

Front 17

The most common hypersensitivity reactions to this antibiotic include maculopapular rash and urticaria

Back 17

Penicillin

Front 18

When given to a patient with severe renal dysfunction, has caused seizures and encephalopathy

Back 18

Penicillin

Front 19

The role of this inhibitor is to prevent the breakdown of beta-lactam by organisms that produce the enzymes

Back 19

Beta-lactamase

Front 20

The first generation of cephalosporins treats gram-__ skin infections

Back 20

Positive

Front 21

The beta-lactam/beta-lactamase inhibitors diffuse into most body tissues except what?

Back 21

CSF and the brain

Front 22

The half-life of beta-lactamase/beta-lactam is _ hour

Back 22

1

Front 23

Beta-lactam/beta-lactase inhibitor combinations are eliminated by what?

Back 23

Glomerular filtration

Front 24

Hemodialysis and peritoneal dialysis do what to beta-lactam/beta-lactamase?

Back 24

Removes them from circulation

Front 25

Beta-lactam interfere with cell __ synthesis by binding to and inactivating PCN binding proteins

Back 25

Wall

Front 26

Used to treat poly microbial infections, including intraabdominal and gynecologic infections, foot infections, and aspiration pneumonia, sinusitis, and lung abscesses

Back 26

Beta-lactam/beta-lactamases

Front 27

Beta-lactam combinations are physically incompatible with parenteral what?

Back 27

Aminoglycosides

Front 28

A beta-lactam group structurally similar to the penicillins

Back 28

Cephaloposporins

Front 29

How many generations of cephalosporins?

Back 29

4

Front 30

The role of this inhibitor is to prevent the breakdown of beta-lactam by organisms that produce the enzymes

Back 30

Beta-lactamase

Front 31

The first generation of cephalosporins treats gram-__ skin infections

Back 31

Positive

Front 32

The beta-lactam/beta-lactamase inhibitors diffuse into most body tissues except what?

Back 32

CSF and the brain

Front 33

The half-life of beta-lactamase/beta-lactam is _ hour

Back 33

1

Front 34

Beta-lactam/beta-lactase inhibitor combinations are eliminated by what?

Back 34

Glomerular filtration

Front 35

Hemodialysis and peritoneal dialysis do what to beta-lactam/beta-lactamase?

Back 35

Removes them from circulation

Front 36

Beta-lactam interfere with cell __ synthesis by binding to and inactivating PCN binding proteins

Back 36

Wall

Front 37

Used to treat poly microbial infections, including intraabdominal and gynecologic infections, foot infections, and aspiration pneumonia, sinusitis, and lung abscesses

Back 37

Beta-lactam/beta-lactamases

Front 38

Beta-lactam combinations are physically incompatible with parenteral what?

Back 38

Aminoglycosides

Front 39

A beta-lactam group structurally similar to the penicillins

Back 39

Cephaloposporins

Front 40

How many generations of cephalosporins?

Back 40

4

Front 41

The progression from first to fourth generation in General reflects an (increase/decrease) in gram-negative coverage and a (increase/decrease) of gram-positive activity

Back 41

Increase
Decrease

Front 42

The cephalosporins are (well/poorly) absorbed by the GI tract

Back 42

Well

Front 43

2nd through 4th play a role in treating bacterial meningitis because they penetrate the ___.

Back 43

CSF

Front 44

Most of the oral and parenteral cephalosporins are excreted by the kidney, with the exception of ceftriaxone (rocephin), which is eliminated by the what?

Back 44

Liver

Front 45

The cephalosporins exhibit a __-sensitive

Back 45

What

Front 46

Mixed aerobic and anaerobic infections maybe treated with what generation of cephalosporins?

Back 46

Second

Front 47

Treating community-acquired bacterial meningitis typically includes a third-generation cephalosporin such as what?

Back 47

Rocephin (ceftriaxone)

Front 48

What are the only oral antibiotics available to treat P. Aeruginosa?

Back 48

Ciprofloxacin and levofloxacin

Front 49

FQ that is a potent inhibitor of the cytochrome P450 (CYP) 1A2 isoenzyme

Back 49

Cipro

Front 50

FQ that may increase the effect of other medications, including theophylline, warfarin (Coumadin), tizanidine, and propranolol.

Back 50

Cipro

Front 51

FQ that may increase the effect of other medications, including Coumadin and propranolol

Back 51

Cipro

Front 52

Antacids, sucralfate, and magnesium, calcium, or iron salts will decrease the absorption of what if given concomitantly

Back 52

FQ's

Front 53

Prolonged administration of FQ's in combo with what increases the risk of tendonitis and tendon rupture?

Back 53

Corticosteroids

Front 54

These agents are referred to as the "anti pneumococcal" or respiratory FQ's because if their usefulness in treating S. Pneumoniae and community-acquired pneumonia

Back 54

Levaquin, moxi, and gemi

Front 55

Most common side effects of FQ's include what?

Back 55

Nausea, diarrhea, dizziness, confusion

Front 56

First class of antimicrobials to be labeled broad spectrum

Back 56

Tetracyclines

Front 57

Doxycycline and mini cyclone are of what antimicrobial class?

Back 57

Tertracyclines

Front 58

What is the only cephalosporin that covers MRSA?

Back 58

Teflaro (ceftaroline fosamil)

Front 59

The tetracyclines possess activity against gram-positive, gram-negative, but not atypical

Back 59

False, atypical as well

Front 60

This class of antimicrobial is separated into short, intermediate, and long-term

Back 60

Tetracyclines

Front 61

The tetracyclines inhibit bacterial protein synthesis by binding to the 30S subunit of the what?

Back 61

Ribosome

Front 62

The ribosomal subunit that tetracyclines bind to is the what?

Back 62

30S

Front 63

These are typically used when beta-lactams are not available

Back 63

Tetracyclines

Front 64

Tetracycline drug that's the drug of choice for treatment of early Lyme disease and used in treating community acquired pneumonia

Back 64

Doxycycline

Front 65

Children less than age _ should not use tetracycline because of a gray-brown discoloration of the teeth

Back 65

8

Front 66

These drugs decrease the half-life of doxycycline, and are known as CYP inducers.

Back 66

Phenytoin (Dilantin) and carbamazepine (tegretol)

Front 67

Separate admin of tetracyclines and antacids, iron, cholecystyramine, and sucralfate by at least _ hour(s).

Back 67

1

Front 68

Tetracyclines potentiate the effect of warfarin how?

Back 68

Impairing vitamin K production by intestinal flora

Front 69

The only fourth generation cephalosporin which is commonly used to treat nosocomial infections

Back 69

Cefepime (maxipime)

Front 70

H

Back 70

H

Front 71

Hypersensitivy reactions to the cephalosporins include maculopapular rash and urticaria. What's urticaria?

Back 71

Hives

Front 72

Most commonly prescribed fluoroquinolones

Back 72

Ciprofloxacin, levofloxacin, moxifloxacin

Front 73

Bactericidal antibiotics which have excellent bioavailability, which make it easy to transition from an IV to an oral formulation

Back 73

FQ's (fluoroquinolones)

Front 74

The half-life for FQ's ranges from _ to _ hours

Back 74

4 to 12 hours

Front 75

All FQ's are eliminated via the what?

Back 75

Kidneys

Front 76

All FQ's exhibit post-__ effect

Back 76

Antibiotic

Front 77

All FQ's exhibit activity against aerobic gram-__ organisms

Back 77

Negative

Front 78

In 1932, the dye prontosil rubrum was found to be effective in treating streptococcal infections. Manipulation of one of its by-products created the class of antibiotics known as the what?

Back 78

Sulfonamides

Front 79

Folic acid synthesis is not required for bacterial cell growth

Back 79

False, it is required

Front 80

What competitively inhibits the bacterial enzyme dihydropteroate synthetase?

Back 80

SMX (sulfamethoxazole)

Front 81

The sulfanomides are active against a wide range of gram-positive and gram-negative organisms, including the pseudomonas species and group A streptococci.

Back 81

False. Sulfanomides are not effective against the pseudomonas species and group A streptococci

Front 82

Sulfasalazine (azulfidine), a sulfonamide lacking significant antimicrobial activity, is poorly absorbed and used in the treatment of ulcerative colitis

Back 82

True

Front 83

Because of their limited spectrum of activity and increasing resistance, the sulfonamides are typically use by themselves to increase efficacy or to expand coverage

Back 83

False. Usually used in combination

Front 84

What is trimethoprim-sulfamethazole?

Back 84

Bactrim

Front 85

What is Bactrim?

Back 85

Trimethoprim-sulfamethoxazole

Front 86

What is the combination of choice to treat urinary tract infections?

Back 86

Bactrim

Front 87

Oral sulfanomides are/are not absorbed from the GI tract.

Back 87

Are

Front 88

Sulfonamides are eliminated by glomerular filtration.

Back 88

Partly true; also eliminated by hepatic metabolism

Front 89

The sulfanomides are eliminated from the body by hepatic metabolism

Back 89

Yes, and glomerular filtration

Front 90

These antibiotics work by inhibiting the incorporation of para-aminobenzoic acid, the basic building block used by bacteria to synthesize dihydrofolic acid, the first step leading to folic acid synthesis.

Back 90

Sulfonamides

Front 91

The basic building block used by bacteria to synthesize dihydrofolic acid

Back 91

Para-aminobenzoic acid

Front 92

The first step leading to folic acid synthesis

Back 92

Dihydrofolic acid

Front 93

Competitively inhibits the bacterial enzyme dihydropteroate synthetase

Back 93

Sulfamethoxazole

Front 94

What does TMP stand for?

Back 94

Trimethoprim

Front 95

What does SMX stand for?

Back 95

Sulfamethoxazole

Front 96

In 1932, the dye prontosil rubrum was found to be effective in treating streptococcal infections. Manipulation of one of its by-products created the class of antibiotics known as the what?

Back 96

Sulfonamides

Front 97

Folic acid synthesis is not required for bacterial cell growth

Back 97

False, it is required

Front 98

What competitively inhibits the bacterial enzyme dihydropteroate synthetase?

Back 98

SMX (sulfamethoxazole)

Front 99

The sulfanomides are active against a wide range of gram-positive and gram-negative organisms, including the pseudomonas species and group A streptococci.

Back 99

False. Sulfanomides are not effective against the pseudomonas species and group A streptococci

Front 100

Sulfasalazine (azulfidine), a sulfonamide lacking significant antimicrobial activity, is poorly absorbed and used in the treatment of ulcerative colitis

Back 100

True

Front 101

Because of their limited spectrum of activity and increasing resistance, the sulfonamides are typically use by themselves to increase efficacy or to expand coverage

Back 101

False. Usually used in combination

Front 102

What is trimethoprim-sulfamethazole?

Back 102

Bactrim

Front 103

What is Bactrim?

Back 103

Trimethoprim-sulfamethoxazole

Front 104

What is the combination of choice to treat urinary tract infections?

Back 104

Bactrim

Front 105

What's the combination of choice for toxoplasmosis?

Back 105

Bactrim (trimethoprim-sulfamethoxazole)

Front 106

Oral sulfanomides are/are not absorbed from the GI tract.

Back 106

Are

Front 107

Sulfonamides are eliminated by glomerular filtration.

Back 107

Partly true; also eliminated by hepatic metabolism

Front 108

The sulfanomides are eliminated from the body by hepatic metabolism

Back 108

Yes, and glomerular filtration

Front 109

These antibiotics work by inhibiting the incorporation of para-aminobenzoic acid, the basic building block used by bacteria to synthesize dihydrofolic acid, the first step leading to folic acid synthesis.

Back 109

Sulfonamides

Front 110

The basic building block used by bacteria to synthesize dihydrofolic acid

Back 110

Para-aminobenzoic acid

Front 111

The first step leading to folic acid synthesis

Back 111

Dihydrofolic acid

Front 112

Competitively inhibits the bacterial enzyme dihydropteroate synthetase

Back 112

Sulfamethoxazole

Front 113

What does TMP stand for?

Back 113

Trimethoprim

Front 114

What does SMX stand for?

Back 114

Sulfamethoxazole