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169 Cards in this Set
- Front
- Back
- 3rd side (hint)
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4 static drugs?
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chloramphenicol
macrolides tetracyclines sulfonamides |
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Gram+ or Gram-
Staphylococcus sp. |
Gram +
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Gram+ or Gram-
Stretpococcus sp. |
Gram +
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Gram+ or Gram-
Corynebacterium sp. |
Gram +
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Gram+ or Gram-
Propionibacterium sp. |
Gram +
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Gram+ or Gram-
Enterococcus sp. |
Gram +
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Gram+ or Gram-
Peptostreptococcus sp |
Gram +
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Gram+ or Gram-
Lactobacillus sp. |
Gram +
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Gram+ or Gram-
Clostriduym sp. |
Gram +
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Gram+ or Gram-
Bacteroides sp. |
Gram -
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Gram+ or Gram-
Neisseria sp. |
Gram -
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Gram+ or Gram-
Haemophilus sp. |
Gram -
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Gram+ or Gram-
Rickettsia rickettsii |
Gram -
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Gram+ or Gram-
Klebsiella sp. |
Gram -
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Gram+ or Gram -
Enterobactreriaceae |
Gram -
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Gram + or Gram -
Actinomyces israelii |
Gram +
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Gram + or Gram -
Pasteurella multocida |
Gram -
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Gram + or Gram -
Bartonella henselae |
Gram -
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Gram + or Gram -
Streptobacillus moniliformis |
Gram -
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Gram + or Gram -
Pseudomonas aeruginosa |
Gram -
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Which organism shows intrinsic resistance?
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P. aurgenosa
(bc it lacks porin channels) |
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Which two PCNs can diffuse thru porin channels?
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Ampicillin
Amoxicillin |
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What do the LPS's cause on Gram (-) organisms?
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They're an endotoxin
stimulate immune response, fever |
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Resistance to Streptococcus sanguis is a result of replacement of resistant ____ from S. ____
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PBPs
pneumoniae |
form of homologous resistance
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MRSA are resistant due to acquisition of additional _____________ with low affinity for _____ from unknown species.
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high molecular weight PBPs
b-lactams |
form of acquired resistance
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In the bacterium ___ can be degraded by enzymes, while _____ can be altered.
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PCN
Aminoglycosides (form of resistance) |
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What is a dip test used for?
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B-lactamase
if present will change colors stick covered with PCN |
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Pen G is useful for uncomplicated Gram + cocci plus what 3 organisms?
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Neisseria gonorrhoeae
Neisseria meningitidis Haemophilus influenzae. |
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What can be used to increase the T1/2 of Pen G?
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Procain acid
Probenecid (can also keep in CSF longer to fight menigitis) |
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Does Pen G cross normal BBB?
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no, only when inflammed
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Can Pen V be used for acutely serious infections?
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No
(but is more acid stable than Pen G) |
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What 2 Strep species do Pen G/V cover?
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S. viridans
S. pyogenes |
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T/F
Pen G/V does cover Listeria monocytogenes? |
True
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T/F
Pen G/V does not cover Bacillis anthracis? |
False
Bacillis anthracis is covered by Pen G/V |
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T/F
Pen G/V covers H. influenzae? |
True
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T/F
Pen G/V covers Staphylococcus sp.? |
False
NOT COVERED!! |
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T/F
Pen G/V covers Lyme Disease and Gonorrhoeae? |
true
covers both!!! |
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T/F
Pen G/V does not cover C. perfingens? |
False
it does cover |
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T/F
Pen G/V covers most Streptococcus pneumoniae? |
False
Most of them are resistant to Pen G/V |
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T/F
Pen G/V covers Syphilis and meningitis? |
True!!!
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Treatment for gas gangrene?
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Penicillin G/V
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Treatment for endocarditis cause by S. viridans?
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Pen G/V
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Anthrax causative agent and treatment?
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Bacillus anthracis
Pen G/V |
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Listeriosis causative agent and treatment?
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Listeria monocytogenes
Pen G/V |
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Which species is classified according to it's antigenic properties?
(Alpha vs Beta, Group A vs Group B) |
Streptococcus sp.
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____ hemolysis is the reduction of heme iron, while ____ hemolysis is the complete rupture of RBC's.
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alpha
betaz |
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What's a classical member of GBS?
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Streptococcus agalactieae
(meningitis in neonates & elderly; bacteremia; LEADING cause of neonatal sepsis) |
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This Lancefield Group contains high-molecular weight polysaccharides?
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Group B
(Group A has 'A' carb cell wall) |
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What protein causes rheumatic fever? How?
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M protein (myosin)
highly antigenic causes inflammation makes AB's against all myosin (in heart & joints) |
on strep species
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What 3 Strep species are alpha hemolytic?
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S. pneumoniae,
S. viridans, S. epidermidis???? |
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What 3 Strep species are beta hemolytic?
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S. pyogenes,
S. aureus????? S. agalactieae |
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Erythrogenic toxins cause what?
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scarlet fever
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strep species
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Expression of Streptokinases catalyzes conversion of ___ to ____.
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plasminogen to plasmin
(altered clotting) |
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DOC for GAS?
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Pen G/V
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T/F
You can treat Streptococcal cellulitis with Pen G/V. |
False
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Strep. gangrene is treat with Pen V/K.
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False
(Necrotizing fasciitis ) |
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____ is the number one cause of post-surgery infection.
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Bacteroides fragilis
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Bacteroides bifidum is found in ___ milk.
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breast
(very protective once in baby's GI tract) |
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What 2 AB's ABSOLUTELY decrease OC effectiveness by inducing hepatic metabolism of estrogens?
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Rifamycins and griseofulvin
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If a woman on OC has a lot of 3A4 expression then what 2 things will happen?
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(1) absorb less
(2) a lot will be hydroxylated causing even less to be available (making only 10% bioavailable) |
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What species coverts inactive EE back into active EE in the gut?
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Clostridium species
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Semi-Synthetic Penicillinase-Resistant PCN's should be used if a bug is known or suspected to be a _______ species which expresses ______.
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staphylococcus
B-lactamse |
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Should you use Semi-Syn Pencillinase-resistant PCN's with bugs that do not express B-lacatmase?
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No!!
(they'll be much LESS active then Pen G/V) |
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Why can MRSA/MRSE's PBPs bind to methicillin?
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PCP's are too big to fit in the B-lactam ring pocket
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How does the bulkiness from methicillin decreases it's spectrum of activity?
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Bc the bulk blocks some PBP's to get to the lactam ring
only ones that will are the regular S. aureus organisms (ones that are not resistant) |
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Nafcillin will work on 2 organims:
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S. aureus
S. epidermidis (but most be methicillin sensitive - the resistant ones have PBP's that are too big so won't work on those) |
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Isoxazyolyl PCNs are potent ____ of the growth of most B-lactamase expressing ______ (sp).
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inhibitors
Staphylococci (particularly S. aureus) *the have NO gram (-) coverage |
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Does S. aureus cause CNS infections?
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yes
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Oxacillin, Cloxacillin, and Dicloxacillin are all ____ PCN's.
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isoxazyolyl
(potency increases al # of clox's increase) |
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Are aminopenicillins resistant to B-lactamase?
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no!
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What 2 things does the NH2 group add to aminopenicillins?
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chiral center at B-position
additional AA mimcy at terminal AA's (3 AA mimced instead of 2) |
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Why does Ampicillin have greater absorption than Pen G/V?
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the positive NH2 group repeals the H+ of the stomach acid (so more acid labile)
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Why does diarrhea rate increase with Ampicillin?
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unabsorbed drug goes thru intestine and out thru feces unchanged
(kills gut flora in process) |
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T/F
Ampicillin treats Proteus mirabilis? |
yes
(Gram -) |
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What AB treats salmonella, shingella, and E. coli?
|
Ampicillin
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Amoxicillin has greater coverage of _____ than amp.
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H. pylori
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What does the p-OH group do for amoxicillin.?
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increases oral absorption --> dec less in GI tract so less diarrhea than Amp
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What's the ester prodrug of ampicillin?
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Bacampicillin (Spectrobid)
(ester inc oral absorption in the duodenum) |
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Can Aminopenicillin be good for lyme disease and listeria?
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yes
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____ is especially good to treat S. pneumoniae.
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amoxicillin
(aminopenicillin) |
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What are the 2 most common organisms that cause otitis media?
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S. pneumoniae
H. influenza |
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____ tube can be placed in the person's tube to prevent swelling and thus future ear infections.
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tympanostomy
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Name the 3 aminopenicillins discussed in class.
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Ampicillin (ominpen, polycillin)
Amoxicillin (amoxil, trimox) Bacampicillin (spectrobid) |
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Name the 5 semi-synthetic pencillinase-resistant pcn's discussed in class.
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methicillin
nafcillin oxacillin cloxacillin dicloxacillin |
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Clavulanic acid binds reversibly or irreversibly?
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irreverisbly to most (plasma encoded) B-lactamases
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This class of pencillins are active against Pseudomonas aeruginosa , Enterobacter sp., and certain Proteus sp.: P. mirabilis and P. vulgaris?
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carboxypenicillins
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Are carboxypenicillins effective against S. aureus? B-lactamase?
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No
Yes |
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Name 2 carboxypenicillins discussed in class
|
Carbenicillin (Geopen, Geocilin)
Ticarcillin (Ticar injection) |
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This class of penicillins are Superior activity against Pseudomonas aeruginosa , Enterobacter sp., and Klebsiella sp
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Ureidopenicillins
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Name 2 ureidopenicillins. Are they senstive to B-lactamase?
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Mezlcillin (Mezlin injection)
Piperacillin (Pipracil injection) Yes |
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This class of penicillins produces enhanced gram (–) activity, less potent gram + activity
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carboxypenicillins
(they're poor GI absorbed bc neg charged and thus draw stomach acid) |
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This penicillin drug class can work against Morganella morganii and Serratia narcescens
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Uridopenicillins
Mezlocillin |
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What 3 bugs is piperacillin most active against?
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Pseudomonas (esp)
Clostridium Bacteroides fragilis |
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Zosyn is distinguishable because of what 2 things?
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(Piperacillin-tazobactam)
1. covers pseudomonas 2. covers B. fragilis well |
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Name 4 antipseudomonal PCN's discussed.
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Carboxypenicillins
Carbenicillin Ticarcillin Ureidopenicillins: Mezlocillin Piperacillin |
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Name two B-lactamase inhibitors discussed. What PCN class are they added with?
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Clavulanic Acid
Sulbactam w/ Aminopenicillins |
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90% of all GI infections is caused by what bug?
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Bacterodies fragilis
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This cephalosporin generation has most activity with Gram + cocci (streptococci, staphylococci)
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1st gen
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This cephalosporin generation is particulary good against Bacterodies fragilis.
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2nd
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This cephalosporin generation is much more active against Enterobacteriacae (including those with B-lactamase expression)
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3rd
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Name 9 genera that fall as Enterobacteriacea
(E, M, P, S, S, S, E, Y, K) |
Enterobacter
Morganella Providencia Salmonella Serratia Shigella Escherichia Yersinia Klebsiella |
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What 3 bugs are cephalosporins inactive against?
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MRSA (expect 5th gen)
MRSE L. monocytogenes (unlike PCNs) |
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Does Probenecid help cep's like PCN?
|
yes
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What 5 cep's penetrate the CSF very well?
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cefuroxime,
cefotaxime, ceftriaxone, cefepime, ceftizoxime |
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Keflex would be used to treat 3 bugs mentioned?
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E. coli
Klebsiella P. vulgaris/mirabilis |
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Duricef (Cefadroxil) is a 1st gen cep. What type of R2 group does it contain.
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amoxicillin like
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This 1st gen ceph is sensitive to B-lactamase and has a longer t1/2 than the others.
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Cefazolin (Ancef, Kefzol)
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C. diff blocks formation of ___. Causing a inhibition of this product.
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GTP (by affected Rho)
Actin |
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What 2 agents should be avoided with a pt who has C. diff?
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Antiperistaltic
Opiates (these cause constipation & keep bug in) |
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2nd gen ceph's have what added to the C7? What does this do for them?
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syn-methoxyimino group (=N-OCH2)
blocks B-lacatamase when rotates |
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Mefoxin's increased steric bulk ___ it's B-lactamase activity. And it is the most active against _____ than any other ceph.
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decreases
B. fragilis |
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This 2nd gen agent is not a true ceph but chemically a carbacephin.
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Loracarbef (Lorabid)
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What are the 4 orally available 2nd gen ceph's?
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Ceftin
Ceclor Lorabid Cefzil |
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How is Cefotaxime and Ceftriaxone similar to Cefuroxime?
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it also has a syn-methoxyimino group that blocks B-lactamase
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What ceph is the grand-daddy of all cephs? What is it's t1/2?
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Ceftriaxone (Rocephin)
8 hours penetrates well into CSF |
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DOC for pen-sensitive meningitis?
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CeftriAXone (Rocephin)
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3 main causitive bugs of Bacterial meningitis?
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N. meningitidis,
H. influenzae, Streptococcus sp. |
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____ can chelate iron and give stool a reddish apperance
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Omnicef (Cefdinir)
3rd gen |
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What functional group on Suprax suppress B-lactamase?
|
syn-oximino acidic ether
3rd gen |
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Which 3rd gen ceph is a prodrug that is cleaved in the gut?
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Vantin
(Cefpodoxime proxetil) |
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If had a Gram + bug and could choose Fortaz or any other ceph what would you chose?
|
any other cep
Fortaz = Gram (-) bugs esp Pseudomonas sp. |
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This ceph drug Coverage includes MRSA , VRSA and linezolid-resistant SA
|
Ceftaroline Fosamil
(Teflaro) IV only 5th gen |
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4th gen cep is esp good against _____ and ____.
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Maxipime
Staph and MSSA |
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When see ESBL think....
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Carbapenems
(very powerful drugs) |
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How is Imipenem cleaved?
|
renal dehydropeptidase-1
(so kidneys must work in order to active drug) |
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What drug is a natural product from Streptomyces cattleva?
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Imipenem
(comp of Primaxin) |
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What are the 2 components of Primaxin?
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Imipenem
Cilastatin (dosed 1:1 ratio) |
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If have Enterobacteriaceae that's ceph resistant what drug would be used?
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Imipenem
(broad spec drug) |
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Meropenem and Doripenem are both indicated for what?
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intra-abdominal infections (caused by all organisms)
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Meropenem also has indication for...
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bacterial meningitis
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Doripenem also has indication for complicated ____ including ____.
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UTI
pyelonephritis |
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Which is more potent: Imipenem, Meropenem, or Doripenem?
|
Doripenem
(Imipenem is the least) |
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This carbapenem has a different spectrum of activity: E. coli, B. fragilis, S. aureus (not MRSA), and S. pyogenes.
|
Ertapenem (Invanz)
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What bug does Invanz not cover?
|
P. aeruginosa
(Ertapenem) |
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Name one Monolactam
|
Aztreonam (Azactam)
|
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What ceph is Aztreonam similar to? How?
|
CefTAZidime
similar C7 but no ring system |
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T/F
Azactan has no Gram + or anaerobe effect. |
True
(monolactam) - does inactivate so B-lactamases |
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What 4 bugs is Azactam excellent against?
|
Enterobacteriaceae
P. aeruginosa H. influenzae N. gonorrhoeae |
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Can a rxn with PCNs cross to cephalosporins or carbapenems?
|
yes
20-30% counseling |
|
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This drug inhibits cell wall syn and is a product of Amycolatopsis orientalis.
|
Vancomycin (Vancocin, Vancoled)
|
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This drug is nephrotoxic, given almost always IV, and can cause red man syndrome.
|
Vancomycin (Vancocin, Vancoled)
|
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T/F.
Vancomycin is limited to Gram + bugs. |
True
(including MRSA, MRSE) |
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With which bug can Vancomycin be given orally? Why?
|
C. difficile
bc will stay in GI tract which is where we want it |
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Telavancin (Vibativ) is a ____ derivative with a long lipo tail.
|
vancomycin
(also limited to Gram + bugs) |
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Which drug is more active than Vanc at VISA?
|
Telavancin (Vibativ)
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T/F.
Vibativ is active against B. antracis, Listeria sp. and C. diff |
true
|
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Which AB discussed causes clot test interference and OTc prolongation?
|
Telavancin (Vibativ)
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What 2 big things does Vibativ cause (SE)?
|
taste distrubances
fetal risk |
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Geriatrics ____ the kidney exretion of Vibativ?
|
increase (substantially)
|
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Where does Vancomycin bind?
|
at the terminal AA's (not the PBP's)
|
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Prior to Telavancin binding to bacterial cell wall it is more ____ outside the cell wall.
|
Positive
(once bound + goes in and causes a leak) |
|
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For which AB is Activity is increased by presence of Zn+?
|
Bacitracin A
|
|
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|
T/F
Bacitracin A can be given oral and and parenteral. |
False
only topically bc of neuro and nephro toxicity |
|
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This AB is a natural product of B/ subtilis and inhibits late stage cell wall synthesis?
|
Bacitracin A
(inter with lipid carrier of PG building blocks) |
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What Gram (-) bugs can Bacitracin A fight?
|
Nisseria sp
H influenza (also C. diff --> Gram +) |
|
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This AB is produced by Bacillus polymyxa, binds to nef charged sites, and causes leakage of bac?
|
Polymyxin B
|
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Which AB binds and inactivates endotoxin LPS in a 1:1 ratio?
|
Polymyxin B
|
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Combo drug containing Colistin and Colistimethate?
|
Polymixin E
|
|
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How does Daptomycin kill bac?
|
LEAKAGE not rupture
K+ leaks bc causes depolarization and loss of membrane potential |
|
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Daptomycin has Gram ___ only. And causes ___ damage.
|
positive (including MRSA, VISA, VRSA)
limited |
|
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|
What is one sign indication for Cubicin?
|
right sided endocarditis (from Enterococci, Staph or Strep)
also skin-skin structure infections |
|
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What 2 Gram + bugs are found in the conjuctiva?
|
Staph sp. (esp epidermidis)
Corynebacterium |
|
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What 4 Gram + bugs are found in the GI tact?
|
Enterococcus sp
Peptostreptococcus sp Lactobacillus sp Clsotriduym sp |
|
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What 2 Gram - bugs are found in teh urogenital tract?
|
Enterobacteriaceae (like E. coli)
Neisseria |
|
|
|
T/F
Haemophilus sp are found in the oronasopharynx. |
TRUE
(along with Neisseria sp) |
|
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|
T/F
Klebsiella sp are found on the skin |
FALSE!!
Klebsiella sp are in the GI tract |
|
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|
Where are propionibacterium sp found?
|
on the skin
(along with Staph, Strep, and Corynbacterium sp) |
|
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T/F
Corynbacterium sp are found in the GI tract. |
FALSE
Cory found on skin, oronasopharynx, urogenital tract, and conjunctiva |
|
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|
What Gram (-) species is found on the skin?
|
Bacteroides sp
|
|
