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39 Cards in this Set
- Front
- Back
List the 4 Subclasses of B-Lactams
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Penicillins
Cephalosporins Carbapenems Monobactams |
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Generally, how are Penicillinas eliminates?
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Renally, this means you have to adjust dosing for renal function
Two exceptions are Nafcilin and and Oxacilin |
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What type of pharmacodynamics do the Penicillins exhibit?
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Bacteriocidal time dependent killing
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What is the MOA of Penicillins?
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Inhibition of cell wall synthesis by binding to Penicillin binding protein and preventing transpeptidation.
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What are two major side effects in the use of Penicillins?
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Hypersensitivity (3-10%) this contraindicates the Cephalosporins and Carbapenems as well
Interstitial Nephritis (Nafcillin is well known) |
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What is the most popular use of Penicillin G?
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Treatment of Syphilis
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What are the bugs affected by Penicillin G?
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Gram (+): PSSP, PSSA, S. Viridans, B-Hemolitic Strep, Enterococcus, Bacilus
Gram (-): Neisseria, Pasturella Multocida Others: Clostridium, Treponema Pallidum |
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What are the names of 4 Penicillinase resistant Penicillins?
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Cloxacillin
Dicolxacillin Oxacillin Nafcillin |
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What is Nafcillin commonly used for?
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PSSA infections
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What are three amino Penicillins?
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Aminopenicillin
Ampicillin Amoxicillin |
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What are the bugs affected by the amino-penicillins
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Gram (+): PSSP, PSSA, S. Viridans, B-Hemolitic Strep, Enterococcus, Bacilus, *Listeria Monocytogenes*
Gram (-): Proteus, Mirablis, Salmonella, Shigella, E.Coli, H. Influenza |
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What bugs are amino-penicillins primarily used for?
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Enterococci
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What are Carboxypenicillin and Ticarcillin used to treat?
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Primarily gram (-) bugs. Particularly Pseudomonas Aerurginosa.
(Remember PMCAT) |
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Name 3 Uropenicillins
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Piperacillin
Azlocillin Mezlocillin |
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What are the major bugs affected by the Uropenicillins?
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Gram (-)'s particularly:Pseudomonas Aeurginosa, Serratia Marcescens, and Klebsiella
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What is unique about Aztreonam?
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It can be used in PT's hypersensitive to Penicillins.
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What is clavulanic acid and how is it used?
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It is a B-Lactamidase inhibitor. It is used in conjunction with B-lactam antibiotics to increase efficacy.
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What is the pharmacodynamic mechanism of Cephalosporins?
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Bacteriocidal, time dependent killing
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What is the biochemical difference between Cephalosporins and Penicillins
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Ceph's are more stable due to a ring
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What generations of Cephalosporins can penetrate the CSF?
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3rd and 4th
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What are the names of the first generation Cephalosporins?
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Cefazolin
Cephalexin |
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What are the bugs covered by the first generation Cephalosporins?
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Gram (+): MSSA, PSSP, B-Hemolitic Streps and S. Viridans
Gram (-) Proteus Mirabilis, E. Coli, Klebsiella Pneumonia (PEK) |
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What are the names of the second generation Cephalosporins?
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Cefuroxime
Cefprozil Cefoxitin Cefotetan |
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What are bugs covered by the second generation Cephalosporins?
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Gram (-) H. Influenza, Enterobacter, Neisseria, Proteus Mirablis, E. Coli, Klebsiella Pneumonia (HENPEK)
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What are the names of the third generation Cephalosporins?
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Ceftriaxone
Cefotaxime Ceftazidme |
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What are bugs covered by the third generation Cephalosporins?
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Gram (+): PS S. Pneumo
Gram (-): H. Influenza, Enterobacter, Neisseria, Proteus Mirablis, E. Coli, Klebsiella Pneumonia, Salmonella, Serratia, Shigella (HENPEKSSS) |
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What is unique about Ceftriaxone
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It is hepatically eliminated
It has a fairly longlife |
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What is the 4th generation Cephalosporin
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Cefepime
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What are the bugs covered by the 4th generation cephalosporins?
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Gram (-): H. Influenza, Enterobacter, Neisseria, Proteus Mirablis, E. Coli, Klebsiella Pneumonia, Salmonella, Serratia, Shigella, P. Aeruginosa (HENPEKSSSP)
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What bacteria exhibit inducible B-Lactamidase?
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Shigella
Pseudomonas Indole (+) Proteus Citrobacter Enterobacter |
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Name 4 Carbapenems
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Imipenem
Meropenem Ertapenem Doripenem |
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What are the pharmacodynamics of the Carbapenems?
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Bacteriocidal, time dependent killing
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Carbapenems have a very broad spectrum. What DON'T they cover?
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MRSA, PRSP, VRE, C. Diff, Nocardia, Atypicals
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What additional bug does Ertapenem not cover?
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P. Aeruginosa
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What is a major interaction of the Cephalosporins?
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Alcohol, you will puke like whoa
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What is a major side effect of the Carbapenems?
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Neurotoxicity (confusion, hallucinations, seizures, spasms). Mainly in renal failure patients.
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What is the one Monobactam?
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Actreonam
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What are the pharmacodynamics of Aztreonam?
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Time dependent bactericidal killing. ONLY on PPB-3
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What is the coverage of Aztreonam?
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Gram (-) Aerobes: E. Coli, K. Pneumonia. P. Mirabilis, S. Marcesens, Citrobacter, Enterobacter, Salmonella, Shigella, P. Aeurginosa
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