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42 Cards in this Set
- Front
- Back
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What is the prototype Penicillin + Adjunct Rx used for pneumonia?
What is each type? |
Amoxicillin/Clavulanic Acid and Piperacillin/Tazobactam
ß-lactam/ß-lactamase inhibitor |
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What is the mechanism of action of ß-lactams? |
Bactericidal: inhibitors of cell wall synthesis |
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What is the spectrum of ß-lactams? |
Broad |
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Which ß-lactam is suitable for outpatient therapy? |
Amoxicillin |
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Can ß-lactams penetrate cells? |
No |
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What are adverse effects for ß-lactams? |
Hypersensitivity |
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For what type of bacteria are these prototype penicillins effective? |
Both gram positive and gram negative bacteria |
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What must piperacillin go through to traverse the outer membrane of gram negative bacteria?
Inner membrane? |
Porin
Penicillin-binding protein (PBP) |
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What 3rd and 4th generation cephalosporins are used to treat pneumonia? |
3rd gen: Ceftriaxone 4th gen: Cefepime |
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What is the mechanism of action of cephalosporins? |
ß-lactam: inhibits cell wall synthesis |
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Can cephalosporins penetrate cell walls? |
No |
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For what types of bacteria are cephalosporins indicated? |
Gram positive and gram negative (depending on generation) |
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What are the adverse effects of cephalosporins? |
Cross-hypersensitivity of penicillin allergy |
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How is ceftriaxone's coverage of gram negatives? |
excellent |
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How does Cefepime stand out from ceftriaxone? |
More pseudomonas activity |
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What enzyme produced by enterobacteriaceae destroy 3rd generation cephalosporins? |
ESBLs (extended spectrum ß-lactamases) |
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What carbapenem is a prototype for treating pneumonia? |
Meropenem |
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What is the mechanism of action of meropenem? |
ß-lactam |
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Against what bacteria is meropenem most effective?
What bacteria in particular? |
Gram positive and negative bacteria;
especially enteric bacteria |
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Can meropenem penetrate cells? |
No |
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What are the adverse effects of meropenem? |
Cross-hypersensitivity with penicillin allergy |
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What is the molecular target for fluroquinolones? |
Topoisomerase II |
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What 2 fluroquinolones are indicated for treating pneumonia?
How do they differ? |
Moxifloxacin
Ciprofloxacin (better for pseudomonas) |
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What is the spectrum of fluroquinolones? |
Broad spectrum |
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Can fluroquinolones penetrate cells? |
Yes |
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What are the adverse effects of fluroquinolones? (2) |
- Prolong QT-interval - Lesions in cartilage & tendons causing rupture (not good for children and elderly) |
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Why are fluroquinolones contra-indicated for cardiac patients?
What can they cause? |
Inhibit K+ channels and can cause Torsades de Pointes |
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What is the prototype macrolide for treating pneumonia? |
Azithromycin |
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What is azithromycin's mechanism of action? |
Bacteriostatic: binds to 50S subunit of ribosome to prevent translation and mitosis |
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What is the spectrum for azithromycin? |
Broad spectrum (including atypicals) |
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Can azithromycin penetrate cells? |
Yes |
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What are the adverse effects of macrolides? (2) |
- Can prolong QT-interval - CYP3A4 inhibitor (clarithro- & erythromycin) |
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What drug class can cover spirochetes as well as G+/G- and intracellular pathogens? |
Tetracyclines |
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If a patient has respiratory MRSA or pseudomonas, what drug is indicated? |
Vancomycin |
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What is vancomycin's mechanism of action? |
Interrupts terminal D-alanine-D-alanine moieties in the cell wall causing cell death |
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What is the spectrum of vancomycin? |
Narrow |
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Can vancomycin penetrate cells? |
No |
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What are vancomycin's adverse effects? |
- Nephrotoxicity - Red-man syndrome due to histamine release |
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What is linezolid's mechanism of action? |
Protein synthesis inhibitor (not well understood) |
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When would you use linezolid? |
If nephrotoxicity of vancomycin is an issue |
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What ß-lactam is most distantly related to penicillin? |
Aztreonam |
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For what pathogen is aztreonam indicated? |
Pseudomonas |
