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42 Cards in this Set
- Front
- Back
what would you want to use for B-lactamase producing staphylococci (2)
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Nafcillin and oxacillin
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person has meningitis, pt is allergic to penicillin, what should you consider for treatment?
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3rd/4th gen ceph
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pt has renal problems and you want to use a cephalosporin that is able to cross the BBB and is good at treating Gram Negatives..what would you give
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ceftriaxone
is cleared through biliary mech |
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what is the drug of choice for wounds infected with E.coli?
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3rd gen Cephs
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3rg gen cephalosporins treat what bugs?
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PSEUDOMONAS (alt; ceftazidime)
Klebsiella (pneumoniae, ceftazidime – DOC) E.coli (wounds, DOC) Proteus Serratia |
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if you have a serious Gram neg infection what do you want to use?
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3rd generation ceph
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Nosocomial infections and bacteremias
Complicated UTIs Complicated skin /soft tissue infections use what? |
3rd gen Cephalosporin
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what is the drug of choice for Gonorrhea and Lyme disease?
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ceftriaxone (3rd gen)
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if you have an immunocompromised host what type of drug do you want to use
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3rd gen
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What is the preferred treatment for community acquired pneumonia? Hospitalized and Outpatient
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Hospital: Ceftriaxone + azithromycin
Outpatient: Azithromycin … or … clarithromycin … or … doxycycline |
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Even wider spectrum, more resistant to beta-lactamases...this describes?
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Cefepime (4th Gen)
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Carbapenems (Imipenem).. bactericidal or static?
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bactericidal
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mech of action for carbapenems?
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similar to pens and ceph
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Primary use for carbapenems?
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Extended spectrum beta-lactamases (aka bugs that are not affected by cephs and pens)
… but … its not usually a 1st choice |
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pt has a serious nosocomial and mixed infections caused by multidrug resistant aerobic and anaerobic enteric bacilli...what might you use?
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carbapenems
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G- pneumonia and bacteremia, complicated UTIs, serious infections by Pseudomonas (alt)
can use? |
carbapenems
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DOC for enterobacter?
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carbapenems (Imipenem)
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DOC for ESBL producing Kleb?
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Carbapenems (Imipenem)
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what is Imipenem always used with? Why
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Cilastatin
Imipenem is rapidly broken down by a dehydropeptidase in the proximal renal tubule cilastatin blocks this breakdown |
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can carbapenems cross the BBB?
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Yeppers
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carbapenems are resistant to most lactamases but there are 2 exceptions (this is probably more just FYI, but will be useful in the future)
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G- porins may resist entry
hydrolyzed by metallo-B-lactamases |
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what bug develops resistance rapidly to carbapenems?
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Pseudomonas
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This drug should NOT be used in patients with seizures, as it can cause them...
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carbapenems
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what is the "magic bullet" for gram negatives?
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Monobactams
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mechanism for monobactam?
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Only binds to a PBP (penicillin binding protein) present in GRAM NEGATIVE bugs
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what are some of the bugs that Monobactams can treat
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Enterobacter, Serratia, Pseudomonas (alt), Neisseria
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do monobactams have cross sensitivity with penicillins? what about carbapenems?
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mono: no
carb: yes |
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Serious G- infections, such as MDR pseudomonoas can be treated with what?
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Monobactams
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what are the beta lactamase inhibitors?
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Clavulanic acid
Sulbactam Tazobactam |
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what is the monobactam drug?
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Aztreonam
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what does the vancomyocin bind to? what does this mean for resistance?
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alanine alanine
if there is resistance, this binding site gets altered, thus it doesn't work |
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vancomycin: bactericidal or static?
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Bactericidal … but
NOT a beta lactam!!! |
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drug for Colitis (C. difficile)
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Vancomycin
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drug for Enterocolitis (S. aureus)
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Vancomycin
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drug of choice for MRSA?
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Vancomycin
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DOC for enterococci?
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Vancomycin
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Alt choice for pseudomembranous colitis...? DOC?
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alt: vanco
DOC: Metronidazole |
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pt has recently been on an antibiotic and now has "Red Man" syndrome...with extreme flushing... what did they take?
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vancomycin
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Bacitracin Bactericidal or static?
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Bactericidal … NOT a beta lactam!!!
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Bacitracin method of use?
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topical
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MOA for bacitracin?
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inhibits carrier protien (bactoprenol) for cell wall building blocks
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DOC for Kleb pneumonia?
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ceftazidime
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