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3b_Boards - SketchyPharm > (7) Antimicrobials: Cell Wall & Mem... (1.1-1.7) > Flashcards

(7) Antimicrobials: Cell Wall & Mem... (1.1-1.7) Flashcards

1
Q

Other than the cocci, name 3 gram (+) organisms which can be treated with Penicillin

A

(1) Actinomyces israelii
(2) Clostridium perfringens
(3) Pasteurella multocida
* (Inhibits peptidoglycan synthesis ∴ it’s particularly effective against organisms with thick peptidoglycan cell walls… such as gram (+) organisms)*

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2
Q

ROA: Penicillin V

A

Oral

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3
Q

ROA: Penicillin G

A

IV

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4
Q

Name 4 Streptococcal-related indications for Penicillin

A

(1) Strep pharyngitis
(2) Rheumatic fever
(3) Endocarditis due to S. bovis/S. viridans
(4) S. agalactiae prophylaxis

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5
Q

Name 2 gram (-) organisms which can be treated with Penicillin

A

(1) Treponema pallidum
(2) Neisseria meningitis
* (Note: Penicillin can only treat meningitis due Neisseria meningitidis, as the inflammation opens the pores in the BBB, allowing the drug to enter the CNS)*

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6
Q

Resistance: Penicillin

A

β-lactamases

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7
Q

Where in a bacteria are β-lactamase genes found?

A

Plasmids

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8
Q

Adverse Effects (3) : Penicillin

A

(1) Type I hypersensitivity ⇒ Anaphylaxis
(2) IgG hemolytic anemia
(3) Drug-induced interstitial nephritis
* (Interstitial nephritis is mediated by mononuclear cells)*

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9
Q

MOA: Penicillin

A

Inhibits PBP

(Leads to osmotic cellular lysis)

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10
Q

Name 2 alternatives to Methicillin

A

(1) Nafcillin
(2) Oxacillin
* (And Dicloxacillin, etc.)*

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10
Q

What is Methicillin’s spectrum of activity

A

Staphylococci

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10
Q

What type of infections are Methicillin derivatives used to treat?

A

(1) Soft-tissue infections
(2) Endocarditis
(3) Osteomyelitis

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10
Q

What is the mechanism of resistance of MRSA?

A

Altered PBPs

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10
Q

How was Penicillin modified to yield Methicillin?

A

Addition of bulky R-group

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11
Q

Which aminopenicillin has good oral bioavailability?

A

Amoxicillin

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12
Q

Which penicillin is used as part of triple therapy for H. pylori infections?

A

Amoxicillin

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13
Q

What infections is Amoxicillin used to treat?

A

(1) Streptococcal pharyngitis
(2) Otitis media & Sinusitis
(3) Pneumonia
(4) Early lyme disease

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14
Q

What is the gram (-) coverage of the aminopenicillins?

A

(1) Haemophilus influenzae
(2) GI/Urinary Gram (-) Rods

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15
Q

ROA: Ampicillin

A

IV

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16
Q

Name 3 infections Ampicillin is used to treat

A

(1) Anaerobic infections
(2) Enterococcus
(3) Meningitis due to Listeria

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17
Q

Which β-lactamase inhibitor is Amoxicillin usually paired with?

A

Clavulanate

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18
Q

Which β-lactamase inhibitors are paired with Ampicillin?

A

(1) Tazobactam
(2) Sulbactam

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19
Q

What antibiotic is used as prophylaxis against encapsulated bacteria in asplenic patients?

A

Amoxicillin

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20
Q

What antibiotic is used as prophylaxis before dental procedures in patients at risk of endocarditis?

A

Amoxicillin

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21
Q

Adverse Effects (2) : Aminopenicillins

A

(1) Steven-Johnson syndrome
(2) Drug-induced liver injury
* (And the usual side effects of all penicillins)*

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22
Q

Which aminopenicillins are active against Pseudomonas?

A

(1) Piperacillin
(2) Ticarcillin

23
Q

Name 2 first-generation cephalosporins

A

(1) Cefazolin
(2) Cephalexin

24
Q

What is the spectrum of activity of first-generation cephalosporins?

A

(1) Gram (+) cocci
(2) Proteus
(3) E. coli
(4) Klebsiella

25
Q

What is the drug of choice for surgical prophylaxis?

A

Cefazolin

(Neomycin to sterilize bowel)

26
Q

Name 3 second-generation cephalosporins

A

(1) Cefuroxime
(2) Cefotetan
(3) Cefoxitin

27
Q

What is the difference in the spectrum of activity of first and second-generation cephalosporins?

A

Second generation has additional coverage of:

(1) H. influenzae
(2) Neisseria
(3) Serratia

28
Q

Name 3 third-generation cephalosporins

A

(1) Ceftriaxone
(2) Cefotaxime
(3) Ceftazidime

29
Q

What antibiotic is used for empiric treatment of meningitis?

A

Ceftriaxone

30
Q

What are third-generation cephalosporins used to treat?

A

(1) Meningitis
(2) Community & Hospital-acquired pneumonia
(3) Pseudomonas infection
(4) Endocarditis
(5) Gram (-) GI bugs
(6) Gonorrhea
(7) Lyme disease (late-stage)
* (Only Ceftazidime can treat pseudomonas)*

31
Q

Which third-generation cephalosporin can be used to treat Pseudomonas?

A

Ceftazidime

(“CefTAZZZZ covers PseudomonAZZZZZ”)

32
Q

Other than Ceftazidime, what cephalosporin can be used to treat Pseudomonas?

A

Cefepime

33
Q

Which Cephalosporins are considered broad-spectrum?

A

(1) Cefepime
(2) Ceftaroline

34
Q

Which Cephalosporin is active against MRSA?

A

Ceftaroline

35
Q

Which generations of cephalosporins are resistant to β-lactamase inhibitors?

A

(1) 3<u>rd</u> generation
(4) 4<u>th</u> generation

36
Q

What is the spectrum of activity of monobactams?

A

Aerobic gram (-) rods

(DOC for Enterobacter)

37
Q

Name a β-lactam that can treat Pseudomonas which is NOT a Cephalosporin or Penicillin

A

Aztreonam

38
Q

What drug should be used in patients with meningitis and a penicillin allergy?

A

Aztreonam

39
Q

Are monobactams sensitive to β-lactamases?

A

No

40
Q

Are Carbapenems broad spectrum?

A

Yes

41
Q

What antibiotic should you use when infection is resistant to multiple other treatments?

A

Carbapenems

42
Q

What enzyme degrades Imipenem?

A

Dehydropeptidase

43
Q

What antibiotic is coadministered with Cilastin?

A

Imipenem

(“Keep it lastin with cilastin!”)

44
Q

Adverse Effects (2) : Carbapenems

A

(1) GI distress
(2) Skin rash

45
Q

Name an antibiotic which lowers the seizure threshold

A

Imipenem

46
Q

Which drug class is indicated against organisms which synthesize extended-spectrum β-lactamase inhibitors?

A

Monobactams

47
Q

What is the spectrum of activity of Vancomycin?

A

Gram (+) Cocci

48
Q

What is the first-line treatment for MRSA?

A

Vancomycin

49
Q

MOA: Vancomycin

A

Binds D-ala-D-ala ⇒ Inhibits cell wall synthesis

(Unlike penicillins which bind PBP)

50
Q

Are β-lactamases effective against Vancomycin?

A

No

51
Q

ROA: Vancomycin

A

IV

(Exception: C. difficile)

52
Q

What’s the empiric treatment for endocarditis?

A

Vancomycin

53
Q

Resistance: Vancomycin

A

Altered peptidoglycan structure ⇒ D-ala-D-lac

(Or D-ala-D-ser)

54
Q

When is Vancomycin administered orally?

A

Treatment of C. difficile

55
Q

Adverse Effects (5) : Vancomycin

A

(1) Redman syndrome
(2) Thrombophlebitis
(3) Ototoxicity
(4) Nephrotoxicity
(5) DRESS syndrome

56
Q

Adverse Effect: Daptomycin

A

Myopathy

57
Q

What is the spectrum of activity of Daptomycin?

A

Gram (+)

58
Q

MOA: Daptomycin

A

Depolarizes cell membrane via insertion of lipid tail

59
Q

Is Daptomycin effective against VRSA?

A

Yes

60
Q

What type of MRSA infection can Daptomycin NOT treat?

A

Pneumonia

(It’s inactivated by surfactant)

3b_Boards - SketchyPharm (32 decks)

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