ABX

Question 1

Bactericidal

Answer 1

Kills bacteria directly via cell wall

Question 2

Bacteriostatic

Answer 2

Kills bacteria indirectly by inhibiting nucleic acid or protein synthesis

Question 3

Beta Lactams

Answer 3

Incl Penicillins, Cephalosporins, Carbapenems, Monobactams

Question 4

Penicillins

Answer 4

Bactericidal, inhibit cell wall synthesis
Safest ABX, safe in preg
Drug:drug interactions: warfarin, oral contraceptives
Concern for allergic reaction/anaphylaxis
GI AE common
Seizure risk

Question 5

Ampicillin

Answer 5

Penicillin (Aminopenicillin)

Highest incidence of N/V among penicillins

Question 6

Amoxicillin

Answer 6

Penicillin (Aminopenicillin)

Rash in peds pts, especially if they have mono; not as concerning at it seems

Question 7

Beta-lactamase inhibitor

Answer 7

Not an ABX, “add on” to ABX tx
Incl Tazobactum
Binds to/inactivates beta-lactamase inhibitor enzyme

Question 8

Cephalosporins

Answer 8

Bactericidal, inhibit cell wall synthesis
Classified as generations (1-5)
Most widely used ABX
Drug:drug interactions: warfarin, oral contraceptives
Cross-sensitivity w/Beta Lactams
Incl Cefazolin, Cephalexin, Ceftriaxone, Ertapenem

Question 9

Ceftriaxone

Answer 9

Cephalosporin (3rd gen)
Drug:drug interactions: warfarin, oral contraceptives; Ca in TPN and LR (form Ca deposits), never give ABX and TPN/LR concurrently

Question 10

Carbapenems

Answer 10

Bactericidal, inhibit cell wall synthesis
Broadest coverage (except MRSA)
All IV
Reserved (only 4 used to avoid resistance)
Highest seizure risk
CNS sx
Small risk of cross-sensitivity w/Beta Lactams
Incl Imipenem-Cilastatin (ABX + “add on” to prevent kidneys from breaking down tx), Ertapenem

Question 11

Monobactams

Answer 11

Bactericidal, inhibit cell wall synthesis
Super small risk of cross-sensitivity w/Beta Lactams (some say no risk)
Incl Aztreonam

Question 12

Glycopeptides

Answer 12

Bactericidal, inhibit cell wall synthesis
NOT Beta Lactams
Monitor: want “trough” levels 10-20 (<10 not killing bacteria, >20 nephrotoxicity)
Drug:drug interaction: other nephrotoxic drugs
Nephrotoxicity
Ototoxicity
Red Man Syndrome
Incl Vancomycin

Question 13

Sulfonamides

Answer 13

Bacteriostatic, inhibit bacteria nucleic acid and protein synthesis
Oldest class of ABX
Drug:drug interactions: hyperkalemia drugs, elevated INR w/warfarin
Hyperkalemia
Hypersensitivity reactions (photosensitivity, SJS, TEN)
Incl Sulfamethoxazole-Trimethoprim

Question 14

Macrolides

Answer 14

Bacteriostatic, inhibit bacteria protein synthesis
Antiinflammatory properties
Drug:drug interactions: QT prolonging drugs, CYP3A4 drugs (warfarin), oral contraceptives
QT prolongation: heart palpations, dysrhythmias
Incl Azithromycin, Erythromycin

Question 15

ABX to tx MRSA

Answer 15

IV Vancomycin (Glycopeptide)

Question 16

ABX to tx C. diff

Answer 16

PO Vancomycin (Glycopeptide)

Question 17

ABX to tx Pseudomonas

Answer 17

Piperacillin-tazobactum (Penicillin + “add on” beta-lactimase inhibitor)
Aztreonam (Monobactum)
Imipenem-Cilastatin (Carbapenem, ABX + “add on” to prevent kidneys from breaking down tx)

Question 18

MOA for ABX

Answer 18

Inhibit bacteria cell wall synthesis/function
Inhibit bacteria protein synthesis
Inhibit bacteria nucleic acid synthesis

Question 19

Resistance

Answer 19

1st saw Penicillinase (bacteria enzyme that inactivates Penicillins)
Then –> dev of Cephalosporinase
Now seeing Carbapenemase in clinical setting (NIH outbreak)