Abx Overview

Question 1

6 types of antibiotics

Answer 1

• Antibacterial
• Antifungal
• Antiviral
• Antimycobacterial
• Antiprotozoal
• Antihelminthic

Question 2

4 mechanisms of actions of antibacterials

Answer 2

• Inhibit cell wall synthesis
• Inhibit translation/transcription
• Inhibit DNA synthesis/integrity
• Inhibit folate synthesis/function

Question 3

Mechanism is generally inhibition of cell wall synthesis

Answer 3

Bactericidal

Question 4

Mechanism is generally inhibition of protein synthesis

Answer 4

Bacteriostatic

Question 5

Susceptible or Resistant to Penicillinase?

Narrow or wide?

• Penicillin G
• Penicillin VK

Answer 5

• Susceptible
• (narrow spectrum)

Question 6

an enzyme which can inactivate penicillin, produced by certain bacteria.

Answer 6

Penicillinase

Question 7

Susceptible or Resistant to Penicillinase?

Narrow or Wide?

• Nafcillin
• Oxacillin

Answer 7

• Resistant (to bacteria which make the enzyme)
• (narrow spectrum)

Question 8

• Most important wide spectrum Penicillin?
• What do wide spectrum penicillins have?

Answer 8

• Amoxicillin
• +/- Penicillinase inhibitor

Question 9

• Patients who are allergic to penicillin are at a higher risk of what 2 infections?
• Why?

Answer 9

• MRSA
• C. diff
• (because they are prescribed wide spectrum abx and become more resistant and get superinfections)

Question 10

PK: Which drugs?

• Rapid renal elimination
• Biliary clearance of ampicillin and nafcillin

Answer 10

PK of penicillins

Question 11

ADE: Which drugs?

• Hypersensitivity reactions of 5 - 6 %

Answer 11

ADE of penicillins

Question 12

ADE: Which drugs?

• Maculopapular rash

Answer 12

ADE of penicllins (ampicillin)

Question 13

Which 2 infections to prescribe penicillin for “narrow spectrum”

Answer 13

Strep and Staph infections

Question 14

Which infections to prescribe wide spectrum Penicillins?

Answer 14

gram neg bacteria

Question 15

Which generation of Cephalosporins?

• Enters the CNS?

Answer 15

3rd

Question 16

Which generation of cephalosporins?

• Have partial cross-reactivity w/ penicillins?

Answer 16

1st

Question 17

Which generation of Cephalosporins?

• Skin
• Soft Tissue
• UTI

Answer 17

1st

Question 18

Which generation of Cephalosporins?

• S. pneumoniae
• H. influenza
• B. fragilis

Answer 18

2nd

Question 19

Which generation of Cephalosporins?

• PNA
• Meningitis
• Gonorrhea

*broad activity

*beta-lactamase stable

Answer 19

3rd

Question 20

Which generation of Cephalosporins?

• Pseudomonas

Answer 20

4th (smelly)

Question 21

Which generation of Cephalosporins?

• Skin (MRSA)
• Soft tissue
• CAP (community acq PNA)

Answer 21

5th

Question 22

Which generation of Cephalosporins?

• May exhibit cross sensitivity w/ penicillins?**

Answer 22

1st

Question 23

Which Generation of Cephalosporins?

• Contaminated w/ penicillin in the past, (which explains cross reactivity in penicillin allergic patients)

Answer 23

1st generation cephalosporins

Question 24

Which generations of cephalosporins?

• Can be given safely to patients who are “penicillin allergic?” (but are withheld if pt has had true penicillin anaphylaxis)

Answer 24

2nd, 3rd, 4th, 5th generations

Question 25

If a pt has had a delayed dermatologic rxn (rash) to penicillin, can we give them cephalosporins?

Answer 25

Yes, Don’t give if pt has had true allergy (anaphylaxis)

Question 26

If a pt has type 1 hypersensitivity rxn (anaphylaxis) to penicillin, can we give cephalosporins?

Answer 26

No

Question 27

W/o skin testing capabilities, what’s the rule of thumb for giving cephalosporins?

Answer 27

• Avoid giving if pt has hx of immediate/accelerated rxn
• Give cephalosporin to patients who have had only a delayed rxn (rash) BUT must observe closely

Question 28

• What do we prescribe for gram neg infection suspected/documented?
• Why?

Answer 28

• Monobactam
• Cross reactivity w/ other B-lactams is non-existent