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Infectious Disease > Abx- part 1 > Flashcards

Abx- part 1 Flashcards

1
Q

_____ layer - provides structural integrity of the cell wall

A

Peptidoglycan (PG)

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2
Q

______ - found in the periplasmic space function to crosslink the peptidoglycan chains

A

Transpeptidase Enzymes

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3
Q

_____ binding layers are kept together by transpeptidase enzymes

A

penicillin

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4
Q

_______ MOA involves breaking down cell wall synthesis

A

Beta lactams

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5
Q

Beta lactams include what 4 types of abxs?

A
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6
Q

What generation of cephalosporin?

A

1st generation

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7
Q

What generation of cephalosporin?

A

2nd generation

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8
Q

What generation of cephalosporin?

A
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9
Q

Cefepime is what generation of ceph?

A

4th generation

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10
Q

Ceftaroline is what generation of cephalosporin?

A

5th generation

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11
Q

What kind of abx class have a ring in their structure?

A

Beta-Lactam

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12
Q

This inhibits bacterial peptidoglycan synthesis preventing bacterial replication is known as _____

A

bacteriostatic

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13
Q

Binding to PBP activates bacterial autolytic enzymes that cause cell wall lysis is known as ______

A

bactericidal

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14
Q

How are gram + bacteria becoming more resistant?

A

reduced binding affinity to PCN binding proteins

production of B-lactamases

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15
Q

How are beta lactamase increasing their methods of resistance?

A

Breaks PCN ring

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16
Q

What are the 2 most commonly prescribed abxs?

A

Azithromycin and amoxicillin are MC prescribed

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17
Q

PCN are indicated for gram (+/-) bacteria

A

mostly Gram +

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18
Q

PCN are first line treatment for ______ and ______

A

Strep throat and Syphilis

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19
Q

**What is the bacteria that causes strep throat?

A

Group A Beta-Hemolytic Streptococcus

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20
Q

** What is the bacteria that causes Syphilis?

A

Treponema pallidum

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21
Q

Which PCNs are considered Antistaphylococcal PCN’s?

A

dicloxacillin, nafcillin, oxacillin

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22
Q

**When are Antistaphylococcal PCN’s indicated? Are they effective against MRSA?

A

Only indicated in the treatment of skin and soft tissue staphylococcal infections

Not effective against MRSA infections

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23
Q

Which Antistaphylococcal PCN’s are PO only? IV only?

A

dicloxacillin PO only

nafcillin IV only
oxacillin IV only

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24
Q

What is the coverage of an aminopenicillin?

A

same as natural PCN plus better gram - coverage

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25
Q

**What 3 bacteria are the likely source of otitis media?

A

Haemophilus influenzae
Streptococcus pneumoniae
Moraxella catarrhalis

26
Q

What is the first line treatment for otitis media?

A

amoxicillin

27
Q

What are the advantages of using an aminopenicillin vs a natural PCN?

A

Higher oral absorption and longer half life = less frequent dosing

Better penetration through Gram - cell wall porins (superior gram - coverage)

28
Q

PCN/Beta-Lactamase Inhibitors include ____ and _____

A

Augmentin and Unasyn

29
Q

What is the first line treatment for sinusitis?

A

Augmentin

30
Q

What is the first line treatment for Pneumonia?

A

Augmentin

31
Q

What is the first line treatment for COPD exacerbations?

A

Augmentin

32
Q

**Augmentin is first line treatment for what 3 bacterial infections? (give the bacteria names)

A

S. pneumo
H. flu
S. aureus

33
Q

**______ has good pseudomonas coverage. What forms does it come in?

A

piperacillin/tazobactam

IV ONLY!

34
Q

What abx has the same as PCN plus increased Gram - coverage including Pseudomonas and Proteus (Broad Spectrum)?

A

piperacillin

35
Q

What would you give a pt who has a severe polymicrobial infection?

A

piperacillin/tazobactam

36
Q

_____ have the same MOA as PCN but tend to be more resistant to B-lactamase

A

Cephalosporins

37
Q

What phrase is true when talking about the generations of cephalosporins and their coverage?

A

The greater the generation, the better the Gram - coverage.

The lower the generation, the better the Gram + coverage

38
Q

What are the 3 first generation cephalosporins?

A

cephalexin (Keflex)
cefazolin (Ancef)
cefadroxil (Duricef, Ultracef)

39
Q

What abx can you give to a pt with a E. coli infection who is preg?

A

cephalexin (Keflex)

40
Q

What are the 2nd generation cephalosporins?

A

cefuroxime (Ceftin, Zinacef)
cefoxitin (Mefoxin)
cefotetan (Cefotan)
cefaclor (Ceclor)
cefprozil (Cefzil)

41
Q

**____ have better Gram - coverage, can be used as surgical prophylaxis for “dirty” procedures

A

cefoxitin/cefotetan

42
Q

**_____ are often used as 2nd line for pharyngitis, sinusitis, OM, upper & lower respiratory tract infections

A

cefuroxime/cefaclor/cefprozi

43
Q

What are the 2 most common 3rd generation cephalosporins?

A

ceftriaxone (Rocephin)
cefdinir (Omnicef)

44
Q

**_____ First line treatment for Neisseria gonorrhoeae

A

ceftriaxone (Rocephin)

45
Q

**_____ has good pneumococcal coverage,
Often used in combination for pneumonia

A

ceftriaxone (Rocephin)

46
Q

____ and ____ are second line treatment for upper and lower respiratory tract infections

A

cefdinir(Omnicef)
cefixime (Suprax)

47
Q

____ has the broadest spectrum
Gram +, Gram -, Pseudomonas for cephalosporins. Only used in very sick people. IV/IM route only

A

cefepime (Maxipime)

48
Q

**_____ is the only Beta-Lactam with MRSA coverage. IV only

A

ceftaroline (Teflaro)

49
Q

Draw the cephalosporin coverage diagram

A
50
Q

____ have good gram - coverage, including Pseudomonas. Virtually no coverage against Gram + or anaerobes

A

Monobactams:
aztreonam (Azactam)

51
Q

**____ are inhaled and are used in severe cystic fibrosis respiratory infections

A

Monobactams:

aztreonam (Azactam)

52
Q

Why are monobactams not often used?

A

3rd & 4th generation cephalosporins with same/better coverage and less side effects

53
Q

In the combo abx imipenem/Cilastatin, why is cilastatin added?

A

cilastatin added to imipenem to prevent inactivation in renal tubule of kidney

54
Q

____ are very broad spectrum, Good Gram -, Gram +, and anaerobes, Susceptible to beta lactamase, Reserved for severe infections , IV/IM Only. NOT indicated for MRSA

A

Carbapenems
(meropenem, ertapenem,
doripenem)

55
Q

What are some common SE of beta-lactams? Which groups are the most common?

A

GI (N/V/D): more likely with Amoxicillin/Clavulanate and higher generation Cephalosporins

Vaginal candidiasis

56
Q

If a patient has a hypersensitivity reaction to one beta lactam, will they react to all beta lactams?

A

Depends on how severe was the reaction, if it was just a rash. probably okay

57
Q

What is considered a true reaction to PCN?

A

-Occurs immediately or within an hour
-Hives
-Angioedema
-Wheezing or SOB
-Anaphylaxis

58
Q

What are the 3 PKs associated factors with beta-lactams?

A

Minimal liver metabolism
Minimal interaction with CYP450
Renal Excretion: may need to dose adjust with renal impairments

59
Q

What labs do you need to monitor with Beta-lactams?

A

-CBC with prolonged treatment
-Monitor kidney function with prolonged treatment
-Pregnancy Category B
-Drug Interactions: decrease effectiveness of oral contraceptives

60
Q

____ and ____ are considered to be more costly

A

PCN/Beta-lactamase inhibitors

Higher generation cephalosporins

Infectious Disease (16 decks)

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