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PHARM3 > ABX review -Table 1 > Flashcards

ABX review -Table 1 Flashcards

1
Q

Which abx is drug of choice for treating enterococcus?

A

Ampicillin

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2
Q

Which ABX is least effective against MRSA?

A

Clindamycin

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3
Q

Which abx are 1st gen cephalosporins?

A

Cephalexin(Kaflex), cefazoli, cefaclor

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4
Q

What is GAS?

A

Group A streptococcus, step pyogenes

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5
Q

What test can quickly decipher Staph. aureus from Staph epidemidids?

A

Coagulase test, S.Aureus is coag positive, while staph epidemidis is coag negative

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6
Q

What is GBS?

A

Group B streptococcus, strep agalactiae, Beta hemolytic

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7
Q

What are some gram negative rods?

A

Enterobacteriacea, pseudomonas, acinetobacter, morazella, xanthomonas, bordatella, legionella, haemophilis influenzae

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8
Q

What are SPACE organisms?

A

Serratia, pseudomonas, acinetobacter, citrobacter, enterobacter, need double coverage of abx d/t virulence

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9
Q

What are some gram negative anaerobes?

A

Bacteroides, Prevotella, Fusobacterium, Clostridium(+), actinomyces, peptostreptococcus(+)

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10
Q

What is traditional PCN used to Tx?

A

Syphilis and GBS in pregnancy

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11
Q

Aminopcns are what drugs?

A

amoxicillin and ampicillin

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12
Q

What are aminopcn’s best at covering?

A

Gram+, specifically enterococci, listeria, strep, H.pylori

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13
Q

What are the antistaphylococcal pcns?

A

Methicillin, oxacillin, nafcillin(IV only), dicloxacillin, cloxacillin,

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14
Q

What do antistaphylococcals cover?

A

Additional staph coverage, with strep, Gram +, NOT MRSA

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15
Q

When switching from Nafcillin(IV) to a PO equivalent, what do you rx?

A

Dicloxacillin

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16
Q

What are the Antipseudomonal pcns?

A

Piperacillin, Ticarcillin

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17
Q

How does piperacillin and ticarcillin contrast?

A

Piper covers enterococcus and Ticar impairs platelet aggregation, ticar is also IV

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18
Q

What are some Beta-lactamase organisms?

A

Staph, H.flu, Klebsiella, B.Fragilis

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19
Q

What is unasyn?

A

Ampicillin/Sulbactam

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20
Q

When taking a pt off of IV unasyn what PO pcn/betalactamase do you use?

A

Augmentin aka. Amoxicillin/clavulanate (PO)

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21
Q

What is the potential cross sensitivity of using a cephalosporin in a pt allergic to other beta lactams?

A

3-5%

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22
Q

What don’t cephalosporins cover?

A

Enterococcus(gram+)

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23
Q

What are the first generation cephalosporins?

A

Cefazolin, cephalothin, (PO)>cephalexin, cephradine, cefadroxil

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24
Q

What do you know about the Proteus species?

A

Gram -, enterobacteriacia, HUMAN PATHOGEN, “buring chocolate” odor, isolated from urine, wounds, ears and bacteremic, Not a nice species

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25
Q

When are 1st generation cephalosporins used?

A

For surgical prophylaxis, staph and strep infections and UTI, d/t their E.coli, proteus, strep, MSSA and klebsiella coverage

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26
Q

When taking a pt off of IV cefazolin, what PO 1st gen can you send them home with?

A

Cephalexin(PO)

27
Q

What are the second generation cephalosporins?

A

Cefaclor, cefprozil, lorcarbef, cefamandole, cefurozime,

28
Q

What are the cephamycins?

A

Cefoxitin and cefotetan (cefo)

29
Q

How do 2nd gen cephalosporins compare to cephamycins?

A

Cephamycins have anaerobic coverage and so used for CAP, Abd. infections, PID, and UTI ….2nd gen cephs

30
Q

What are the 3rd generation cephalosporins?

A

Cefpodoxime, ceftibuten, cefdinir, cefixime, cefditoren, IV>Cefotaxime, ceftriaxone, ceftizoxime, ceftazidime,

31
Q

Which 3rd gen ceph has activity against pseudomonas?

A

Ceftrazidime

32
Q

What is different from 3rd gen cephs compared to 2nd gen?

A

3rd gen- has better gram neg coverage, and covers spirochetes(borrielia, T.pallidum(syphilis))

33
Q

What does 4th gen ceph treat?

A

Nosocomial infections(pseudomonas) and febrile neutropenia

34
Q

What are the 5th gen cephs?

A

Ceftaroline fosamil and ceftaroline tazobactam

35
Q

What is updated about 5th gen cephs that is different from other cephs?

A

Covers MRSA and s.pneumoniae,

36
Q

Aztreonam covers?

A

Most gram negatives(pseudomonas included), no gram pos coverage

37
Q

What is ceph is comparable to aztreonam?

A

Ceftazidime(3rd gen), d/t similar side-chains, so has cross reactivity potential and similar gram neg coverage

38
Q

What do macrolides cover?

A

Strep, atypicals, whooping cough(pertussis), neisseria, H.flu,

39
Q

Of the macrolides, which one has the fewest drug interactions?

A

Azithromycin, whereas clarithromycin interacts with statins and erythromycin has most interactions

40
Q

When switching from IV to PO macrolides which do you choose?

A

Azithromycin(iv) to erythromycin(PO)

41
Q

Does ampicillin/sulbactam(unasyn) cover pseudomonas?

A

Nope, Zosyn(pipercillin/taxo), cefepime and primaxin (imipenem-cilastin) do though

42
Q

What ABX are considered to have a narrow spectrum of coverage?

A

Penicillin, oxacillin/nafcillin, cefazolin, cephalexin/cephradine, aztreonam,

43
Q

Penicillins: renal clearance EXCEPT?

A

Oxacillin and nafcillin

44
Q

Sulfonamides compete for albumin with:

A

Bilirrubin: given in 2°,3°T, high risk or indirect hyperBb and kernicterus in premies
Warfarin: increases toxicity: bleeding

45
Q

Beta-lactamase (penicinillase) Suceptible

A 
Natural Penicillins (G, V, F, K)
    Aminopenicillins (Amoxicillin, Ampicillin)
    Antipseudomonal Penicillins (Ticarcillin, Piperacillin)
46
Q

Beta-lactamase (penicinillase) Resistant:

A 
Oxacillin, Nafcillin, Dicloxacillin
    3°G, 4°G Cephalosporins
    Carbapenems 
    Monobactams
    Beta-lactamase inhibitors
47
Q

Penicillins enhanced with:

A

Clavulanic acid & Sulbactam (both are suicide inhibitors, they inhibit beta-lactamase)
Aminoglycosides (against enterococcus and psedomonas)

48
Q

Cephalosporines: renal clearance EXCEPT

A

Cefoperazone & Cefrtriaxone (bile)

49
Q

2°G Cephalosporines: none cross BBB except

A

Cefuroxime

50
Q

3°G Cephalosporines: all cross BBB except

A

Cefoperazone bc is highly highly lipid soluble, so is protein bound in plasma, therefore it doesn’t cross BBB.

51
Q

Cephalosporines are “LAME“ bc they do not cover this organisms

A

L isteria monocytogenes
A typicals (Mycoplasma, Chlamydia)
M RSA (except Ceftaroline, 5°G)
E nterococci

52
Q

Drugs that cause disulfiram-like reaction: Colorado Cannabis Consumers Got Marihuana legalized

A 
C efotetan
    C efoperazone
    C hlorpropamide
    G riseofulvin
    M etronidazole
53
Q

Cefoperanzone: all the exceptions!!!

A

All 3°G cephalosporins cross the BBB except Cefoperazone.
All cephalosporins are renal cleared, except Cefoperazone.
Disulfiram-like effect

54
Q

Against Pseudomonas:

A

3°G Cef taz idime (taz taz taz taz)
4°G Cefepime, Cefpirome (not available in the USA)
Antipseudomonal penicillins
Aminoglycosides (synergy with beta-lactams)
Aztreonam (pseudomonal sepsis)

55
Q

Covers MRSA:

A

Ceftaroline (rhymes w/ Caroline, Caroline the 5°G Ceph), Vancomycin, Daptomycin, Linezolid, Tigecycline.

56
Q
  • Covers VRSA:
A

Linezolid, Dalfopristin/Quinupristin

57
Q

DEMECLOCYCLINE is ?

A

tetracycline that’s not used as an AB, it is used as tx of SIADH to cause Nephrogenic Diabetes Insipidus (inhibits the V2 receptor in collecting ducts)

58
Q

Phototoxicity: Q ue S T ion?

A

Q uinolones
Sulfonamides
T etracyclines

59
Q

p450 inhibitors:

A

Cloramphenicol, Macrolides (except Azithromycin), Sulfonamides

60
Q

Macrolides SE

A

Motilin stimulation, QT prolongation, reversible deafness, eosinophilia, cholestatic hepatitis

61
Q

Bactericidal

A

beta-lactams (penicillins, cephalosporins, monobactams, carbapenems), aminoglycosides, fluorquinolones, metronidazole.

62
Q

Baceriostatic

A

tetracyclins, streptogramins, chloramphenicol, lincosamides, oxazolidonones, macrolides, sulfonamides, DHFR inhibitors.

63
Q

Pseudomembranous colitis

A

Ampicillin, Amoxicillin, Clindamycin, Lincomycin.

64
Q

QT prolongation:

A

macrolides, sometimes fluoroquinolones

PHARM3 (16 decks)

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