Anti-Infectives 1

Question 1

All antibiotics can cause what?

Answer 1

Diarrhea due to disruption of the normal flora

Question 2

Bactricidal vs bacteriostatic?

Answer 2

cidal kiills bacteria, static inhibits replication and then the immune system destroys it

Question 3

Gram negative vs gram positive?

Answer 3

Negative: do not stain, have extra polylipophilic layer and harder to kill

Question 4

Penicillin G is used for what?

Answer 4

IV

Syphilis, it is mixed with Benzathine (a local anesthetic) but still IM and painful

Question 5

What is Penicillin V? how does it work?

Answer 5

PO. first antibiotic

Arrests cell wall synthesis by binding to penicillin binding proteins (bactericidal)

Question 6

What does Penicillin V cover?

Answer 6

Gram positive

Some anaerobes

Question 7

What should you remember with Penicillin V? (4 things)

Answer 7

Take on empty stomach
Take ATC
May cause rash & diarrhea
Renal elimination

Question 8

What is the gram positive bug that is everywhere?

Answer 8

staphylococcus aureus

Question 9

What was the gold standard for staph aureus?

Answer 9

Methicillin

Question 10

What are the aminopenicillins?

Answer 10

Ampicillin

Amoxicillin

Question 11

What do aminopenicillins cover?

Answer 11

Same as penicillin + gram negatives E. Coli & H. flu

Question 12

Aminopenicillins used to treat what?

Answer 12

Uncomplicated UTI and Otitis media

Question 13

How do you take the aminopenicillins?

Answer 13

Ampicillin on empty stomach

Amoxycillin has added OH group, which enhances absorption

Question 14

Ampicillin has added coverage of what bugs?

Answer 14

• Enterococcus

- Listeria (newborn meningitis, food illnesses)

Question 15

What is the virulent gram positive bug?

Answer 15

enterococcus

Question 16

What is the virulent gram negative bug?

Answer 16

Pseudomonas aeuroginosa

Question 17

What is Beta Lactamase?

Answer 17

enzymes the bacteria produce that destroy and deactivate antibiotics

Question 18

What is a Beta-lactimase inhibitor?

Answer 18

Clavulanic acid

Question 19

What is the popular antibiotic with beta-lactimase inhibitors?

Answer 19

Augmentin – amoxicillin + clavulanic acid

Question 20

Augmentin is used for what?

Answer 20

beta-lactimase producing strains of SA, H. flu, and M. cat (NOT MRSA)

Question 21

Is augmentin 1st or 2nd line?

Answer 21

2nd

Question 22

Caution your patients about what with penicillin?

Answer 22

• Oral contraceptives (estrogen activated in colon for 2 weeks)
• Anaphylaxis (very antigenic)
• Drug fever
• C. diff

Question 23

What are the extended spectrum PCNs used for?

Answer 23

gram negative coverage, including pseudomonas aeuroginosa

POOR gram positive coverage

Question 24

Why are extended spectrum PCNs unique?

Answer 24

only available parenterally

Question 25

What are examples of extended spectrum PCNs?

Answer 25

Timentin
Zosyn

combined with B lactamase inhibitors

Question 26

What do the cephalosporin generations cover?

Answer 26

First- gram positive
Second- gram positive, some gram negative
Third- gram negative

Question 27

What are the first generation cephalosporins?

Answer 27

Cefazolin
Cephalexin (staph, strep)

NOT for MRSA

Question 28

The cephalosporins are related to what?

Answer 28

PCNs- 10-15% cross reactivity

Question 29

What are some of the 2nd generation cephalosporins?

Answer 29

Cefuroxime Axetil

Cefaclor (kids)

Question 30

What are the 3rd generation cephalosporins?

Answer 30

Ceftriaxone

Question 31

What cephalosporin is used in ED?

Answer 31

Ceftriaxone- long T1/2 so 1 g IM QD, inject patient and send them to PCP

Question 32

What is the new brand of cephalosporin drugs?

Answer 32

Ceph-Bactam Combination

Cephalosporin + B lactamase inhibitor

they increase Gram Negative coverage

Question 33

Risks with Cephalosporins?

Answer 33

Anaphylaxis

C. diff