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MOD1 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Which drug cannot be used for pneumonia and why not?

A

Daptomycin –inactivated by lung surfactant

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2
Q

How should you treat pseudomonas systemic infection and why

A

Use fluorquinolones in combination, since pseudomonas has efflux pumps

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3
Q

All cephalosporins have NO clinically reliable activity against what bacteria?

A

Enterococci

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4
Q

Which antibiotic should never be used alone to treat any infection? Why?

A

Rifampin due to rapid resistance development

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5
Q

Which drug treatment is associated with a life-threatening serotonin syndrome if on antidepressant theory and why?

A

Linezolid – it is a reversible MAO inhibitor

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6
Q

Which antibiotic may cause hypertension if given with tyramine containing foods?

A

Linezolid

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7
Q

What are two important clinical precautions with tetracycline?

A

-can cause photosensitivity -chelated by divalent cations (bad because can stick to calcium and discolor teeth during development in children)

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8
Q

Quinupristin/Dalfopristin has NO activity against this bacteria

A

Enterococcus faecalis

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9
Q

What is an important alarm regarding aminoglycosides?

A

Use in combination only, since high resistance risk with monotherapy

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10
Q

What two drug must be used in combination since there is high resistance development?

A
  1. Rifampin 2. Aminoglycosides
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11
Q

Which two antibiotics are associated with prolonged QT intervals?

A
  1. Macrolides 2. FQs
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12
Q

Which drug can cause taste perversion/metallic taste?

A

Metronidazole

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13
Q

List the 4 beta lactam cell wall active antibiotics

A
  1. Penicillins 2. Cephalosporins 3. Carbapenems 4. Monobactams
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14
Q

What are the 5 classifications of penicillins?

A
  1. Natural PCNs 2. Penicillinase resistance (anti-staph) 3. Aminopenicillins 4. Antipseudomonal 5. PCN-beta lactamase enzyme inhibitor combinations
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15
Q

What is the best (only) treatment for syphilis?

A

Natural penicillin (even if allergic!)

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16
Q

What are the two important anti-staph PCNs?

A
  1. Nafcillin 2. oxacillin
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17
Q

What is the first modified PCN group to increase reactivity against gram negative bacteria?

A

Aminopenicillins

18
Q

Most cephalosporins have NO reliable activity against anerobes. Which two drugs are the exception?

A

Cefotetan, and Cefoxitin (2nd generation)

19
Q

What is the one important monobactam and main function?

A

Aztraonam -A TREe has fallen through the center of our house, leaving only the square portion (beta-lactam ring) standing, and letting all the air in (aerobic). If this happened to your house it’d be a negative experience -treats gram negative aerobic bacteria, including pseudomonas aeruginosa

-NO activity against gram (+), anaerobes, or atypical

20
Q

What are beta lactamases (penicillinase) and what are their function?

A

-serine proteases -evolved from penicillin binding protein (transpeptidase) -catalyze the hydrolysis of the antibiotic’s beta-lactam bond -only need a small amount of enzyme to destroy large amount of drug

21
Q

How has Methicillin-Resistant Staph aureus (MRSA) acquired resistance to anti-staph PCNs?

A
  • change in PBP enzyme targets
22
Q

What are the 2 available agents for anti-staphylococcal PCNs (penicillinase-resistance), and what is their main spectrum of activity?

A
  1. cloxacillin / dicloxicillin (po)
  2. nafcillin / oxacillin (iv)

SOA:

  • Streptococci (Group A, B, C)
  • Strep pneumoniae
  • MSSA

~Staph epidermidis

23
Q

Aminopenicillins are often combined with beta-lactamase inhibitors. What is the important structural change in beta-lactamase inhibitors compared to penicillins??

A
  • Lacks the 6-acylamino side chain of the penicillins
  • allows for a better fit into the active site of the beta-lactamase (penicillinase) and more **persistent binding **
24
Q

Amoxicillin and Ampicillin (aminopenicillins) alone target mostly _____ bacteria. However, when coupled with beta-lactamase inhibitors, what is their increased spectrum of activity?

A

alone target most gram (+) bacteria (strep, enterococci) and limited gram negative (Neisseria, Haemophilus influenzae, E. coli)

combined:

  • improved gram positive (staph)
  • broader gram negative
  • improved anaerobic

combined =

ampicillin/sulbactam (Unasyn)

amoxacillin/clavulanate (Augmentin)

25
Q

Which penicillin group has broad spectrum empiric therapy use or targeted therapy of hostpial-acquired infections?

A

Anti-pseduomonal PCNs

26
Q

Most important Anti-psuedomonal PCN

A

Piperacillin

27
Q

Anti-psuedomonal PCNs spectrum of activity

A
  • more active against Gram (-) and less active against Gram (+)
  • concern for increasing resistance against Pseudomona aeruginosa!
  • active against most anaerobes (clostridium)
  • **enterics **
28
Q

What makes cephalosporins more stable to penicillinase (beta-lactamase) degradation than penicillin?

A

-Ceph’s ring structure is less strained and more planar = less reactive = reduced tendency to hydrolyze = more stable

29
Q

4th generation cephalosporin

A

Cefepime

30
Q

Cephalosporins are (Bactericidal/Bacteriostatic)

A

Bactericidal

31
Q

Relative cross-allergenicity risk of carbapenems for patients with PCN allergies

A

only 5-10% risk

32
Q

Most skin-test confirmed cross-reactivity occurs with penicillin allergies and which generation cephalosporin?

A

1st generation

33
Q

Two narrow spectrum antibiotics

A
  1. penicillin (only aerobic gram positive cocci
  2. metronidazole (only aerobes)
34
Q

Nearly 50% of documented PCN-allergic patients have cross-reactivity to ____

A

imipenem

35
Q

Which antibiotics can cause “Red-man syndrome?”

A
  • related to histamine release
  • Vancomycin
  • Dalbavancin
36
Q

Macrolides are (bacteriostatic/bactericidal)

A

Bacteriostatic

37
Q

List the bacteriostatic drugs (6)

A
  1. Penicillin (static towards enterococci and have no activity against atypical pathogens like chlamydia, legionella, myco)
  2. Macrolides (think of the birds just sitting in all the sketchy videos, static, not moving)
  3. Tetracycline (its such a baby drug obviously it is)
  4. Chloramphenicol
  5. Clindamycin
  6. Linezolid (against staph and entero! but its cidal against strep!)

*some, like sulfonamides, may be both static and cidal, depending on the organism or drug concentration

38
Q

List two important broad spectrum drugs

A
  1. meropenem (all aerobic and anaerobic gram pos and neg)
  2. levofloxacin (majority of aerobic gram pos and neg)
  3. glycycyclines
39
Q

You cannot use IV unfractionated heparin for 48 hours after infusion of which drug? Why not?

A

Oritavancin –interferes with PTT test

40
Q

Which antibiotic is known to cause hypermesis?(nausea, vomiting, hung-over feeling)

A

Tigecycline

41
Q

Which antibiotic is strongly associated with seizures?

A

Imipenum

42
Q

Which carbapenem has NO activity against pseudomonas?

A

Ertapenem (carbapenem)

MOD1 (9 decks)

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