antibiotics

Question 1

Bugs treated by penicillin

Answer 1

viridans group strep, other oral anaerobes, strep pyogenes, syphillis, leptospira (both are spirochetes right? treponema and leptospira..?)

Question 2

Bugs treated by Amox/ampilicciln

Answer 2

same as pcn, plus lyme disease and HELPS with some other gram negs
(H flu, E coli, Listeria, proteus, salmonella)

Question 3

PCNs (pun, amok, amp) are best initial therapy for what?

Answer 3

Otitis media, Lyme disease limited to rash/joint pain/7th CN involvement, dental infections, endocarditis prophylaxis, UTI in pregnancy, Listeria monocytogenes, enterococcal infections

Question 4

Pencillinase resistant PCNS are

Answer 4

naficillin and the ox’s: oxacillin (methicillin equivalent–remember methicillin is not used in the body because it causes allergic intersitial nephritis and renal failure), dicloxacillin, cloxacillin

Question 5

PCNase resistant PCNs are used for

Answer 5

Skin infections: impetigo, erysipelas (whatever the hell that is), and cellulitis
osteomyelitis and septic arthritis when susceptibility has been proven
endocarditis, meningitis and bacteremia caused by staphylococci
NOT EFFECTIVE AGAINST MRSA (DUH) OR ENTEROCOCCUS

Question 6

antipseudomonals are___ and cover what else besides the obvious
when you administer them you do what?

Answer 6

Piperacillin, ticarcillin, azlocillin, mezlocillin
cover gram negs from the large enterobacteraciea family which includes Ecoli and proteus, as well as pseudo-monads
Also cover streptococci and anaerobes but would not be used for uncomplicated infections from these bugs alone (would use a narrower spectrum drug)

administer these with a beta-lactamese inhibitor: e.g. tazobactam, or clavulanate (clavulanic acid)

Question 7

antipseudomonals are the best initial therapy for what illnesses?

Answer 7

Pylonephritis, bactermia, acute cholecystitis/ascending cholangitis, hospital acquired/vent assoc pneumonia, fever with neutropenia

Question 8

All cephalosporins cover

Answer 8

E coli, klebsiella, Proteus mirabelis, viridans strep, Groups A-C strep (A-pyogenes, B-agalactsiea)

Question 9

No cephalosporins cover

Answer 9

MRSA, Listeria, enterococci,

Question 10

billy gets a rash to PCN what can you give him?

Answer 10

Cephalsporins, per master boards cross reactivity is less than 3%

Question 11

Sally get annaplhaxis from PCN what should you give her?

Answer 11

Not a fucking cephlasporin, or any other beta-lactam antibiotic for that matter

Question 12

Name the first generation cephsporins if you want

Answer 12

Cefzolin, cephalexin, cephadrine, cefadroxyl

Question 13

Name the second generation cephsporins if you want

Answer 13

Cefuroxim, loracarbef, cefotetan, cefoxitin, cefprozill, cefaclor

Question 14

Name the third generation cephsporins if you want

Answer 14

Ceftriaxone, ceftazidime, cefotaxime

Question 15

Name the fourth generation cephsporins if you want

Answer 15

cefepime

Question 16

Name the fifth generation cephsporins if you want

Answer 16

ceftarolene

Question 17

Generalizations and exceptions about cephsporins

Answer 17

(they are beta lactam antibiotics–cell wall synthesis inhibutors–> bactericidal)
more resistant to PCNases
–>generally don’t cover pseudo- LAME organisms: pseudomonas, Listeria atypical (mycoplasma and chlamydia), MRSA, enterococci,
–> exceptions: Ceftazidime covers pseudomonas, and so do some 4th generations? cefepime? Also ceftaroline (5th gen) covers MRSA
Rule from DIT?–as you go up the generation you add G- coverage and lose g+ coverage?? double check at home
–>Dont cover anaerobes
–>exceptions: Cefotetan, cefoxitin

Question 18

First gen cephalosporins cover/are used for:

Answer 18

G+ cocci– MSStaph, and strep species (not enterococcus), PEcK: Proteus miribalis, E coli, Klebsiella pneumo
INfections: Osetomyelitis, septic arthritis, cellulitits, endocarditis

Question 19

2nd gen cephalosporins cover/are used for:

Answer 19

HENS PEcK: H flu, Enterobacter aerogenes, Neiseria, Serattia (Proteus, ecoli klebsiella)

the non cephamycins (ones beside cefotetan and cefoxitin) aka cefprazol, lorcarbef, cefuroxime, are used for respiratory infections: bronchitis, otitis media, sinusitis

cefotetan and cefoxitin, with their anaerboic coverage (maybe this is why?) are FIRST LINE for PID when used in combination with Doxycycline, (not enough gram pos coverage for respiratory infections per wiki though)

Question 20

3rd gen cephalosporins cover/are used for:

Answer 20

Serious gram neg infections resistant to other beta lactams,
ceftriaxone first line for Pneumococcus infections–even if partially resistant: meningitis, community acquired pneumonia (with a macrolide), also gonorrhea, lyme disease when it’s involving heart or brain
Cefotaxime is better than ceftriaxone in neonates
ceftazidime for psuedomonas and spontaneous bacterial peritonitis

Question 21

4th gen cephalosporins cover/are used for:

Answer 21

cefipime– more gram positive and increased psuedomonal coverage
treats:
neutropenia with fever
vent associated pneumonia

Question 22

5th gen cephalosporins cover/are used for:

Answer 22

ceftaroline– broad spectrum gram pos and neg, does NOT cover pseudomonas, COVERS MRSA (only one)

Question 23

Dangers of cephsporins

Answer 23

ceftriaxone–not good for neonates with their deceased biliary function /metabolism
cephamycins (cefoxiitin, and cefotetan) – deplete prothrombin and increase risk for bleeding, also cause disulfarim-like reaciton with etOH