Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MJ- Pharmacology Exam 1 > Antibiotics- Bacterial cell wall inhibitors > Flashcards

Antibiotics- Bacterial cell wall inhibitors Flashcards

1
Q

What are penicillinase-susceptible, narrow spectrum penicillins?

A
  1. Penicillin G
  2. Penicillin VK*

*these are susceptible to penicillinase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are penicillinase-resistant, narrow spectrum penicillins?

A

Nafcillin*

Oxacillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which antibiotics are classified as wider spectrum penicillins?

A
  1. Ampicillin
  2. Amoxicillin*
  3. Piperacillin
  4. Ticarcillin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pharmacokinetics of penicillin

A
  • Rapid renal elimination
  • Some biliary clearance of ampicillin and nafcillin

*don’t give in pediatric patients or patients with liver/gallbladder problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ADEs of penicillins

A
  1. Hypersensitivity reactions***** (~5-6%incidence)
  2. Maculopapular rash (ampicillin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Activity spectrum and clinical uses of narrow spectrum penicillins

A
  • Streptococcal infections*
  • Staphylococcal infections*
  • Meningococcal infections
  • Syphilis

*= highlighted in red on powerpoint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Activity spectrum and clinical uses of wider spectrum penicillins

A

Greater activity vs. gram negative bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some first generation Cephalosporins?

A

Cephalexin (Keflex)

this is the narrowest spectrum and the oldest Cephalosporin- always want to try to use this first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some second generation Cephalosporins?

A
  1. Cefotetan (injectable)
  2. Cefoxitin(injectable)
  3. Cefuroxime*

*= bolded on powerpoint slide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some third generation cephalosporins?

A
  • Ceftriaxone* (injectable)
  • Cefixime*
  • Cefotaxime (injectable)
  • Ceftazidime (injectable)

*= bolded on slide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some fourth generation cephalosporins

A

Cefipime (injectable)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Fifth generation cephalosporins

A

Ceftaroline (injectible)

5th generation= deiscovered most recently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When should you not give cephalosporins

A

if patient has a penicillin allergy (anaphylaxis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Pharmacokinetics of cephalosporins

A
  • Oral use for older drugs
  • Mostly IV for newer drugs
  • Renal elimination
  • Third-generation drugs enter CNS****
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ADEs of cephalosporins

A
  • Hypersensitivity reactions (~2% incidence)
  • Assume complete cross-reactivity between cephalosporins**
  • First generation partial cross-reactivity with penicillins***
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What cephalosporin is not given to newborns and why?

A

Ceftriaxone is contraindicated in neonates because it displaces bilirubin from albumin binding sites, resulting in a higher free bilirubin serum concentration with subsequent accumulation of bilirubin in the tissues.

Also precipitates calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the activity spectrum and clinical uses of 1st generation cephalosporins?

A

skin

soft tissue

UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the activity spectrum and clinical uses of 2nd generation cephalosporins?

A

More active against S. pneumoniae and H influenza

B fragilis (cefotetan)

19
Q

What is the activity spectrum and clinical uses of 3rd generation cephalosporins?

A
  • Many uses including pneumonia, meningitis, and gonorrhea
  • Broad activity, beta-lactamase-stable
20
Q

What is the activity spectrum and clinical uses of 4th generation cephalosporins?

A

Pseudomonas coverage

21
Q

What is the activity spectrum and clinical uses of 5th generation cephalosporins?

A

Skin

soft tissue

CAP (community acquired pneumonia)

22
Q

_____ generation cephalosporins may exhibit cross sensitivity with ____

A

First, Penicillins

First generation cephalosporins were found to be contaminated with penicillin in the past, probably explaining cross-reactivity in penicillin-allergic patients

23
Q

Is there cross reactivity in 2nd-5th generation cephalosporins with penicillins?

A

these can usually be given safely to penicillin-allergic patients, though commonly witheld if the patient suffered true penicillin-induced anaphylaxis

24
Q

Cephalosporin cross sensitivity with penicillins- delayed dermatologic reactions vs. Type I hypersensitivty rxns

A

Delayed dermatologic rxns (i.e. rash) to penicillin generally can receive cephalosporins

However, Type I hypersensitivity rxns (anaphylaxis) to penicillins should not receive cephalosporins

25
Q

What are some alternatives to cephalosporins if the patient is penicillin allergic?

A

Aztreonam

quinolones

sulfonamide antibiotics

vancomycin

26
Q

What is the rule of thumb for giving cephalosporins to patients allergic to penicillin in the absence of complete penicillin skin testing capabilities?

A

Avoid giving cephalosporins to patients who give a good history for immediate or accelerated rxns (eg, anaphylaxis, laryngospasm) and to give them under close supervision to patients with a hx of delayed rxns (rash)

27
Q

What antibiotic should be given if a gram-negative infection is suspected or documented?

A

Therapy with a monobactam may be appropriate because cross reactivity with other B-lactams is nonexistent

28
Q

ADEs of Carbapenems

A

These are beta-lactams so they have similar structure to penicillins and cephalosporins

They have a broad spectrum of activity but have CNS adverse effects including confusion and seizures (this is why carbapenems are different than B lactams)

29
Q

Types of Carbapenems

A

Imipenem-cilastatin (Primaxin)*

Dorpenem

Meropenem

Ertapenem

*= bolded on slide

30
Q

What do Carbapenems treat?

A

They are broad spectrum

  • Some PRSP (Penicillinase resistant srep pneumoniae) but not MRSA
  • Gram negative rods
  • Pseudomonas sp
31
Q

Monobactam

A

This is beta-lactam

-does NOT have cross allergenicity with other beta-lactams

32
Q

What is an example of a Monobactam?

A

Aztreonam

*No cross-allergenicity with beta-lactams

33
Q

What are Monobactams active against?

A

They are active only vs. gram-negative bacteria:

  1. Klebsiella
  2. Pseudomonas
  3. Serratia spp
34
Q

ADEs of Monobactam

A

CNS: Headache, vertigo

35
Q

________ is a glycopeptide that covers MRSA and PRSP

A

Vancomycin

36
Q

What are vancomycin agents?

A
  1. Vancomycin*
  2. Dalbavancin
  3. Oritavancin
  4. Telavancin

2-4 are primarily for skin and skin structure infections; Telavancin is also used for hospital acquired and ventilator associated bacterial pneumonia

37
Q

What are the pharmokinetics of Vancomycin?

A
  • Parenteral for systemic infections
  • oral vancomycin for C. diff colitis
  • renal elimination
38
Q

How do you treat C. diff?

A

ORAL vancomycin (IV vancomycin will NOT tx C. diff)

39
Q

What are toxicities of vancomycin?

A
  • Red-neck or red man syndrome (Erythematous rash on face and upper body–> Infusion rate cause and not an allergic reaction)
  • Rare nephrotoxicity
40
Q

What is the activity spectrum of vancomycin?

A

Gram positive activity includes MRSA and PRSP strains

41
Q

Daptomycin

A

Daptomycin is a lipopeptide with activity against MSSA and MRSA

Agent: Daptomycin

42
Q

Pharmacokinetics of Daptomycin

A

renal elimination

43
Q

Toxicities of Daptomycin

A

Myopathy (this is a unique toxicity)

Must monitor CPK (Creatinine kinase) weekly

44
Q

What is the activity spectrum of Daptomycin?

A
  1. Gram-positive activity
  2. Endocarditis and sepsis*
  3. Off-labeled uses- osteomyelitis and prosthetic joint infections
  4. MSSA and MRSA coverage

MJ- Pharmacology Exam 1 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions