Antibiotics exam 1 Flashcards

1
Q

This cell-wall inhibitor is NOT penicillin related, it has no beta lactam ring. It is the drug of choice for MRSA

A

Vancomycin

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2
Q

How do you administer Vancomycin for a C. Diff infection?

A

PO only! it is not absorbed systemically when given PO, and reaches the intestinal tract

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3
Q

what is Vanco’s coverage?

A
gram positive
MRSA
MRSE
Enterococcus 
C. diff (po)
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4
Q

What do you have to monitor when administering vanco?

A

serum drug concentrations, aka TROUGHS

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5
Q

This cell wall inhibitor is a bactericidal, concentration-dependent alternative choice to quinupristin or linezolid

A

Daptomycin

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6
Q

Daptomycin coverage

A

Gram positive
MRSA
VRE
S. aureus skin infections

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7
Q

This cell wall inhibitor can cause myalgia, elevated hepatic transaminases, elevated creatinine phosphokinase, and rhabdomyolysis

A

Daptomycin

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8
Q

NEVER use this drug in treating pneumonia or lung infection because it is inactivated by pulmonary surfactants

A

Daptomycin

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9
Q

this cell wall inhibitor has a similar structure to vanco, and is a good alternative to vanco, dapto, and linezolid for complicated skin infections

A

Telavancin

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10
Q

televancin coverage?

A

drug-resistant gram (+), MRSA, VRE

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11
Q

What is the last possible choice for antibiotic to treat hospital acquired bacterial pneumonia, only when nothing else is suitable?

A

Televancin

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12
Q

Can you safely administer telavancin in pregnant women?

A

NO - not recommended in pregnancy

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13
Q

Adverse effects of this drug include taste disturbances, foamy urine, QT prolongation, and can interfere with coag labs

A

Telavancin

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14
Q

This cell wall inhibitor works as a bactericidal and is often used to treat E.coli in UTIs

A

Fosfomycin

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15
Q

When treating UTIs with fosfomycin, which organism(s) are we targeting?

A

E.coli and E. faecalis

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16
Q

How do you describe the absorption speed of fosfomycin?

A

RAPID (given po)

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17
Q

Which organs/areas does fosfomycin distribute well to?

A

kidneys, bladder, prostate

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18
Q

This cell wall inhibitor binds to gram (-) cell membranes and disrupt their wall integrity, causing leakage and death of the cell

A

Polymixin

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19
Q

Coverage of polymixins?

A
gram negative
p. aeruginosa
e.coli
k. pneumonia
acinetobacter
enterobacter
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20
Q

What 2 organisms is polymixin intrinsically resistant to?

A

proteus and serratia

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21
Q

This antibiotic is used as a desperate choice for multi drug resistant gram-negative infections (salvage therapy)

A

Polymixins

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22
Q

What subtype of penicillin do amoxicillin and ampicillin fall under?

A

Extended spectrum

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23
Q

Which cell-wall inhibitors are susceptible to beta lactamase?

A

Extended spectrum
natural penicillins
antipseudomonals

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24
Q

extended spectrum penicillins have the usual coverage against gram(+), but with the added coverage of _____

A

gram (-)

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25
Q

What is the drug of choice for gram (+) bacillus LISTERIA MONOCYTOGENES

A

Ampicillin

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26
Q

Penicillin DOES NOT COVER:

A

mycobacteria, protozoa, fungi, viruses

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27
Q

what are the antistaphylococcal penicillins?

A

Dicloxacillin

Oxacillin

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28
Q

What is the coverage for antistaphylococcal penicilins?

A

gram positive staph; including penicillinase-producing staph (MSSA)

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29
Q

what is NOT covered by antistaphylococcal penicillin

A

gram negative or

MRSA

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30
Q

What are the antipseudomonal penicillins?

A

Piperacillin

Ticarcillin

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31
Q

piperacillin and ticarcillin coverage?

A

pseudomonas aeruginosa, (gram (-) bacilli)

32
Q

Do the antipseudomonals cover Klebsiella?

A

NO

33
Q

What is the reason that cephalosporins and penicillins cross react?

A

they have similar beta lactam ring structures

34
Q

These meds do not have significant antibiotic activity, and are often combined with Abx to increase resistance to beta lactamase

A

Beta lactamase inhibitors

35
Q

Gram positive coverage ____ with each cephalosporin generation, while gram negative coverage ____

A

decreases; increases

36
Q

which cephalosporin is the drug of choice for renal dysfunction?

A

ceftriaxone (3rd generation) - it is not renally eliminated

37
Q

Which cephalosporins are able to cross into the CSF?

A

Ceftriaxone

cefotaxime

38
Q

How are cephalosporins similar in structure to penicillins?

A

they both have a beta-lactam ring

39
Q

cephalosporins tend to be more resistant to beta lactamases, but susceptible to ____

A

ESBL

40
Q

1st generation cephalosporins (Cefazolin and Cephalexin) are predominantly gram positive coverage, with SOME gram negative coverage of which organisms?

A

proteus mirabilis
e. coli
k. pneumonia
(gram negative bacilli)

41
Q

What is Cefazolin used most frequently for and why?

A

pre-surgery, due to its short 1/2 life and activity against s. aureus. It can also penetrate bone

42
Q

As we progress to the 2nd generation cephalosporins, they lose some gram positive coverage, but gain 3 more gram negative coverages. What are they?

A

H. influenza, enterobacter aerogenes, neisseria

43
Q

Which 2nd generation cephalosporins have activity against anaerobes?

A

Cefotetan

Cefoxitin

44
Q

Moving into the 3rd generation cephalosporins, we are gaining even more activity against

A

gram negative bacilli.

45
Q

True or False: 3rd generation cephalosporins are great antibiotics, but if you can choose something less broad coverage, go with that instead to avoid resistance

A

TRUE

46
Q

Does 4th generation cephalosporin (Cefepime) have activity against MSSA and MRSA?

A

NO - only gram positive staph/strep

47
Q

What does Cefepime cover regarding gram negative organisms?

A
AEROBIC GRAM (-):
enterobacter
e. coli
k. pneumonia
p. mirabilis.
p. aeruginosa
48
Q

Does ceftaroline (5th gen ceph) have MRSA coverage?

A

YES - only cephalosporin that does.

49
Q

What is the distribution of Carbapenems?

A

Penetrates the CSF

50
Q

Imipenem, Merpenem, and Ertapenem are all what type of antibiotic?

A

Carbapenems

51
Q

Which carbapenem should be combined with cilastin to avoid renal toxicity?

A

Imipenem

52
Q

Are carbapenems susceptible to or resistant against beta lactamase?

A

resists beta-lactamase

53
Q

Carbapenem coverage

A

beta-lactamase producing gram positive and gram negative anaerobes. also p. aeruginosa, but some resistance happening

54
Q

Aztreonam is what type of antibiotic?

A

Monobactam

55
Q

Aztreonam (monobactam) coverage?

A

mostly gram negative

56
Q

Does Aztreonam cover gram positive?

A

NO coverage of gram positive of anaerobes

57
Q

What anatomic sites are normally sterile?

A

CSF
blood
Urine

58
Q

Infection arising from one’s own normal flora is known as ______

A

endogenous infection

59
Q

The presence of bacteria NOT causing disease is known as ______

A

colonization

60
Q

The presence of bacteria that are causing disease is called ____

A

an infection

61
Q

infections acquired from an external source (human-human transmission) are called _____

A

exogenous bacterial infections

62
Q

What are the 2 most common resistant pathogens?

A

MRSA

VRE (vanco resistant enterococcus)

63
Q

what is called when resistance is occurring in a patient’s non-2targeted flora that can cause secondary infections? (c. diff)

A

collateral damage

64
Q

Tetracycline coverage

A

gram (+) gram (-), protozoa, spirochetes, mycobacteria, atypicals

65
Q

True or False: If a patient is resistant to 1 tetracycline they will be resistant to all

A

FALSE. try another one if they are resistant to one

66
Q

Is tetracycline used in pregnancy?

A

Avoid in pregnancy. Crosses placenta and affects fetal bones,

67
Q

Which tetracycline is the best choice for renal dysfunction

A

Doxycycline

68
Q

This class of antibiotics binds to tissues that undergo calcifications, such as teeth, bones.

A

Tetracyclines

69
Q

When do you avoid administering tetracyclines due to bone dysfunction, growth shunting

A

pregnancy, lactation, kids

70
Q

What is the only bacteriocidal protein synthesis antibiotic?

A
Aminoglycosides:
amikacin
gentamycin
tobramycin
streptomycin
71
Q

Amikacin
Gentamycin
Tobramycin
Streptomycin

A

Aminoglycosides (protein synthesis inhibitors)

72
Q

aminoglycosides have post-anti-biotic effect. What does this mean?

A

still have bacterial suppression after below target concentration

73
Q

What is the one BACTERICIDAL class of protein synthesis inhibitors?

A

aminoglycosides

74
Q

What infection can occur from overuse of fluoroquinolones?

A

C. diff

75
Q

Which fluoroquinolones are great for respiratory infections caused by s. pneumoniae (CAP)

A

moxifloxacin and levofloxacin

76
Q

Which fluoroquinolone would be best for someone with kidney dysfunction?

A

Moxifloxacin - eliminated through liver