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Pharmacology Unit 6 > Antibiotics III > Flashcards

Antibiotics III Flashcards

1
Q

What is the primary goal when treating skin and soft tissue infections with beta hemolytic streptococcal species?

A

Every effort must be made to sue an appropriate penicillin or cephalosporin

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2
Q

If failing to use a penicillin or cephalosporin w/i the first 24 hrs of infection, what is the outcome?

A

Patient at a significant risk of morbidity and has prompted a marked increase in hospitalization

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3
Q

Compared to their corresponding cephalosporins, are penicillins more or less effective?

A

Penicillins are MORE effective

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4
Q

What is a benefit of cephalosporins compared to their corresponding penecillins?

A

Cephalosporins have a broader spectrum of action

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5
Q

What is the bacterial spectrum of penicillins?

A

Strep species and oral anaerobes

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6
Q

What do penicillinase resistant penicillins and 1st gen cephalosporins treat?

A

Strep species and MSSA

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7
Q

What are aminopenicillins and 2nd generation cephalosporins used to treat?

A

Strep species, and H. flu (non-penicillinase-producing)

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8
Q

When clavulanic acid is added to aminopenicillins, what is the spectrum include?

A

Strep species, all anaerobes, all H. flu, and MSSA

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9
Q

What do the extended spectrum penicillins and 3rd generation cephalosporins treat?

A

Strep species and Gram negative rods

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10
Q

What is the coverage for extended spectrum penicilns +tazobactam and 4th generation cephalosporins?

A

Strep species, Gram negative rods, all anaerobes, MSSA

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11
Q

What are 30% of Strep pneumoniae resistant to and why?

A

Resistant to all penicillins and 1st generation cephalosporins because of alteration in PBP2b

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12
Q

What is the carbapenem that we’re responsible for?

A

Imipenem

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13
Q

What do carbapenems (imipenem) cover?

A

Broad Gram positive (except MRSA) and Gram negative coverage

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14
Q

What is the monobactam that we’re responsible for?

A

aztreonam

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15
Q

What are monobactams effective against?

A

Gram negatives

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16
Q

A patient with lobar pneumonia has Gram postive diplococci. What should be used?

A

Patient has streptococcus pneumoniae. 30% of S. pneumoniae are resistant to penicillins because of the mutation in PBP 2b and therefore it would be wise to use a drug that binds to PBP2x (Cephalosporin 2nd, 3rd, 4th gen)

17
Q

What are the glycopeptides that inhibit cell wall synthesis?

A

Vancomycin (it’s the only one)

18
Q

What is the MOA of Vancomycin?

A

Vancomycin binds to the two D-alanine residues at the end of a peptide chain and inhibits the proper interaction with the cell wall cross-linking enzyme

19
Q

What is the MOR of Vancomycin?

A

The D-alanine AA at the end of the polypeptide is replaced with D-lactate. Vancomycin cannot bind and therefore the crosslinking enzyme can properly operate.

20
Q

What is the drug of choice for MRSA?

A

Vancomycin

21
Q

What are the adverse reactions for Vancomycin?

A
  • Panoply of drug allergy
  • REdman Syndrome - FLushing, tachycardia, hypotension,
22
Q

What is the spectrum of activity for Vancomycin?

A

Give IV for serious Gram (+) infections such as:

  • MRSA
  • Staphylococcus epidermidis
  • Ampicillin-Resistant Group D Strep faecalis
  • pneumococcal meningitis
  • metronidazole-resistant strains of C. difficile
23
Q

What are the cell membrane toxins?

A
  1. Cyclin lipopeptide (Daptomycin)
  2. Polymixins (Colistin)
24
Q

What is the MOA of daptomycin?

A

Cyclic lipopeptide in which the lipophilic tail goes thru the teichoic acid backbone of the cell membrane of Gram (+) organisms [Not effective against Gram (-) because of LPS]

25
Q

Adverse reactions to Daptomycin

A
  • Allergy
  • Risk of drug-induced rhabdomyolysis especially after prolonged exposure >7 days
26
Q

What is the AB spectrum of daptomycin?

A

Strictly for infections with Gram (+) organisms that are vanco and lactam resistant OR patient has severe vanco or lactam allergy

27
Q

Two specific bugs where daptomycin should be used?

A
  1. Vancomycin-Resistant Enterococci
  2. Vancomycin-Resistant Staphylococcus aureus
28
Q

What is the mechanism of action of Colisitin?

A

A polymixin that is essentially the Gram (-) counterpart of daptomycin

Binds to LPS causing the disruption of outer cell membrane in Gram (-) bacteria

29
Q

What are the adverse reactions to colistin?

A
  1. Highly nephrotoxic
30
Q

What situations are colistin used?

A

Reserved for Gram (-) bacteria (usually Pseudomonas species) resistant to all other ABs as frequently occur in patients with cystic fibrosis

Pharmacology Unit 6 (15 decks)

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