Antimicrobials 1 Flashcards
1
Q
What is the MOA of penicillin
A
Disrupt the synthesis of the cell wall
2
Q
what must be happening for penicillin to be effective
A
Bacteria must be growing and dividing
3
Q
6 Classes of drugs that inhibit cell wall synthesis
A
Penicillins Cephalosporins Carbapenems Vancomycin Aztreonam Televancin
4
Q
what does penicillin inhibit
A
transpeptidases which are essential for cell wall synthesis
5
Q
penicillin activates what
A
autolysis
6
Q
T/F penicillin has low toxicity
A
TRue
7
Q
Penicillin A/E (3)
A
urticaria
pruritis
angioedema
8
Q
6 indications for penicillin
A
Gonorrhea
perionitis
UTI
Pneumonia and other Resp Infections
Septicemia
Meningitis
9
Q
S/E for Penicillin (5)
A
GI distress
oral/vaginal candidiasis
general rash
Anaphylaxis
Itchiness
10
Q
4 Types of Penicillins
A
Natural
Penicillinase-Resistant
Aminopenicillins
Extended-Spectrum
11
Q
2 Natural penicillins
A
PCN G
PCN V
12
Q
Penicillinase-Resistant drug
A
nafcillin
13
Q
2 aminopenicillin drugs
A
amoxicillin
ampicillin
14
Q
Extended-spectrum penicillin
A
piperacillin
15
Q
how are Natural pcns: penicillin g& V given
A
IV/IM (PO avaliable)
16
Q
what does Natural pcns work on
A
Works on Gram +, gram – cocci, anaerobic bacteria, spirochetes
17
Q
what is 1.2 life of natural pcn
A
30 minutes
18
Q
what can natural pcn be used with
A
aminoglycosides - disrupts protein synthesis
19
Q
T/F Nafcillin is the drug of choice for this class of PCNs
A
TRUE
20
Q
T/F Nafcillin is IV only
A
TRUE
21
Q
T/F Nafcillin Resist breakdown by the penicillanse enzyme
A
True
22
Q
What is a common adverse effect with Ampicillin
A
diarrhea and rash
23
Q
how is ampicillin administered
A
PO/IV
24
Q
T/F ampicillin is renal sensitive
A
True
25
T/F Amoxicillin has less SE than ampicillin
True
26
Who is amoxicillin common in
pediatrics
27
route of amoxicillin
PO
28
What areas are amoxicillin common for treating
ear
nose
throat
genitourinary
skin infections
29
T/F piperacillin is Always given with a beta lactamase inhibitor
True
30
What infection is piperacillin good for
pseudomonas
31
what should you watch for with piperacillin
patients with renal dysfunction as it also affects platelet function
32
5 classes of Cephalosporins
1st gen
2nd gen
3rd gen
4th gen
5th gen
33
what is the MOA of cephalosporins
Structurally similar to PCNs
Inhibit cell wall synthesis through same penicillin-binding protein -> activate autolysis
34
T/F cephalosporins have a low toxicity
TRUE
35
most common A/E of cephalosporins
Mild diarrhea
abdominal cramps
rash
pruritis
redness
edema
36
indications of cephalosporins
same as penicillins
37
pregnancy category of cephalosporins
Category B
38
T/F Cephalosporins have poor oral absorption
True
39
2 1st Generation cephalosporin drugs
Cefazolin
cephalexin
40
what do 1st gen cephalosporin drugs work well for
gram + bacteria
staph and non-enterococcal strep infections
41
route of 1st gen cephalosporin drugs
PO or IV
| Cefazolin only IV
42
What is cefazolin common for
surgical prophylaxis
43
2nd generation cephalosporin drugs
cefuroxime
cefotetan
44
coverage for 2nd generation cephalosporin drugs
More gram – coverage AND the gram + coverage
45
Route of 2nd gen cephalosporins
IV/PO
46
What does Cefuroxime not kill
anerobic bacteria
47
Name the 3 3rd generation drugs
ceftriaxone
ceftazidime
Cefotaxine
48
Action of 3rd generation cephalosporins
Most potent in fighting gram – bacteria BUT much less activity against gram +
49
routes avaliable for 3rd gen cephalosporins
IV/IM
Other forms available in PO
50
T/F Ceftriaxone is EXTREMELY long-acting (once per day dosing benefit)
True
51
Are 3rd gen cephalosporins able to cross the BBB
Able to cross the blood brain barrier so effective in treating meningitis and other infections within the CNS
52
Who do we not give give 3rd gen cephalosporins to
patients with liver failure
53
what does ceftazidime work well for
pseudomonas
54
what is the 4th generation drug
Cefepime
55
what does cefepime work against
gram - & + (very broad spectrum)
56
What infections do cefepime work for
Uncomplicated/complicated UTIs, skin infections and pneumonias
57
does cefepime cross the BBB
yes
58
5th generation cephalosporin
ceftaroline
59
what does ceftaroline treat
Treats MRSA and MSSA works again some VRSA/VISA
60
what does ceftaroline not cover
No Enterobacter, Pseudomonas, ESBL, Klebsiella coverage
61
how is ceftaroline dosed
renally
62
route of ceftaroline
IV
63
what does Ceftolozane/tazobactam (Zerbaxa) NEWEST cephalosporin do
treats complicated infections
64
name the 2 Carbapenems
imipenem/cilastin (Primaxin)
meropenem
65
MOA of carbapenems
Bactericidal & cell wall inhibitor (same as previous two classes)
66
Biggest A/E of carbapenems
drug-induced seizure activity
67
Caution with carbapenem IVs
ALL are IV and must be INFUSED OVER 60 MINUTES
68
what are carbapenems usually used as
last resort medication
69
T/F Carbapenems are the BROADEST spectrum of all antibiotics
True
70
what does Imipenem/cilastin bind to
penicillin-binding proteins -> inhibits the cell wall synthesis
VERY RESISTANT TO BETA-LACTAMASE
71
T/F Imipenem/cilastin (primaxin) is the most broad spectrum
TRUE
72
route of Imipenem/cilastin (primaxin)
IV
73
T/F Imipenem/cilastin (primaxin) can penetrate BBB and meninges
TRUE
74
What do we watch for with Imipenem/cilastin (primaxin)
WATCH FOR SEIZURES especially in elderly and with other meds that can induce seizures
75
what is Imipenem/cilastin (primaxin) used form
complicated infections
76
coverage for meropenem
A little less coverage than imipenem; but still gram + and – aerobes and anaerobes
77
facts about meropenem
Doesn’t degrade in kidneys
Less seizure activity
78
S/E for meropenem
rash and diarrhea
79
ertapenem
less spectrum; but only have to give once a day
80
doripenem
newest; less seizure activity; NOT FOR PNEUMONIA
81
What kind of antibiotic is Vanomycin
Glycopeptide
82
what is the MOA of Vanomycin
Destroys by binding to bacterial cell wall, producing immediate inhibition of cell wall synthesis and death
83
what does Vanomycin work on
gram + infections -> including MRSA and PCN resistant pneumococcus
84
what is oral vancomycin given to treat
clostridium difficile and pseudomembranous colitis
85
what does vancomycin not work for
CNS infections
86
how is vancomycin eliminated
Kidneys eliminate drug; decrease doses for renal dysfunction
87
Toxic side effects of vancomycin (5)
Ototoxicity with high levels (can be reversible)
Immune-mediated thrombocytopenia
Nephrotoxic watch when using with other drugs (aminoglycosides, cyclosporin's, IV contrast) that affect kidneys
Watch with neuromuscular blockades (paralyzers)
88
what is Red man syndrome
usually related to rapid infusion
Flushing, rash, pruritis, urticaria, tachycardia, hypotension
Infuse slowly and over longer time periods
Usually NOT harmful
89
Monobactam drug
Aztreonma
90
what is aztreonma most commonly used for
gram - bacteria
91
MOA of aztreonam
Still uses the penicillin binding protein; inhibits cell wall synthesis and cell lysis
92
route of aztreonam
IV/IM
93
S/E of Aztreonam
thrombophlebitis/pain at injection site
94
t/f aztreonam Can work for CNS infections- crosses the BBB
True
95
MOA of televancin
inhibits cell wall synthesis
96
route of televancin
IV only: usually for skin infections r/t gram + bacteria (works for MRSA)
97
A/E for televancin
renal toxicity, infusion-related reactions, prolonged QT interval
98
2 derivatives of televancin
dalbavancin
oritavancin
*long half life
99
Teicoplanin is a semisynthetic what
glycopeptide
100
MOA of Teicoplanin
Inhibits peptidoglycan polymerization, results in inhibition of cell wall synthesis and cell death
101
route of teicoplanin
PO
102
what does teicoplanin treat (2)
C Diff and pseudomembranous colitis
or
Treats gram-positive bacterial infections like MRSA and Enterococcus [similar to Vanc]
103
T/F teicoplanin has a long half life
True
