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Pharmacology > Antimicrobials - CWI > Flashcards

Antimicrobials - CWI Flashcards

1
Q

What does de-escalation mean?

A

Go from broad to more targeted therapy

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2
Q

Does aztreonam cover Gram+ or Gram-? Which microbe is most important?

A

Gram-

Pseudomonas

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3
Q

What is it called when you inhibit or kill and organism without damaging the host cells?

A

Selective toxicity

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4
Q

What is the difference between bacteriostatic and bacteriocidal?

A

Bacteriostatic - drug reversibly impairs replication

Bactericidal - drug destroys organism

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5
Q

What is the difference between concentration-dependent and concentration-independent?

A

Concentration-dependent - killing increases as concentration increases - one large dose
Concentration-independent - dose needs to be above MIC for as long as possible

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6
Q

What are the two pain 1st generation cephlosporins?

A

Cefazolin

Cephalexin

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7
Q

Which beta-lactam can be given when a person has a true penicillin allergy?

A

Axtreonam

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8
Q

Which category do 1st generations typically work on best? Which two specifically?

A

Gram +
MSSA
Penicillin susceptible S. pneumoniae

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9
Q

What is a general trend of all carbapenems?

A

Broad spectrum

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10
Q

What is the only 4th generation cephalosporin?

A

Cefepime

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11
Q

What is the main organism targeted by penicillinase resistant? Which strain specifically?

A

S. aureus, MSSA

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12
Q

What do beta-lactamases do? How do we get around this?

A

Beta-lactamases bind to PBP, reducing affinity for antimicrobial agent
Give betalactamase inhibitors - inhibit beta-lactamases so drug can get through cell wall/membrane

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13
Q

What are 4 penicillinase resistant antimicrobials?

A

Methicillin
Oxacillin
Nafcillin
Dicloxacillin

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14
Q

What group does Cefoxitin mainly cover? Which two are only covered by cefoxitin?

A

Anaerobes

Baceroises and Clostridium

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15
Q

What is the only monobactam?

A

Aztreonam

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16
Q

What is MIC?

A

Minimum inhibitory concentration - lowest concentration of antimicrobial agent required to prevent visible growth of microorganism

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17
Q

What are two types of natural penicillins?

A

Penicillin VK

Penicillin G

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18
Q

Which carbapenem is in group 1? Whicha re in group 2 (MOD)?

A

Group 1 - ertapenem

Group 2 - meropenam, imipenem, doripenem

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19
Q

What are two major AD for vancomysin?

A

Red-man Syndrome (release of histamine causes red rash on face and torso)
Nephrotoxicity/Ototoxicity

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20
Q

What are the three main organisms targeted by vancomycin?

A

S. aureus (MSSA and MRSA)
Enterococcus
C. Diff

21
Q

What are two main 2nd generation cephlosporins?

A

Cefoxitin and Cefuroxime

22
Q

What are two aminopenicillins?

A

Amoxicillin

Ampicillin

23
Q

Is daptomycin in the same family as vanc? What is a contraindication? What must be monitored during use?

A 
Pulmonary infections (inactivated by surfactant)
Monitor CPK during therapy
24
Q

Is colistin used often? What are two ADE?

A

No
Neuromuscular paralysis
Nephrotoxicity

25
Q

What is the main organism targeted by natural penicillins?

A

S. pyogenes - Group A Strptococcus

26
Q

How does Oritavancin differ in dose from Vancomyosin and Televancin? What is the half life?

A

1 large dose

Half-life = 245 hours

27
Q

What are two pain drugs in 3rd generation cephalosporins? What do each treat best?

A

Ceftriaxone - community aquired pneumonia

Ceftazidime - pseudamonas

28
Q

What is the only fifth generation? What specific microbe is it used against?

A

Ceftaroline

MRSA

29
Q

What two microbes does Colistin mainly work against?

A

Acinetobacter

Pseudomonas

30
Q

What are three betalactamases?

A

Clavulanate, Sulbactam, Tazobactam

31
Q

Is cefepime stable or unstable against beta-lactamases?

A

Stable

32
Q

What is the ADE for cefepime?

A

Delerium

33
Q

What are two main organisms targeted by amoxicillin and ampicillin?

A 
Enterococcus faecalis
Strep pneumoniae (high dose)
34
Q

What is the main ADE of aztreonam?

A

Nephtrotoxicity

35
Q

When is IV vanc used? When is oral?

A

IV - systemic infections

Oral - C. Diff

36
Q

What is the ADE of ceftriaxone?

A

Biliary sludging

37
Q

Which carbapenem has the highest risk of seizure?

A

Imipenem

38
Q

Is cefepime narrow or broad spectrum? What group is it used for typically?

A

Broad

Gram-

39
Q

What do beta-lactams bind to on the bacteria cell wall/membrane?

A

Penicillin Binding Protein (PBP)

40
Q

What are two unique ADE of penicillin VK and G?

A

Black hairy tongue

Hemolytic anemia

41
Q

Which beta-lactam/beta-lactamase inhibitor combination works against pseudomonas?

A

Piperacillin/Taxobactam

42
Q

Which 5 organisms are not covered by carbapenaems? Which additional 6th is not covered by ertapenem?

A 
MRSA
VRE
C. Diff
Stenotrophomonas
Nocardia
Pseudomonas - ertapenem only
43
Q

What are the three types of antimicrobial therapy used today? What do each target/do?

A

Empiric - educated guess
Definitive/Targeted - known organism
Prophylactic - ahead, just in case

44
Q

Does Televancin have the same coverage as vancomyosin? How is it given?

A

Yes

1 large dose daily - concentration dependent

45
Q

How does dalbavancin differ in dose from Vanc, Televancin, and oritavancin?

A

1 1500mg dose or 1 1000 mg dose and 1 500mg dose 1 week later

46
Q

What are two unique ADE of Televancin?

A

Metallic tase

Foamy Urine

47
Q

What is an AD of penicillinase resistant?

A

Interstitial nephritis

48
Q

What other drugs effect may increase when taking 2nd and 3rd generation cephlosporins?

A

Warfarin

49
Q

What are general trends made about cephalospoin generations?

A

Lower - better gram + coverage

Higher - better gram - coverage

Pharmacology (7 decks)

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