Antimicrobials I

Question 1

Agents that inhibit bacterial cell wall synthesis (classes)

Answer 1

penicillins, cephalosporins, vancomycin, carbapenems, monobactams

Question 2

Angetns that affect protein synthesis (classes)

Answer 2

macrolides/lincosamindes, tetracyclines, aminoglycosides, linezolids (chlormphenicol, streptogramins, oxazolidinones)

Question 3

Agents that affect bacteria nucleic acid metabolism

Answer 3

quinolones (and rifamycins)

Question 4

Agents which block folate metabolism

Answer 4

trimethoprim and sulfonamide

Question 5

Miscellaneous agents

Answer 5

daptomycin and metroniazole

Question 6

Mechanism of resistance to penicillins

Answer 6

efflux pumps, changes in the permeability channels, beta lactamase, or mutations of the penicillin binding proteins (esp. gram positives)

Question 7

major adverse effect of penicillins

Answer 7

allergy: rash to anaphylaxis
may cause lower the seizure threshold
may have bone marrow suppression effects, esp. with WBCs (ESPECIALLY nafcillin)

Question 8

Penicillin: coverage, sides, administration

Answer 8

strep, syphillis, gram pos cocci, some enterococci. PO for penK, IV for Pen G, IM for syphilis

Question 9

Nafcillin/oxacillin: coverage, sides

Answer 9

covers MSSA and strep. not enterococci or gram negativivs. Nafcillinc can cause profound neutropenia. oxacillin can cause hepatic stasis. both can cause AIN. bulky side chains resist staph beta lactamases

Question 10

ampicillin/amoxicillin: coverage, administration

Answer 10

good for strep A and B, MSSA, gram neg rods like E coli. IV or PO.

Question 11

Piperacillin/ticarcillin. uses, andmin, CNS

Answer 11

good for pseudomonas (but requires a higher dose: 4.5 q 6 hrs), staph, gram negatives, anaerobes. Taz is a beta lactimase inhibitor. IV only and doesn’t reach CNS.

Question 12

unasyn

Answer 12

kil staph, strep, and enterococcus. does not kill pseudomonas. aka amp and sulbactam. IV only.

Question 13

Augmentin

Answer 13

amoxicillin + clauvulante. good for staph, strep, enterococcus. doesn’t kill pseudomonas. good for recent dental infections, those who have had ampicillin recently, non-MRSA skin infections. ORALLY available.

Question 14

First generation cephalosporins

Answer 14

cefazolin and cephalexin.

Question 15

cefazolin

Answer 15

1st generation cephalosporin used for cellulitis and surgical procedures. give IV. coveers stap, strep, some gram neg rods like E coli and klebsiella (no enteroccoccus, anaerobes, pseudomonas)

Question 16

cephalexin

Answer 16

1st gen cephalosporin. covers staph, strep, some gram neg rods (E coli, klebsiella). doesn’t cover enterococcus. this is oral. used for cellulitis, surgical prophylaxis, and strep in kids.

Question 17

What should I know about 2nd generation cephalosporins?

Answer 17

rarely used. two kinds- respiratory group (cefuroxime) (covers s pneumon, h flu, m catt, strep), and anaerobic group cefotetan (covers GNE, anaerobes, strep). cephotetan has a disulfram effect.

Question 18

Ceftriaxone: class, admin, CNS? use

Answer 18

3rd gen cephalosporin given Q24 hrs. has CNS penetration:

Question 19

Ceftriaxone: use

Answer 19

first choice for meningitis caused by pneumonococcus and meningococcus. and in hospital pts with community acquired pneumonia.
covers S pneumo, enteric gram negatives, and meningococcus

Question 20

Ceftriaxone: side effects

Answer 20

biliary sludge- but no worries about renal pts

Question 21

Cefotaxime: class, use, admin

Answer 21

IV, 3rd gen cephalosporin, treats S pneumo, enteric gram negatives, meningococcus. used for meningitis caused by pneumococcus and meningococcus and in hospital pts with CAP. covers S pneumo, enteric gram negatives, and meningococcus

Question 22

What 3 generation cephalosporin covers pseudomonas?

Answer 22

ceftazidme

Question 23

use of ceftazidme

Answer 23

gram negative CNS infections, including pseudomonas. not as good for gram positive coverage or enterococcus