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Antimicrobials Josi > Antimicrobials I > Flashcards

Antimicrobials I Flashcards

1
Q

What are the 2 natural penicillin?

A

Pen G and Pen VK

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2
Q

What is the mechanism of Pen G and Pen VK?

A

Inhibit Transpeptidase (penicillin binding protein)
Bactericidal
Penicillinase sensitive

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3
Q

Clinical use of Pen G and Pen VK

What makes Pen V different than Pen G?

A

Common strep, pneumo, entero, meningococci, Treponema pallidum

Pen VK is acid stable and so it is orally active

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4
Q

What are the toxicity/contraindications for Pen G and Pen VK?

A

Hypersensitivity rxns
Hemolytic anemia
Cross Sensitivity

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5
Q

What are the Penicillinase Resistant Penicillins? 3

A

Nafcillin, Methicillin, Dicloxacillin, Oxacillin

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6
Q

What is the mechanism of action for Penicillinase resistant penicillins? (Naf, Meth, Oxa and Diclox)

A

Same as Penicillin = Inhibit Transpeptidase (penicillin binding protein)
BUT these are narrow spectrum and are penicillinase resistant

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7
Q

Clinical use of Penicillinase Resistant Penicillins?1

A

Anti Staphylococcal penicillins!
Nafcillin is the Drug of choice for Staph infxns

USE NAF FOR STAPH

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8
Q

Toxicity/contraindications for Penicillinase resistant penicillins

A

headache

metallic taste

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9
Q

Name the aminopenicllins (2)

A

Ampicillin and Amoxicillin

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10
Q

What is the MOA for aminopenicillins (ampi, amoxicllin)

A

Same as penicillins = Inhibit Transpeptidase (penicillin binding protein)
BUT wide spectrum when combined w/ clavulanic acid

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11
Q

Clinical use of aminopenicillins

A

Gram + and Gran - rods
Drug of choice for Listeria Monocytogenes and Enterococci
Drug of choice of prophylaxis of Infective endocarditis

  • Amping up AMO helps kills wide spectrum of entero
  • AmOxicillin has better Oral bioavailibility
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12
Q

Toxicity and Contraindications of aminopenicillins?

A

Hypersensitivity rxns
Ampicillin rash
C. diff infection

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13
Q

Name the Anti-pseudomonal penicillins (3)

A

Ticarcillin
Carbenicillin
Piperacillin

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14
Q

MOA of Anti-pseudomonal penicillins?

A

Same as penicillins = Inhibit Transpeptidase (penicillin binding protein)
BUT extended specrtum

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15
Q

Clinical use of Anti-pseudomonal penicillins?

A

Pseudomonas and Gram - rods
Synergistic with aminoglycosides

TCP Takes Care of Pseudomonas

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16
Q

Toxicity and contraindications of antipseudomonal penicillins?

A

Hypersensitivity rxns

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17
Q

Cool fact about Piperacillin

A

Piperacillin is the broadest spectrum penicillin

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18
Q

Name the 1st generation Cephalosporins?

A

Cefazolin, Cephalexin

LIN, XIN

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19
Q

Name the 2nd generation of Cephalosporins

A

cefoxitin, cefaclor, cefuroxime

TIN, LOR, OXIME

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20
Q

Name the 3rd generation of cephalosporins

A

Ceftriaxone, Cefotaxime, Ceftaxidime, Cefdinir

TRI TAX TAZ DINIR

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21
Q

Name the 4th gen of cephalosporins

A

Cefepime

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22
Q

Name the 5th gen of cephalosprins

A

Ceftaroline

LAST IN LINE

23
Q

MOA for cephalosporins?

A

Penicillinase resistant

24
Q

Clinical use of 1st gen of cephalosporins?

A

Proteus mirabilis
E. Coli
Klebsiella pneumo

PEcK

25
Q

Clinical use for 2nd gen of cephalosporins?

A 
H. flu
Entero
Neisseria
Proteus mirabilis
E. Coli
Klebsiella pneumo
Serratia marcescens

HENPEcKS

26
Q

Clinical use for 3rd gen cephalosporins?

A

Cross BBB – gram + and - cocci, gram - bacilli, meningitis, anaerobes and gonococci and pseudomonas

27
Q

Clinical use for 4th gen cephalosporins?

A

Pseudomonas

28
Q

Clinical use for 5th gen cephaplosporins?

A

covers MRSA

29
Q

Toxicity and contraindications of Cephalosporins?

A

Hypersensitivity rxns, increasing toxicity of aminoglycosides, C. diff inxn

30
Q

MOA of Aztreonam

A

Same as penicilliin = Inhibit Transpeptidase (penicillin binding protein)
BUT a monobactam and penicillinase resistant

31
Q

Clinical use of Aztreonam?

A

Works synergistically with aminoglycosides
Gram -, aerobic rods like serratia, pseudomonas, klebsiella

Tx SPiKe

32
Q

Toxicity and contraindications of Aztreonam?

A

C diff, hematological disorders, fever, diarrhea, cellulitis

33
Q

Name the Carbapenems

A

Imipenem (must be administered with Cilastin)
Meropenem
Ertapenem

34
Q

MOA of carbapenems?

A

Same as penicillin = Inhibit Transpeptidase (penicillin binding protein) BUT is broad spectrum and penicillinase resistant

35
Q

Clinical use of carbapenems?

A

Gram + cocci, Gram - rods, anaerobes = imipenem is the broadest anitbacterial available

Drug of choice for eneterobacteria

36
Q

Toxicity and Contraindications for carbapenems?

A

Seizures, GI distress, Rash, Skeletal muscle toxicity

37
Q

MOA of Vancomycin

A

Inhibits cell wall formation by binding D-Ala portions of cell wall precursors

38
Q

Clinical use of vancomycin?

A

Tx multidrug resistant gram +
Staph aureus
C. diff

39
Q

Toxicity and contraindications of vancomycin?

A

nephrotoxic
ototoxic
thrombophlebitis
Red man syndrome

The red man will NOT take vanco

40
Q

MOA of Bacitracin

A

Blocks peptidoglycan synthesis

41
Q

Clinical use of bacitracin

A

Topical tx

42
Q

Toxicity and contraindications of bacitracin?

A

Nephrotoxic and Ototoxic

43
Q

MOA of Daptomycin

A

Inserts in cell membrane and forms ion channels - bactercidal

44
Q

Clinical use of daptomycin?

A

Vanco and methicillin resistant gram + bacteria

45
Q

Toxicity and contraindications of daptomycin?

A

headache, GI upset, insomnia, rhabdomyolosis

46
Q

Amoxicillin and clavulanic acid =

47
Q

ampicillin and sulbactam =

48
Q

piperacillin and taxobactam =

49
Q

Name all the drugs (or categories) that target cell wall synthesis – there are 11.

A 
Natural Penicillins
Penicillinase resistant
Aminopenicillins
Anti-pseudomonal penicillins
Cephalosporins
Aztreonam
Carbapenems
Vancomycin
Bacitracin
Daptomycin
50
Q

How do Beta lactam drugs work?

A

Bind to the Transpeptidase penicillin binding protein and prevent transpeptidation!
Transpeptidation covalently bonds chains of peptidoglycan, making rigid cells walls. Without a rigid cell wall, bacteria undergo lysis.

51
Q

What do all Beta Lactam drugs need to work?

A

Require actively proliferating organisms, need organisms with peptidoglycans, and should be dosed for T>MIC (Type II TIme dependent dosing)

52
Q

Name the Beta Lactam drugs:

A

Natural penicillins, Aminopenicillins, penicillinase resistant penicillins, antipseudomonal penicllins, cephalosporins and carbapenems

53
Q

Name the non Beta Lactam drugs

A

Bacitracin, Vancomycin and daptomycin

Antimicrobials Josi (6 decks)

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