Beta Lactam and Vancomycin

Question 1

whats hiB and LMCG structures

Answer 1

HiB is gram neg rod

LMCG is Gram pos rod :)

Question 2

Penicillin susceptibility against streptococcus

Answer 2

alpha plus enterococci resistant
- should be PBP changes

beta hemolytic SENSITIVE

Question 3

Syphillis give what

Answer 3

Pen G - IV/IM

Pen V - oral

Question 4

Staph aureus structure

Answer 4

Gram Pos clusters

Question 5

What penicillin for Pseudomonas?

Route?

Answer 5

PIPERICILLIN

IV

Question 6

Klebsiella Pneumonia give what

Answer 6

Pipericillin

Question 7

Penicillin clearance?

Aminopenicillin ROA?

Answer 7

RENAL

- both Oral and IV can

Question 8

Give the 3 combo penicillins

which one is suicide inhibitor

Answer 8

Clavulanic acid + Amoxicilin - ORAL IV
- suicide inhibitor

Sulbactam + Ampicillin - IV
Tazobactam + Piperacillin - IV

Question 9

Penicillin AE

know top 2

Answer 9

Allergy - SJS, TEN Type IV
CDAD
- esp for broad spectrum which is aminopenicillin

• neurotox, anosmia
• hepatotox for PRP;

Question 10

Name the IV cephalosporin
Name the cephalosporins ok for Pseudomonas
Whats LMAE
ROA of Cephalosporin
Elimination?

Answer 10

Gen 1 Cefazolin IV
Gen 3 Ceftazidime ok for Psuedo; Gen 4 and 5 can also
- gen 4 cefepime; gen 5 ceftobiprole, ceftaroline

LISTERIA, Atypical, MRSA, Enterococci

• note Gen 5 ok for MRSA
• Gen 4 and 5 ok for pseudomonas
• cephalosporin ORAL only Gen 1 and Gen 2 except cefazolin gen 1
• ALL RENAL except ceftriaxone hepatic

Question 11

Cephalosporin AE

Answer 11

Hypersensitivity
CDAD
- same as Penicillin

Cos IV
- thrombophlebitis

Question 12

Carbapenems THINK MICE
– note for ESBL and gram negs

• name all
• ROA
• AE

Answer 12

Imipenem + Cilastatin which blocks DHP1 at kidney
Meropenem

• Ertapenem - CANNOT pseudomonas

AE:

• GIT, rashes
• neurotoxicity
• CROSS HS w penicillin;

Question 13

Whats aztreonam

• against
• Route of admin
• excretion

Answer 13

Monobactam

GRAM NEG AEROBES ONLY

• IM/IV
• renal

NO cross reactivity to penicillin

Question 14

Vancomycin

MOA

• USE
• AE

Answer 14

Glycopeptide
- inhibit transglycosylase

GRAM POS ONLY

• oral for CDAD, second to metronidazole
• IV for everything else - MRSA can

Red man syndrome
Thrombophlebitis - chills, fever
NO - nephrotoxicity, Ototoxicity

Question 15

Whats clostridium diff

- meds?

Answer 15

GPR ITS POSITIVE

• anaerobe
• CDAD first give metronidazole; then oral vancomycin

Question 16

Aminoglycoside careful when giving Vancomycin why?

Answer 16

Both nephrotoxicity, ototoxicity

Question 17

N gonorrhea give what

Answer 17

Azithromycin oral and IM ceftriazone