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Beta Lactams Flashcards

1
Q

What is the mechanism for natural penicillin?

A

Bind penicillin binding proteins (transpeptidases) - block transpeptidase cross-linking of peptidoglycan - activate autolytic enzymes

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2
Q

Name the natural penicillins.

A 
Penicillin G (IV and IM)
Pencillin V (PO)
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3
Q

What are the clinical uses for natural penicillins?

A

Mostly used for gram (+) organisms:
S. pneumoniae
S. pyogenes
Actinomyces

Also:
N. meningitidis
Treponema pallidum

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4
Q

What toxicities should we be aware of for natural penicillins?

A

Hypersensitivity reactions and hemolytic anemia

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5
Q

Name the penicillnase-resistant penicillins.

A

Oxaclillin
Nafcillin
Dicloxacillin

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6
Q

What are the clinical uses for penicillnase-resistant penicillins?

A

S. aureus - except MRSA resistant because of altered penicillin binding protein target site.

“Use naf for staph”

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7
Q

What toxicities should we be aware of for penicillnase-resistant penicillins?

A

Hypersensitivity reactions and interstitial nephritis.

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8
Q

Name the aminopenicillins.

A

Ampicillin

Amoxicillin

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9
Q

What are the clinical uses for aminopenicillins?

A 
These are extended spectrum penicillins. :
Haemophilus influenzae
E. Coli
Listeria monocytogenes
Proteus mirabilis
Salmonella
Shigella

Amp/Amox HELPSS kill enterococci

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10
Q

What toxicities should we be aware of for aminopenicillins?

A

Hypersensitivity reactions; ampicillin rash; pseudomembranous colitis

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11
Q

Name the antipseudomonals.

A

Ticarcillin

Piperacillin

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12
Q

What are the clinical uses for antipseudomonals?

A

Pseudomoas spp. and gram (-) rods; susceptible to penicillinase; use with clavulanic acid

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13
Q

What toxicities should we be aware of for antipseudomonals?

A

Hypersensitivity reactions.

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14
Q

What are the Beta Lactamase Inhibitors?

A

Clavulanic Acid
Sulbactam
Tazobactam

Often added to penicillin antibiotics to protect the antibiotic from destruction by Beta Lactamase (penicillinase)

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15
Q

What are the organisms not typically covered by cepalosporins?

A

Listeria
Atypicals (Chlamydia, Mycoplasma)
MRSA
Enterococci

Cephalosporins are LAME

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16
Q

Name the 1st Generation cephalosporins.

A

Cefazolin

Cephalexin

17
Q

What are the uses of the 1st Generation cephalosporins?

A

Gram (+) cocci
Proteus mirabilis
E. coli
Klebsiella pneumoniae

PEcK

18
Q

Name the 2nd Generation cephalosporins.

A

Cefotoxin
Cefaclor
Cefuroxime

19
Q

What are the uses of the 2nd Generation cephalosporins?

A 
Gram (+) cocci
Haemophilus influenzae
Enterobacter aerogenes
Neisseria spp.
Proteus mirabilis
E. coli
Klebsiella pneumoniae
Serratia marcescens

HEN PEcKs

20
Q

Name the 3rd Generation cephalosporins.

A

Ceftriaxone
Cefotaime
Ceftazidime

21
Q

What are the uses of the 3rd Generation cephalosporins?

A

serious gram (-) infections resistant to other Beta Lactams

Ceftriaxone - meningitis and gonorrhea
Ceftazidime - pseudomonas

22
Q

Name the 4th Generation cephalosporins.

A

Cefepime

23
Q

What are the uses of the 4th Generation cephalosporins?

A

increased activity against Pseudomonas and gram (+) organisms

24
Q

What toxicities should we be aware of for cephalosporins?

A

Hypersensitivity reactions, vit K deficiency, Low cross reactivity with penicillins, increased nephrotoxicity of aminoglycosides.

25
Q

Name the monobactam.

A

Aztreonam

26
Q

What is the mechanism for monobactam

A

A monobactam resistant to Beta Lactamases

Prevent peptidoglycan cross-linking by binding to PBP3 - synergistic with aminoglycosides

27
Q

What are the uses of monobactam?

A

Gram (-) rods only

For penicillin allergic patients and those with renal insufficiency who cannot tolerate amino glycosides

28
Q

What toxicities should we be aware of for monobactam?

A

usually nontoxic

ocasional GI upset

29
Q

Name the carbapenems.

A

Imipenem

Meropenem

30
Q

What are the uses of carbapenems?

A

Gram (+) cocci
Gram (-) rods
Anaerobes

Side effects limit use to life threatening infections or after other drugs have failed

31
Q

What toxicities should we be aware of for carbapenems?

A

GI distress
skin rash
CNS toxicity at high plasma levels

32
Q

What is the mechanism for Vancomycin?

A

Inhibits cell wall peptidoglycan formation by binding D-ala- D-ala portion of cell wall precursors

It is bactericidal.

33
Q

What are the uses of Vancomycin?

A

Gram (+) only

serious multi drug resistant organisms including MRSA, enterococci and C. Diff

34
Q

What toxicities should we be aware of for Vancomycin?

A

Nephrotoxicity
Ototoxicity
Thrombophlebitis
Red Man Syndrome

Well tolerated in general - does NOT have many problems

ID (8 decks)

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