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Antibiotics > Beta Lactams > Flashcards

Beta Lactams Flashcards

1
Q

Ex of beta-lactams

A

PCN
Cephs
Glycopeptides:Vanco
Lipoglycopeptide

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2
Q

Mnemonic for bacteriocidal

A

Very Finely Proficient At Cell Murder

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3
Q

inhibits cell wall synthesis of batercia by inhibiting PBP-causes lysis of bacteria and release of intracellular contents

A

MOA of PCN

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4
Q

uses of PCN

A

pharyngitis-GABHS
Syphillis-DOC
chemoprophylaxis against diphtheria

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5
Q

PCN not used for

A
  • cellulitis caused by staph aureus-produces pencillinases

- chlamydia trachomatis-does not have PBP

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6
Q

issues with Aqueous PCN G

A

IV/IM only

issues hyperkalemia

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7
Q

Procaine PCN G issues

A
  • IM only

- if used for neurosyphillis give with probenecid

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8
Q

-blocks renal tubular secretion of PCN-2x fold increase in AUC

A

MOA of probenic

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9
Q

PCN V Potassium

A

PO-give on empty stomach

compliance issue given Q6-8hrs

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10
Q

Benzathine PCN G ( Bicillin LA)

A

IM only. IV causes CV death
duration of action 1-4wks
peak 12-24 hrs

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11
Q

Benzathine PCN plus PCN G Procaine

A

IM only

-not for syphillis

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12
Q

SE of PCN

A

anaphylaxis
rash, nausea
-Pts with condylommata kata-give IM PCN can develop Jarish-Herxheimer rxn (fever, muscles aches, HA)

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13
Q

3 Penicillinase resistant PCN drugs

A

-Dicloxacillin, Nafcillin, Oxacillin

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14
Q

Aminopenicillans drugs

Amp’ed up PCN

A

Ampicillin

Amoxicillan

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15
Q

mnemonic for use of aminopenicillans

HELPSS

A 
H.influenza
E.coli
Listeria
Proteus mirabilis
Salmonella
Shigella
-kills enterococcus
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16
Q

DOC for listeria caused meningitis

A

ampicillin

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17
Q

Extended spectrum PCN issues

A

coverage i/c pseudomonas and enterobacter
-only given parenterally
combined with beta-lactamese inhibitor (BLI) to combat bacterial resistance

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18
Q

Beta lactamase inhibitor (BLI) drugs

mnemonic CAST

A

Clavulanic Acid, Sulbactam, Tazocatam

-act like suicide, protecting the abc

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19
Q

Extended spectrum PCN drugs

A

Amoxicillin/CA
Ampicillin/SUB
Ticarcillin/CA
Pipercillin/TZ

all Preg cat B/Lact Cat L1

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20
Q

2 extended spectrum PCN that cover pseudomonas

A

Pipercillin/TZ-best

Ticarcillin/CA

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21
Q

which extended spectrum PCN gives best enterococcus coverage

A

ampicillin/SUB

-no pseudomans coverage

22
Q

1st generation PO Cephs

A

-great affinity to PBP’s in s. aureus
PO-only drugs with “ph”
Cephalexin (Keflex)
Cefadroxil (Duricef)

23
Q

2nd gen Cephs coverage

HEN PECKS

A 
H.influenza
E.coli
N. meningitis & gono
Proteus spp
enterobacter aerogenes
klebsiella spp
serratia marcescens
24
Q

2nd gen PO cephs meds

A 
cefamodole (Mandol)
cefaclor (Ceclor)
cefurozine acetil (ceftin)
cefprozil (ceflin)
loracarbef (lorabed)
25
Q

2nd gen cephs IV meds

A

cefoxitin (mefoxin)
cefotetan (cefotan)
cefuroxime (zinacef, kefurox)

26
Q

uses of 1st gen Cephs

A

MSSA, s.pneumoniae, s.pyogenes, h.influenza

27
Q

issue with cefotetan

A

cause hypoprothrombinemia and bleeding
disulfiram-like rxns
give Vit K 1mg 2x/wk

28
Q

3rd gen oral cephs

A 
cefdiner (omnicef)
cefditoren (spectracef)
cefixime (suprax)
cefpodexime ( vantin)
ceftibuten (cedax)
29
Q

3rd gen IV cephs

A

cefotaxime (claforan)
ceftazidime (fortaz)
ceftriaxone (rocephin)

30
Q

reduction in gram positive coverage
better against PCN-resistant s.pneumoniae
gram neg coverage increases against enterobacteriaceae

A

3rd gen cephs

31
Q
  • improved gram positive and negative coverage
  • used in complicated/uncomplicated UTIs, febrile neutropenia, skin infection, mod-severe pneumonia, complicated intra-abdominal infxn (give IV flagyl)
A

4th gen cephs

32
Q

4th gen ceph

A

IV only

cefepime (Maxipime)

33
Q

5th gen ceph

A

IV only

Ceftaroline (teflaro)

34
Q

uses of ceftaroline

A

CA pneumonia
completed skin and soft tissue infections
MRSA-only ceph approved
improved gram positive coverage

35
Q
  • high affinity for PBP3 (necessary in septum formation)
  • “mono”- only covers for 1 type of bacteria (gram negative)
  • can be used in PCN allergy patients
A

MOA of monobactams

aztreonam

36
Q

aztreonam SE

A

pain, phlebitis, rash, n/v, eosinphila, increases liver enzymes

37
Q
  • high affinity for PBP1 and 2- resistant to beta-lactamases & ESBL
  • coverage: MDR pathogens, good for gram positive and negative, anaerobic coverage
A

MOA of carbapenems

38
Q

used for complicated and uncomplicated UTIs, febrile neutropenia, soft tissue infections, complicated intra-abdominal infection, bacterial meningitis (>3months)

A

carbapenems

39
Q

ADR of imipenem

A

seizures
nephrotoxic-requires renal dose adjust
not for PCN allergy patients

40
Q

monobactam drugs

A

impimenem/Cilastin
meropenem (merrem)
Ertapenem (invanz)
Doripenem (Doribax)

41
Q

inhibits cell wall synthesis by inhibiting peptiglycan synthesis
binds to amino acids within cell wall preventing the addition of new units to peptidoglycan

A

MOA of vanco

42
Q

1st gen IV cephs

A

Cefazolin (ancef)
Cephalothin (Keflin)
Cephradine (velosef)

43
Q

uses of vanco

A

MRSA

c-diff PO only

44
Q

vanco trough

A

MRSA 15-20mg/l

10-20mg/l

45
Q

Treatment of C-diff

A

Flagyl 500mg PO TID 10-14 days (mild-mod)
Vanco 125 mg POQIDx1014-days severe +/- IV flagyl
Fidaxomian (difid) 200mg PO BID x 10 days

46
Q

uses of Telavancin

A

adults with complicated skin and skin structure infections (cSSSI) caused by MRSA, strep progenies, strept agalactiae, enterococcus faecalis

47
Q

issues with Penicillinase resistant PCN drugs

A
  • narrowed spectrum to s.aureus and staph epidermitis-cellulitis and endocarditis
  • naf is for staph

*NO gram neg coverage, not to treat MRSA or enterococci

48
Q

abc associated with thrombocytopenia

A

vanco and zyvox

49
Q

which two ceph drugs are used to treat pseudomonas

A

ceftazidime (fortaz)

cefepime (maxipime)

50
Q

ceph used to treat gram positive

A

cephalexin

Antibiotics (7 decks)

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