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THER > beta lactams > Flashcards

beta lactams Flashcards

1
Q

MOA penicillins

A

interfere with bacterial cell wall synthesis by binding PBPs

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2
Q

bacteriostatic or bactericidal

A

bactericidal

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3
Q

exception to bactericidal activity of penicillins?

A

enterococcus

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4
Q

exception to bactericidal activity of aminoglycosides?

A

enterococcus

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5
Q

3 MOR penicillins

A

destruction of penicillin by beta lactamases
alteration in PBP penicillin binding site
decreased membrane permeability (G-)

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6
Q

the natural penicillins…

A

aqueous pen G
benzathine pen G
procaine pen G
pen VK

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7
Q

spectrum of activity of natural penicillins in G+

A

group streptococci
viridans streptococci
some enterococcus
some streptococcus pneumoniae

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8
Q

very little natural penicillin against this G+ due to penicillinase production

A

staphylococcus

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9
Q

spectrum of activity of natural penicillins in G-

A

only against some G- cocci

pasteurella

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10
Q

spectrum of activity of natural penicillins in anaerobes

A 
good activity against G+ anaerobes
mouth and above the belt anaerobes
peptococcus
peptostreptococcus
actinomyces
clostridium with the exception of C. difficile
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11
Q

antibiotic given for syphilis infections

A

single dose of benzathine pen G

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12
Q

penicillin is drug of choice for 8 infections, name them.

A 
syphilis
meningitis
diptheria
anthrax
C. perfringens
C. tetani
viridians
group streptococci
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13
Q

drugs in the penicillinase resistant penicillins

A

nafcillin
oxacillin
dicloxacillin
methicillin

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14
Q

spectrum of activity penicillinase resistant penicillins in G+

A

MSSA (NOT MRSA)

group and viridans strep

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15
Q

penicillinase resistant penicillins NOT active against

A 
MRSA
enterococcus
S. pneumo
G-s
anaerobes
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16
Q

why were aminopenicillins developed?

A

to extend the activity of penicillins against G- aerobes

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17
Q

difference between the two aminopenicillins

A

amoxacillin is better absorbed orally than ampicillin

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18
Q

aminopenicillins are the drug of choice for ___________ and __________ infections

A

Listeria monocytogenes

Enterococcus

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19
Q

why were carboxypenicillins developed?

A

to address the emergence of more resistant G- bacteria and P. aeruginosa as a nosocomial infection

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20
Q

name the carboxypenicillin

A

ticarcillin

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21
Q

spectrum of activity carboxypenicillin

A

very weak against the G+s

enhanced G- activity, including pseudomonas

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22
Q

carboxypenicillins NOT active against

A

klebsiella
serratia
actinobacter

23
Q

reason for developing ureidopenicillins

A

enhance activity against G- bacteria

24
Q

name the ureidopenicillin

A

piperacillin

25
Q

the only ureidopenicillin that is still available on the market is in the form of a combination drug with tazobactam called…

A

zosyn

26
Q

piperacillin is the most active penicillin against…

A

pesudomonas infections

27
Q

composition of beta lactamase inhibitor combination: augmentin

A

amoxicillin and clavulanate

28
Q

composition of beta lactamase inhibitor combination: unasyn

A

ampicillin and sulabactam

29
Q

composition of beta lactamase inhibitor combination: zosyn

A

piperacillin and tazobactam

30
Q

beta lactamase inhibitor combinations DO NOT work against

A 
the SPICE bacteria (have inducible beta lactamases)
Serratia marsecens
Pseudomonas aeruginosa
Indole positive proteus
Citrobacter
Enterobacter
31
Q

organism of note susceptible to ticarcillin/clavulanate

A

stenotrophomonas maltophilia

32
Q

anaerobic activity of beta lactamase inhibitor combination

A

B. fragilis

33
Q

penicillins are not bactericidal for…

A

enterococcus

34
Q

adding a _________ makes penicillin active against _______

A

aminoglycoside and enterococcus

35
Q

penicillin penetration into CNS?

A

only in the presence of inflamed meninges and high doses

36
Q

most penicillins eliminated…

A

renally

37
Q

exception: these penicillin eliminated hepatically

A

nafcillin

oxacillin

38
Q

given to inhibit the renal excretion of penicillins

A

probenecid

39
Q

these penicillins are the only ones not eliminated by hemodialysis

A

nafcillin

oxacillin

40
Q

this penicillin given with A TON of salt when administered parenterally

A

ticarcillin

41
Q

for N. meningitidis, give

A

natural penicillin

42
Q

for MSSA, give

A

penicillinase resistant penicillin

43
Q

for pseudomonas aeruginosa infections, give

A

piperacillin (a ureidopenicillin)

44
Q

for enterococcal infections, give

A

ampicillin

45
Q

for s. pneumoniae (penicillin susceptible or intermediate strains)

A

natural penicillin

46
Q

for polymicrobial infections involved nosocomial G- infections, give

A

piperacillin-tazobactam (zosyn)

47
Q

for treponema palladium, give

A

natural penicillin (benzathine pen G)

48
Q

for clostridium infections (excluding C. difficile), give

A

natural penicillin

49
Q

for salmonella infections, give

A

aminopenicillin

50
Q

for actinomycosis, give

A

natural penicillin

51
Q

for shigella infections, give

A

aminopenicillin

52
Q

important neurological side effect penicillins

A

seizures

53
Q

penicillins with transient increases in liver enzymes

A

oxacillin and nafcillin

54
Q

associated with adverse effect interstitial nephritis

A

nafcillin

THER (18 decks)

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