Beta Lactams

Question 1

What are the natural penicillins?

Answer 1

Pencillin VK (oral)
Penicilin G (IV, IM)

Question 2

What are the general indications for the natural penicillins?2

What are the specific bacteria that it targets?3

Answer 2

Gram Positive bacteria

Non B-lactamase producing gram positive cocci
Gram positive aneroebes

1. Staph, Strep, Enterococci (Non B-lactamase producing
   gram positive cocci)
2. Closstridium sp (Gram positive aneroebes)
3. Menigococcus- negative

Question 3

What specific diseases would natural penicillins be first line for?3

Answer 3

Strep pharyngitis
Oral/dental infections
Syphilis

Question 4

Which medications are Antistaphylococcal PCNs?

3

Answer 4

Dicloxacillin,
oxacillin, and
nafcillin

Question 5

General indications for Antistaphylococcal PCNs?

Why were they primarily designed?

Answer 5

Narrow spectrum activity for gram positive bacteria

To go against B-lactamase producing staphylococcus

Question 6

What bacteria will Antistaphylococcal PCNs not cover?3

Answer 6

MRSA
Enterococcus
Gram negatives

Question 7

What specific diseases would Antistaphylococcal PCNs be first line for?

Answer 7

Staphylococcal skin/soft tissue infections

Question 8

What is a defining characteristic of the Antistaphylococcal PCNs?

Answer 8

The only group of PCN’s effective vs B-lactamase bugs on their own

Question 9

Which medications are the Amino-penicillins?2

Answer 9

Amoxicillin (PO)

Ampicillin (PO, IM, IV)

Question 10

General indications for amino-penicillins?

What does it not cover?

Answer 10

Gram positive and Gram negative coverage

B-lactamase bacteria

Question 11

What specific diseases would amino-penicillins be first line for?
9

Answer 11

Active vs. enterococcus
Otisis media
UTI's in pregnancy
H.Flu
E. Coli
L. monocytogenes (Listeriosis)
Strep spp (Group B Strep)
Proteus
Salmonella

Question 12

What drugs are Augmentin and Unasyn?

Answer 12

Amino-penicillin with B-lactamase inhibitor

Amoxicillin + Clavulanate (Augmentin
Ampicilin + Sulbactam
Unasyn)

Question 13

Amino-penicillin with B-lactamase inhibitor cover what kinds of bacteria?

Answer 13

1. B-lactamase

2. anaerobes

Question 14

What are examples of B-lactamase bacteria?

Answer 14

M. Catarrhalis
H. Influenza
E. coli
B. fragilis

Question 15

What specific disease would augmentin be a first line drug for?
5

Answer 15

OM
sinusitis
ABECB (acute bacterial exacerbation of chronic bronchitis)
dental infections
bites

Question 16

What specific disease would unasyn be a first line drug for?

Answer 16

Skin/soft tissue infections (bolded)

intraabdominal/peritonitis

Question 17

What are the broad spectrum penicillins?

3

Answer 17

Carbenicillin (PO)
Piperacilin/tazobactam (Zosyn) - IV
Ticarcillin/Clavulanate (Timentin)-IV

Question 18

What are the broad spetrum antibiotics reserved for?

WHat does it not cover?

Answer 18

Infections that are suspected to be causes by pseudomonas

Legionella
Mycoplasma
Chlamydia

Question 19

What bacteria will Carbenicllin specifically cover?

3

Answer 19

E. coli
Protues mirabilis
Pseudomonas

Question 20

Name the three beta-lactamase inhibitors?

Answer 20

Clavulanante
Sulbactam
Tazobactam

Question 21

WHat are the 1st generation cephalosporins and what is their general use?
3

Answer 21

cephalexin (Keflex) PO
*cefazolin (Ancef)-IV version

cefadroxil oldest,*

Skin and soft tissue infections

Question 22

What bacteria do 1st generation cephalosporins cover?

4

Answer 22

Gram Positive Cocci (including beta-lactamase drugs)

Anaerobes
E. coli
H.Flu

Question 23

What diseases/infections would 1st generation cehpalosporins be first line for?2

Answer 23

skin and soft tissue infections caused by staph and strep

Cephalexin- uncomplicated cellulitis
Cefazolin- complicated cellulitis

Surgical prophylaxis

Question 24

What are the 2nd generation cephalosporins (4) and what is their general use (4)?

Answer 24

cefaclor (Ceclor)
cefuroxime (Ceftin)
cefoxitin (Mefoxin)
cefotetan

Skin
Respiratory/ENT
UTI
Anaerobes

Question 25

What kind of bacteria do 2nd generation cephalosporins cover? Examples?4

Answer 25

Broader gram negatove coverage H. flu Proteus Neisseria Moraxella

Question 26

What specific diseases would 2nd generation cephalosporins be used for? 5

Answer 26

``` OM Pneumonia UTIs Abdominal infections -anaerobes Skin and soft tissue infections ```

Question 27

What diseases specifically is Cerfuoxime used for? | 2

Answer 27

Acute epiglotitis | Early Lyme disease

Question 28

What are the 3rd generation cephalosporins (3) and what are they generally used for? (3)

Answer 28

cefotaxime ceftazidime ceftriaxone PNA CNS Gram negative- is broad spectrum

Question 29

Specific diseases where 3rd generation cephalosporins are the first line use?

Answer 29

1. Menigitis(has good CNS penetration) 2. Gonorrhea 3. pts hospitalized with CAP

Question 30

What specifically does Ceftazidamine cover?

Answer 30

pseudomonas

Question 31

What is the 4th generation cephalosporin? What does bacteria does it target? WHat does it treat well?

Answer 31

cefepime Gram positive and negative for pseudomonas Menigitis and other serious infections and sepsis -penetrates the BBB well

Question 32

What are the carbapenems? 2 What do we use them for? What kind of bacteria does it cover?3

Answer 32

Imipenem/cilastatin (IV) Meropenem (IV) Significantly ill pts who have very drug resistant forms of bacteria -menigitis, neutropenis pts (lowers seizure threshold) Gram + Gram - Anaerobes