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IDIT Final Pharm > Carbapenems > Flashcards

Carbapenems Flashcards

1
Q

What type of bacteria do Carbapenems target?

A

G+/G- and anaerobes

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2
Q

How would one administer Imipenem w/ cilistatin?

A

IV or IM

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3
Q

How do bacteria resist carbapenems?

A

They have little cross resistance as they enter G- by a different route than normal

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4
Q

Side effects of cilastatin?

A

Nausea, vomiting, seizures (1.5%)

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5
Q

Mechanism of cilastatin?

A

Inhibits dehydropeptidase

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6
Q

What might meropenem cause?

A

Seizures (0.5%)

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7
Q

How often do you take ertapenem?

A

1x/day

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8
Q

When and how do you use doripenem?

A

Parenteral for complicated intra-abdominal infections & UTIs

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9
Q

What should doripenem not be used for?

A

Any form of pneumonia = up risk of death and down cure rates when compared to imipenem/cilastatin

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10
Q

What are the general uses for carbapenems?

A

Resistance infections including:
UTIs
Lower RTIs
Intra-abdominal & gynecological infections
Bacterial Septicemia
Bone, joint & skin infections
Carbapenem-resistant Klebsiella pneumonia (CRKP)

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11
Q

What are drug class interactions with carbapenems?

A

Decreased levels of valproic acid results in increased risk of seizures

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12
Q

Tell me about Aztroenam.

A 
A monobactam
Mechanism: binds PBP-3 of G- Bacteria > lysis of long filamentous bacteria
IV/IM
Excreted in Urine Unchanged
Use on G- aerobes
Crosses inflamed meninges
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13
Q

What is the main use for Vancomycin?

A

IV for MRSA of MSSA if allergic to beta-lactams

Oral vs pseudomembranous colitis

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14
Q

What causes pseudomembranous colitis?

A

C. difficile

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15
Q

What is the mechanism of Vancomycin?

A

Binds to D-ala-D-ala terminus & prevents removal of terminal D-ala

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16
Q

What are the side effects of Vancomycin?

A

Red Man Syndrome
Ototoxicity
Nephrotoxicity (w/ other nephrotoxic Rxs)

17
Q

What is Red Man Syndrome?

A

Flushing of upper body & face, hypotension, tachycardia and shock.
Caused by histamine release.

18
Q

What is ototoxicity?

A

Renal failure cause by Rx accumulation (may be permanent)

19
Q

What is telavancin?

A

A semisynthetic derivative of vancomycin

An IV cidal lipoglycopeptide

20
Q

What are the uses of telavancin?

A

Complicated skin & skin structure infections; hospital-aquired & ventilator-associated pneumonia from S. aureus

21
Q

What are the mechanisms of telavancin?

A

1) binds D-ala terminus

2) disrupts membrane potential which increases membrane permeability

22
Q

What are the side effects of telavancin?

A

NVD, taste disturbance, foamy urine

Potentially teratogenic

23
Q

What is oritavancin?

A

IV lipoglycopeptide for ABSSSI, including MRSA

24
Q

What is ABSSSI?

A

Acute bacterial skin & skin structure infections

25
Q

What are the mechanisms of Orivavancin?

A

1) binds stem peptide of peptidoglycan precursors (inhibits polymerization)
2) Binds peptide bridging segments (inhibits crosslinking)
3) Disrupts membrane integrity (depolarization, up membrane permeability, cell death)

26
Q

What are the side effects of oritavancin?

A

NVD, headache, SQ abscesses

27
Q

What are some possible Rx interactions of oritavancin?

A

Wait 48 hours before giving heparin or may increase activated partial thromboplastin time (aPTT)

28
Q

What is dalbavancin?

A

semisynthetic lipoglycopeptide for ABSSSI

29
Q

What as the mechanism of dalbavancin?

A

binds D-alanyl-d-ala terminus preventing crosslinking

30
Q

What are the side effects of dalbavancin?

A

Nausea, diarrhea, headache

31
Q

What is bacitracin?

A

A cidal vs. G+ cocci and rods

32
Q

What is the mechanism of bacitracin?

A

complexes w/ P~P

33
Q

What is the side effect of bacitracin?

A

Nephrotoxic

34
Q

How can bacitracin be used topically?

A

For minor cuts and scrapes

35
Q

What ophthalmic uses are there for bacitracin?

A

Ulcerative conjunctivitis

Bacterial conjunctivitis

36
Q

What uses are there for fosfomycin?

A

For short course, uncomplicated UTIs in women

37
Q

What is the mechanism of fosfomycin?

A

Inhibits enolpyruvate transferase

Blocks adding PEP to UDP-N-acetylglucosamine

38
Q

What is the action of fosfomycin?

A

Inhibits cell wall synthesis

IDIT Final Pharm (7 decks)

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