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Q2 Pharm ABX, Vomit > Cephalosporins (Lec 13) > Flashcards

Cephalosporins (Lec 13) Flashcards

1
Q

Cephalosporins mechanism of action

A

blocks cross-link of peptidoglycan ->

activates cell wall autolytic enzymes

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2
Q

What part of the cephalosporin structure ↑ drug’s resistance to β-lactamase?

A

7-methyl group

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3
Q

1st generation cephalosporin active against?

A

Most G+ cocci
MSSA
some G-

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4
Q

1st generation cephalosporin prototype?

A

Cefazolin

DOC for surgical prophylaxis

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5
Q

2nd generation cephalosporin active against?

A

G-

lower against G+

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6
Q

2nd generation cephalosporin NOT active against?

A

pseudomona

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7
Q

1st generation cephalosporin spectrum is?

A

narrow

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8
Q

2nd generation cephalosporin spectrum is?

A

intermediate

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9
Q

2nd generation cephalosporin prototype?

A

Cefaclor

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10
Q

3rd generation cephalosporin spectrum is?

A

broad

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11
Q

3rd generation cephalosporins will penetrate?

A

CNS

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12
Q

3rd generation cephalosporin prototype?

A

Ceftriaxone

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13
Q

Which 3rd generation cephalosporin is metabolized in the liver?

A

Cefoperazone

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14
Q

3rd generation cephalosporin very active against?

A

enterobacteriaceae

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15
Q

Some 3rd generation cephalosporin active against what if combined w/ aminoglycoside?

A

pseudomonas aeruginosa

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16
Q

3rd generation cephalosporin Ceftriaxone is DOC for what bacteria?

A

n. gonorrheae

* not for neonates

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17
Q

4th generation cephalosporin drug is?

A

Cefepime IV

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18
Q

4th generation cephalosporin active against?

A

G+
pseudomonas
enterobacteriaceae
MSSA

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19
Q

4th generation cephalosporin specturm is?

A

most broad

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20
Q

Ceftaroline fosamil IV (unnamed cephalosporin) active against?

A

MRSA (binds to PBP2A)

VRSA

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21
Q

Which cephalosporin is DOC against

m. catarrhalis?

A

2nd or 3rd gen

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22
Q

Which cephalosporin is DOC against

n. gonorrhoeae?

A

ceftriaxone

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23
Q

Which cephalosporin is DOC against

e. coli, klebsiella, proteus?

A

1st or 2nd gen

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24
Q

Which cephalosporin is DOC against

salmonella

A

3rd gen

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25
Q

Which cephalosporin is DOC against

PCN-resistant strep pneumoniae?

A

ceftriaxone

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26
Q

Which cephalosporin is DOC against

b. burgdorferi?

A

ceftrioxone (late)

27
Q

Cephalosporin toxicity causes? (3)

A

1) superinfections
2) allergy
3) renal tube necrosis

28
Q

What superinfections can cephalosporin cause? (4)

A

1) enterococci
2) G- bacilli
3) pseudomembranous colitis
4) candida

29
Q

What drug is a monobactim?

A

Aztreonam

30
Q

Aztreonam’s unique structure?

A

monocyclic β-lactam ring

31
Q

Aztreonam active against?

A

G- aerobic rods

32
Q

Aztreonam resistant to?

A

β-lactamases

33
Q

Aztreonam is not active against?

A

G+ and anaerobes

34
Q

Aztreonam has no cross sensitivity w/?

A

other β-lactams making it a good sub for PCN allergies

35
Q

Broad spectrum, IV carbapenem drugs?

A

Imipenem

Meropenem

36
Q

Imipenem and meropenem active against?

A

G- and G+

stable against β-lactamases

37
Q

Imipenem and meropenem are DOC for what type of infections?

A

β-lactamase producing (G-):
enterobacter
citrobacter
serratia

38
Q

Imipenem must be administered in comb w/?

A

cilastatin (dihydropepdidases inhibitor):

kidney dihydropepdidases rapidly inactive Imipenem

39
Q

Side-effect of imipenem at high levels?

A

seizures

40
Q

Carbapenem drug Ertapenem active against?

A

anaerobes, G- and G+ BUT not pseudomonas

stable against β-lactamases

41
Q

Vancomycin mechanism of action?

A

ICWS (not β-lactam)

binds D-ala preventing cross-link of peptidoglycan chains

42
Q

Vancomycin active against?

A

G+

methicillin-resistant

43
Q

Vancomycin adverse effects? (3)

A

1) ototoxic
2) nephrotoxic
3) red man synd (histamine flushing)

44
Q

Fosfomycin mechanism of action?

A

ICWS (not β-lactam)

prevents NAG to NAM reduction inhibiting cell wall synth

45
Q

Fosfomycin active against?

A

G+ and G-

46
Q

Fosfomycin primarily used for?

A

uncomplicated lower UTI in women

47
Q

Bacitracin mechanism of action?

A

ICWS (not β-lactam)

prevents transport of NAG-NAM across inner membrane inhibiting cell wall synth

48
Q

Bacitracin active against?

A

G+

49
Q

Bacitracin primary route of tx?

A

topical

50
Q

Why isn’t Bacitracin used parenterally?

A

high risk of nephrotoxicity

51
Q

Bacitracin typically used in combo w/?

A

neomycin and polymyxin (against G-)

52
Q

Cycloserine mechanism of action?

A

(not β-lactam)

inhibits D-ala

53
Q

Cycloserine is second-line for what 2 types of infections?

A

1) TB

2) UTI

54
Q

Cycloserine is bactericidal or bacteriostatic?

A

both

55
Q

Cycloserine adversely effects?

A

CNS:
HA
depression
psychosis

56
Q

DOC for m. catarrhalis

A

(G- cocci)

TMP-SMZ, cephalosporin (2nd or 3rd gen)

57
Q

DOC for n. gonorrhoeae

A

(G- cocci)
ceftriaxone
cefpodoxime

58
Q

DOC for enterobacter

A

(G- rods, aerobic)

TMP-SMZ, carbapenem

59
Q

DOC for citrobacter

A

(G- rods, aerobic)

TMP-SMZ, carbapenem

60
Q

DOC for serratia

A

(G- rods, aerobic)

TMP-SMZ, carbapenem

61
Q

DOC for salmonella

A

(G- rods, aerobic)

TMP-SMZ, cephalosporin (3rd gen)

62
Q

DOC for methicillin-resistane G+ cocci?

A

vancomycin

63
Q

DOC for bacillus G+ aerobic rods?

A

vancomycin

64
Q

DOC for late b. burdorferi?

A

(spirochete)

ceftriaxone

Q2 Pharm ABX, Vomit (13 decks)

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