D3 Flashcards
What are the representative members of B-Lactam?
Penicillin,
Cephalosporins,
Carbapenems,
Monobactams
What is the cellular target of B-Lactam?
Penicillin-binding proteins (PBPs) transpeptidase
What cellular structure is affected by B-Lactam?
Cell wall synthesis
What are the B-Lactam associated toxicities?
Hypersensitivity, Anaphylaxis (except Aztreonam), Seizure, CDAD
What are the members of glycopeptide?
Vancomycin
Teicoplanin
What is the cellular target of Glycopeptides?
BP-NAG-NAM monomers
What cell structure is affected by glycoprotein?
Cell wall synthesis
What are some of the toxicities associated with Glycoprotien?
Nephrotoxicity, Ototoxicty, red man syndrome.
What are the members of first groups of cephalosporin?
Cephalexin/Cefazolin, Cefadroxil
What are the members of second group of cephalosporin?
Cefaclor,Cefprozil,Cefuroxime, Cefotetan/cefoxitin
What are the members of third groups of cephalosporin?
Cefdinir/cefpodoxime
Ceftriaxone/Cefotaxime
Ceftazidime
What are the members of fourth group of cephalosporin?
Cefepim
What are the members of fifth groups of cephalosporin?
Ceftaroline and Ceftolozane
What is the list of carbapenems?
Imipenem/Metropenem/Doripenem
List the Monobactams
Aztreonam
List the Glycobactams
Vancomycin
What bacteria groups are covered by Group 1 Cephalasporins?
Staph/MSSA, Strep/Pneumonia, PEK
What bacteria groups are covered by Group2 cephalosporins? (Cefaclor/Cefprozil/Cefuroxime)
Staph/MSSA, Strep/Pneumonia, PEK, PIDDLY
What bacterias are covered by Group 2? (Cefotetan/cefoxitin)
Staph?MSSA, Strep/Pneumoniae, PEK, PDDLY, Anaerobes (except C.diff)
What bacterias are covered by group 3 Cephaloporin? (Cefdinir/cefpodoxime)
Staph/MSSA, Strep/Pneumonia, PEK, PIDDLY
What bacterias are covered by group 3 Cephaloporin? (Ceftriaxone/Cefotaxime)
Staph/MSSA, Strep/Pneumonia, PEK, PIDDLY, SACE
What bacterias are covered by group 3 Cephaloporin? (Ceftazidime)
Staph/MSSA, Strep/Pneumonia, PEK, PIDDLY, SPACE
What Bacterias are covered by Group 4? (Cefepime)
Staph/MSSA, Strep/Pneumonia, PEK, PIDDLY, SPACE
What bacterias are covered by Group 5? (ceftaroline)
Staph/MRSA, Strep/Pneumo, PEK
What bacterias are covered by Carbapenems? Imipenem/Meropenem/Doripenem
Staph/MSSA, Strep/Pneumo, Enterococcus, PEK, PIDDLY, SPACE, anaerobes
What bacterias are covered by Monobactam?
Gram (-) only (PEK, PIDDLY, SPACE, Anaerobes
What bacterias are covered by Glycopeptides?
Staph/MRSA, Strep/Pneumo, enterococcus , Clostridium C.diff
Are Cephaloporin Bacteriocidal?
Yes
CEPs can be destroyed by what?
Gram (-) cephalosporinases like ESBLs.
What are some drug interactions of CEPs?
Probenecid (for gout) may decrease renal tubular secretion and prolong CEP serum levels.
All CEPs can interfere with the enterohepatic circulation of oral estrogens resulting in sub therapeutic estrogen concentrations.
Describe pharmacokinetics/dynamics of Cefazolin (Ancef)
Releases free NMT which inhibit vitamin K Epoxide reductase (Causing impaired blood clotting) and aldehyde dehydrogenase (causing disulfiram-like)
whats the brand name of Cefadroxil?
Duricef
whats the brand name of Cefazolin
Ancef
whats the brand name of Cephalexin
Kelfex
Are 2nd gen CEPs more stable to Gram (-) B-Lactamase?
Yes
What are 3 types of 2nd gen CEPs?
- Amino cephalosporin
- Oxyimino Cephlasporin
- Cephamycins
Amino Cephaloporins are ______ to gram (+) B-lactamase but ___________ by Gram (-) B-lactamase
Stable; Destroyed
What is the activity spectrum for 2nd CEPs?
Less active for gram (+) and more active against Gram (-) than 1st generation.
What are some fo the adverse reactions of CEPs?
- Risk of bleeding
- Disulfram reaction
What is a adverse reaction associated with Cefaclor?
Serum-like sickness
Cefaclor brand name
Ceclor
Cefprozil brand name
Cefzil
Do you need to adjust cefuroxime dose for renal impairment
No
What is the parenteral form of Cefuroxime?
Zinacef
WHat is the oral prodrug form of Cefuroxime?
Ceftin
Cefoxitin only treats upper respiratory infections (T/F)
False, it is useful for intravenous-abdominal infections due to some anaerobe coverage (Except C.diff)
whats the brand name of Cefoxitin?
Mefoxin
What are the adverse reaction of Cefotetan?
Blood clots and disulfram-like reaction
Brand name for cefotetan?
Cefotan
What antibiotic have the best respiratory secretions in 2nd gen CEPs?
Cefprozil (Cefzil)
Why do 3rd gen CEPs causes increase risk of CDAC?
Due to their broad spectrum effects
What are some drug-drug interactions of Cefdinir?
Do not take is with Antacids containing metals. This can reduce the absorption; avoid 2 h before/after dose
Complex with Fe may turn stool red
Whats the brand name of Cefdinir?
Omnicef
What is a drug to drug interactions of Cefpodoxime proxetil?
Do not take is with Antacids containing metals. This can reduce the absorption; avoid 2 h before/after dose
Whats the brand name of Cefpodoxime proxetil?
Vantin
Whats the brand name of cefixime?
Suprax
What drug causes cholelithiasis (Gall-stones)?
Ceftriaxone (Binds calcium)
Do you need to renally modify Ceftriaxone?
No, its excreted through bile
Brand name of Ceftriaxone?
Rocephin
What are the side effects of taking Ceftazidime?
Convulsions and seizure may occur with ceftazidime
Should the dose be adjusted of Ceftazidime?
Yes! Motha focka
Brand name for Ceftazidine
Fortaz
Brand name for Ceftazidime + Avibactam (Cephalosporinase/ESBL inhibitor)
Avycaz
Whats the prefered 3rd generation CEPs for neonatal and pediatric infections?
Cefotaxime
Brand name for Cefotaxime?
Claforan
Are 4th generation CEPs broad?
Yes
What is Cefepime used for?
Used in hospitals for treating MDR infections
Is dose adjustment required for Cefepime?
Yes
Brand name for cefepime?
Maxipime
What does Ceftaroline have a high affinity to?
PBP2a and is very good anti-MRSA
Brand name of Ceftaraline?
Teflaro
Which CEP is used as “Trojan horse”?
Cefiderocol. Cephalosporin-siderophore conjugate that tricks the bacteria to uptake for iron use.
What is the mechanism of action for Carbapenems?
Blocks cell wall synthesis by inhibiting PBPs
Are carbapenems bacteria static?
No they are bacteriocidal
What is a side effect of carbapenems?
They could dramatically reduce the valproic acid (anticonvulsants) level resulting in seizures
Whats the effect of Dehydropeptidase (DHP-1) on Imipenem? What to add with it?
Severely reduces the half-life. Cilistatin to deactivate DHP-1
Brand name of Doripenem?
Doribax
brand name for meropenem
Merrem
whats the active product in Vabomere?
Meropenem and Vaborbactam (Carbapenamase inhibitor)
What bacteria is erta-penem inactive against?
Entreococcus, Pseudomonas and Acinetobacter
Whats the best thing about ertapenem (Invanz)
Longer half life than other carbapenems allowing for 34h dosing
Brand name for Ertapenem.
Invanz
brand name of Aztreonam?
Azactam
Do glycopeptides only work on Gram (+) bacteria?
Yes, Narrow spectrum bactericides with activity only against Gram (+) bacteria
GLycopeptide binds noncovalently to ___________ monomers.
NAG-NAM monomers
What bacteria was the first one that developed resistance to Vancomycin?
Enterococcus faecium when at NAM-terminal, D-ala to D-lactates, weakening Vancomycin ability to bind.
What is Vancomycin susceptibility to S. aureus
MIC of 2 microgram/ml or less
What is Vancomycin intermediate susceptibility to S. aureus?
4-8 microgram/ml
What are some of the toxicities of Vancomycin?
Nephrotoxicity, ototoxicity, Tinnitus, Hypotensive reaction (Red-man)
why does VAN not orally absorbed?
Due to large MW
Why is oral vanc used for CDAD if oral absorption is low?
Not absorbed in GI tract, it concentrates in GI and really good for treating CDAD
