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D3 Flashcards

1
Q

What are the representative members of B-Lactam?

A

Penicillin,
Cephalosporins,
Carbapenems,
Monobactams

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2
Q

What is the cellular target of B-Lactam?

A

Penicillin-binding proteins (PBPs) transpeptidase

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3
Q

What cellular structure is affected by B-Lactam?

A

Cell wall synthesis

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4
Q

What are the B-Lactam associated toxicities?

A

Hypersensitivity, Anaphylaxis (except Aztreonam), Seizure, CDAD

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5
Q

What are the members of glycopeptide?

A

Vancomycin
Teicoplanin

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6
Q

What is the cellular target of Glycopeptides?

A

BP-NAG-NAM monomers

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7
Q

What cell structure is affected by glycoprotein?

A

Cell wall synthesis

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8
Q

What are some of the toxicities associated with Glycoprotien?

A

Nephrotoxicity, Ototoxicty, red man syndrome.

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9
Q

What are the members of first groups of cephalosporin?

A

Cephalexin/Cefazolin, Cefadroxil

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10
Q

What are the members of second group of cephalosporin?

A

Cefaclor,Cefprozil,Cefuroxime, Cefotetan/cefoxitin

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11
Q

What are the members of third groups of cephalosporin?

A

Cefdinir/cefpodoxime
Ceftriaxone/Cefotaxime
Ceftazidime

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12
Q

What are the members of fourth group of cephalosporin?

A

Cefepim

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13
Q

What are the members of fifth groups of cephalosporin?

A

Ceftaroline and Ceftolozane

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14
Q

What is the list of carbapenems?

A

Imipenem/Metropenem/Doripenem

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15
Q

List the Monobactams

A

Aztreonam

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16
Q

List the Glycobactams

A

Vancomycin

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17
Q

What bacteria groups are covered by Group 1 Cephalasporins?

A

Staph/MSSA, Strep/Pneumonia, PEK

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18
Q

What bacteria groups are covered by Group2 cephalosporins? (Cefaclor/Cefprozil/Cefuroxime)

A

Staph/MSSA, Strep/Pneumonia, PEK, PIDDLY

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19
Q

What bacterias are covered by Group 2? (Cefotetan/cefoxitin)

A

Staph?MSSA, Strep/Pneumoniae, PEK, PDDLY, Anaerobes (except C.diff)

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20
Q

What bacterias are covered by group 3 Cephaloporin? (Cefdinir/cefpodoxime)

A

Staph/MSSA, Strep/Pneumonia, PEK, PIDDLY

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21
Q

What bacterias are covered by group 3 Cephaloporin? (Ceftriaxone/Cefotaxime)

A

Staph/MSSA, Strep/Pneumonia, PEK, PIDDLY, SACE

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22
Q

What bacterias are covered by group 3 Cephaloporin? (Ceftazidime)

A

Staph/MSSA, Strep/Pneumonia, PEK, PIDDLY, SPACE

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23
Q

What Bacterias are covered by Group 4? (Cefepime)

A

Staph/MSSA, Strep/Pneumonia, PEK, PIDDLY, SPACE

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24
Q

What bacterias are covered by Group 5? (ceftaroline)

A

Staph/MRSA, Strep/Pneumo, PEK

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25
Q

What bacterias are covered by Carbapenems? Imipenem/Meropenem/Doripenem

A

Staph/MSSA, Strep/Pneumo, Enterococcus, PEK, PIDDLY, SPACE, anaerobes

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26
Q

What bacterias are covered by Monobactam?

A

Gram (-) only (PEK, PIDDLY, SPACE, Anaerobes

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27
Q

What bacterias are covered by Glycopeptides?

A

Staph/MRSA, Strep/Pneumo, enterococcus , Clostridium C.diff

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28
Q

Are Cephaloporin Bacteriocidal?

A

Yes

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29
Q

CEPs can be destroyed by what?

A

Gram (-) cephalosporinases like ESBLs.

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30
Q

What are some drug interactions of CEPs?

A

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.

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31
Q

Describe pharmacokinetics/dynamics of Cefazolin (Ancef)

A

Releases free NMT which inhibit vitamin K Epoxide reductase (Causing impaired blood clotting) and aldehyde dehydrogenase (causing disulfiram-like)

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32
Q

whats the brand name of Cefadroxil?

A

Duricef

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33
Q

whats the brand name of Cefazolin

A

Ancef

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34
Q

whats the brand name of Cephalexin

A

Kelfex

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35
Q

Are 2nd gen CEPs more stable to Gram (-) B-Lactamase?

A

Yes

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36
Q

What are 3 types of 2nd gen CEPs?

A
  1. Amino cephalosporin
  2. Oxyimino Cephlasporin
  3. Cephamycins
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37
Q

Amino Cephaloporins are ______ to gram (+) B-lactamase but ___________ by Gram (-) B-lactamase

A

Stable; Destroyed

38
Q

What is the activity spectrum for 2nd CEPs?

A

Less active for gram (+) and more active against Gram (-) than 1st generation.

39
Q

What are some fo the adverse reactions of CEPs?

A
  • Risk of bleeding
  • Disulfram reaction
40
Q

What is a adverse reaction associated with Cefaclor?

A

Serum-like sickness

41
Q

Cefaclor brand name

A

Ceclor

42
Q

Cefprozil brand name

A

Cefzil

43
Q

Do you need to adjust cefuroxime dose for renal impairment

A

No

44
Q

What is the parenteral form of Cefuroxime?

A

Zinacef

45
Q

WHat is the oral prodrug form of Cefuroxime?

A

Ceftin

46
Q

Cefoxitin only treats upper respiratory infections (T/F)

A

False, it is useful for intravenous-abdominal infections due to some anaerobe coverage (Except C.diff)

47
Q

whats the brand name of Cefoxitin?

A

Mefoxin

48
Q

What are the adverse reaction of Cefotetan?

A

Blood clots and disulfram-like reaction

49
Q

Brand name for cefotetan?

A

Cefotan

50
Q

What antibiotic have the best respiratory secretions in 2nd gen CEPs?

A

Cefprozil (Cefzil)

51
Q

Why do 3rd gen CEPs causes increase risk of CDAC?

A

Due to their broad spectrum effects

52
Q

What are some drug-drug interactions of Cefdinir?

A

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

53
Q

Whats the brand name of Cefdinir?

A

Omnicef

54
Q

What is a drug to drug interactions of Cefpodoxime proxetil?

A

Do not take is with Antacids containing metals. This can reduce the absorption; avoid 2 h before/after dose

55
Q

Whats the brand name of Cefpodoxime proxetil?

A

Vantin

56
Q

Whats the brand name of cefixime?

A

Suprax

57
Q

What drug causes cholelithiasis (Gall-stones)?

A

Ceftriaxone (Binds calcium)

58
Q

Do you need to renally modify Ceftriaxone?

A

No, its excreted through bile

59
Q

Brand name of Ceftriaxone?

A

Rocephin

60
Q

What are the side effects of taking Ceftazidime?

A

Convulsions and seizure may occur with ceftazidime

61
Q

Should the dose be adjusted of Ceftazidime?

A

Yes! Motha focka

62
Q

Brand name for Ceftazidine

A

Fortaz

63
Q

Brand name for Ceftazidime + Avibactam (Cephalosporinase/ESBL inhibitor)

A

Avycaz

64
Q

Whats the prefered 3rd generation CEPs for neonatal and pediatric infections?

A

Cefotaxime

65
Q

Brand name for Cefotaxime?

A

Claforan

66
Q

Are 4th generation CEPs broad?

A

Yes

67
Q

What is Cefepime used for?

A

Used in hospitals for treating MDR infections

68
Q

Is dose adjustment required for Cefepime?

A

Yes

69
Q

Brand name for cefepime?

A

Maxipime

70
Q

What does Ceftaroline have a high affinity to?

A

PBP2a and is very good anti-MRSA

71
Q

Brand name of Ceftaraline?

A

Teflaro

72
Q

Which CEP is used as “Trojan horse”?

A

Cefiderocol. Cephalosporin-siderophore conjugate that tricks the bacteria to uptake for iron use.

73
Q

What is the mechanism of action for Carbapenems?

A

Blocks cell wall synthesis by inhibiting PBPs

74
Q

Are carbapenems bacteria static?

A

No they are bacteriocidal

75
Q

What is a side effect of carbapenems?

A

They could dramatically reduce the valproic acid (anticonvulsants) level resulting in seizures

76
Q

Whats the effect of Dehydropeptidase (DHP-1) on Imipenem? What to add with it?

A

Severely reduces the half-life. Cilistatin to deactivate DHP-1

77
Q

Brand name of Doripenem?

A

Doribax

78
Q

brand name for meropenem

A

Merrem

79
Q

whats the active product in Vabomere?

A

Meropenem and Vaborbactam (Carbapenamase inhibitor)

80
Q

What bacteria is erta-penem inactive against?

A

Entreococcus, Pseudomonas and Acinetobacter

81
Q

Whats the best thing about ertapenem (Invanz)

A

Longer half life than other carbapenems allowing for 34h dosing

82
Q

Brand name for Ertapenem.

A

Invanz

83
Q

brand name of Aztreonam?

A

Azactam

84
Q

Do glycopeptides only work on Gram (+) bacteria?

A

Yes, Narrow spectrum bactericides with activity only against Gram (+) bacteria

85
Q

GLycopeptide binds noncovalently to ___________ monomers.

A

NAG-NAM monomers

86
Q

What bacteria was the first one that developed resistance to Vancomycin?

A

Enterococcus faecium when at NAM-terminal, D-ala to D-lactates, weakening Vancomycin ability to bind.

87
Q

What is Vancomycin susceptibility to S. aureus

A

MIC of 2 microgram/ml or less

88
Q

What is Vancomycin intermediate susceptibility to S. aureus?

A

4-8 microgram/ml

89
Q

What are some of the toxicities of Vancomycin?

A

Nephrotoxicity, ototoxicity, Tinnitus, Hypotensive reaction (Red-man)

90
Q

why does VAN not orally absorbed?

A

Due to large MW

91
Q

Why is oral vanc used for CDAD if oral absorption is low?

A

Not absorbed in GI tract, it concentrates in GI and really good for treating CDAD

ID (13 decks)

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