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Infectious Diseases Module > EXAM ONE COVERAGE > Flashcards

EXAM ONE COVERAGE Flashcards

1
Q

Skin Normal Flora

A
  1. Staphylococcus
  2. Streptococci
  3. Diptheroids
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2
Q

Mouth Normal Flora

A
  1. Streptococci
  2. Neisseria Sp.
  3. Haemophilus Sp.
  4. Bacteroides Sp.
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3
Q

GU Tract Normal Flora

A
  1. Enterobacterales
  2. Lactobacillus Sp.
  3. Staphylococci
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4
Q

GI Tract Normal Flora

A
  1. Enterobacterales
  2. Bacteroides Sp.
  3. Clostridium Sp.
  4. Streptococci
  5. Enterococci
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5
Q

Staphylococci Aureus

A

Gram Pos Cocci
Coagulase +
Rapid Test = PNA-FISH
Can alter PBP to as form of resistance to beta-lactams

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6
Q

Staphylococci Epidermis

A

Gram Pos Cocci
Coagulase -

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7
Q

Streptococci Pneumoniae

A

Gram Pos DIPLOcocci
Alpha Hemolytic
Upper Respiratory Tract infection and Otitis Media

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8
Q

Streptococci Pyogenes

A

Gram Pos Cocci
Beta Hemolytic

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9
Q

Enterococcus Faecalis

A

Gram Pos Cocci
Gamma Hemolytic
More Sensitive

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10
Q

Enterococcus Faecium

A

Gram Pos Cocci
Gamma Hemolytic
More Resistant

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11
Q

Peptostreptococcus

A

Gram Pos Cocci
Anaerobe

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12
Q

Lactobacillus

A

Gram Pos Bacilli
Concomitant

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13
Q

Diptheroids

A

Gram Pos Bacilli
Concomitant

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14
Q

Clostridium Difficle

A

Gram Pos Bacilli
Anaerobe in GI Tract

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15
Q

E.Coli

A

Gram Neg Bacilli (enterobacterales)
Oxidase Negative

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16
Q

Klebsiella Sp.

A

Gram Neg Bacilli (enterobacterales)
Oxidase Negative

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17
Q

Proteus Sp.

A

Gram Neg Bacilli (enterobacterales)
Oxidase Negative

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18
Q

Enterobacter Sp.

A

Gram Neg Bacilli (enterobacterales)
Oxidase Negative

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19
Q

Pseudomonas Aeruginosa

A

Gram Neg Bacilli
Oxidase Positive = highly resistant, death in a matter of days
Piperacillin or Ceftazidime has good activity against
Cefepime or Ceftolozane or Cefiderocol has excellent activity against

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20
Q

Acinetobacter Sp.

A

Gram Neg Bacilli
Oxidase Negative

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21
Q

Bacteroides Fragilis

A

Gram Neg Bacilli
Strict Anaerobe

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22
Q

Moraxella Catarrhalis

A

Gram Neg DIPLOcocci

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23
Q

N. Gonorrhae, Meningilidis

A

Gram Neg DIPLOcocci

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24
Q

Coagulase Properties

A

Differentiate between STAPH
+ = fibrinogen to fibrin = clots = need treatment
- = no action = rarely causes infection

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25
Q

Hemolytic Properties

A

Differentiate between STREP

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26
Q

Oxidase Properties

A

Test gram NEG bacteria for specific electron oxidase pathway
+ = Pathogen

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27
Q

Oxidase Properties

A

Test gram NEG bacteria for specific electron oxidase pathway
+ = Pathogen

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28
Q

What are the 1st Generation Cephalosporins?

A
  1. Cefazolin
  2. Cefadroxil
  3. Cephalexin
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29
Q

What are the 2nd Generation Cephalosporins?

A
  1. Cefoxitin
  2. Cefaclor
  3. Cefuroxime
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30
Q

What are the 3rd Generation Cephalosporins?

A
  1. Ceftazidime
  2. Cefotaxime
  3. Cefpodoxime
  4. Ceftriaxone
  5. Cefdinir
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31
Q

What are the 4th Generation Cephalosporins?

A
  1. Cefepime
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32
Q

What are the 5th Generation Cephalosporins?

A
  1. Ceftaroline
  2. Ceftolozane
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33
Q

What are the Siderophore Cephalosporins?

A
  1. Cefiderocol
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34
Q

Ceftolozane

A

5th Generation
Treat Intra-Abdominal and UTIs
Administered with Tazobactam
Most POTENT Anti-Pseudomonal

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35
Q

Tazobactam

A

Beta-Lactamase Inhibitor
Combo with Ceftolozane
Heavily modified penAM backbone

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36
Q

Ceftazidime

A

Third Generation
Improved stability against certain beta-lactamases
Administered with AVIBACTAM

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37
Q

Avibactam

A

Broad Spectrum Inhibitory Activity against beta-lactamases
Bridged BICYCLIC scaffold
NON-BETA-LACTAM INHIBITOR
Reversible mechanism of inhibition, recyclizes

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38
Q

Relebactam

A

Board spectrum inhibitory activity against beta-lactamases
Bridged BICYCLIC scaffold
Admin with Imipenem/Cilastatin

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39
Q

What are 2 Carbapenems and what can they be administered in combination with?

A
  1. Thienamycin
  2. Imipenem

Admin with Cilastatin Sodium

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40
Q

Aztreonam Disodium

A

Monobactam

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41
Q

List clinically useful Carbapenems where the SULFA is located outside the ring?

A
  1. Ertapenem
  2. Doripenem
  3. Meropenem
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42
Q

Vancomycin

A

Glycopeptide
Narrow G+
Binds D-Ala-D-Ala, does not directly inhibit CMT
IV/PO, PO= C.Diff
TIME DEPENDENT antibiotic
AEs: Nephrotoxicity, Ototoxicity, Infusion Related Effects

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43
Q

Dalbavancin

A

Second Generation LipoGLYCOPEPTIDE
Gram Positive Bacteria: MRSA and MRSE
MOA: DIMERIZES and Inserts LIPOPHILIC side chain into membrane
Binds D-Ala-D-Ala
ABSSSI
IV once weekly
346 hr half life

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44
Q

Oritavancin

A

Semisynthetic lipoGLYCOPEPTIDE
Gram Pos SKIN infections
More active than Vanc for certain strains of C.Diff
MOA: disrupts cell membrane, inhibits transglycosylation and transpeptidation
195 hr half life
CAN BIND D-Ala-D-Lactate active against VRSA

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45
Q

Telavancin

A

LipoGLYCOPEPTIDE
9 hr half life
IV QD
AE: Nephrotoxicity and Teratogenic

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46
Q

Daptomycin

A

LipoPEPTIDE
Narrow Gram + including MRSA and VRSA, last resort antibiotic
MOA: lipid protein inserts into the bacterial cytoplasmic membrane where it aggregates and forms an ion-conducting channel
1: binds in a calcium dependent manner
2: oligomerizes, disrupts membrane
3: release of intracellular ions causes rapid cell death
IV QD/Infusion
AE: Muscular Toxicity
DDI: STATINS

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47
Q

Linezolid

A

Oxazolidinone
Narrow Gram +, MRSA, VRSA, Strep Pneumoniae, and VRE
C-Ring provides great flexibility in SAR
MOA: binds to the 23S portion of the 50S ribosomal subunit preventing the formation of the functional 70S initiation complex, intracellular target can bind in Gram + but CANNOT cross Gram - outer membrane
BEST ORAL drug for MRSA
Broken down in the liver = PO BID
AE: bone marrow suppression, peripheral neuropathy
DDI: MAOI monoamine oxidase inhibitor an SSRI

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48
Q

Tedizolid

A

Second Generation Oxazolidinone
Narrow Gram +, MRSA, VRSA, Strep Pneumoniae, and VRE
More potent against Staphylococci and Enterococci
MOA: binds to 50S subunit, more affinity than Linezolid
IV QD, transported by albumin
AE: same as Linzeolid but less effects due to lower doses
DDI: MAOI and SSRI

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49
Q

Streptogramins

A

Dalfopristin + Quinupristin = Macrolide Like
MOA: Bind 50S subunit
Always take in combination

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50
Q

Quinupristin

A

Streptogramin
Narrow Gram +, last resort VRSA, VRE, MRSA
MOA: binds MLSb on bacterial ribosome subunit
IV/3-4x daily
Metabolized in liver
AE: muscular toxicity, infusion related reactions

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51
Q

Dalfopristin

A

Streptogramin
Narrow Gram +, last resort VRSA, VRE, MRSA
MOA: binds nearby site, increased affinity of Quinupristin for 50S subunit
IV/3-4x daily
Metabolized in liver
AE: muscular toxicity, infusion related reactions

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52
Q

Lincosamides

A

MOA: Bind 50s subunit
ONLY ACT ON GRAM POS, due to extremely polar structure

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53
Q

Clindamycin

A

Lincosamide
Narrow Gram +, anaerobic gram + infections, penicillin allergy substitute, and some MRSA
MOA: REVERSIBLY bind 50s subunit
BETTER ORAL absorption and antimicrobial activity than Lincomycin
EXCELLENT penetration in bone, abscesses, macrophages, NOT CNS
AEs: increased risk for C.Diff (not sensitive to Clinda)

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54
Q

Sulfonamides

A

First Type: aniline substitute
Second Type: PRODRUGS
Third Type: Non-Alanine, no cleavage

55
Q

Sulfanilamide

A

Newer versions have lower pKa vales to prevent Crystalluria
MOA: replacement of PABA

56
Q

Sulfamethoxazole

A

Sulfonamide
BROAD spectrum, MRSA
Good Oral absorption
AE: nephrotoxicity, hyperkalemia, pancytopenia, photosensitivity, rash, SJS, epidermal necrolysis
KERNICTERUS IN NEONATES

57
Q

Dihydrofolate Reductase Inhibitiors

A

Trimethoprime will target dihydrofolate reductase to stop DNA/RNA synthesis

58
Q

Trimethoprim

A

Dihydrofolate Reductase Inhibitor
BROAD spectrum, MRSA
Good Oral absorption
AE: nephrotoxicity, hyperkalemia, pancytopenia, photosensitivity, rash, SJS, epidermal necrolysis
KERNICTERUS IN NEONATES

59
Q

Bactrim

A

Sulfamethozaole (sulfanilamide) + Trimethoprim
DDI: WARFARIN, slowing drug metabolism

60
Q

Mupirocin

A

Monocarboxylic Acid Class
Narrow Gram +
MOA: interrupting peptide-chain elongation, reversibly binds to bacterial isoleucyl-tRNA synthetase
TOPICAL ONLY
AE: allergic reactions, irritation

61
Q

Teixobactin

A

MOA: binds to lipid II and lipid III cell wall peptidoglycan precursors
Acts on GRAM POS: Staph Aureus, Enterococci Faecalis, and M. tuberculosis

62
Q

Penicillin G

A

Parent Penicillin
Narrow G+
Poor Oral absorption, Continuous IV
Unstable in acidic environments

63
Q

Penicillin V

A

Parent Penicillin
Narrow G+
Oral absorption

64
Q

Pen-VK

A

Acid Stable Form of Penicillin V
Pen V + Potassium Salt

65
Q

Parent Penicillin V and G

A

Short half life 30-60 mins
Accumulate in renal insufficiency
Rapid renal elimination
Narrow G+

66
Q

Oxacillin

A

Narrow G+
Penicillinase Resistant
IV
AE: hepatotoxicity

67
Q

Methicillin

A

Prototype
Renal toxicity
No longer available

68
Q

Nafcillin

A

Narrow G+
Penicillinase Resistant
IV
AE: interstitial nephritis, bone marrow suppression

69
Q

Dicloxacillin

A

Narrow G+
Penicillinase Resistant
Oral, take on empty stomach

70
Q

MRSA Resistant to what?

A

Oxacillin, Nafcillin, and Dicloxacillin, and other B-Lactams

71
Q

Ampicillin

A

Extended G+
Penicillinase Sensitive
IV/PO, limited oral absorption affected by food

72
Q

Amoxicillin

A

Extended G+
Penicillinase Sensitive
PO, 100% absorption, no effect with food

73
Q

Piperacillin

A

Extended G+, more gram- most extended of ALL penicillins
Penicillinase Sensitive
IV
GOOD ACTIVITY against Pseudomonas Aeruginosa

74
Q

Unasyn

A

Ampicillin + Sulbactam
IV
Broad Spectrum

75
Q

Augmentin

A

Amoxicillin + Clavulanic Acid
PO
Broad Spectrum

76
Q

Zosyn

A

Piperacillin + Tazobactam
IV
Broad Spectrum

77
Q

Cefazolin

A

First Generation
Extended G+
IV, longest half life in 1st gen
DDI: Warfarin = increased anticoagulant effect

78
Q

Cephalexin

A

First Generation
Extended G+
PO
Most widely used

79
Q

Cefadroxil

A

First Generation
Extended G+
PO, best absorbed after oral admin

80
Q

Cefoxitin

A

Second Generation
More Extended G+
Less Sensitive to Beta-Lactamases
IV

81
Q

Cefuroxime

A

Second Generation
More Extended G+
Less Sensitive to Beta-Lactamases
IV/PO

82
Q

Cefaclor

A

Second Generation
More Extended G+
Less Sensitive to Beta-Lactamases
PO

83
Q

Cefotaxime

A

Third Generation
Broad Spectrum, Gram + and Enterobacteriaceae Rod Gram -
Resistant to B-Lactamase
Cross BBB
IV
First approved 3rd gen

84
Q

Ceftriaxone

A

Third Generation
Broad Spectrum, Gram + and Enterobacteriaceae Rod Gram -
Resistant to B-Lactamase
Cross BBB
IV
Most widely used, long half life
AE: BILIRUBIN DISPLACEMENT

85
Q

Ceftazidime

A

Third Generation
Broad Spectrum, Gram + and Enterobacteriaceae Rod Gram -
SENSITIVE to B-Lactamase
Cross BBB
IV, take in combo with AVIBACTAM
HIGH ACTIVITY AGAINST P.Aeruginosa

86
Q

Cefdinir

A

Third Generation
Broad Spectrum, Gram + and Enterobacteriaceae Rod Gram -
Resistant to B-Lactamase
Cross BBB
PO
Can chelate with iron = stool discoloration

87
Q

Cefpodoxime

A

Third Generation
Broad Spectrum, Gram + and Enterobacteriaceae Rod Gram -
Resistant to B-Lactamase
CANNOT cross BBB
PO

88
Q

Cefepime

A

Fourth Generation
Broad Spectrum
Resistant to B-Lactamase
Cross BBB
Excellent activity against P.Aeruginosa
AE: INCREASED risk of seizures

89
Q

Ceftaroline

A

Fifth Generation
Broad Spectrum
Resistant to B-Lactamase
NOT effective against P.Aeruginosa but EFFECTIVE against MRSA and VRSA (FDA approved)

90
Q

Ceftolozane

A

Fifth Generation
USE IN COMBO with Tazobactam
Sensitive to B-Lactamase
Broad

91
Q

Cefiderocol

A

Siderophere Cephalosporin: forms a complex w/iron to cross gram- outer membrane
Resistant B-Lactamase
Narrow Gram -
IV, last resort antibiotic for MDR gram -

92
Q

Acinetobacter Baumannii

A

Gram Neg
Rod
Cefiderocol has excellent activity against

93
Q

Imipenem

A

Carbapenem
Extreme Broad Spectrim
Resistant B-Lactamase
IV, Metabolites can cause kidney damage
AE: nephrotoxicity
Can use in combo with Cilastatin and Relebactam

94
Q

Meropenem

A

Carbapenem
Extreme Broad Spectrim
Resistant B-Lactamase
IV, Resistant to dehydropeptidase
Can use in combo with Vaborbactam to target MDR

95
Q

Ertapenem

A

Carbapenem
Extreme Broad Spectrim
Resistant B-Lactamase
IV, resistant to dehydropeptidase

96
Q

Aztreobactam

A

Monobactam
Narrow G-
IV
No cross-allergic reactions with other B-Lactams

97
Q

ALL Penicillin AEs

A

CNS Excitation and Seizures at HIGH concentrations

98
Q

ALL Cephalosporins AEs

A

Rash
Cross Reactivity with penicillin allergy

99
Q

ALL Carbapenems AEs

A

INCREASED risk of seizures
Cross Reactivity with penicillin allergy

100
Q

Beta-Lactamase Inhibitor + Aminopenicillin AEs

A

Diarrhea

101
Q

Narrow G+ Penicillins

A
  1. Penicillin G (IV/IM)
  2. Penicillin V (PO empty stomach)
  3. Oxacillin (IV)
  4. Nafcillin (IV)
  5. Dicloxacillin (PO empty stomach)
102
Q

Extended G+ Penicillins

A
  1. Ampicillin (IV, PO empty stomach)
  2. Amoxicillin (PO)
  3. Piperacillin (IV), P.Aeruginosa
103
Q

Broad Spectrum Penicillins

A
  1. Unasyn (IV)
  2. Augmentin (PO)
  3. Zosyn (IV)
104
Q

Which beta lactams have the broadest spectrum?

A

Carbapenems

105
Q

For CNS Symptoms which beta lactams are the most problematic?

A

Carbapenems

106
Q

Lefamulin

A

Pleuromutilins
Extended Gram +, MRSA, community pneumonia
MOA: unique binding site on 50s bacterial ribosome, inhibit protein synthesis
IV/PO
AE: QT prolongation, teratogenic

107
Q

Enterococcus vs Enterobacterales

A

Coccus = gram positive
Bacterales = gram negative
Entero = gut

108
Q

Pen G, Pen VK Coverage

A

Gram + Narrow
Gram Pos = Strep/S.Pneumo/E.Faecalis/Listeria
Gram Neg = T.Pallidum
Anaerobes = Gram +

109
Q

Nafcillin, Oxacillin, and Dicloxacillin Coverage

A

Gram + Narrow
Gram Pos = Staph/Strep/S.Pneumo

110
Q

Ampicillin and Amoxicillin Coverage

A

Extended Gram +
Gram Pos = Strep/S.Pneumo/E.Faecalis/Listeria

111
Q

Unasyn and Augmentin Coverage

A

Broad Spectrum
Gram Pos = Strep/S.Pneumo/Staph/E.Faecalis/Listeria
Gram Neg = HENPEcK
Anaerobes = +/-

112
Q

Zosyn Coverage

A

Broad Coverage
Gram Pos = Strep/Staph/E.Faecalis/Listeria
Gram Neg = HENPEcK and Pseudomas
Anaerobes = +/-

113
Q

PEcK

A

Proteus
E.Coli
Klebsiella

114
Q

HENPEcK

A

H.Influenzae
Enterobacter
Neisseria
Proteus
E.Coli
Klebsiella

115
Q

Cephalexin, Cefadroxil, and Cefazolin Coverage

A

Gram Pos = Staph, Strep, S.Pneumo
Gram Neg = PEcK
Anaerobe = Peptostrepto

116
Q

Cefoxitin, Cefuroxime, and Cefaclor Coverage

A

Gram Pos = Staph, Strep, S.Pneumo
Gram Neg = HENPEcK
Anaerobes = Peptostrepto, Cefoxitin = GN

117
Q

Cefdinir, Cefpodozime, Ceftriazone, Ceftazidime, and Cefotazime Coverage

A

Gram Pos = Staph, Strep, S.Pneumo (except Ceftaz)
Gram Neg = HENPEcK (Ceftaz = pseudomonas)
Anaerobes = Peptostrepto, Cefotax = GN

118
Q

Cefepime Coverage

A

Gram Pos = Staph, Strep, S.Pneumo
Gram Neg = HENPEcK and Pseudomonas
Anaerobe = Peptostrepto

119
Q

Ceftaroline +++
Ceftolozane/Taxo —
Coverage

A

Gram Pos = Staph, S.Pneumo, Ceftaro = Staph/MRSA
Gram Neg = HENPEcK, Ceftolo = Pseudomonas
Anaerobe = Peptostreto, Ceftolol = GN

120
Q

Cefiderocol Coverage

A

Gram Neg = Enterics, Pseudomonas

121
Q

What drugs can cover Pseudomonas?

A
  1. Ceftazidime
  2. Cefepime
  3. Ceftolozane/Tazobactam
  4. Cefiderocol
  5. Zosyn
  6. Imipenem
  7. Meropenem
  8. Aztreonam
122
Q

Imipenem/Cilstatin Coverage

A

Gram Pos = Staph, Strep, S.Pneumo, E.Faecalis
Gram Neg = HENPEcK, Pseudomonas
Anaerobe = +/-
Listeria

123
Q

Meropenem Coverage

A

Gram Pos = Staph, Strep, S.Pneumo
Gram Neg = HENPEcK, Pseudomonas
Anaerobe = +/-

124
Q

Ertapenem Coverage

A

Gram Pos = Staph, Strep, S.Pneumo, E.Faecalis
Gram Neg = HENPEcK
Anaerobe = +/-

125
Q

Aztreonam Coverage

A

Gram Neg = Enterics, HENPEcK, and Pseudomonas

126
Q

Vancomycin Coverage

A

Gram Pos = Strep, S.Pneumo, Staph, MRSA, E.Faecalis
Anaerobes = Peptostrepto, Clostridia

127
Q

Telavancin, Oritavancin, and Dalbavancin Coverage

A

Gram Pos = Strep, S.Pneumo, Staph, MRSA, E.Faecalis
Anaerobes = Peptostrepto, Clostridia

128
Q

Daptomycin Coverage

A

Gram Pos = Strep, S.Pneumo, Staph, MRSA, E.Faecalis, VRE
Anaerobes = Peptostrepto

129
Q

Linezolid and Tedizolid Coverage

A

Gram Pos = Strep, S.Pneumo, Staph, MRSA, E.Faecalis,VRE (Linezolid = Listeria)
Anaerobes = Linezolid = Peptostrepto, Clostridia

130
Q

Quin/Dalfopristin Coverage

A

Gram Pos = Strep, S.Pneumo, Staph, MRSA, E.Faecalis, VRE

131
Q

Clindamycin Coverage

A

Gram Pos = Strep, S.Pneumo, Staph, MRSA,
Anaerobes = Peptostrep

132
Q

Bactrim Coverage

A

Gram Pos = Staph, MRSA, Listeria
Gram Neg = Enterics

133
Q

Mupirocin Coverage

A

Gram Pos = Strep, Staph, MRSA

134
Q

What drugs cover VRE?

A
  1. Daptomycin
  2. Linezolid
  3. Tedizolid
  4. Quinupristin/Dalfopristin

Infectious Diseases Module (5 decks)

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