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Cooper AFN Pharm II > Exam V - Antibiotics > Flashcards

Exam V - Antibiotics Flashcards

1
Q

_______ _______ is almost always the first step in the identification of a bacterial organism

A

Gram stain

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2
Q

staining with crystal violet dye differentiates bacteria by the chemical and physical properties of their cell walls by detecting _____________

A

peptidoglycan

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3
Q

Peptidoglycan is present in a THICK layer in gram-_________ bacteria

A

positive

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4
Q

Gram-________ bacteria retain the crystal violet dye

A

positive

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5
Q

Gram-__________ bacteria stain a red or pink coloring 2/2 a counterstain (commonly safranin or fuchsine)

A

negative

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6
Q

(t/f) Antibiotics save more lives than any other class of drugs

A

true

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7
Q

Which two classes of bacteria cannot be definitively classified by the gram-stain procedure

A

Gram-variable

Gram-indeterminate

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8
Q

_________ bacteria require O2 to live, and __________ bacteria cannot live in the presence of O2

A

Aerobic

Anaerobic

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9
Q

Purple bacteria is which type?

A

Gram-positive

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10
Q

Pink/red bacteria is which type?

A

Gram-negative

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11
Q

Steps of the gram-stain procedure

A
  1. crystal violet
  2. Iodine
  3. alcohol wash (decolorization)
  4. Safranin (counterstain)
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12
Q

Why do you have to continue taking Abx’s for the full schedule of your prescription?

A

Compliance with proper time intervals maintains the MEC/MIC (minimum effective/inhibitory concentration)

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13
Q

Lowest concentration of an ABX that prevents visible growth of microorganisms

A

MEC/MIC (minimum effective/inhibitory concentration)

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14
Q

What is the most common cross-sensitivity that we will deal w/ all the time in the OR?

A

Cefazolin (Ancef) and Penicillin

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15
Q

Units used to quantify vitamins, hormones, some medications, vaccines, blood products, and similar biologically active substances.

A

IU (International unit)

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16
Q

Acute infections MEC day range is average ___-___ days or until the patient is asymptomatic/afebrile for ___-___ hours

A

7-10 days

48-72 hours

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17
Q

Oral bioavailability greater than ___% for most antibiotics

A

70%

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18
Q

sulfonamides are ______ soluble and are used to treat _______

A

Lipid soluble

UTIs

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19
Q

Inhibitors of folic acid & nucleotide biosynthesis is the MOA for what Abx?

A

Sulfonamides

*Folic acid & fonamides (F&F)

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20
Q

Which abx’s are bacterial cell wall synthesis inhibitors?

A

Penicillins
Aztreonam
Vancomycin
Cephalosporins

-Reaking PAVC on the cell walls

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21
Q

Which Abx’s are inhibitors of DNA replication & RNA synthesis?

A

Quinolones (cipro)
Rifampin

*DNA/RNA is the QR code for our body

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22
Q

Never give _________ fast in peds pts b/c it’s ototoxic

A

Gentamicin

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23
Q

Which abx’s are protein synthesis inhibitors?

A

Tetracycline
Aminoglycosides
Microlides
Isoniazid

*TAMI hates protein
*This A is w/ an M in TAMI for AMinoglycosides

*AND Clindamycin (TAMI & LINDA hate protein)

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24
Q

3 things you have for true anaphylaxis

A

-angioedema

-bronchoconstriction

-pruritis (central mediated itching, nothing to do w/ histamine)

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25
Q

Vancomycins + Furosemide/ASA = increased ___________

A

ototoxicity

*think ototoxicity w/ LASIX

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26
Q

Cephalosporins interfere with ________ metabolism

A

ethanol

*Can’t give ur Ancef w/ drunk pt before surgery

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27
Q

Tetracylcines reduce the effectiveness of _________ _____________

A

oral contraceptives

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28
Q

What 2 abx types are you gonna give for initial therapy before culture reports come back?

A

Single Broad Spectrum

Combination ABX

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29
Q

Most laboratory tests to ID an organism take ___-___ hours (except for gram-stains)

A

48 - 72 hrs

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30
Q

__________ ID’s the causative organism

A

Culture

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31
Q

___________ tests determine which drug is likely to be effective against the organism

A

Sensitivity

*which drug is this organism going to be SENSITIVE to

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32
Q

Culture & sensitive especially important with gram-________ bacteria due to the high incidence of drug-resistant organisms

A

negative

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33
Q

What bacteria is often responsible for UTI’s

A

E.Coli

*shit going to the urethra

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34
Q

Many ABX are _______ excreted and therefore effective against ______

A

Renally

UTI’s

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35
Q

Prophylactic Therapy in
perioperative infections in high risk clients helps _________ resistance

*BLUE BOX

A

decrease

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36
Q

What are the 4 high risk surgical procedures

*BLUE BOX

A

-Cardiac

-GI

-Transplants

-Orthopedic (hardware)

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37
Q

What is the 1st Generation Cephalosporin with activity against Staph Aureus or Strep that we use for pre-op?

You know this

A

Cefazolin (Ancef)

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38
Q

Intraop Cefazolin (Ancef) given every ___ hours

A

4 hrs

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39
Q

Repeat administration is recommended after_______mL of EBL or volume loss of __%

A

1500mL

OR

20%

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40
Q

(t/f) Your repeat abx dose is the same as your first dose

A

True

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41
Q

normal flora of skin and upper resp tract

A

Staphylococci

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42
Q

normal flora of throat/nasopharynx

A

Streptococci

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43
Q

normal flora of human intestine

A

Enterococci

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44
Q

Is there a repeat dose for Vancomycin?

A

NO

*1 dose per 24hrs

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45
Q

Pt has a rash w/ PCN allergy. Can you give Ancef?

A

Yes

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46
Q

Pt has anaphylaxis w/ PCN allergy. Can you give Ancef?

A

NO obviously

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47
Q

Pt has allergy to PCN but s/s not documented. Ok to give Ancef?

A

No

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48
Q

Staphylococcus _________: boils, carbuncles, burn & surgical wound infections

A

aureus

*normal staff infections not caused by pieces of equipment

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49
Q

Staphylococcus _________: endocarditis, bacteremia.

Infections associated with the use of treatment devices

A

Non-aureus

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50
Q

Streptococcus ___________: pneumonia, sinusitis, otitis media, meningitis

A

Pneumoniae

*think pulmonary infections

51
Q

Streptococcus ___________ (beta-hemolytic strep):

-Severe pharyngitis “strep throat”

-Scarlet fever, rheumatic fever, endocarditis

A

pyogenes

*scarlete & rheumatic FEVER from PYROGENIC agents

52
Q

What type of bacteria:

Nosocomial (hospital acquired) infections

Secondary invaders in wound infections and UTI’s

Also found in soil, food, water and animals

A

Enterococcus faecalis & faecium

53
Q

Staphylococci
Streptococci
Enterococci

Gram + or -?

A

positive

54
Q

Bacteroids
Escherichia Coli
Klebsiella
Proteus

Gram + or -?

A

negative

55
Q

Which bacteria?

Anaerobic bacteria in digestive, respiratory, and genital tracts

Bacteremia

Abscesses: intra-abdominal, pelvic, and brain

A

Bacteroids

*bacteroid=brain (BB)

56
Q

Which bacteria?

Normal to the intestinal tract

UTI’s, pneumonia, sepsis, diarrhea, dysentery, hemorrhagic colitis

A

Escherichia Coli (E-coli)

57
Q

Which bacteria?

Normal bowel flora

Infect respiratory tract, urinary tract, bloodstream, burn wounds, and meninges

Pneumonia, bacteremia, sepsis

A

Klebsiella

58
Q

Collin’s notes: if you see a question about a fistula infection, which bacteria?

A

Klebsiella

Fist-ula = Kelbsie-lla

59
Q

What 4 bacteria can cross BBB?

A

Gram +
-Streptococci

Gram -
-Klebsiella
-Pseudomonas
-Bacteroids

*SKPB - Strep Kills People’s Brains

60
Q

Pseudomonas _____________ is resistant to many antibiotics and can get to the brain

A

Aeruginosa

61
Q

Cocci bacteria are the gram-________ bacteria

A

Positive

*Coccs are positive

62
Q

Which bacteria? (hint: gram -)

Nosocomial infections:

UTI, respiratory tract, skin, burn wounds, & bloodstream

A

Serratia

63
Q

Which bacteria?

Diarrhea to severe dysentery after ingesting contaminated food or water

A

Shigella

64
Q

All beta lactam compounds have a
___ membered beta lactam ring

A

4

*its the SQUARE in the compound stucture (has 4 sides)
*could be a hotspot question

65
Q

Penicillins
Cephalosporins Monobactams Carbepenems
Beta Lactamase Inhibitors

These are all _______ _______ compounds and have cross-sensitivity

A

Becta-lactam compounds

66
Q

Vancomycin is in what class?

A

Glycopeptide

67
Q

The outer membrane, a lipid bilayer, is present in Gram-__________ but not Gram-__________ organisms

A

negative

positive

68
Q

The lipid bylayer of the gram-negative bacteria is penetrated by ______ which are proteins that form channels providing hydrophilic access to the cytoplasmic membrane

A

porins

69
Q

The peptidoglycan layer is unique to bacteria and is much thicker in Gram-_________ organisms than in Gram-________ ones.

A

positive

negative

70
Q

__________ __________ _________ are membrane proteins that cross-link peptidoglycan (AKA make the peptidoglycan layer)

A

Penicillin-binding proteins (PBPs)

71
Q

(t/f) Beta-lactams work on both gram-positive and negatvie bacteria

A

true

*both + & - have peptidoglycan

72
Q

Beta-lactams act by binding to _______ _______ ________

This interferes w/ ___________

Which is required for the PBPs to build the cross-links in the peptidoglycan (aka cell wall synthesis)

A

PBPs

Transpeptidation

73
Q

(t/f) Beta-lactams are only effective only when bacteria are actively growing and synthesizing a cell wall.

A

True

*remember they affect CELL WALL SYNTHESIS

74
Q

________ perform transpeptidation in bacteria

A

PBPs

75
Q

Look @ slide 24 and note the difference btw gram-positive and gram-negative bacteria structures

A

Do it

76
Q

What are 4 ways that resistance can be formed to beta-lactams?

A

***Inactivation of ABX by β-lactamases (most common)

-Modification of target PBP’s

-Impaired penetration of ABX to the target PBP

-Efflux

77
Q

Staph Aureus
Haemophilus Influenzae E.Coli

These 3 bacteria can secrete ____________, which is the most common reason for the resistance of beta-lactams

A

Beta-lactamases

*SHE lactates beta-lactamases

78
Q

Abx class of choice in individuals with a history of penicillin allergy OTHER THAN AN IMMEDIATE HYPERSENSITIVITY?

*BLUE BOX

A

Cephalosporins

(1st gen is Ancef)

79
Q

Pencillin & cephalosporins are what kind of abx’s?

A

Beta-lactams

80
Q

Which beta-lactam abx class is less prone to being innactivated by beta-lactamases

A

Cephalosporins

81
Q

Is cefazolin (ancef) useful in meningitis?

A

no

doesn’t cross BBB

82
Q

__________ – only IV 1st Generation Cephalosporin in use within the US

A

Cefazolin (ancef)

83
Q

First-generation cephalosporins are active predominantly againstGram-_________bacteria, and successive generations have increased activity againstGram-__________bacteria (albeit often with reduced activity against Gram-positive organisms).

A

positive

negative

84
Q

any bacterium that has a spherical, ovoid, or generally round shape

A

Cocci

85
Q

Rod-shaped bacteria

A

Bacillus

86
Q

1st gen Cephalosporins work best w/ which bacteria?

A

Gram +

Pneumonococci
Steptrococci
Staphylococci

*cocc’s
*The reason we give Ancef all the time in the OR is b/c the 2 big bacteria we worry about during surgery is STREP & STAPH and Ancef covers those gram + bacteria

87
Q

Which gen cephalosporins have extended gram negative coverage

A

2nd gen

88
Q

(t/f) 2nd gen cephalosporins can cross BBB

A

True

89
Q

What class is Cefuroxime (Zinacef)

A

2nd gen cephalosporin

90
Q

Which gen cephalosporin is best for treatment against commonly acquired pneumonia

A

2nd gen

*you get pneumonia in ur 2 lungs (2nd gen)

91
Q

Ceftriaxone (Rocephin) or Cefotaxime are what gen cephalosporins?

A

3rd gens

*Triaxone (Tri=3)

92
Q

Are beta-lactams bacteriostatic or bactericidal?

A

Bactericidal

93
Q

Which beta-lactam abx has no cross allogenicity with PCNs

A

Aztreonam (Azactam)

94
Q

_____________ is a beta-lactam can be given PO and is avoided IM d/t pain

A

Cefuroxime (zinacef)

*XIM (NOT give IM)

95
Q

(t/f) Piperacillin/Tazobactam (Zosyn) works on both gram positive and negative

A

True

96
Q

Neuromuscular Hypersensitivity can be commonly cause by what abx class

A

Beta-lactams

97
Q

What is the only glycopeptide abx

A

Vancomycin

98
Q

This abx can cause “Red Man’s Syndrome”

A

Vanc

99
Q

Inhibits cell wall synthesis by binding to the D-Ala-D-Ala terminus of nascent peptidoglycan

A

Vancomycin

100
Q

Vancomycin kills staphylococci relatively ______ than beta-lactams

A

slower

101
Q

__________ + ___________ = treatment for enterococcal endocarditis if you have serious penicillin allergy

A

Vancomycin + Gentamycin

102
Q

Pre-op Vancomycin dose is what

A

15mg/kg

*in order to drive a VAN, you gotta be 15 yo (learners permit)

103
Q

What is the only abx that is bacteriostatic?

A

Clindamycin

104
Q

With vancomycin, __________ is a rare complication & __________ is a common complication

A

Ototoxicity

nephrotoxicity

105
Q

You worried about kidneys w/ Vancomycin?

A

Yep

106
Q

Which abx you gonna need for the dentist if you are trying to prevent endocarditis if you have a valvular heart disease and have a PCN allergy?

*BLUE BOX

A

Clindamycin

107
Q

Enterococci(+) and Gram (-) bacteria are resistant to __________

A

Clindamycin

108
Q

Gram (-) have an outer membrane resulting in poor permeability of __________

A

Clindamycin

109
Q

Clindamycin is only useful for gram-________ bacteria except for ___________

A

positive

enterococci

110
Q

What abx for skin & soft tissue infections - MRSA

A

Clindamycin

111
Q

What abx’s can cross BBB? (only ones on the PP)

A

-2nd & 3rd cephalosporins

-Cipro

112
Q

What is the only abx in the Lincosamides abx class?

A

Clindamycin

*LINda (duh)

113
Q

Do you need to do dose change in renal pts w/ clindamycin?

A

Nope

114
Q

Which abx is the aminoglycoside?

A

Gentamycin

*GYMtamycin & aminos/protein

115
Q

This abx has synergistic effects when combined with β-lactams or Vanco

A

Gentamicin

*think about endocarditis tx. w/ PCN allergies (Vancomycin + Gentamicin)

116
Q

This abx has synergistic effects when combined with β-lactams or Vanco

A

Gentamicin

117
Q

Which abx has concentration dependent killing with significant POST-ANTIBIOTIC effect

A

Gentamicin

*You get ur POST GYM PUMP after ur GYMtomysin w/ ur aminos/protein

118
Q

This abx can cause ototoxicity that is IRREVERSIBLE d/t nerve injury. Can cause Vertigo

A

Gentamicin

*dropping weights in the GYM is too loud and causes ototoxicity IRREVERSIBLE

119
Q

Which abx is the fluoroquinolone

A

Ciprofloxacin

120
Q

Inhibits DNA replication by binding to DNA gyrase and topoisomerase IV

(2 sites of action and works on both 2 types gram + & -)

A

Ciprofloxacin

*PRO tennis takes 2 players

*gyro toppings (DNA gyrase & topoisomerase IV)

*causes TENdonitis in ankles

121
Q

Which abx is a Nitroimidazole

A

Metronidazole (Flagyl)

*DAZOLE Flagyl

122
Q

Which abx causes a disulfuram like reaction when given with alcohol

A

Metronidazole (Flagyl)

*can’t be drinking while putting up a flag

123
Q

This abx MOA is via disruption of electron transport chain

A

Metronidazole (Flagyl)

*be careful putting up the flag (NOT DRUNK) b/c you can get ELECTROCUTED

124
Q

Which abx for planned or unplanned disruption of the bowel?

A

Metronidazole (Flagyl)

*People SHITTING their pants in the METRO

Cooper AFN Pharm II (5 decks)

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