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NAPLEX > general and beta lactams > Flashcards

general and beta lactams Flashcards

1
Q

an antibiogram shows what

A

susceptibility patterns

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2
Q

characteristics of a gram positive organism

A

thick cell wall, stains purple

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3
Q

characteristics of a gram negative organism

A

thin cell wall, stains pink

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4
Q

characteristics of an atypical organism

A

no cell wall, no stain

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5
Q

MIC

A

minimum inhibitory concentration

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6
Q

explain the rationale of synergistically using aminoglycosides and beta lactams

A

beta lactams allow aminoglycosides to reach the intracellular target permitting a lower dose of aminoglycosides

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7
Q

intrinsic resistance

A

resistance is natural to the organism

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8
Q

selection pressure resistance

A

antibiotics kill only susceptible bacteria and leaves behind more resistant bacteria strains that multiply

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9
Q

acquired resistance

A

bacterial DNA with resistant genes

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10
Q

enzyme inactivation resistance

A

bacteria-produced enzymes break down the antibiotic

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11
Q

high risk of CDI

A

broad spectrum penicillins and cephalosporins, quinolones, carbapenems, clindamycin* (BBW)

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12
Q

bacteriostatic

A

inhibit bacterial growth

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13
Q

bacteriocidal

A

kill bacteria

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14
Q

hydrophillic agents

A

beta lactams, aminoglycosides, vancomycin, daptomycin, polymixins

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15
Q

characteristics of hydrophilic agents

A

1-small VD = less tissue penetration; 2-renal elimination = drug accumulation & SE; 3-low intracellular conc = no atypical activity; 4-poor/mod bioavailability = IV:PO is NOT 1:1

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16
Q

lipophilic agents

A

quinolones, macrolides, rifampin, linezolid, tetracyclines

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17
Q

lipophilic agent characteristics

A

1-large VD = tissue penetration; 2-hepatic elim = DDIs & hepatotoxicity; 3-intracellular = atypical activity; 4-excellent bioavailability = IV:PO is 1:1

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18
Q

spectrum of penicillins: natural, antistaphylococcal, aminopenicillines, extended-spectrum

A

Natural-strep/entero/gram+ anaerobes; Antistaphylococcal- strep/MSSA; Aminopenicillins- strep/enter/gram neg(HNPEK); Extended-spectrum- gram pos and neg(pseudamonas, CAPES)

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19
Q

Penicillin G Benzathine BBW

A

not for IV use (must use IM); can cause cardiorespiratory arrest and death

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20
Q

zosyn

A

pip/taz

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21
Q

augmentin

A

amoxicillin/clavulanate

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22
Q

unasyn

A

ampicillin/sulbactam

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23
Q

penicillins contraindication

A

CrCl<30 ml/min

24
Q

what is the rationale behind using probenecid with penicillins

A

probenecid can inc levels of beta lactams by interfering with renal excretion

25
Q

t/f: all beta lactams enhance the anticoagulation effect of warfarin

A

f; all except nafcillin and diclozacillin

26
Q

accumulation of penicillins put patients at inc risk of

A

seizure

27
Q

first line tx for pharyngitis

A

penicillin VK

28
Q

first line tx for AOM

A

amoxicillin, augmentin (also for nasal pharyngitis)

29
Q

drug of choice for infective endocarditis prophylaxis before dental procedures

A

amoxicillin

30
Q

drug of choice for syphilis

A

Penicillin G benzathine (G for george from grey’s)

31
Q

drugs that have exposure dependent dosing

A

vancomycin, macrolides, tetracyclines, polymixins

32
Q

drugs that have time dependent dosing

A

beta lactams

33
Q

drugs that have concentration dependent dosing

A

aminoglycosides, quinolones, daptomycin

34
Q

the gram __(negative/positive)___ spectrum of cephalosporins ___(inc/dec)___ with each generation

A

negative; inc

35
Q

cephalosporins have no activity against

A

enterococci and atypical organisms

36
Q

first gen cephalosporins and which one(s) has IV formulation

A

cefazolin (IV), cephalexin, cephadroxil

37
Q

second gen cephalosporins and which one(s) has IV formulation

A

IV: cefuroxime (also PO), cefotetan, cefoxitin; PO only: cefaclor, cefprozil

38
Q

second gen cephalorsporins with gram negative anaerobe activity

A

cefotetan, cefoxitin

39
Q

third gen cephalosporins and which one(s) has IV formulation

A

IV: ceftriaxone, cefotaxime, ceftazidime; PO: cefdinir, cefixime, cefpodoxime

40
Q

third gen cephalosporin that covers pseudemonas

A

ceftazidime

41
Q

fourth gen cephalosprin

A

cefepime

42
Q

fifth gen cephalosporin

A

ceftaroline

43
Q

only beta lactam that covers MRSA

A

ceftaroline

44
Q

beta lactamase inhibitors may be used with cephalosporins to inc acitivty against

A

MDR gram negative rods

45
Q

ceftriaxone contraindication

A

hyperbilirubinemic neonates, concurrent use with Ca-containing IV products in neonates <28 days (can form precipitates with Ca)

46
Q

cefotetan warning

A

inc risk of bleeding/disulfram rxn if ingested with alcohol due to NMTT side chain

47
Q

cephalosporin SE

A

seizures (renal accumulation), GI upset, diarrhea, rash/allergy, hemolytic anemia

48
Q

ceftriaxone clinical pearl

A

no renal adjustments!

49
Q

cephalosporin DDIs

A

separate from antacids; avoid H2RAs and PPIs

50
Q

carbapenems are generally reserved for

A

MDR gram neg

51
Q

ertapenam must only be diluted in

A

NS

52
Q

carbapenem major DDI

A

dec serum conc of valproic acid

53
Q

invanz

A

ertapenem

54
Q

ertapenem does not cover

A

pseudamonas, enterococcus, acinetobacter (PEA)

55
Q

carbapenems do not cover

A

atypicals, VRE, MRSA, C diff, stentrophomonas

56
Q

CAPES

A

citrobacter, acinetobacter, providencia, enterobacter, serratia

57
Q

aztreonam spectrum

A

gram neg, CAPES, pseudamonas (no gram pos or anaerobic activity)

NAPLEX (10 decks)

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