Griffith Flashcards
First gen cephalosporins - chef zorro and chef flexing + club-sealing prometheus while E-coal-eye and Graham angel watch
cefazolin and cephalexin
Klebsiella, E. coli, Proteus mirabilis and GPC
Klebsiella
GN, ox- bacilli
Proteus mirabilis
GNB, - lactose, facultative anaerobe, swarming, urease, struvite stone (alk urine)
2nd gen ceph - chef fox w/ apple core + chef furry ox + GPC, Heme man w/ knife and serrated knife, Club-seal, and enterobacter attacking prometheus
- cefoxitin, cefaclor, cefuroxime
- GPIC, H. flu, Neisseria, Serrratia, Klebsiella, enterobacter, Proteus mirabilis
Which second generation ceph can cross BBB?
Cefuroxime
H. flu
GN C-B “EMOP”
Serratia marcescens
enterobacteriaceae - nosocomial infections, GNB
Neisseria
GN diplococci
General MOA of cephalosporins?
B-lactams - inhibit bacterial cell wall synthesis (not susceptible to penicillanases)
3rd gen ceph = “3 chefs in the 3 tree” - chef spore-head in ‘3 tree’ holding tax form, chef holding 3 axes, chef Taz w/ a dime + fighting evil Graham devil
- cefotaxime, ceftriaxone (gonorrhea), ceftazidime (pseudo)
- serious GN infections resistant to other beta lactams
Which ceph is given at single IM injection to treat gonorrhea?
ceftriaxone (+ doxy or azithro for chlam) = chef with 3 axes on 3 tree
Which 3rd gen ceph is active against pseudomonas?
ceftazidime = chef Taz holding dime on 3 tree
4th gen ceph - chef spore head stuck on pine tree stabbing sumo-monas and Graham angel with ‘4 fork’
- Cefepime
- pseudomonas
- GP
Two infections associated with A. israelii? Tx?
oral (normal flora)/tooth or facial abscess - dental work, oral trauma (sulfur granules), UTI’s w/ IUD’s (Tx with high dose penicillin)
“Acting mice” - Graham angel overlooks Director Pencil-villain film ant-in-robe with rod speaker as other mice store cheese crumbles in blocked uterus under lights held by branches
- GPB, branching, anaerobe
- Tx penicillin
- Sulfur granules
- UTI w/ IUD
Primary MOA of aminoglycosides? Requirement for uptake by bacteria?
irreversibly bind 30S to interfere with mRNA proofreading
oxygen
Two aminoglycoside toxicities that can be exacerbated with other meds?
- nephrotox w/ ceph
- ototox w/ loop diuretics
Which aminoglycoside is used to treat hepatic encephalopathy and in bowel surgery? Why?
neomycine = neon mouse operating on a liver/GIT
not absorbed by GIT so limited systemic AE’s
How do organisms develop resistance to aminoglycosides?
amigo glider battling the Graham devil is tied up by a sea gull transformer with a phosphate head and crosses on his wings = transferase enzymes acetylate, phosphorylate and adenylate
What AB causes a rash in EBV mono patients?
ampicillin
What AB is associated with induction of pseudomembranous colitis?
ampicillin (C. diff)
What is Augmentin?
amoxicillin (oral) + clavulanic acid (aminopenicillins are susceptible to beta lactamases)
Amino-penicillins? Target? Which can be given orally?
amoxicillin and ampicillin (BROAD: GP, some GN) - amOxicillin = Oral
Aminopenicillins - armored ox holding amigo pen uses amp to stun Heme-man who is slapping prometheus strapped to E coal with a salmon and siccing his lizard on him to eat his intestines
- amoxicillin, ampicillin
- H. flu, Proteus mirabilis, E. coli, Salmonella, Listeria, Enterococci (GDS +)
Anti-pseudo penicillins = ant-tie holding sumo-Mona Lisa blocks tiger smoking pipe on carpet while Graham devil watches
- ticarcillin, piperacillin, carbenicillin
- pseudomonas, GN (broad spectrum)
General MOA of penicillins?
- bind PBP and disrupt cell wall synthesis
- block transpeptidase involved in peptidoglycan cross-linking
monomorphic, septate hyphae branching at acute angles?
aspergillus fumigatus
3 presentations of aspergillus?
ABPA (eosinophilia in asthmatics), invasive (IC), and aspergilloma (cavity, hemoptysis)
How does pneumococcus become resistant to penicillin?
alteration of PBP’s (can overcome by giving large dose)
What drug is commonly used to treat syphilis and GAS?
penicillin
Which cillin is good for Listeria?
ampicillin (also covers enterococcus)
Which respiratory infection should not be treated with AB’s?
bronchitis (except in COPD exacerbation)
What is Unasyn? Admin?
Ampicillin + beta lactamase inhibitor, IV (mixed infections, infected diabetic foot ulcer but doesn’t cover MRSA)
Which two drugs are anti-pseudomonas?
ticarcillin (Timentin), piperacillin (Zosyn)
What 3 drugs are used to Tx non-MRSA staph aureus?
nafcillin and oxacillin IV; PO dicloxacillin
What group of microorganisms are NOT covered by cephalosporins?
anaerobes
What are 2nd gen cephalosporins used to treat clinically?
persistent minor infections (like Augmentin = amox)
Which ceph’s are anti-pseudomonal?
ceftazidime (but induces beta lactamase) so cefepime is preferred (chef on pine tree) - also ticarcillin and piperacillin
Which drugs are quick to induce resistance with extended-spectrum beta lactamase producing GN’s? Examples?
- cephalosporins
- Kleb, Actinobacter, enterobacter, Proteus, pseudomonas, Serratia, E. coli
- don’t use in ICU’s!
Primary use of aminoglycosides?
Severe GN infections (neomycin in bowel surgery)
What drugs are synergistic with beta lactams?
aminoglycosides (endocarditis combo)
3 aminoglycosides from weakest to strongest?
gentamicin, tobramycin, amikacin
Which group of antibiotics cover the atypical pneumonias well?
macrolides (block 50S, bacteriostatic) - myco pneumo, chlamydophila, legionella)
DOC for uncomplicated CA pneumonia?
macrolides
Additional function of erythromycin?
motilin agonist = diarrhea
Cardiac AE of macrolides like erythromycin?
prolonged QT interval