Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology I Exam #2 > ICWS > Flashcards

ICWS Flashcards

(63 cards)

Start Studying
1
Q

Name the 4 Penicillin groups

A
  1. Natural Penicillins
  2. Penicillinase Resistant Penicillins
  3. Extended spectrum penicillins
  4. Antipseudomonal penicillins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name the Natural Penicillins

A

Pen G (IV, IM)
Pen V (oral)
Benzathine pen. (IM)
Procaine pen. G (IM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name the Penicillinase Resistant Penicillins

A

Nafcillin (IV/IM)
Dicoloxacillin (oral)
Oxacillin (IV/IM, oral)
Methicillin (testing only)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name the extended spectrum penicillins

A

Ampicllin (oral)

Amoxicillin (oral)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name the antipseudomonal penicillins

A

Piperacillin (IV/IM)

Ticarcillin (IV/IM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the general rules regarding ICWS?

A
  • All ICWS (lyse cells)
  • All have B-lactam rings
  • All are bacterioCIDAL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the spectrum of the penicillins?

A

Progress from very G+++ w/ some G- to very G— w/ some G+

  • Extended spectrum: More extended G- coverage (more broad spectrum)
  • Antipsuedomonals are the only ones with coverage for psuedomonas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the MOA for penicillins?

A

Target penicillin binding proteins (PBPs) which form the trans-pep and trans-glyco bonds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the MOR for penicillins?

A

Penicillinase: Inactivates abx by hydrolyzing B-lactam ring

*Excludes penicillinase resistant class

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why do Penicillinase Resistant Penicillins not work against MRSA?

A
  • MRSA has nothing to do with B-lactamase

- MRSA produces an alternate PBP which decreases the binding affinty of B-Lactam abx to PBPs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the only B-Lactam that can be used against MRSA?

A

Ceftaroline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which penicillin is metabolized by the liver?

A

Penicillinase Resistant (Hepatic metabolism w/ kidney excretion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the purpose of the B-Lactamase inhibitors

A

When used in conjunction w/ the antipsuedomonal penicillins or extended spectrum penicillins, they help to extend the spectrum of the abx to include many organisms that are resistant due to B-lactamase production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Name the 3 B-Lactamase inhibitors

A

Clavulnaic acid, Sulbactam, and Tazobactam

+extended spectrum/antipsuedomonal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Toxicities of Penicillins

A
  • Allergy (all forms)
  • Electrolyte imbalances
  • GI distubrances
  • Superinfections
  • Relatively safe though
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

While very similar, what is the advantage cephelosporins have over penicillins?

A

7-methyl group increases their resistance to B-lactamase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name the 1st gen. cephalosporins

A

1st gen: Narrow spectrum

  • Cephazolin IV/IM
  • Cephalexin (Keflex) ORAL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Name the 2nd gen. cephalosporins

A

2nd gen: Intermediate spectrum

  • Cefaclor ORAL
  • Cefuroxime IV/IM
  • Cefprozil ORALe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name the 3rd gen cephalosporins

A

3rd gen: Broad spectrum (but remember, this does not mean the most broad of all abx)

  • Cetrioxone IV/IM
  • Cefotaxime IV/IM
  • Ceftazidime IV/IM
  • Cefixime ORAL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name the 4th gen cephalosporins

A

4th gen:

-Cefepime IV (100% bioavailability)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Name the 5th gen cephalosporins

A

“Unnamed”

-Cetaroline fosamil IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which class has the broadest spectrum coverage of all B-lactams?

A

4th gen cephalosporins (Cefepime)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

MOA for cephalosporins

A

Bind to PBP’s to interfere with bacterial cell wall synthesis (same as penicillins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the spectrum of the 1st gen cephalosporins

A 
Good G+
Moderate G-
Increased B-lactamase resistance
No antipseduomonal
(similar to natural penicillins)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the spectrum of the 2nd gen cephalosporins
Lower G+ activity Somewhat increased G- activity Increased B-lactamase resistance No antipseduomonal
26
What is the spectrum of the 3rd gen cephalosporins
Less active against G+ | Much more active against Enterobacteriaceae
27
What is the spectrum of the 4th gen cephalosporins
More resistant to some B-lactamases (compared to 3rd gen) Antipsuedomonal! Better G+ coverage Very good broad spectrum coverage
28
Penicillinase Resistant penicllins are the DOC for:
MSSA
29
Extended spectrum penicillins are the DOC for:
Lysteria | H. pylori
30
Antipseudomonal penicillins are the DOC for:
P. aeruginosa and acinetobacter
31
Ceftazolin is the DOC for:
Surgical prophylaxis
32
When would be an appropriate time to use 4th gen cephalosporins?
Important for serious infections (pseudomonas, enterobacteriaciae, etc.)
33
What is the spectrum of the 5th gen cephalosporins
- Effective against MRSA and VRSA! Binds to mutated PBP (PBP2A) with very good affinity (unlike the other B-lactams) - Also good for CABP (complicated skin infections) - No antipseudomonal activity
34
What are the contraindications for 3rd gen. cephalosporins?
Neonates (bilirubin displacement)
35
What are the toxicities of the cephalosporins?
* Fairly safe - Superinfection - Disulfiram-like rxn after alcohol consumption - Allergy (10% cross sensitivity w/ penicillins) - Dose dependent renal tubular necrosis (synergistic nephrotoxicty w/ amingoglycosides!) so avoid in pts with poor renal function - Diarrhea
36
What is the MOR for the cephalosporins?
Same as penicillins
37
Name the Monobactams (1)
Aztreonam IV/IM/ inhalation
38
What is the spectrum of Aztreonam (Monobactam class)
Aerobic G-
39
What is an appropriate use of Aztreonam?
Good alternative for G- rxns in penicillin allergic pts
40
Is there cross sensitivity with Aztreonam and other B-Lactam abx?
No! Good alternative for people with pen. allergies
41
What is the toxicity of Aztreonam?
Very minimal - Phlebitis - Skin rash - Abnormal liver function
42
Name the Carbapenems (3)
- Imipenem + Cilastin IV - Meropenem IV - Ertapenem IV/IM CarbaPENEMS end in PENEM
43
What is the spectrum of the Carbapenems
- Mixed aerobic/anaerobic infections - One of the best classes for broad spectrum coverage (empirical therapy!) - Indicated for organisms resistant to other antimicrobials
44
What is the purpose of cilastin being paired with Imipenem?
- Imipenem is rapidly inactivated by renal tubule dihydropeptidases - Cilastin is a dihydropeptidase inhibitor
45
Which bacteria rapidly develops resistance against imipenem and meropenem?
Pseudomonas (recommend giving in combo w/ aminoglycoside)
46
Which carbapenem should you never use for a psuedomonas infection?
Ertapenem (not effective enough)
47
What is a major toxicity concern for imipenem?
``` Imipenem can cause SEIZURES at high levels! Use cautiously in pts with: -Brain lesions -Head trauma -Hx of CNS disorders such as seizures ``` **Meropenem less likely to cause seizures
48
Name the 3 drugs that are ICWS but are NOT B-Lactams
Vancomycin Fosfomycin Bacitracin
49
What is the MOA for Vancomycin?
Prevents elongation of the polypeptide chain by binding to terminal D-Ala-D-Ala (= no tethering)
50
Imipenem/cilastin and Meropenem are the DOC for:
Serratia | Enterobacter
51
What is the MOR to Vancomycin?
Modification of the D-ala-D-ala binding site, inhibiting Vanco from binding (Vancomycin-resistant enterococci - VRE)
52
What is the spectrum coverage of Vanco?
G+ only
53
Vancomycin is the DOC for:
MRSA C. diff* Staph superinfection HOWEVER, due to emergence of Vanco-resistant enterocci (VRE), Vanco is the drug of last resort (*exception is C. Diff)
54
When would you give Vanco via an IV? When would you give Vanco orally?
IV- systemic infections | Oral- GI infections caused by c. diff and staph
55
What are the adverse affects of Vanco?
- Ototoxicity - Nephrotoxicity - "Red man" syndrome: flushing from histamine release
56
What is the MOA for Fosfomycin?
f by preventing NAG to NAM reduction
57
What is the spectrum coverage of Fosfomycin?
G+ and G-
58
What is the use of fosfomycin?
Uncomplicated lower UTIs in women (but not necessarily drug first choice)
59
Fosfomycin plus what other drugs cause a synergistic rxns? (3)
B-lactam Aminoglycosides Fluorquinolones
60
What is the spectrum of Bacitracin?
Mainly G+ bacteria
61
What is the MOA of Bacitracin?
Interferes with the final dephosphorylation step in the phospholipid transmembrane carrier cycle
62
What is Bacitracin commonly use in combo with?
Neomycin and Polymyxins (think Neosporin)
63
What is the most common use of Bacitracin
Superficial skin and eye infections following minor injuries

Pharmacology I Exam #2 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions