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ID 17 Flashcards

1
Q

Cephalosporins as a class..

A

beta lactase that are less susceptible to penicillinases.

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2
Q

organisms not covered by 1st-4th generation cephalosporins? exception?

A 
LAME
Listeria
Atypicals (chlamydia, mycoplasma)
MRSA
Enterococci 
Exception: ceftaroline (5th generation cephalosporin, which covers MRSA)
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3
Q

1st gen cephalosporins?

A

Cefazolin

Cephalexin

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4
Q

1st gen cephalosporin use?

A

Proteus
E coli
klebsiella

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5
Q

other use for cefazolin?

A

prior to surgery to prevent s aureus wound infections

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6
Q

2nd gen cephalosporins?

A

Cefaclor
Cefoxitin
Cefuroxime

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7
Q

2nd gen cephalosporin use?

A 
H influenza
Enterobacter aerogenes
Neisseria
Serratia
Proteus
E coli
Klebsiella
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8
Q

3rd gen cephalosporins?

A

Ceftriaxone
Cefotaxime
Ceftazidime

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9
Q

ceftazidime uses..

A

pseudomonas

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10
Q

ceftriaxone uses..

A

meningitis
gonorrhea
disseminated lyme disease

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11
Q

4th generation cephalosporins…

A

cefepime

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12
Q

cefepime uses…

A

gram negatives with increased activity against pseudomonas

gram positives

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13
Q

cephalosporin AE’s

A

1) hypersensitivity reactions
2) AIHA
3) disulfiram-like reaction
4) vitamin K deficiency
5) cross-reactivity with penicillins
6) increase nephrotoxicity of aminoglycosides

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14
Q

carbapenems

A

imipenem
meropenem
ertapenem
doripenem

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15
Q

imipenem as a drug and caveat

A

1) broad spectrum, b-lactamase resistant.

2) always administered with cilastatin

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16
Q

what is cilastatin? why do you give it with imipenem?

A

1) inhibitor of renal dehydropeptidase I

2) decreases inactivation of drug in renal tubules.

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17
Q

meropenem benefits

A

1) Decreased seizure risk

2) stable to dehydropeptidase I

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18
Q

carbapenem uses

A

Gram positive cocci
gram negative rods
anaerobes

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19
Q

Carbapenem AE’s

A

1) CNS toxicity, seizure
2) skin rash
3) GI distress

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20
Q

benefits of aztreonam

A

1) less susceptible to beta-lactamases

2) no cross-allergenicity with penicllins

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21
Q

aztreonam mechanism

A

Prevents peptidoglycan cross-linking by binding to penicillin-binding protein 3.

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22
Q

aztreonam has activity against

A

only gram negative rods

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23
Q

aztreonam uses?

A

penicillin-allergic patients and those with renal insufficiency who can’t tolerate ahminoglycosides.

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24
Q

vancomycin characteristics

A

1) bactericidal against most bacteria, except c diff

2) not susceptible to beta-lactamses

25
vancomycin uses..
*only gram positives--serious multidrug-resistant organisms like enterococcus, MRSA, C diff, S epidermidis
26
vanco AE's
1) nephrotoxic 2) ototoxic 3) thrombophlebitis 4) diffuse flushing/red man syndrome
27
how do you prevent red man syndrome?
Pretreat with antihistamines + slow infusion rate.
28
vanco resistance mechanism
amino acid modification of D-ala D-ala to D-ala D-lac
29
bactericidal protein synthesis inhibitor?
ahminoglycosides, linezolid is variable
30
peptidyl transferase function
Forms peptide bonds between adjacent amino acids using tRNAs during translation.
31
amino glycoside mechanism
1) irreversible inhibition of initiation complex through 30s binding 2) can cause misreading of mRNA 3) also block translocation
32
antibiotic used for bowel surgery?
neomycin
33
amino glycoside use?
severe gram negative rods. synergistic with beta-lactams
34
other aminoglycoside AE?
neuromuscular blockade
35
main concern for ototoxicity with ahminoglycosides?
when combined with loop diuretics
36
amino glycoside mechanism of resistance?
acetylation, phosphorylation, or adenylation
37
other things that interact with tetracyclines?
iron-containing preparations
38
tetracycline for use in renal failure?
doxycycline (fecally eliminated)
39
tetracyclines and CNS penetration?
limited
40
why are tetracyclines good at treating rickettsia and chlamydia?
can accumulate intracellularly
41
MOA of resistance to tetracyclines?
Decreased uptake or increased efflux out of bacterial cells by *plasmid encoded transport pumps.
42
chloramphenicol mechanism?
Blocks peptidyltransferase at 50S ribosomal subunit.
43
chloramphenicol uses
RMSF | Meningitis
44
Why are premies at increased risk of chloramphenicol induced aplastic anemia?
they lack UDP-glucoronyl transferase.
45
chloramphenicol MOA of resistance
*Plasmid-encoded* acetyltransferase inactivates the drug.
46
clindamycin MOA
blocks peptide transfer (*translocation) at 50S ribosomal subunit.
47
other clindamycin use...
invasive group A strep infection
48
clindamycin vs. metronidazole uses
clindamycin for anaerobes above the diaphragm, metro for below diaphragm
49
linezolid drug class
oxazolidinones
50
linezolid MOA
Inhibit protein synthesis by binding to 50s subunit and preventing formation of the initiation complex.
51
linezolid AE's
1) bone marrow suppression (especially thrombocytopenia) 2) peripheral neuropathy 3) serotonin syndrome
52
Linezolid MOA of resistance
point mutation of ribosomal RNA
53
where do macrolides bind to?
23S rRNA of 50S ribosomal subunit
54
CYP450 inhibitor macrolides?
clarithromycin and erythromycin
55
macrolide MOA of resistance?
methylation of 23s rRNA binding site prevents drug binding.
56
macrolides AE's
``` gastrointestinal motility issues arrhythmia/QT prolongation acute cholestatic hepatitis rash eosinophilia ```
57
migratory thrombophlebitis?
Vein inflammation related to recurrent thrombus formation in different locations.
58
How does migratory thrombophlebitis present?
Redness and tenderness on palpation of extremities.
59
phlebitis
vein inflammation

STEP (85 decks)

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