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NAPLEX 21 > ID I: Beta-lactams COPY > Flashcards

ID I: Beta-lactams COPY Flashcards

1
Q

As a class, penicillins are NOT active against

A

MRSA or atypical organisms

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2
Q

Natural penicillins coverage

A

Gram positive cocci (streptococci and enterococci, NOT staphylococci)

Gram positive anaerobes (mouth flora)

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3
Q

Aminopenicillins coverage

A

Gram positive cocci (streptococci and enterococci)

Gram positive anaerobes (mouth flora)

Gram negative bacteria (Haempaphilus, Neisseria, Proteus, E.coli

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4
Q

Aminopenicillins + beta lactamase inhibitors

(clavulaunte, sulbactam, tazobactam) have activity against:

A

MSSA

more resistant strains of gram-negative (HNPEK)

gram negative anaerobes (B. fragilis)

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5
Q

Extended-spectrum penicillins combined with a beta-lactamase inhibitor (pip/tazo) = coverage

A

BROAD!!!!

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6
Q

What do ESBLs cover?

A

Gram positive (MSSA, streptococci, enterococci)

Gram positive mouth flora

mores resistant strains of HNPEK

Gram negative anaerobes (B. fragilis)

PLUS

CAPES & pseudomonas aeruginosa

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7
Q

What organisms are in CAPES

A

citrobacter

acinetobacter

providencia

enterobacter

serratia

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8
Q

Antistaphylococcal penicillins cover

A

streptococci

enhanced activity against MSSA

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9
Q

What are the natural penicillins?

A

Pen V potassium

Pen G Benzathine (Bicillin L-A) - IM

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10
Q

What are the aminopenicillins?

A

Amoxicillin

Amox/Clav

Ampicillin (NS)

Ampicillin/Sulbactam (NS)

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11
Q

What are the Extended spectrum penicillins?

A

Pip/Tazo - INJ

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12
Q

The antistaphylococcal penicillins?

A

Dicloxacillin - PO

Nafcillin - INJ

Oxacillin

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13
Q

The preferred agent for MSSA soft tissue, bone and joint, endocarditis and bloodstream infections?

A

anti staphylococcal penicillins

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14
Q

Which penicillin is a vesicant?

A

nafcillin

cold packs & hyaluronidase if extravasation occurs

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15
Q

What drug can increase levels of beta lactams by interfering with renal excretion?

A

probenecid

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16
Q

What is the exception of administering penicillins in those that have a beta-lactam allergy?

A

pregnant patients with syphilis

*desensitize and treat with benzathine penicillin

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17
Q

All penicillins increase the risk of … if accumulation occurs

A

SEIZURES

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18
Q

First line treatment for strep throat and mild non purulent skin infections (no abscess)

A

PenVK

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19
Q

First line treatment for acute otitis media (80-90mg/kg/day)

A

Amoxicillin

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20
Q

Drug of choice for infective endocarditis prophylaxis before dental procedures (2g PO x1 30-60 mins before procedure)

A

amoxicillin

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21
Q

First line treatment for acute otitis media (90mg/kg/day) and for sinus infections (if an antibiotic is indicated)

A

amox/clav (augmentin)

lowest dose of clav to reduce diarrhea

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22
Q

Drug of choice for syphillis

A

Pen G benathine (Bicillin L-A) 2.4 million units IM x1

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23
Q

Only penicillin active against pseudomonas

A

Pip/Tazo (Zosyn)

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24
Q

Cover MSSA only, no renal adjustment needed

A

Dicloxacillin, Oxacillin, Nafcillin

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25
Q

As a class, cephalosporins are not active against…

A

Enterococcus or atypical organisms

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26
Q

First generation coverage:

A

gram-positive cocci (streptococci, staphylococci)

if cephalosporin used for MSSA, first generation is it

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27
Q

Second generation (cefuroxime) coverage:

A

staphylococci

more resistant strains of S. pneumoniae

plus HNPEK

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28
Q

Second generation coverage (cefotetan, cefoxitin) coverage:

A

staphylococci

more resistant strains of S. pneumoniae

plus HNPEK

Gram-negative anaerobes (B. fragilis)

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29
Q

Third generation coverage (ceftriaxone, cefotaxime)

A

more resistant streptococci (S. Pneumoniae and viridian’s group streptococci)

staphylococci (MSSA)

Gram positive anaerobes (mouth flora)

More resistant strains of HNPEK

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30
Q

Third generation coverage (ceftazidime)

A

LACKS gram positive

*covers pseudomonas

31
Q

ceftazadime/avibactam and ceftolozane/tazobactam have added activity against..

A

MDR pseudomonas and other MDR gram negative rods

32
Q

Fourth generation coverage (cefepime)

A

broad gram negative activity (HNPEK, CAPES, pseudomonas)

(+ similar gram pos activity to ceftriaxone:

more resistant streptococci (S. Pneumoniae and viridian’s group streptococci)

staphylococci (MSSA)

Gram positive anaerobes (mouth flora))

33
Q

Fifth generation (ceftaroline) coverage:

A

~HNPEK (meh gram negative)

but broad gram positive activity, covers MRSA

34
Q

What cephalosporin has broad gram negative activity?

A

cefepime

*covers pseudomonas too!

35
Q

What cephalosporin has broad gram positive activity?

A

ceftaroline
*covers MRSA
first gen
*covers MSSA

36
Q

Brand: Ancef

A

generic: cefazolin

37
Q

Brand: Keflex

A

generic: cephalexin

PO: 250-500mg PO Q6-12H

38
Q

Brand: cefuroxime

A

generic: ceftin

39
Q

Brand: Cefotetan

A

generic: cefotan

40
Q

Brand: Fortaz

A

Generic: ceftazidime

41
Q

Brand: Maxipime

A

generic: cefepime

42
Q

Brand: Teflaro

A

generic: ceftaroline fosamil

43
Q

Cefazolin

Cephalexin

A

first gen

44
Q

Cefuroxime
Cefotetan
Cefoxitin

A

second gen

45
Q

Cefdinir
Ceftriaxone
Cefotaxime

A

3rd generation group 1

46
Q

Ceftazidime

A

3rd generation group 2

47
Q

cefepime

A

4th generation

48
Q

ceftaroline

A

5th generation

49
Q

What is the contraindication of ceftriaxone?

A

do not use in hyperbilirubienmic neonates

OR concurrent use in calcium containing IV products in neonates <28 days old

50
Q

Which cephalosporin has a side chain that increases bleeding and causes a disulfiram-like reaction with alcohol?

A

cefotetan

51
Q

Side effects of cephalosporins

A

seizures with accumulation

52
Q

Due to small risk of cross-reactivity do not choose a cephalosporin on the exam if a patient has a penicillin allergy EXCEPT FOR WHEN:

A

pediatric patients with acute otitis media

53
Q

Patient has skin infection (MSSA) and strep throat.. which generation is best?

A

first! cephalexin

54
Q

acute otitis media

CAP

sinus infection

A

2nd gen: cefuroxime

55
Q

first line CAP

A

3rd generation: cefdinir

56
Q

Surgical prophylaxis

A

1st gen cefazolin

57
Q

anaerobic coverage (B. fragilis)

A

2nd gen: Cefotetan and cefoxitin

58
Q

surgical prophylaxis with colorectal procedures

A

2nd gen: Cefotetan and cefoxitin

59
Q

CAP, meningitis, SBP, pyelonephritis

A

3rd gen: ceftriaxone and cefotaxime

60
Q

cephalosporins that are active against pseudomonas

A

ceftazidime and cefepime

61
Q

Used for MDR gram negative organisms (including pseudomonas)

A

ceftolozane/tazo

and

ceftazidime/avibactam

62
Q

only beta lactic active against MRSA

A

ceftaroline

63
Q

Drug of choice in ESBL-producing organisms

A

carbapenems

64
Q

All carbapenems cover pseudomonas except

A

ertapenem

65
Q

What do carbapenems not cover?

*caution with drugs that are used for seizure control!!!

A

atypicals

VRE

MRSA

C diff

stenotrophomonas

66
Q

Ertapenem does not cover:

A

PEA

pseudomonas

acinetobacter

enterococcus

67
Q

moderate-severe diabetic foot infection treatment

A

carbapenem (erta)

68
Q

empiric therapy when resistant organisms are suspected

A

carbapenems

69
Q

Resistant pseudomonas or acinetobacter infections

A

carbapenems (not erta)

70
Q

Brand: Merrem

A

generic: meropenem

71
Q

Brand: Ivanz

A

generic: ertapenem

72
Q

This beta lactic can be used in a penicillin allergy

A

monobactam

73
Q

Aztreonam coverage

A

gram negative (including pseudomonas)

NO gram- positive or anaerobic activity*

74
Q

Brand: Azactam

A

generic: aztreonam

NAPLEX 21 (60 decks)

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