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Pharm Summer A > Kaplan- Antibacterial Agents > Flashcards

Kaplan- Antibacterial Agents Flashcards

1
Q

Which organism is treated with the synergistic regimen of penicillins + amino glycosides

A

Enterococci or Pseudomonas aeruginosa

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2
Q

Example of antagonistic effect = Penicillins + ______ to treat _____.

A

tetracyclines ; pneumococcal meningitis

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3
Q

Penicillins are ________ of cell wall synthesis.

A

bactericidal inhibitors

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4
Q

mechanism of resistance w. penicillin

A

Penicillinase (beta-lactamases) break lactam ring structure
Structural cahngs in PBPs
Change in porin structure

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5
Q

Penicillin Resistance to this organism? is caused by penicillinases (beta-lactamases) breaking lactam ring structure

A

Staphylococci

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6
Q

Penicilin Resistance to this organism? is caused by structural change in PBPs

A

methicillin-resistance Staphylococcus aureus [MRSA] , penicillin-resistant pneumococci

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7
Q

Penicillin REsistance to this organism? is caused by change in porin structure

A

Pseudomonas

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8
Q

Penicillin G active verses

A
  1. Streptococci
  2. Pneumococci (increased resistance)
  3. Meningococci
  4. Treponema pallidum
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9
Q

Penicillin V active verses

A

Steptococci

oral pathogens

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10
Q

oral, or IV extended spectrum penicillin

A

Ampicillin

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11
Q

oral extended spectrum penicillin

A

Amoxicillin

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12
Q

What are the extended spectrum penicillin antibiotics formulated w.

A

(ampicillin or amoxicillin) with clavulanic acid or sulbactam

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13
Q

Ampicillin and Amoxicillin active verses

A

Gram + cocci (except MRSA)
E. Coli
H. influenzae

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14
Q

What is Ampicillin active against that amoxicillin is not

A

Listeria monocytogense

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15
Q

Amoxicillin is also used for back up drug in _____ and to eradicate ______

A

Lyme disease

H. pylori in GI ulcers

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16
Q

increased activity verses gram negative rods compared to the other pencillins

A

Ticarcillin (Ticar)

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17
Q

Ticarcillin (Ticar) is active verses

A

Psudomonas aeruginosa and other gram - rods

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18
Q

How is activity of Ticarcillin enhanced

A

penicillinase inhibiors clavulanic acid or tazobactam

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19
Q

Timentin is what combo

A

Ticarcillin + clavulanate potassium

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20
Q

penicillin + aminogycosides is active verses

A

enterococci and psudomonal species

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21
Q

how are most penicillins secreted? half life?

A

active tubular secretion w. half life < 60 min

22
Q

Which penicillins are largely eliminated in bile?

A

Nafcillin and oxacillin

23
Q

Which penicillin undergoes enterohepatic cycling, but is excreted by kidneys?

A

Ampicillin

24
Q

which penicillin is a repository form w. a half life of 2 wks?

A

Benzathine penicillin G

25
Q

When is dose reduction needed w. penicillins?

A

major renal dysfunction

26
Q

Common adverse effects of penicillins

A

Urticarial skin rash

severe anaphylaxis is possible

27
Q

Common side effete of methicillin

A

Interstitial Nephritis

28
Q

T/F Assume complete cross-allergenicity between individual penicillins

A

true

29
Q

GI distress (NVD) is especially assoc with what penicillin

A

ampicillin

30
Q

What is a common reaction in treatment of syphilis

A

Jarish-Herxheimer reaction

31
Q

What is common adverse effect of ampicillin

A

maculopapular rash

32
Q

common adverse effect of methicillin

A

interstitial nephritis

33
Q

Name 3 first generation Cephalosporins

A

Cefadroxil (Duricef)
Cefazolin (Ancef, Kefzol)
Cephalexin (Keflex)

34
Q

What do first generation cephalosporins protect against

A

Gram + Cocci (except MRSA)
E. coli
Klebsiella pneumoniae
some proteus species

35
Q

common use of cephalosporins is

A

surgicla prophylaxis

36
Q

which cephalosporins enter the CNS

A

NONE

37
Q

Second generation cephalosporins active verses

A

increased gram - coverage including some anaerobes

38
Q

Bacteroidesfragilis is covered w. which cephalosporin

A

Cefotetan (Cefotan)

39
Q

H. influenzae & Moraxella entarrhalis is covered by which cephalosporin

A

Cefaclor

40
Q

Third generation cephalosporins active verses

A

gram + & gram - cocci, plus many gram - rods

41
Q

Which third generation cepaholsporin does NOT enter the CNS?

A

cefoperazone

42
Q

What are 3rd generation cephalosporins important in empire management of

A

meningitis and sepsis

43
Q

treatment of gonorrhea

A

ceftriaxone (Rocephin) (IM) and cefixime (Suprax) (PO) used in single dose

44
Q

cephalosporin active against most most bacteria causing meningitis

A

cefotaxime (Claforan)

45
Q

3rd generation Cephalosporin active agianst B. fragilis

A

Ceftizoxime (Cefizox)

46
Q

name what most Fourth gerneation cephalosporins active against also name a specific antibiotic in this class

A

resistant to most beta-lactamases - Cefepime (IV)

47
Q

Cephalosporins renal clearance similar to penicillins, with active tubular secretion blocked by ______.

A

probenecid

48
Q

Dose modification in renal dysfunction, except _____ & _____, which is largely eliminated in the bile.

A

Cefoperazone & Ceftriaxone

49
Q

Most authorities recommend avoiding cephalosporins in patients allergic to penicillins. For gram + organisms recommend _____.
For gram - rod organisms recommend _____.

A

+ macrolide

- rods aztreonam

50
Q

Cefotetan, Cefoperazone, Cefamandole, Moxalactam cause

A

Hypoprothrombinema

& disulfiram-like-interactions w. ethanol

51
Q

Adverse effect of IV injection of cephalosporins

A

phlebitis

52
Q

IM adverse effect of cephalosporins

A

pain

Pharm Summer A (4 decks)

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