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Pharmacology Second > L10+11 - Cell Wall Inhibitors > Flashcards

L10+11 - Cell Wall Inhibitors Flashcards

1
Q

State all old generation penicillins, their β-lactamase inhibitor, and their combination name

A

Amoxicillin - Clavulanic acid (Amoxiclav)
Ampicillin - Sulbactam (Sultamicillin)
Piperacillin - Tazobactam (Tazocin)

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2
Q

Brand name of Amoxiclav

A

Augmentin

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3
Q

Brand name of Sultamicillin

A

Unasyn

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4
Q

Brand name of Tazocin

A

Zosyn

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5
Q

State all new generation of penicillins and their β-lactamase inhibitors

A

Ceftazidime - Avibactam
Meropenem - Vaborbactam
Imipenem - Relebactam

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6
Q

Which gram +ve bacteria can modify their PBP sites?

A

MRSA & Enterococci

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7
Q

Which penicillin isn’t affected by food intake?

A

Amoxicillin

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8
Q

Which penicillin is not excreted by kidneys?

A

Ceftriaxone

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9
Q

Management of gas gangrene

A

1) Clean area
2) Administer 20M units of Penicillin G
3) Clindamycin daily

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10
Q

Causative agent of gas gangrene?

A

Clostridium Perfringens

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11
Q

RoA of Penicillin G

A

IV (not IM); IM painful w/o anesthesia

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12
Q

Duration of Action of Penicillin G

A

Very short - 30 mins

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13
Q

Causative agent of necrotizing fasciitis?

A

Streptococcus pyogenes

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14
Q

Management of necrotizing fasciitis

A

1) Clean area
2) Administer 20M units of Penicillin G
3) Clindamycin daily

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15
Q

Causative agent of cellulitis

A

Staphylococcus aureus & Streptococcus pyogenes

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16
Q

Management of cellulitis

A

IV 20M units of penicillin G

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17
Q

Causative agent of actinomycosis

A

Actinomyces israelii

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18
Q

Management of actinomycosis

A

IV 20M units of penicillin G

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19
Q

What is procaine

A

Local anesthetic

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20
Q

Why is procaine sometimes coupled with penicillin G?

A

LA allows for IM injection
Acts as reservoir for drug; ↑ Duration of action (20 hours)

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21
Q

Why is procaine penicillin G never administered IV?

A

Blocks Na+ channels of heart; arrhythmia
May cause other symptoms like dizziness/headache/seizures; due to rapid liberation of procaine toxicity

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22
Q

Why is benzathine administered with penicillin G?

A

Increases its absorption and slows its release; ↑ Duration of action (4 weeks)

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23
Q

Why is benzathine never administered IV and always IM?

A

Benzathine is associated with cardiopulmonary arrest = death

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24
Q

What is benzathine penicillin G indicated for? With what doses?

A

Syphilis (2.4M units once every 1 week) & Rheumatoid Arthritis (1.2M units every 1 month)

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25
Q

RoA of penicillin V

A

The only natural penicillin given ORALLY

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26
Q

Indication of penicillin V

A

Group A Streptococcus Tonsillitis & Pharyngitis (given penicillin V orally every 4 hrs)

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27
Q

Management of superinfection caused by penicillin

A

Rehydrate pt
Discontinue penicillin with other drugs

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28
Q

How does ampicillin cause superinfection?

A

Not well absorbed; stays in GIT; kills normal flora; allows Clostridium difficile to grow; causes Pseudomonas colitis

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29
Q

Indication of ampicillin

A

Listeriosis
Shigellosis (Bacillary dysetnery)
Neonatal meningitis
Infective endocarditis
UTIs

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30
Q

Management of listeriosis

A

Administer IV Sultamicillin (2g every 6 hrs) with Gentamycin
OR
TMP/SMX in penicillin allergy

31
Q

Management of shigellosis

A

Administer IV Sultamicillin (1g every 6 hours for 5 days) OR TMP/SMX in penicillin allergy

32
Q

Management of neonatal meningitis

A

Empirical therapy with IV Sulatmicillin (1g every 6 hrs) with Cefotaxime

33
Q

Causative agent of neonatal meningitis

A

Listeria monocytogenes

34
Q

Causative agent of infective endocarditis

A

Enterococcus faecalis

35
Q

Management of infective endocarditis

A

IV Sultamicillin (2g every every 6 hrs) with (Gentamycin or Ceftriaxone)

36
Q

Causative agent of UTIs

37
Q

Management of UTIs

A

IV or Oral Sultamicillin (2g every 6 hrs)

38
Q

Management of otitis media

A

Oral suspension amoxiclav (2.66mg/day or 4.27ml/day) three times a day

39
Q

Causative agent of otitis media

A

Haemophilus influenzae

40
Q

Causative agent of community-acquired pneumonia

A

Streptococcus pneumonia & Haemophilus influenzae (H. influenzae main causative)

41
Q

Management of community-acquired pneumonia

A

Oral amoxiclav (3 times a day)

42
Q

Causative agent of impetigo

A

Streptococcus pyogenes & Staphylococcus aureus

43
Q

Management of impetigo

A

Oral amoxiclav (3 times a day) with topical ointment eg. Mupirocin or Fusidic acid

44
Q

Causative agent of peptic ulcer

A

Helicobacter pylori

45
Q

Management of peptic ulcers

A

Triple therapy:
PPIs
Clarythromycin
Amoxicillin or Metronidazole

46
Q

Prevention drug against infective endocarditis before dental surgery for pt with prosthetic valves

A

Amoxicillin

47
Q

First line drug for acute sinusitis

A

Amoxicillin

48
Q

Anti-staphylococcal aminopenicillins

A

Methicillin
Cloxacillin
Flucloxacillin

49
Q

Main anti-pseudomonal penicillin + β-lactamaase inhibitor + RoA

A

Piperacillin with Tazobactam given IV

50
Q

Causative agent of bacteremia

A

Pseudomonas aeruginosa & E. coli

51
Q

Management of bacteremia

A

IV Piperacillin with tazobactam

52
Q

Causative agent of pneumonia of gram -ve

A

Pseudomonas aeruginosa & Klebsiella pneumoniae

53
Q

Managemet of pneumonia of gram -ve

A

IV Piperacillin with tazobactam

54
Q

Causative agent of bacterial peritonitis

A

Pseudomonas aeruginosa & bacteroids fragilis

55
Q

Management of bacterial peritonitis

A

IV Piperacillin with tazobactam

56
Q

Causative agent of Nosocomial complicated UTIs

A

Pseudomonas aeruginosa & Enetrococcus faecalis

57
Q

Management of Nosocomial complicated UTIs

A

IV piperacillin (pores in bacterial CW) with tazobactam & gentamicin (enter through these pores) given in different sites & IV syringes → piperacillin (-) and gentamicin (+) → combining causes inactive complex to form

58
Q

Management of anaphylactic shock in cases of penicillin allergy

A

Maintain airways
Epinephrine (IM)
Antihistamines
Hydrocortisone (immunosuppressant)

59
Q

Cephalosporins are ineffective against which MOs?

A

MRSA (except 5th gen)
Atypical bacteria (eg. Mycoplasma/Chlamydia/MTB)
Listeria spp. & Legionella
Enterococcus
Clostridia spp.

60
Q

Penicillins are ineffective against which MOs?

A

Strep pneumonia
N. gonorrhea
Staph aureus
E. coli
H. influenza
P. aeruginosa

61
Q

1st Generation cephalosporins

A

Cephalexin
Cefazoline

62
Q

Indications of cephalexin

A

Pharyngitis
Mild G+ve UTIs

63
Q

Cephalexin RoA

64
Q

Indications of cefazoline

A

Pre-operative prophylaxis
Infective Endocarditis & Bacteremia
Prophylaxis against S. pneumonia

65
Q

Causative agent of preoperative prophylaxis

A

MSSA & S. pyogenes

66
Q

Causative agent of infective endocarditis & bactereima

A

S. pyogenes & MSSA

67
Q

2nd gen cephalosporins

A

Cefaclor
Cefoxitin & Cefotetan
Cefuroxime

68
Q

Cefaclor RoA

69
Q

Spectrum of 1st gen cephalosporins

A

G+ve: S. pyogenes / S. aureus / S. pneumonia

70
Q

Spectrum of 2nd gen cephalosporins

A

G+ve Bacteria
G-ve: H. flu / E. coli

71
Q

Indications of cefoxitin & cefotetan

A

Pre-operative gynecological prophylaxis → S. epidermis
Peritonitis → Bacteroids fragilis

72
Q

Indications of cefurixime

A

Community Acquired Pneumonia → S. pneumonia & H. flu
Otitis media → H. flu
Septicemia → E. coli

73
Q

Cefazoline Adverse effects

A

Reduces coagulation with its anti-vitamin K → causes bleeding
Measure INR

Pharmacology Second (14 decks)

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