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Penicillins Flashcards

1
Q

What is the MOA of PCN?

A

-Inhibit cell wall synthesis
-Beta-lactam d/t beta lactam rings

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2
Q

Is PCN bactericidal or bacteriostatic?

A

bactericidal

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3
Q

What is the resistance of pcn?

A

-Gram negative outer membrane
-Penicillinases - beta lactamases
-Altered pcn binding code decreases affinity to PBP ( ex: MRSA)

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4
Q

What is the bacterial genetic code that decreases affinity to PBP?

A

MRSA

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5
Q

Name two narrow spectrum antibiotics of PCN?

A

PCN V and PCN G

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6
Q

What gram is PCN V and PCN G?

A

gram +

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7
Q

What gram + bacteria does PCN V and PCN G have?

A

streptococcus ( group A strep) , Neisseria gonorrhea

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8
Q

Is narrow spectrum PCN V and PCN G penicillinase sensitive?

A

YES

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9
Q

Which PCN is anti-staph?

A

dicloxacillin, nafcillin

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10
Q

Which PCN is penicillinase-resistant?

A

dicloxacillin, nafcillin

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11
Q

What gram is dicloxacillin, nafcillin?

A

Gram + and gram -

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12
Q

Which staph is dicloxacillin, nafcillin?

A

staph aureus

Gram + and gram -

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13
Q

Which PCN is broad spectrum?

A

Aminopenicillins

Ampicillin ( Polycillin)
Amoxicillin (Amoxil)

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14
Q

Uses:
Acute sinusitis
strep pharyngitis
cellulitis
acute otitis media
uncomplicated uti

A

Aminopenicillins

Ampicillin ( Polycillin)
Amoxicillin (Amoxil)

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15
Q

What gram is Aminopenicillins-
Ampicillin ( Polycillin) and Amoxicillin (Amoxil)

A

Gram + and increased gram - activity

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16
Q

who has this bacteria?

Haemophiles (H. flu), E. coli, proteus Mirabellis, enterococcus, Neisseria

A

Ampicillin ( Polycillin) and Amoxicillin (Amoxil)

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17
Q

What is a potential AE for PCN?

A

hives, itching, rash, bronchospasm (anaphylaxis)

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18
Q

What do you ask a patient about pcn allergy?

A

What was the allergic reaction?

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19
Q

What category is pcn?

A

category B

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20
Q

which pcn is extended spectrum?

A

piperacillin (Zosyn)

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21
Q

where is piperacillin ( Zosyn) given?

A

acute care IV

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22
Q

which antibiotic is antipseudomonal?

A

piperacillin (Zosyn)

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23
Q

uses:
pyelonephritis, cellulitis, pneumonia

A

piperacillin (Zosyn)

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24
Q

who has this bacteria?

proteus Mirabellis, enterococcus, Neisseria, pseudomonas aeruginosa, Enterobacter

A

piperacillin (Zosyn)

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25
what is the step up antibiotic?
amoxicillin/ clavulanic (Augmentin) and ampicillin/sulbactam (UNASYN)
26
what is combined with beta lactamase inhibitor?
amoxicillin/ clavulanic (Augmentin) and ampicillin/sulbactam (UNASYN)
27
why is amoxicillin/ clavulanic (Augmentin) and ampicillin/sulbactam (UNASYN) used?
to combat resistance
28
What MOA is tetracycline?
-inhibit BACTERIAL protein synthesis -Bacteriastatic
29
is tetracycline bacteriostatic or bactericidal?
bacteriostatic
30
what gram spectrum is tetracycline?
gram + and gram - and atypical
31
what are the names of antibiotics for tetracycline?
Tetracycline Doxycycline (vibramycin)(vibramycin) minocycline (minocin)
32
what does the pt avoid while taking tetracycline?
dairy, ca, mg, antacids, iron supplements
33
what serious Ae does tetracycline have?
permanent teeth staining and photosensitivity.
34
what are the drug-drug interactions does tetracycline? have?
COC anticoagulants digoxin theophylline
35
what uses are for tetracycline?
respiratory infections skin infections (acne) PID Lyme disease CA-MRSA
36
what antibiotic does a person with Lyme disease take?
Doxycycline (Vibramycin)
37
how is the antibiotic tetracycline administered?
PO
38
how is Doxycycline (Vibramycin) administered?
PO, IV
39
How is minocycline (minocin) administered?
PO
40
what antibiotic does someone with acne take?
tetracycline
41
what spectrum is tetracycline?
broad spectrum
42
what is contraindicated in tetracyclines?
pregnancy/lactating women and children under 8 yo
43
what MOA is macroslides?
inhibit bacterial PROTEIN synthesis bacteriostatic
44
what activity is macroslides?
gram + gram - Atypicals
45
what are the antibiotics of macroslides?
-erythromycin (prototype) -Azithromycin (Zithromax) -Clarithromycin (Biaxin)
46
how is erythromycin (prototype) administered?
PO/IV, multiple daily dosing
47
what AE does erythromycin (prototype) have?
more GI
48
-Azithromycin (Zithromax) Azithromycin (Zithromax) administered?
PO/IV, convenient once day dosing=more resistance
49
how is -Clarithromycin (Biaxin) administered?
PO
50
what inhibitor is -Clarithromycin (Biaxin)?
CYP450
51
what does -Clarithromycin (Biaxin) increase?
-Clarithromycin (Biaxin) increases plasma levels and AE of substrate
52
uses of macroslides?
-wide range of infections d/t spectrum of activity
53
one reason we use of Erythromycin?
Diphtheria
54
one reason we use Azithromycin?
-chlamydia -atypical pneumonia (Mycobacterium)
55
one reason we use Clarithromycin?
many deep respiratory infections (AOM, acute sinusitis
56
what serious AE does microslides have?
-QT prolongation -Ventricular dysrhythmias- (Torsade's de Pointes )
57
what other AE does macroslides have?
GI
58
what do we offer in a PCN allergic teenager with Group A strep?
Cephalosporin or Macroslides
59
what antibiotic for otitis media for first infection under 2yo? first line?
PCN Amoxicillin 80-90 mg/kg/day
60
what antibiotic for otitis media for antibiotic resistance toddler age less than 2yo?
Amoxicillin and clavulanate 80-90 mg/kg/day
61
what antibiotic for otitis media for antibiotic resistance toddler less than 2 yo and that has PCN allergy?
Cefdinir 14 mg/kg/day BID or Azithromycin 10mg/kg Day 1, then 5 mg/kg once daily x Days 2,3,4,5
62
what MOA id Lincosamide?
-Inhibits PROTEIN synthesis -Usually bacteriostatic
63
what activity is Lincosamide?
Gram - and Gram +
64
is Lincosamide an alternative to PCN?
yes
65
An example of a Lincosamide?
Clindamycin ( Cleocin)
66
How is Lincosamide Clindamycin ( Cleocin) administered?
PO/IV/IM/Topical its versatile
67
what uses does Lincosamide Clindamycin ( Cleocin) have?
-Group A strep -CA-MRSA -Acne
68
what AE does Lincosamide Clindamycin ( Cleocin) have?
-C.diff - Pseudomembranous cellulitis - limited use d/t serious AE
69
what groups of people is Lincosamide Clindamycin ( Cleocin) not good for?
elderly, frail, pediatrics, immunocompromised
70

Antibiotics (4 decks)

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