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ID > Pharm: Cell wall synthesis inhibitors > Flashcards

Pharm: Cell wall synthesis inhibitors Flashcards

1
Q

What are the five types of penicillins?

A
  1. Penicillin G
  2. Aminopenicillins
  3. Anti-staph
  4. Anti-pseudomonas
  5. Combo with beta-lactamase
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2
Q

What are the components of augmentin?

A

amoxicillin and clavulanate

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3
Q

What are the components of unasyn?

A

ampicillin and sulbactam

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4
Q

What are the components of zosyn?

A

piperacillin and tazobactam

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5
Q

What property makes nafcillin and dicloxacillin good for most staph?

A

It has resistance to the beta lactamase produced by s. aureus

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6
Q

What is piperacillin good for?

A

pseudomonas, klebsiella and other GRAM NEGATIVE RODS.

NOT effective against MRSA

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7
Q

Is piperacillin resistant to beta lactamase?

A

No, it’s degraded

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8
Q

What is penicillin G good for?

A

Strep (pharyngitis/pneumonia/meningitis/endocarditis), enterococcus, meningococcus, and syphilis. Also oral/dental infections. Also to prevent GAS rheumatic fever

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9
Q

What does the procaine suspension of penicillin do?

A

IM, lasts 1-2 days

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10
Q

What does the benzathine suspension do?

A

IM, lasts for 1-4 WEEKS!

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11
Q

What is the formulation of ampicillin?

A

IV/PO

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12
Q

What is the formulation of amoxicillin?

A

ONLY po (it’s got an O in the name!)

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13
Q

When would you use ampicillin?

A

otitis media, neonatal sepsis, URI

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14
Q

What does amoxicillin have that ampicillin does not?

A

amoxicillin has more oral availability and a wider spectrum. It’s also less likely to cause diarrhea

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15
Q

Which tx for MSSA is oral/IV?

A

dicloxacillin is oral

Nafcillin and oxacillin are IV and for more serious infections

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16
Q

Which one of the MSSA drugs is NOT effective against gram - rods?

A

nafcillin

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17
Q

What form does piperacillin come in?

A

IV ONLY

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18
Q

What are the beta lactams not that good for?

A

The SPACEK creatures

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19
Q

Why don’t we use methacillin anymore?

A

Because it causes allergic interstitial nephritis

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20
Q

What’s different about the structure of monobactams (aztreonam)?

A

It only has one ring and is less likely to cause an allergic cross reaction

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21
Q

Why do cephalosporins have a wide spectrum?

A

Resistant to beta lactamases

22
Q

What do cephalosporins NOT cover?

A

enterococcus and listeria

23
Q

What do first generation cephalosporins cover?

A

staph and strep

24
Q

What do later generation cephalosporins cover?

A

GNR

25
Q

What is the name of the first generation cephalosporin?

A

cefazolin

26
Q

What does cefazolin cover?

A

Strep and Staph. Good for UTIs (covers some E coli), and surgical prophylaxis

27
Q

What form does cefazolin come in?

A

Not PO! But cephalexin is PO

28
Q

When would you use ceftriaxone?

A

MENINGITIS, also serious pneumonia

29
Q

Which bugs do ceftriaxone cover?

A

Strep (most common cause of meningitis)
Strep pneumo (serious pneumonia)
Can also cover MSSA and GNRs

30
Q

What is the other 3rd gen cephalosporin?

A

Ceftazidine

31
Q

When would you use ceftazidine?

A

It’s better at GNR and PSEUDOMONAS***

32
Q

Patients who are given cephalosporins are at increased risk of getting what infections?

A

fungal infections

33
Q

What is the broadest spectrum Abx we have?

A

meropenem

34
Q

What does meropenem not cover?

A

MRSA. Covers GPC, GNR, pseudomonas

35
Q

What type of situation would we want to use meropenems for?

A

abdominal infections

36
Q

What does aztreonam cover?

A

Aerobic, GNR (E coli and pseudomonas)

37
Q

What situations would you use aztreonma?

A

UTI or intraabdominal infection. However, coverage is pretty narrow so you need to be sure that the infection is only from aerobic GNRs!

Think SPACEK

38
Q

Describe the structure of vancomycin. How does this work?

A

No beta lactam ring–huge structure

–It inhibits cell wall cross linking by altering COOH of D-ala-D-ala

39
Q

When would you use vancomycin acid from MRSA?

A

Coagulase negative staph
enterococcus
strep pneumo that’s resistant
C difficile (po)

40
Q

What is a serious contraindication to daptomycin?

A

pneumonia–interferes with surfactant in lungs

Also, don’t use with a statin

41
Q

What is a side effect of daptomycin?

A

myopathy

42
Q

In what formulation does daptomycin come

A

IV only

43
Q

What is best for enterococcus?

A

penicillin. Much better than cephalosporins

44
Q

What do you use for listeria?

A

Ampicillin or penicillin

45
Q

When would you use cefazolin?

A

strep/staph covered but also oral anaerobes and GNR: use in abdominal infections

46
Q

Are cephalosporins effective in MRSA?

A

NO

47
Q

Why do you add vancomycin to the empiric treatment of strep pneumo?

A

Because 10% of pneumococcus is resistant to ceftriaxone

48
Q

What is the only cephalosporin that we can use for MRSA?

A

cefarolin(5th generation)

49
Q

What do you use to treat N. Meningitidis?

A

Penicillin G–it has excellent penetration of the CSF

50
Q

Side effect of vanc?

A

red man syndrome, with large release of histamine. Need to infuse slowly over 60 minutes

51
Q

When would you use Daptomycin?

A

Drug of last resort in VRE

ID (24 decks)

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