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Pharm Exam 2 Flashcards

1
Q

B-lactams - inhibitors of cell wall synthesis

A

Penicillins
Cephalosporins
Monobactams
Carbapenems

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2
Q

Other inhibitors of cell wall synthesis

A

Vancomycin
Phosphomycin
Bacitracin

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3
Q

Penicillin subgroups

A
  1. Natural Penicillins
  2. Penicillinase Resistant
  3. Extended Spectrum
  4. Antipseudomonal
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4
Q

Natural Penicillin

A

GOLD STANDARD for GRAM + infection

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5
Q

Penicillin G

A
  1. Natural Penicillin

IV, IM, Oral

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6
Q

Benzathine Penicillin

A
  1. Natural Penicillin

IM depot

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7
Q

Procaine Penicillin G

A
  1. Natural Penicillin

IM

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8
Q

Penicillin V

A
  1. Natural Penicillin

Oral

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9
Q

Nafcillin (Unipen)

A
  1. Penicillinase Resistant

IM/IV

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10
Q

Dicloxacillin (Cloxapen) and

Oxacillin (Prostaphlin)

A
  1. Penicillinase Resistant

Oral

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11
Q

Methicillin

A
  1. Penicillinase Resistant

Only used in testing

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12
Q

MRSA mechanism of resistance

A

CHANGES the actual PBP (penicillin binding protein) shape!! the bacteria is still there and ready to go, but it can’t bind to the PBP bc it has changed shape

Changes target

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13
Q

Natural Penicillins

A

Benzathine Penicillin
Procaine Penicilin G
Penicillin V

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14
Q

Penicillinase Resistant

A

Nafcillin
Dicloxacin
Oxacillin (Prostaphlin)
Methicillin

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15
Q

Extended Spectrum Penicillin

A

Amoxicillin

Ampicillin

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16
Q

Antipseudomonal Penicillin

A

Piperacillin

Ticarcillin

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17
Q

Drug of choice for Lysteria

A

Extended spectrum PCN

Ampicillin or Amoxicillin

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18
Q

Extended spectrum PCNs

A

Ampicillin

Amoxicillin

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19
Q

Drug of choice for Pseudamonas

A

Antipseudomonas PCN

always in combo with aminoglycoside- prevent resistance

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20
Q

Route of administration for Pseudomonal PCN

A

Parenteral only

acid sensitive, cant survive in stomach

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21
Q

Drug of choice for gram (-)

A

Extended coverage Penicillins

Ampicillin & Amoxicillin

22
Q

b-lactamase inhibitors

A

clavulanic acid, sulbactam, tazobactam

distracts (binds) the ring of b-lactamase so that the other drug can be effective

23
Q

main adverse rxn to Penicillin

A

Hypersensitivity rxn

24
Q

gram +

A

Pen G

Pen V

25
Advantage of Cephalosporins
7 methyl group increases their resistance to b-lactamase/penicillinase dont have to worry about penicillinase anymore
26
known for excellent CNS penetration
Ceftriaxone (Rocephin)
27
treat Neisseria
Ceftriaxone (Rocephin)
28
treat N. gonorrhoeae
Ceftriaxone (Rocephin)
29
contraindication to using Ceftriaxone in neonate
bilirubin displacement --> Pseudolithiasis | brain image
30
Cefepime (Maxipime) IV- 100% bioavaiability gram+ and gram- coverage
Phenomenal drug for empiric therapy for a very sick patient when you don't know what's going on Short term-when trying to keep patient alive
31
only beta-lactam against MRSA and VRSA reserved for MRSA and VRSA
Ceftaroline Fosamil (Teflaro)
32
Borrelia Burgdorferi (Lyme disease)
Ceftriaxone
33
E.Coli
1st or 2nd generation Cephalosporin
34
Neisseria Gonorrhoeae
Ceftriaxone (parenteral) or Cefixime (oral)
35
Penicillins that can have Beta-lactam inhibitors added to them
Ampicillin Amoxicillin Piperacillin Ticarcillin
36
Review of the Beta-lactam inhibitors | added to PCNs to keep the drug active
Clavulanic Acid Sulfbactam Tazobactam
37
Traits of Natural Penicillins: | Pen G, Pen V, Benzathine PCN, and Procaine PCN G
***Gold Standard for Gram (+) *** Pen G: IV, IM, Oral? Pen V: Oral Benzo and Procaine: IM
38
PCNase Resistant Penicillins: | Nafacillin, Dicloxacillin, Oxacillin, Methicillin
Drug of choice for MSSA and MRSA Hepatic metabolism and Renal excretion Nafcillin (used in life threatening instances): IV, IM, Unipen Dicloxacillin, Oxacillin: Oral Methicillin: testing only
39
Extended Spectrum Penicillins: Ampicillin, Amoxicillin
``` Extended gram (-) coverage **Drug of choice for Lysteria!!!** ``` Ampicillin, Amoxicillin: Oral
40
Antipseudomonal Penicillins: Piperacillin, Ticarcillin Cannot be taken orally bc they are acid sensitive
Used to treat same bacteria as Extended Spectrum, plus additional gram (-) *Major use: Pseudomonas Aeruginosa (with Aminoglycosides to prevent resistance) Other major use: Acinetobacter Piperacillin, Ticarcillin: Parenteral
41
5th Generation Cephalosporin
--taroline (IV)
42
5th Generation Cephalosporin
``` --taroline (IV) MRSA, MRSA, MRSA "odd duck" treats MRSA and VRSA Only beta-lactam that can cover MRSA ``` No antipseudomonal activity
43
4th Generation Cephalosporin
--epime (IV)
44
4th Generation Cephalosporin
--epime (IV) EMPIRIC DRUG of choice: covers Enterobacteria, MSSA, and Pseudomonas more resistant to some Beta-lactamases similar to 3rd gen
45
3rd Generation Cephalosporins
- -triaxone - -otaxime sodium - -tazadime - -ixime
46
3rd Generation Cephalosporins
Cefrtiaxone, Cefotaxime sodium, Ceftazidime- IM, IV Cefixime- Oral
47
3rd Generation Cephalosporins
Ceftriaxone: Neisseria Gonorrhea Ceftazidime w/Aminoglycosides: Pseudomonas Aeruginosa Ceftriaxone and Cefotaxime sodium: CNS penetration Contraindication: neonates- bilirubin displacement
48
2nd Generation Cephalosporins
- -aclor - -prozil - -uroxime
49
2nd Generation Cephalosporins
Cefaclor, Cefprozil (Oral) Cefuroxime (IV, IM) very similar to 1st gen (less gram +, more gram -, increased PCNase resistance)
50
1st Generation Cephalosporins
Cephalexin (Oral) Cefazolin (IV, IM) Cefazolin- Surgical Prophylaxis good against gram + alternate for PCN Allergies increased PCNase resistance

Quarter 2 (16 decks)

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