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Pharm exam 3 > Principles of Antibiotics > Flashcards

Principles of Antibiotics Flashcards

1
Q

Beta-Lactams

A
  • Penicillins
  • Cephalosporins
  • Carbapenems
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2
Q

Natural Penicillins

A
  • Penicillin VK

- Penicillin G

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3
Q

Aminopenicillins

A
  • Ampicillin
  • Amoxicillin
  • Anti-staph penicillin’s
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4
Q

Anti-staph penicillins

A
  • Methicillin
  • Nafcillin
  • Dicloxacillin
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5
Q

Penicillin-based antibiotics

A
  • Amoxicillin/clavulanate
  • Ampicillin/subactam
  • Piperacillin/tazobactam
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6
Q

Cephalosporins- First generation

A
  • Cefazolin

- Cephalexin

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7
Q

Cephalosporins-Second generation

A

Cefuroxime, cefoxitin

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8
Q

Cephalosporins- Third generation

A

Ceftriaxone, ceftazidime, cepodoxime

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9
Q

Cephalosporins-Fourth generation

A

Cefepime

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10
Q

Imipenem

A

Carbapenems

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11
Q

Meropenem

A

Carbapenems

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12
Q

Doripenem

A

Carbapenems

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13
Q

Ertapenem

A

Carbapenems

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14
Q

Monobactam

A

Aztreonam

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15
Q

Lipopeptides

A

Daptomycin

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16
Q

streptococcus- aerobic or anaerobic

A

Aerobic

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17
Q

staphylococcus-aerobic or anaerobic

A

Aerobic

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18
Q

E. Coli- aerobic or anaerobic

A

Aerobic

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19
Q

Klebsiella- aerobic or anaerobic

A

Aerobic

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20
Q

Enterobacter-aerobic or anaerobic

A

Aerobic

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21
Q

Pseudomonas-aerobic or anaerobic

A

Aerobic

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22
Q

Most common place to find streptococcus

A

Community pathogen

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23
Q

Most common place to find staphylococcus

A

Community or hospital

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24
Q

Most common place to find enterococcus

A

Community or hospital

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25
Q

Most common place to find Neiserria

A

Community

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26
Q

Most common place to find Escherichia (E. coli_

A

Community or hospital

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27
Q

Most common place to find Klebsiella

A

Community or hospital

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28
Q

Most common place to find Pseudomonas

A

Hospital

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29
Q

Most common place to find Enterobacter

A

hospital

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30
Q

Most common place to find Acinetobacter

A

Hospital

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31
Q

Most common place to find Serratia

A

Hospital

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32
Q

Most common place to find Citrobacter

A

Hospital

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33
Q

Most common place to find Bacgteroides

A

Community

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34
Q

Most common place to find Peptostreptococcus

A

Community

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35
Q

Empiric therapy

A
  • Initial antibiotic regimen that attempts to improve outcomes
  • No culture data yet….. educated guess
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36
Q

Definitive/Targeted therapy

A
  • Target specific pathogen –> modify regimen

- Minimize resistance, toxicity, improve cost-effectiveness

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37
Q

Prophylaxis

A

Administration of drug to prevent disease.

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38
Q

Epithelial cells on sputum gram stain report

A

skin cells in mouth. A lot of these means pt just coughed up spit, we need sputum from down in lungs. This usually means culture is not very good.

39
Q

PMNs on sputum gram stain report

A

Generally means bacterial infections

40
Q

Purple stain

A

Gram positive

41
Q

Pink stain

A

Gram negative

42
Q

what is MIC

A

Minimum inhibitory concentration

-Lowest concentration of antibiotic to show no growth of bacteria.

43
Q

The higher the breakpoint….

A

the harder to treat the bug.

44
Q

SIR, S=

A

Infection likely to respond

-MIC is less than the breakpoint

45
Q

SIR, I=

A

Response is indeterminate, may respond

-MIC is equal to the breakpoint

46
Q

SIR, R=

A

Therapy is likely to fail

-MIC is greater than the breakpoint.

47
Q

Common indications:
MSSA Cellulitis, bacteremia, joint infections, prosthetic device infections,
E.coli and Klebsiella uncomplicated urinary tract infections

A

First generation: Cefazolin, Cephalexin

48
Q

Common indications:
Otitis media or sinus infections
Prophylaxis for intra-abdominal surgery

A

Second generation: cefuroxime, cefoxitin

49
Q

Common indications:
Hospital-acquired pneumonia
Febrile neutropenia
-not good for gram positive

A

ceftazidime

50
Q

Common indications for:
Severe community-acquired pneumonia
Intra-abdominal infection (usually in combination with another drug that covers anaerobes)
Complicated urinary tract infections

A

ceftriaxone and cefuroxime

51
Q

Great coverage for strep:

A

Ceftriaxone/cefuroxime

Ceftriaxone: great 1st choice.

52
Q

Common Indications:
Febrile neutropenia
Hospital acquired or health-care associated pneumonia

-Also covers pseudomonas

A

Cefepime

53
Q

What does cefepime not cover?

A

Enterococcus faecalis, Bacteroides fragilis, VRE, and MRSA

54
Q

Common indications:

Intra-abdominal infections, diabetic foot infections

A

Ertapenem

55
Q

Which drug class may lower the seizure threshold?

A

Carbapenems

56
Q

Used for gram-negative coverage when beta-lacgam allergy

A

Aztreonam
Use when you can’t use zosyn.
Great for gram - bacteria and life threatening allergies.

57
Q

MOA: binds to D-Ala-D-Ala residue of peptidoglycan precursor at surface of cytoplasmic membrane (inhibits cell wall synthesis)

A

Vancomycin

58
Q

Spectrum: aerobic and anaerobic G(+) bacteria only

A

Vancomycin

59
Q

Clinical uses:

meningitis, endocarditis, cellulitis, bacteremia, HAP, osteomyelitis

A

IV vanco

PO Vance- C. diff.

60
Q

Red man syndrome may be seen with?

A

Vanco

61
Q

MOA: Binds to bacterial membrane causing rapid depolarization of membrane potential
Inhibits protein, DNA and RNA synthesis

A

Daptomycin

62
Q

Spectrum: aerobic and anaerobic G(+) bacteria only

- MRSA, VRE

A

Daptomycin

63
Q

binds to 50S ribosomal subunit, prevents protein synthesis

A

Macrolides (erythromycin, clarithromycin, azithromycin)

64
Q

Spectrum: G(+), selective G(-), atypicals

A

Macrolides (erythromycin, clarithromycin, azithromycin)

65
Q

MOA: inhibition of protein synthesis by binding to 30s ribosome subunit

A

Tetracyclines

66
Q

Spectrum: G(+), G(-), anaerobes, atypicals

A

Tetracyclines

67
Q

Great for ESBL organisms

A

Tigecycline

68
Q

MOA: Inhibit DNA-gyrase in bacteria, promote breakage of double-stranded DNA

A

Quinolones

69
Q

Spectrum:
G(-): Enterobacteriaceae, enteric pathogens
G(+): MSSA, some Strep
Atypicals: Legionella, Mycoplasma, Chlamydia

A

Quinolones

70
Q

Which quinolone is good for anti-pseudomonal bacteria?

A

Ciprofloxacin and levofloxacin

71
Q

Which quinolone is good for Respiratory organisms?

A

Moxifloxacin and levofloxacin

72
Q

Which quinolone is good for anaerobes?

A

Moxifloxacin

73
Q

Clinical uses: CAP, UTI (except moxifloxacin), ocular infections, intra-abdominal, prostatitis, prophylaxis in chemo-induced neutropenia

A

Quinolones

74
Q

MOA: Inhibits protein synthesis by binding to a site on the ribosomal RNA 50S subunit

A

Linezolid

75
Q

Spectrum: G(+) only

MRSA, VRE

A

Linezolid.

76
Q

MOA: binds to the 50S subunit preventing peptide-bond formation and inhibiting protein synthesis

A

Clindamycin

77
Q

Spectrum:
G(+): MSSA, MRSA, Strep spp
Anaerobes, protozoa (Plasmodium, Toxoplasma), incr resistance to B. fragilis
Not used: Enterococcus, Group D strep, G(-)

A

Clindamycin

78
Q

One of the worst drugs for the GI tract

A

Clindamycin

79
Q

Clinical uses: adjunct therapy in infections with toxin production (ex. Necrotizing fascitis), aspiration pneumonia

A

Clindamycin

80
Q

MOA: interferes with bacterial folic acid synthesis and growth via inhibition of dihydrofolate formation from PABA

A

Sulfamethoxazole

81
Q

MOA: inhibits dihydrofolate reduction to tetrahydrofolate, resulting in sequential inhibition of the folic acid pathway.

A

Timethroprim

82
Q

Spectrum
G(+): MSSA, MRSA, Strep spp, Listeria
G(-): Enterobacteriaceae, E. coli, H. influenzae, Stenotrophomonas
Does not cover: Pseudomonas

A

Sulfamethoxazole-Trimethoprim

83
Q

MOA: interacts with DNA causing a loss of helical DNA structure and strand breakage, resulting in inhibition of protein synthesis

A

Metronidazole

84
Q

Spectrum:
All anaerobes, except Actinomyces, Propionibacterium acnes, and Lactobacillus spp.
Antiprotozoal, amebicide
Inactive against aerobic bacteria

A

Metronidazole

85
Q

Spectrum of Activity:
No gram-positive or anaerobic activity
Active against all gram-negatives

A

Aminoglycosides: Gentamicin, Tobramycin, Amikacin

86
Q

Common Indications:
Rarely used as monotherapy
Often combined with beta-lactams for moderate-severe gram-negative infections in critically ill patients

A

Aminoglycosides.

87
Q

27yo pregnant female presents with UTI. Which antibiotics would you avoid?

A

Tetracyclines, bactrim, quinolones, flagyl in first trimester.

88
Q

Cephalosporins spectrum of activity is similar to:

A

Antistaph penicillin…..MSSA!

89
Q

Which drug is preferred for life-threatening MSSA infections

A

Nafcillin

90
Q

Common indications for 1st gen cephalosporins

A

MSSA cellulitis, bacteremia, joint infections, prosthetic device infections.
-E.coli and klebsiella uncomplicated UTI

91
Q

Common indications for 2nd gen cephalosporins

A

Otitis media or sinus infections.

Ceftoxitin= prophylaxis for intra-abdominal surgery

92
Q

What drugs are superior to vancomycin against MSSA?

A

Beta-lactams

93
Q

Deptomycin does not penetrate the ________

A

Lungs

Pharm exam 3 (2 decks)

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