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Pharm Final > Topic 19 Antimicrobials > Flashcards

Topic 19 Antimicrobials Flashcards

1
Q

Deep sternal wound infections:

~Significantly worse long-term survival what is the cost to treat???

A

*Costs between $200 and $250k to treat

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2
Q

Major causes of device “failure” (like with VADS)

A

Infection/sepsis

along with thrombosis/hemorrhage

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3
Q

Biggest source of infection from the patient is the what?

A

patient’s skin

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4
Q

What is capitated payment ?

A

medicare only pays a certain amount for each type of procedure and if it goes over that it the hospital has to absorb it

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5
Q

Failure with assist devices means that what happens to the patient?

A

death

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6
Q

No amount of antibiotics can overcome the effects of what?

A

sterile technique

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7
Q

*MIC=stands for what?

A

“Minimum INHIBITORY Concentration”

the lowest concentration of antibiotic that inhibits bacterial growth

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8
Q

MBC= stands for what?

A

“Minimum BACTERIOCIDAL Concentration”

the lowest concentration of antibiotic that kills 99.9% of bacteria

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9
Q

They will use MIC and MBC on VAD patients with what?

A

infections

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10
Q

BacteriCidal antibiotic agent does what?

A

designed to kill bacteria

ex: penicillin

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11
Q

BacterioStatic antibiotic agent does what?

A

Stops the bacterias growth

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12
Q

If you mix a BacteriCidal and BacterioStatic Antibiotic what happens?

A

the static antibiotic prevents the bacteria from growing so it kinda works against the cidal. The combination is actually less effective

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13
Q

Major Pathogen Category: Gram Positive Bacteria

A

the bacteria takes up the blue dye for a positive result in the Gram stain test.

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14
Q

which type of bacteria has a thick Peptidoglycan layer? making it harder to be attacked

A

Gram Positive Bacteria

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15
Q

β-Lactam antibiotics - what type of antibiotics

A

are cidal antibiotics

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16
Q

β-Lactam antibiotics prevent the bacterial cell wall from doing what?

A

Prevent bacterial cell wall peptidoglycan cross-linking so newly produced bacterial cell walls are “weak” and the bacteria “fall apart” (think bacterial Marfan’s Disease)

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17
Q

“First Generation” Penicillins

are effective against what type of organisms?

A

gram-positive organisms (particularly Strep), gram negative cocci (what’s that?) and a few others, but resistance levels are high and growing

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18
Q

Penicillin-G

A

benzylpenicillin

“First Generation” Penicillins

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19
Q

benzylpenicillin

A

Penicillin-G

“First Generation” Penicillins

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20
Q

Staph grows in what shapes?

A

big colonies

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21
Q

strep grows in what shape?

A

long strips

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22
Q

Anti-staphylococcal Penicillins - 3 drugs

A
  • Dicloxacillin (Dynapen)
  • Nafcillin (Nallpe)
  • Oxacillin

These antibiotics have a much narrower “spectrum” and are used specifically for Methicillin resistant Staphylococcus aureus
…AND SHOULD BE USED SPARINGLY

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23
Q

-Dicloxacillin

A

Dynapen

Anti-staphylococcal Penicillins

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24
Q

-Nafcillin

A

Nallpe

Anti-staphylococcal Penicillins

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25
Q

Dynapen

A

-Dicloxacillin

Anti-staphylococcal Penicillins

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26
Q

Nallpe

A

-Nafcillin

Anti-staphylococcal Penicillins

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27
Q

When is methicillin used clinically?

A

METHICILLIN IS NO LONGER USED CLINICALLY.

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28
Q

Amoxicillin: DRUG OF CHOICE for what?

A

for pre-cardiac surgery dental prophyllaxis !

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29
Q

Broad Spectrum Penicillin resistance

A

Resistance to broad -spectrum pens has increased dramatically (especially MRSA)

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30
Q

Broad Spectrum Penicillin Drugs (2)?

A

Ampicillin

Amoxicillin

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31
Q

Pseudomonas aeruginosa is notorious for causing what ?/

A

blue/green pus

32
Q

Pseudomonas aeruginosa is what?

A

very pathogenic gram negative that readily develops resistance to antibiotics.

USE Antipseudomonal Penicillins

33
Q

Antipseudomonal Penicillins Drugs (3)

A

Carbenicillin (Geocillin)
Piperacillin (Piperacil)
Ticarcillin (Ticar)

34
Q

Carbenicillin

A

Geocillin

Antipseudomonal Penicillins

35
Q

Piperacillin

A

Piperacil

Antipseudomonal Penicillins

36
Q

Ticarcillin

A

Ticar

Antipseudomonal Penicillins

37
Q

Geocillin

A

Carbenicillin

Antipseudomonal Penicillins

38
Q

Piperacil

A

Piperacillin

Antipseudomonal Penicillins

39
Q

Ticar

A

Ticarcillin

Antipseudomonal Penicillins

40
Q

Clavulanic Acid does what

A

It is a suicide inhibitor of - bacterial β-lactamase - it attaches to and permanently deactivates the bacterial β-lactamase enzyme

41
Q

Combine Clavulanic Acid with amoxicillin makes what ?

A

Augmentin

42
Q

Combine Clavulanic Acid with ticarcillin makes what ?

A

Timentin

43
Q

Inflamed meninges are more permeable to what

A

penicillin

permitting rapid penetration of the drug into the CSF

44
Q

Cephalosporins very commonly used in what part of open heart surgery ??

A

Very commonly used in open heart surgery and as part of the “prime”

45
Q

Cephalosporins are what? and how are they classified?

A

β-lactams essentially just like penicillins
*Classified as 1st, 2nd, 3rd, & 4th generation based on their resistance to β-lactamases and their antimicrobial spectrums

46
Q

Cefazolin

A

Kefzol

1st generation Cephalosporins

47
Q

Kefzol

A

Cefazolin

1st generation Cephalosporins

48
Q

1st generation Cephalosporins: main open-heart infection culprits are Staph. (mostly) and Strep. sp SOOO WHAT DOES THIS MEAN FOR US AND ITS USAGE

A

no advantage found using more expensive later-generation cephalosporins for ECC prophyllaxis!

49
Q

Cefazolin (Kefzol) has a cross sensitivity with what?

1st generation Cephalosporin

A

Cross sensitivity with penicillins is high

50
Q

2nd generation Cephalosporin advantages on pump?

A

Again, no proven advantage over 1st gens when used in the pump prime!

51
Q

2nd generation Cephalosporin drugs (3)

A

Cefoxitin (Mefoxin)
Cefotetan (Cefotan)
Cefuroxime (Ceftin)

52
Q

Cefoxitin

A

Mefoxin

2nd generation Cephalosporin

53
Q

Cefotetan

A

Cefotan

2nd generation Cephalosporin

54
Q

Cefuroxime

A

Ceftin

2nd generation Cephalosporin

55
Q

Mefoxin

A

Cefoxitin

2nd generation Cephalosporin

56
Q

Cefotan

A

Cefotetan

2nd generation Cephalosporin

57
Q

Ceftin

A

Cefuroxime

2nd generation Cephalosporin

58
Q

MRSE stands for ?

A

Methicillin Resistant Staph epidermidis

59
Q

Use what antibiotic for Methicillin Resistant Staph epidermidis (MRSE) and enterococcal infections

A

Vancomycin

60
Q

Vancomycin side affects

A

fever, chills, flushing and phlebitis

61
Q

Aminoglycosides interfere with what synthesis of ribosomal subunits?

A

Interfere with bacterial protein synthesis by
binding to bacterial ribosomal 30S subunit

This action is CIDAL

62
Q

order of resistance of Aminoglycosides Drugs (4)

A

Streptomycin (little used, lots of resistance)
Tobramycin (Nebcin)
Gentamicin
Amikacin (Amikin)= LEAST bacterial resistance

63
Q

Tobramycin

A

Nebcin

Aminoglycosides

64
Q

Amikacin

A

Amikin

Aminoglycosides

65
Q

Aminoglycosides side affects “classic triad”

A
  1. Ototoxicity: Vestibular and or cochlear
    (bc they are toxic to middle ear)
  2. Neuromuscular paralysis: PARTICULARLY with myasthenia gravis patients.
  3. Nephrotoxocity ranging from mild to total renal failure
66
Q

Amikin

A

Amikacin

Aminoglycosides

67
Q

Nebcin

A

Tobramycin

Aminoglycosides

68
Q

Aminoglycosides do what when used with pens, cephs and vancomycin for resistant bacteria?

A

Exhibit a synergistic effect when used with pens, cephs, and vancomycin (why?) for resistant bacteria.

69
Q

Aminoglycosides are used with what for resistant bacteria?

A

Exhibit a synergistic effect when used with pens, cephs, and vancomycin

70
Q

Aminoglycosides are given how?

A

parenterally or used topically

71
Q

Aminoglycosides Exhibit concentration-dependent killing: - what is this?

A

Exhibit concentration-dependent killing:

-Increasing concentrations of aminoglycosides kill increasing proportions of bacteria at increasing rates

72
Q

Aminoglycosides cross what??

A

All aminoglycosides cross the blood/placenta barrier and concentrate in fetal tissue!

73
Q

Neomycin: used how?

A

used only topically (too nephrotoxic)

74
Q

Streptomycin: produced? resistance?

A

first produced. LOTS of microbial resistance has developed

75
Q

Gentamicin and Tobramycin: resistance?

A

mid-level microbial resistance

76
Q

Amikacin: resistance ?

A

least microbial resistance (also most expensive!)

Pharm Final (6 decks)

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