U9.1 BETA LACTAMS Flashcards
Identify the beta lactam inhibitor:
for Gram (+) organisms, Gram (-) cocci, and Gram (-) rods
Penicillins
Identify the beta lactam inhibitor:
High activity in staphylococci & streptococci
Antistaphylococcal penicillins
Identify the beta lactam inhibitor:
High activity in Gram (-) rods
Extended-spectrum penicillin
Identify the beta lactam inhibitor:
Orally administered but is not impaired by food
Amoxicillin
Identify the beta lactam inhibitor: (2)
For delayed absorption
Benzathine & Procaine
Identify the beta lactam inhibitor: (3)
Acid-stable and well-absorbed
Dicloxacillin, ampicillin, amoxocillin
Identify the penicillin:
For streptococci, meningococci, enterococci
Penicillin G
Identify the penicillin:
For T. pallidum, Clostridium sp., Actinomyces, spirochetes
Penicillin G
Identify the penicillin:
Oral form (PO)
Penicillin V
Route of Administration:
Benzathine & Procaine
IM
Identify the extended-spectrum penicillin:
Better absorbed orally
Amoxicillin
Identify the extended-spectrum penicillin: (2)
Most active against pneumococci
Amoxicillin, Ampicillin
Identify the extended-spectrum penicillin:
For bacterial sinusitis, otitis, LRTI
Amoxicillin
Identify the extended-spectrum penicillin:
For shigellosis and anaerobes, enterococci, but NOT active against Klebsiella sp., Enteroacter sp., P. aeruginosa, Citrobacter sp.
Ampicillin
T/F: Ampicillin is no longer used for empirical UTI & typhoid fever
T
Identify the extended-spectrum penicillin: (3)
Broaden spectrum against Gram (-) such as P. aeruginosa
Carboxypenicilline, carbenicillin, ticarcillin
Identify the extended-spectrum penicillin: (2)
For Gram (-) such as Klebsiella pneumoniae and P. aeruginosa
Ureidopenicillin, Piperacillin
Piperacillin is often combined with ___
Tazobactam
B-lactamase inhibitors in combination w/ ampicillin, amoxicillin, piperacillin, ticarcillin
Clavulanic acid, sulbactam, tazobactam
Which antibiotic gives this adverse effect:
Neutropenia & nephritis
Nafcillin
Which antibiotic gives this adverse effect:
Hepatitis
Oxacillin
Which antibiotic gives this adverse effect:
Pseudomembranous colitis
Ampicillin
Which antibiotic gives this adverse effect:
Skin rashes with Eipstein-Barr
Ampicillin + Amoxicillin
Which antibiotic gives this adverse effect:
Interstitial nephritis
Methicillin
Which antibiotic gives this adverse effect:
Acute kidney injury
Piperacillin-Tazobactam w/ Vancomycin
B-lactamase inhibitor combined with:
Ceftolozane
Tazobactam
B-lactamase inhibitor combined with:
Ceftazidime
Avibactam
Cephalosporin for:
Community-acquired pneumonia
Ceftaroline fosamil
Cefuroxime
T/F: Cephalosporins are active against L. monocytogenes
F
Other beta lactams:
Against aerobic Gram (-) such as P. aeruginosa with NO activity against Gram (+) and anaerobes
Monobactams (Aztreonam)
T/F: Aztreonam penetrates the CSF
T
Other beta lactams:
No cross allergenicity with penicillins
Aztreonam
T/F: Aztreonam has no cross allergies with penicillin but may have cross allergies with ceftazidime
T
T/F: The antibacterial action of b-lactamase inhibitors is comparable with penicillins
F (weak antibacterial action)
They protect hydrolyzable penicillins
B-lactamase inhibitors
Imipenem is often combined with ___ because it can be inactivated by dehydropeptidase in renal tubules
Cilastatin
Carbapenems not hydrolyzed by dehydropeptidase in renal tubules
Doripenem
Meropenem
Ertapenem
Carbapenems less likely to cause seizures
Doripenem
Meropenem
Ertapenem
Carbapenem not effective against P. aeruginosa & Acinetobacter
Ertapenem
Carbapenem with the longest half life
Ertapenem
Effective for Gram (-) rods, Gram (+) organisms, and anaerobes
Carbapenems
Glycopeptide antibiotics:
Derived from Amycolatopsis orientalis
Vancomycin
Glycopeptide antibiotics:
Binds to D-Ala-D-Ala terminus
Vancomycin
Glycopeptide antibiotics:
For gram (+) bacteria and lacks gram (-) penetration
Vancomycin
Glycopeptide antibiotics:
Synergistic with gentamicin & streptomycin against E. faecium & E. faecalis
Vancomycin
Glycopeptide antibiotics:
For bloodstream infections, endocarditis from MRSA
Vancomycin
Glycopeptide antibiotics:
Combined with cefotaxime, ceftriaxone, and rifampin for meningitis caused by pen-resistant pneumoniae
Vancomycin
Glycopeptide antibiotics:
Causes phlebitis at the site of injection
Vancomycin
Glycopeptide antibiotics:
Causes ototoxicity rarely and nephrotoxicity regularly
Vancomycin
ROA of vancomycin
IV
Glycopeptide antibiotics:
Long half-life
Teicoplanin
ROA of teicoplanin
IM/IV
Glycopeptide antibiotics:
Semisynthetic lipoglycopeptide derivative of vancomycin
Telavancin
Glycopeptide antibiotics:
Potentially teratogenic
Telavancin
Glycopeptide antibiotics:
Derivatives (2) of teicoplanin
Dalbavancin, Oritavancin
ROA of Dalbavancin & Oritavancin
IV
Dalbavancin/Oritavancin:
Longer infusion
Oritavancin
How many hours of infusion is required for Oritavancin?
3
How many hours of infusion is required for Dalbavancin?
30 mins
Dalbavancin/Oritavancin:
MOA: disruption of RNA synthesis alongside disruption of cell membrane permeability
Oritavancin
Other cell wall/Membrane-Active agents:
Novel cyclic lipopeptide fermentaton
Daptomycin
Other cell wall/Membrane-Active agents:
More rapid bactericidal than vancomycin
Daptomycin
Other cell wall/Membrane-Active agents:
Bind to Ca2+ and depolarize the cell with K+
Daptomycin
Other cell wall/Membrane-Active agents:
Should not be used vs. pneumonia as it is a surfactant antagonist
Daptomycin
Other cell wall/Membrane-Active agents:
Inhibits early cell wall synthesis
Fosfomycin
Other cell wall/Membrane-Active agents:
For both gram (+) and gram (-)
Fosfomycin
Other cell wall/Membrane-Active agents:
Safe for pregnancy
Fosfomycin
Other cell wall/Membrane-Active agents:
Cyclic peptide of Bacillus subtilis
Bacitracin
Other cell wall/Membrane-Active agents:
Vs. Gram (+)
Bacitracin
Other cell wall/Membrane-Active agents:
Highly nephrotoxic
Bacitracin
Other cell wall/Membrane-Active agents:
Poorly absorbed; used as topical
Bacitracin
Other cell wall/Membrane-Active agents:
Streptmyces orchidaceous
Cycloserine
Other cell wall/Membrane-Active agents:
Mostly used against TB
Cycloserine
Other cell wall/Membrane-Active agents:
Structural analog of D-Alanine
Cycloserine
Other cell wall/Membrane-Active agents:
CNS toxicity w/ headaches, tremors, acute psychosis, & convulsions
Cycloserine
Causes “red man” syndrome
Vancomycin
1st line drug against T. pallidum (syphillis)
Benzathine + Penicillin G
Causes Jarisch-Herxheimer rxn.
Penicillins
ROA:
Methicillin
IM/IV
ROA:
Penicillin G
IM/IV
ROA:
Penicilline V
PO
ROA:
Nafcillin
IM/IV
ROA:
Oxacillin
IM/IV
ROA:
Dicloxacillin
PO
ROA:
Ampicillin
PO/IM/IV
ROA:
Piperacillin & Ticarcillin
IV
Often combined with amoxicillin
Clavulanic acid
ROA:
Cephalexin
PO
ROA:
Cefazolin
IM/IV
ROA:
Cefuroxime
PO
First to be effective vs. H. influenzae but was replaced by cefuroxime
Cefamandole
ROA:
Cefaclor
IV/IM
ROA:
Cefoxitin, Cefotetan
IV/IM
Often combined with ampicillin
Sulbactam
Often combined with meropenem
Avorbactam