U9.1 BETA LACTAMS Flashcards by EJ E

Q

Identify the beta lactam inhibitor:

for Gram (+) organisms, Gram (-) cocci, and Gram (-) rods

A

Penicillins

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Q

Identify the beta lactam inhibitor:

High activity in staphylococci & streptococci

A

Antistaphylococcal penicillins

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Q

Identify the beta lactam inhibitor:

High activity in Gram (-) rods

A

Extended-spectrum penicillin

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Q

Identify the beta lactam inhibitor:

Orally administered but is not impaired by food

A

Amoxicillin

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Q

Identify the beta lactam inhibitor: (2)

For delayed absorption

A

Benzathine & Procaine

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Q

Identify the beta lactam inhibitor: (3)

Acid-stable and well-absorbed

A

Dicloxacillin, ampicillin, amoxocillin

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Q

Identify the penicillin:

For streptococci, meningococci, enterococci

A

Penicillin G

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Q

Identify the penicillin:

For T. pallidum, Clostridium sp., Actinomyces, spirochetes

A

Penicillin G

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Q

Identify the penicillin:

Oral form (PO)

A

Penicillin V

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Q

Route of Administration:

Benzathine & Procaine

A

IM

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Q

Identify the extended-spectrum penicillin:

Better absorbed orally

A

Amoxicillin

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Q

Identify the extended-spectrum penicillin: (2)

Most active against pneumococci

A

Amoxicillin, Ampicillin

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Q

Identify the extended-spectrum penicillin:

For bacterial sinusitis, otitis, LRTI

A

Amoxicillin

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Q

Identify the extended-spectrum penicillin:

For shigellosis and anaerobes, enterococci, but NOT active against Klebsiella sp., Enteroacter sp., P. aeruginosa, Citrobacter sp.

A

Ampicillin

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Q

T/F: Ampicillin is no longer used for empirical UTI & typhoid fever

A

T

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Q

Identify the extended-spectrum penicillin: (3)

Broaden spectrum against Gram (-) such as P. aeruginosa

A

Carboxypenicilline, carbenicillin, ticarcillin

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Q

Identify the extended-spectrum penicillin: (2)

For Gram (-) such as Klebsiella pneumoniae and P. aeruginosa

A

Ureidopenicillin, Piperacillin

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Q

Piperacillin is often combined with ___

A

Tazobactam

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Q

B-lactamase inhibitors in combination w/ ampicillin, amoxicillin, piperacillin, ticarcillin

A

Clavulanic acid, sulbactam, tazobactam

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Q

Which antibiotic gives this adverse effect:

Neutropenia & nephritis

A

Nafcillin

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Q

Which antibiotic gives this adverse effect:

Hepatitis

A

Oxacillin

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Q

Which antibiotic gives this adverse effect:

Pseudomembranous colitis

A

Ampicillin

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Q

Which antibiotic gives this adverse effect:

Skin rashes with Eipstein-Barr

A

Ampicillin + Amoxicillin

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Q

Which antibiotic gives this adverse effect:

Interstitial nephritis

A

Methicillin

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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