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PCOL MIDTERMS > UNIT 11: INTRO TO ANTIMICROBIALS > Flashcards

UNIT 11: INTRO TO ANTIMICROBIALS Flashcards

1
Q

Enumeration

Narrow-Spectrum Penicillins (2)

A

Penicillin G
Penicillin V

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2
Q

Enumeration

Antistaphylococcal penicillins (4)

Very-Narrow Spectrum

A

Cloxacillin, dicloxacillin
Nafcillin
Oxacillin
Methicillin
Isoxazolyl Penicillins

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3
Q

Enumeration

Extended-spectrum penicillins (3)

Wider-Spectrum

A

Aminopenicillins (Ampicillin, Amoxicillin)
Carboxypenicillins (Carbenicillin, Ticarcillin)
Ureidopenicillins (Piperacillin)

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4
Q

Enumeration

Aminopenicillins (2)

A

Ampicillin
Amoxicillin

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5
Q

Enumeration

Carboxypenicillins (2)

A

Carbenicillin
Ticarcillin

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6
Q

Piperacillin is what type of Penicillin?

A

Ureidopenicillins

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7
Q

First-generation cephalosporins (6)

A

Cefazolin
Cefadroxil
Cephalexin
Cephalothin
Cephapirin
Cephradine

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8
Q

Second-generation cephalosporins (9)

A

Cefaclor
Cefamandole
Cefonicid
Cefuroxime
Cefprozil
Loracarbef
Ceforanide
Cefotetan
Cefoxitin

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9
Q

Third-generation cephalosporins (12)

A

Cefoperazone
Cefotaxime
Ceftazidime
Ceftizoxime
Ceftriaxone
Cefixime
Cefpodoxime proxetil
Cefdinir
Cefditoren
Pivoxil
Ceftibuten
Moxalactam

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10
Q

Fourth-generation cephalosporins (1)

A

Cefepime

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11
Q

Cephalosporin–β-lactamase inhibitor combinations (2)

Effective against gram (-) infections

A

Ceftolozane-tazobactam
Ceftazidime-avibactam

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12
Q

Siderophore Cephalosporin

A

Cefiderocol

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13
Q

Cephalosporins Active Against Methicillin-Resistant Staphylococci (1)

A

Ceftaroline fosamil

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14
Q

Carbapenems (4)

A

Ertapenem
Imipenem
Meropenem
Doripenem (not available in USA)

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15
Q

Drugs with a monocyclic β-lactam ring

A

Monobactams

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16
Q

Enumeration

Glycopeptides (5)

A

Vancomycin
Teicoplanin
Telavancin
Dalbavancin
Oritavancin

DOT TV

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17
Q

The following are glycopeptides, EXCEPT:
Vancomycin
Teicoplanin
Telavancin
Daptomycin
Dalbavancin
Oritavancin

A

Daptomycin

Daptomycin is a lipopeptide

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18
Q

Drugs that inhibit the growth/replication, or kill microrganisms

A

Antimicrobials

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19
Q

Types of antimicrobials (5)

A

Antibacterial
Antifungal
Antiviral
Anti-protozoal
Anti-parasitic

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20
Q

First-line drug for syphillis

A

Benzathine Penicillin G

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21
Q

Penicillin G is the drug of choice for infections caused by:

A

Streptococci
Meningococci
Enterococci
Penicillin-susceptible pneumococci
Non-B-lactamase-producing staphylococci
Spirochetes (Treponema pallidum)
Actinomyces
Non-B-lactamase-producing Gram (-) anaerobic organisms

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22
Q

Oral form of penicillin, indicated only in minor infections due to poor bioavailability

A

Penicillin V

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23
Q

Most active of oral B-lactam antibiotics against pneumococci

A

Aminopenicillins (ampicillin & amoxicillin)

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24
Q

Given orally to treat:
Bacterial sinusitis
Otitis
Lower respiratory tract infections

A

Amoxicillin

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25
Q

Effective for shigellosis

A

Ampicillin

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26
Q

Ampicillin is effective against serious infections including: (5)

A

Anaerobes
Enterococci
L. monocytogenes
E. coli
Salmonella sp.

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27
Q

Ampicillin is not active against:

A

Klebsiella sp.
Enterobacter sp.
P. aeruginosa
Citrobacter sp.
Serratia marcescens
Indole-positive Proteus species
Gram (-) aerobes

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28
Q

Resistant agents of Penicillin G:

A

Penicillin-Resistant S. pneumoniae (PRSP) strains
S. aureus
N. gonorrhoeae

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29
Q

Used for oropharyngeal infections

A

Penicillin V

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30
Q

Developed to broaden spectrum of penicillins against gram (-) pathogens, including Pseudomonas aeruginosa

A

Carboxypenicillins (carbenicillin, tricarcillin)

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31
Q

Active against Gram (-) bacilli:
Klebsiella pneumoniae
Pseudomonas aeruginosa

A

Ureidopenicillin (piperacillin)

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32
Q

Available only as co-formulation with tazobactam

A

Ureidopenicillin (piperacillin)

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33
Q

Antipseudomonal B-lactams used in combination with Ureidopenicillin due to P. aeruginosa developing resistance (2)

A

Aminoglycoside
Fluoroquinolone

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34
Q

B-lactamase inhibitors used in combination with Ampicillin, Amoxicillin, Piperacillin, and Ticarcillin (3)

A

Clavulanic acid
Sulbactam
Tazobactam

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35
Q

B-lactamase inhibitors extends the activity of penicillins against:

A

B-lactamase-producing strains of S. aureus
B-lactamase-producing Gram-negative bacteria

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36
Q

Degradation products of penicillins and products of alkaline hydrolysis

A

Antigenic determinants

Penicilloic acid

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37
Q

Associated with neutropenia

A

Nafcillin

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38
Q

Causes hepatitis

A

Oxacillin

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39
Q

Causes interstitial nephritis

A

Methicillin

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40
Q

Associated with pseudomembranous otitis

A

Ampicillin

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41
Q

Associated with skin rashes

A

Ampicillin

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42
Q

Caused by large doses of oral penicillins

A

GI disturbances

Nausea, vomiting, diarrhea

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43
Q

When combined with vancomycin, associated with greater incidence of acute kidney injury

A

Piperacillin-tazobactam

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44
Q

Generation of Cephalosporins effective against:
Gram (+) cocci
E. coli
Klebsiella pneumoniae
Proteus mirabilis
Anaerobic cocci (peptococci, peptostreptococci)

A

1st Generation

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45
Q

1st Generation Cephalosporins are not effective against:

A

Gram (-) cocci
Enterococci
MRSA
Most gram (-) rods
Methicillin-resistant strains of staphylococci
Pseudomonas aeruginosa
Indole-positive Proteus species
Enterobacter sp.
Serratia marcescens
Citrobacter sp.
Acinetobacter sp.

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46
Q

Drug of choice for surgical prophylasxis

A

Cefazolin

1st Generation

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47
Q

Effective for serious staphylococcal infections such as bacteremia

A

Cefazolin

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48
Q

Suitable for urinary tract infections and staphylococcal or streptococcal infections, including cellulitis or soft tissue absess

A

Oral cephalosporins

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49
Q

A heterogenous group with individual differences in activity, pharmacokinetcs, and toxicity

A

2nd Generation Cephalosporins

50
Q

2nd Generation Cephalosporins effective against Haemophilus influenzae but NOT Serratia and Bacteroides fragilis (2)

A

Cefuroxime
Cefaclor

51
Q

2nd Generation Cephalosporins effective against Bacteroides fragilis and Serratia but NOT Haemophilus influenzae (2)

A

Cefoxitin
Cefotetan

52
Q

True or False

2nd Generation Cephalosporins are active against enterococci and P. aeruginosa

A

False

No member is active

53
Q

True or False

2nd Generation Cephalosporins can be used to treat Enterobacter infections

A

False

Should not be used

54
Q

2nd Generation Cephalosporin effective against extended-spectrum B-lactamases produced by E. coli and Klebsiella sp.

A

Cefoxitin

55
Q

2nd Generation

Most commonly used oral cephalosporin

A

Cefuroxime axetil

56
Q

2nd generation cephalosporins used to treat mixed anaerobic infections such as: (2)

Peritonitis
Diverticulitis
Pelvic inflammatory disease

A

Cefoxitin
Cefotetan

57
Q

2nd Generation

Used to treat community-acquired pneumonia

A

Cefuroxime

58
Q

2nd Generation Cephalosporins are effective against: (4)

Extended gram (-) activity

A

Klebsiella
H. influenzae
Bacteroides fragilis
Serratia

59
Q

2nd Generation Cephalosporins are NOT effective against: (2)

A

Enterobacter
P. aeruginosa

60
Q

3rd Generation Cephalosporins are effective against: (4)

A

Citrobacter
Serratia
Providencia
Pseudomonas

61
Q

The only 3rd Generation Cephalosporin effective against P. aeruginosa

A

Ceftazidime

62
Q

3rd Generation Cephalosporins are NOT effective against:

A

Enterobacter

63
Q

3rd Generation Cephalosporins less active against pneumococci and S. aureus (2)

A

Cefixime
Ceftibuten

64
Q

Generation of Cephalosporins that penetrate body fluids and tissues well, and can reach cerebrospinal fluid

A

3rd Generation

65
Q

3rd Generation Cephalosporins

____ combined with ____ is the preferred regimen for treating most gonococcal infections

A

Intramuscular Ceftriaxone + azithromycin

66
Q

The only 3rd Generation Cephalosporin excreted through the biliary tract

A

Ceftriaxone

67
Q

The only penicillin excreted through the billiary tract

A

Nafcillin

68
Q

3rd Generation

Most active cephalosporins against penicillin-non-susceptible strains of pneumococci (2)

A

Ceftriaxone
Cefotaxime

69
Q

3rd Generation

Approved for treating meningitis caused by pathogens such as: (2)

Pneumococci
Meningococci
H. influenzae
Enteric Gram-negative rods (except L. monocytogenes)

A

Ceftriaxone
Cefotaxime

70
Q

3rd Generation

Recommended for empirical therapy of serious infections caused by penicillin-non-susceptible strains of pneumococci (2)

A

Ceftriaxone
Cefotaxime

71
Q

The only available fourth generation cephalosporin

A

Cefepime

72
Q

4th generation cephalosporins are effective against: (6)

A

P. aeruginosa
Enterobacteriaceae
Methicillin-susceptible S. aureus (MRSA)
S. pneumoniae
Haemophilus sp.
Neisseria sp.

73
Q

Valuable for treating Enterobacter infections due to good activity against most penicillin-resistant strains of streptococci

A

Cefepime

4th Generation

74
Q

Commonly used empirically in patients with febrile neutropenia

A

Cefepime

4th Generation

75
Q

First-beta-lactam antibiotic approved in the USA with activity against MRSA

Prodrug of ceftaroline

A

Ceftaroline fosamil

76
Q

Used off-label to treat bacteremia, endocarditis, and osteomyelitis

A

Ceftaroline

77
Q

Ceftolozane-tazobactam and Ceftazidime-avibactam are effective against:

A

P. aerugnosa
AmpC and extended-spectrum B-lactamase-producing Enterobacterieae

78
Q

Ceftolozane-tazobactam and Ceftazidime-avibactam are combined with ____ when treating complicated intra-abdominal infections

A

Metronidazole

79
Q

Effective for carbapenemase-producing organisms

A

Ceftazidime-avibactam

80
Q

Ceftolozane-tazobactam and Ceftazidime-avibactam are NOT effective against:

A

Organisms producing metallo-B-lactamases

81
Q

Patients with history of penicillic anaphylaxis should avoid which generations of cephalosporins?

A

1st and 2nd generation

82
Q

Cephalosporins that may cause hypoprothrombinemia and bleeding disorders (4)

A

Cephalosporins containing a methylthiotetrazole group:
Cefamandole
Cefmetazole
Cefoperazone
Cefotetan

83
Q

Drugs with a monocyclic B-lactam ring

A

Monobactams

84
Q

Monobactams are effective against:

A

Aerobic Gram-negative organisms (including P. aeruginosa)

85
Q

Monobactams are NOT effective against:

A

Gram-positive bacteria or anaerobes

86
Q

Monobactams

Can be given to penicillin-allergic patients without reaction

A

Aztreonam

87
Q

Beta-lactamase Inhibitors (4)

A

Clavulanic acid
Sulbactam
Tazobactam
Avibactam

CATS

88
Q

Beta-lactamase Inhibitors are most effective against:

A

Ambler class A B-lactamases produced by:
Staphylococci
H. influenzae
N. gonorrhoeae
Salmonella
Shigella
Escherichia coli
Klebsiella pneumoniae

89
Q

Non-B-lactam B-lactamase inhibitor active against Ambler class A, Ambler class C, and some class D B-lactamases

A

Avibactam

90
Q

Active against B-lactamase-producing S. aureus and H. influenzae but not against Serratia

A

Ampicillin-Sulbactam

91
Q

Trrue or False

Piperacillin-Tazobactam is active against P. aeruginosa

A

False

92
Q

Carbapenem effective against:
Gram-negative rods (P. aeruginosa)
Gram-positive organisms
Anaerobes

A

Imipenem

93
Q

Imipenem is NOT active against:

A

Enterococcus faecium
MRSA
Clostridium difficile
Burkholderia cepacia
Stenotrophomonas maltophilia

94
Q

Inactivates Imipenem, resulting in low urinary concentrations

A

Dehydropeptidases

95
Q

An inhibitor of renal dehydropeptidase, administered with Imipenem for clinical use against pneumonia and sepsis

A

Cilastatin

96
Q

Clinical use:
Streptococcal infections
Meningococcal infections
Neurosyphilis

A

Penicillin G

Narrow-spectrum Penicillin

97
Q

Clinical use:
Skin and soft tissue infections
Urinary tract infections
Surgical prophylaxis

A

Cefazolin

1st Generation Cephalosporin

98
Q

Clinical use:
Infections caused by aerobic, Gram-negative bacteria in patients with hypersensitivity to penicillins

A

Aztreonam

Monobactam

99
Q

Clinical use:
Serious infections such as pneumonia and sepsis

A

Imipenem-cilastatin

100
Q

Intravenous carbapenem, stable to renal dehydropeptidase, lowers incidence of seizures

A

Meropenem

101
Q

Clinical use:
Infections caused by Gram-positive bacteria including sepsis, endocarditis, and meningitis

C. difficile colitis

A

Vancomycin

102
Q

Narrow-Spectrum Penicillins
Penase-susceptible
(2)

A

Penicillin G
Penicillin V

103
Q

Narrrow-Spectrum Penicillins
Penase-resistant
(2)

A

Nafcillin
Oxacillin

104
Q

Monobactam active only against Gram-negative bacteria:
Klebsiella
Pseudomonas
Serratia spp

A

Aztreonam

105
Q

Novel cyclic lipopeptide fermentation product of Streptomyces roseusporus

A

Daptomycin

106
Q

Active against vancomycin-resistant strains of enteroccoci and S. aureus

A

Daptomycin

107
Q

Binds to the cell membrane via calcium-dependent insertion of its lipid tail

A

Daptomycin

108
Q

Can cause myopathy

A

Daptomycin

109
Q

Inhibits the cytpolasmic enzyme enolpyruvate transferase

A

Fosfomycin

110
Q

Fosfomycin is active against:

A

Both gram-positive and gram-negative organisms

111
Q

Approved for use against uncomplicated lower urinary tract infections in women

A

Fosfomycin

112
Q

Cyclic peptide mixture obtained from the Tracy strain of Bacillus subtilis

A

Bacitracin

113
Q

Inhibits cell wall formation by interfering with dephosphorylation

A

Bacitracin

114
Q

An antibiotic produced by Streptomyces orchidaceous

A

Cycloserine

115
Q

Almost exclusively used to treat tuberculosis caused by strains of Mycobacterium tuberculosis resistant to first-line agents

A

Cycloserine

116
Q

Causes serious dose-related CNS toxicity with headaches, tremors, acute psychosis, and convulsions

A

Cycloserine

117
Q

An antibiotic isolated from Amycolatopsis orientalis

A

Vancomycin

118
Q

Inhibits cell wall synthesis by binding to the d-Ala-d-Ala terminus of nascent peptidoglycan pentapeptide

A

Vancomycin

119
Q

Synergistic with vancomycin against Enterococcus faecium and Enterococcus faecalis strains (2)

A

Gentamicin
Streptomycin

120
Q

Combined with vancomycin as an alternative regimen for treating enterococcal endocarditis in patients with serious penicillin allergy

A

Gentamicin

PCOL MIDTERMS (10 decks)

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