Walters

Question 1

What Carbapenems used for?

Answer 1

B-lactams. G+/G-, anaerobes.
Reserved for resistant infections

UTIs
Lower Respiratory Tract infections
Bone, joint, skin infections
Intra-abdominal and gynecological infections

Question 2

What are the 4 Carbapenems?

Answer 2

I- Imipenem
M - Meropenem
E- Ertapenem
D- Doripenem

Question 3

Imipenem

Answer 3

With - Cilastatin
Inhibits dehydropeptidase

Side effects - nausea/ vomiting, 1.5% seizures, Inc. risk C. difficile infection

Question 4

Meropenem

Answer 4

Not metabolized by dehydropeptidase

Side effects - Seizures 0.5%

Question 5

Ertapenem

Answer 5

Once a day dosing

Question 6

Doripenem

Answer 6

Intra-abdominal infections, UTIs
Not used for pneumonia - inc. death
Dec. cure rates compared to Imi/Cil

Question 7

What are the drugs used for Misc. B-lactams and other inhibitors of cell wall synthesis?

Answer 7

All Vegetables Tell Oranges Don't Be Fuckers 
A - Aztreonam 
V- Vancomycin 
T- Telavancin 
O - Oritavancin 
D- Dalbavancin 
B- Bacidtracin 
F - Fosfomycin

Question 8

Aztreonam

Answer 8

G- anaerobes, PBP-3

Excreted unchanged in urine,
adjust does for renal failure
Causes inflamed meninges

Question 9

Vancomycin

Answer 9

IV for MRSA or Staph if allergic B-lactams
Binds D-ala-D-ala - No crosslinking

Ototoxicity (permanent)
Nephrotoxicity
Histamine Release - Red Man’s Syndrome

Question 10

Telavancin

Answer 10

G+, skin and skin structure infections

Binds D-alanyl-D-ala - inhibits crosslinking
Lysis

Teratogenic - avoid in pregnant women

Question 11

Oritavancin

Answer 11

ABSSSI - G+ organisms including MRSA

Inhibits polymerization
Inhibits cross linking
Increase permeability

Headache, Nausea, vomiting, diarrhea, limb and SQ abscesses
Watch for C. difficile - colitis

Question 12

Dalbavancin

Answer 12

Cidal - ABSSI
D-ala-D-ala
Prevents cross-linking

Nausea, Diarrhea, headache

Question 13

Bacitracin

Answer 13

Cidal, G+ cocci and bacilli
Nephrotoxic
NAG/NAM
w/ Pyrophosphate preventing dephosphorylation

Inhibits cell wall synthesis
topical - minot cuts/ scrapes
ophthalmic - blepharitis

Question 14

Fosfomycin

Answer 14

uncomplicated UTIs
blocks PEP
Inhibition of cell synthesis

Question 15

What are Aminoglycosides used for?

Answer 15

Given orally to clean out bowel 
Enter porin channels - G-
Inhibit protein synthesis - mRNA misreading 
CIDAL
Not effective against anaerobes 

Nephrotoxicity - renal cortex
Ototoxicity - inner ear
Pregnant - neonatal ototoxicity
Don’t use with myasthenia gravis

Question 16

What are the aminoglycoside drugs?

Answer 16

G - Gentamicin 
T - Tobramycin 
A - Amikacin 
S - Streptomycin 
K - Kanamycin 
N - Neomycin 
P - Paromomycin

Question 17

Gentamicin

Answer 17

topical
Burns/ Catheter infections
Ophthalmic

Question 18

Tobramycin

Answer 18

Interchangeable with gentamicin

But less ototoxic

Question 19

Amikacin

Answer 19

Enzyme resistant

Nosocomial Infections

Question 20

Streptomycin

Answer 20

generic

Question 21

Kanamycin

Answer 21

rarely used

Question 22

Neomycin

Answer 22

Oral prep for bowel surgery

Question 23

Paromycin

Answer 23

kill cysts that cause amebic dysentery

Question 24

Tetracyclines used for?

Answer 24

Static
G+/G- and intracellular organisms
Enterohepatic recycling

Inhibit aminoacyl tRNA binding

Question 25

Short acting tetracyclines?

Answer 25

6-8 hours
Tetracycline - acne
Oxytetracycline - ophthalmic w/ polymyxin

Question 26

Intermediate acting tetracyclines?

Answer 26

12 hours
Demeclocycline - chronic dilution hyponatremia
SIADH - inappropriate ADH

Question 27

Long acting tetracyclines?

Answer 27

16-18 hours
Doxycycline
Minocycline - acne

improve stroke outcome
Nail, skin, and sclera pigmentation - reversible
gum pigmentation - gum

Question 28

Side effects of tetracyclines

Answer 28

GI - upset (food)
Slowed growth
Brown discoloration - teeth
Photosensitive

Question 29

Tigecycline

Answer 29

Minocycline
CIDAL
G+/G- and MRSA
Skin infections