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Pharm 1- k > Week 3- Antibiotics > Flashcards

Week 3- Antibiotics Flashcards

1
Q

What are narrow spectrum antibiotics?

A

antibiotics effective against only a few microorganism with a very specific metabolic pathway or enzyme

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1
Q

tetracycline is contraindicated for which types of pts and has an adverse effect on which population?

A

contraindicated for children under 8 bc TCN binds to calcium causing discoloration and hypoplasia of teeth and has an adverse effect on pregnant women bc TCN may retard fetal skeletal development

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1
Q

MOA of aminoglycosides

A

Bacteriocidal

most effective for aerobic gram (-) bacteria

for serious to life-threatening infections with serious toxicities (ototoxicity and nephrotoxicity most prevelant)

rearely used in PO form except for bowel pre-op bowel cleanse

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2
Q

Adverse effects of macrolides?

A

Jaundice
Hepatotoxicity
Superinfection

Macrolides are highly protein bound and can have serious interaction with other protein-bound drugs

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3
Q

what is the MOA of Sulfonamides?

A

bacteriostatic by preventing Bacteria (not human) synthesis of Folic Acid

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3
Q

Is pyridium an antibiotic? If not, what is it?

A

no, its an analgesic

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3
Q

Amoxicillin (PO) and Ampicillin (PO/IM/IV) fall under which type of Penicillan? Which bacteria are they good for?

A

Aminopenicillins. Good for gram (-) and gram (+) but not Beta lactamase organisms.

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3
Q

In which one of the following clinical situations is the prophylactic use of antibiotics NOT warranted?

A. Preventions of meningitis among individuals in close contact with infected pts

B. Pt with a hip prosthesis who is having a tooth removed

C. Presurgical treatment for implantation of a hip prosthesis

D. Pt who compains of frequent respiratory illness

E. Presurgical treatment in GI procedures

A

D- respiratory illness may be of viral origin and chronic disorders may not warrant prophylactic use of AB

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3
Q

Name the drug in 4th gen cephalosporin and explain its importance

A

Cefepime (maxipime) IV/IM

better gram (+) than 3rd gen and effective against bugs that have developed resistance to earlier generations of cephalosporins

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3
Q

An elderly diabetic pt is admitted to the hospital with pneumonia. The sputum culture stains for a gram(-) rod. The pt is started on IV ampicilin. Two days later, the pt is not imporving, and the microbiology lab reports the orgnism to be a B-lactamase-producing H.influenzae. What course of treatment is indicated?

A. continue IV ampicillin

B. switch to IV cefotaxime

C. switch to oral vancomycin

D. add gentamicin to the ampicillin therapy

A

B- cefotaxime (claforan) IV/IM 3rd gen for gram (-) and resistant to B-lactamase

Ampicillin is not resistant

vancomycin is for gram (+) serious infections

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4
Q

Name the gram (-) bacteria

A

Salmonella

Klebsiella

Helicobacter

Legionella

Escherichia

Spirochaetes

Neisseria

Shigella

Moraxella

Proteus

Hemophilus

Yersinia

Pseudomonas

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4
Q

Macrolides are the drug of choice for which illnesses?

A

Drug of Choice for “Atypical” Pneumonias:
Legionnaire’s disease (Azithromycin)
Mycoplasma pneumonia (erythromycin or tetracycline)
Chlamydia pneumonia

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5
Q

A pt with degenerative joint disease is to undergo insertion of a hip prostheis. To avoid complications dur to postoperative infection, the surgeon will pretreat this pt with an AB. This hospital has problems with MRSA. Which is adequate?

A. Ampicillin

B. Imipenem/cilastatin

C. gentamicin/piperacillin

D. Vancomycin

E. cefazolin

A

D. Vancomycin

none of the others can combat MRSA

Imipenem/cilastatin is a carbapenem

ampicillin and cefazolin (1st gen) do nothing

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6
Q

Describe the antibiotic MOA: Bactericidal

A

they cause the death of susceptible bacteria DIRECTLY (bacteriCIDAL- suiCIDAL)

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6
Q

identify the aminoglycosides

A

Gentamicin (Garamycin) (IM/IV)
Kanamycin (Kantrex) (IM/IV)
Neomycin sulfate (PO)
Streptomycin (IM)
Tobramycin (Nebcin) (IM/IV)
Amikacin (Amikin) (IM/IV)
Paromomycin (Humatin) (PO)

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7
Q

Diagnosis? Caused by what?

A

Yeast Vaginitis caused by low levels of microflora (superinfection)

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8
Q

what can you prescribe to a pt with pseudomembranous colitis caused by C. diff?

A

DOC is metronidazole (flagyl) then try vancomycin is all fails

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9
Q

A 30 year old male is diagnosed to be HIV +. His CD4+ count is 200 cells/cm and his viral load is 10,000 copies/mL. In addition to receiving antiviral therapy, which of the following is indicatd to protect him agaisnt pneumonia due to PCP (pneumocystis jiro-veci)?

A. trimethoprim

B. Ciprofloxacin

C. Co-trimoxazole (bactrim)

D. Clindamycin

A

C- Co-trimoxazole or Bactrim is = Sulfamethoxazole + trimethoprim

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10
Q

Describe 1st Gen Cephalosporins

A

Beta lactam ring

sensitive to lactamase

good gram + coverage

Indicated for: URI, OM, surgical prophylaxis

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11
Q

What are the Mechanism of Action (MOA) of antibiotics?

A

Bactericidal or Bacteriostatic

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11
Q

Identify the Carbapenems and their routes

A

Ertapenem (Invanz) (IV/IM)
Meropenem (Merrem) (IV)
Imipenem/cilastatin (Primaxin) (IM/IV)
Doripenem (Doribax) (IV)

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12
Q

Which Penicillans are more likely to cause a hypersensitivity reaction and why?

A

Natural Penicillans becuase it comes from a mold

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12
Q

If a pt tests positve for meningitis, which Ab is the DOC [drug of choice]? why?

A

Ceftriaxime (Rocephin) IV/IM because they can cross the CSF, longer half life and once a day dosing

(*or Cefotaxime (Claforan) IV/IM* but not once a day dosing)

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13
Q

Why are Penicillins not effective against some bacteria?

A

Some bacteria secrete penicillinase (betalactamse) that splits the beta-lactam ring** **

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13
Q

What makes 3nd gen cephalosporin so great?

A

longer duration of action, most effective against gram (-) and resistant to beta lactamase producing bacteria and **only cephalosporins to penetrate CSF **

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14
Q

Under what conditions would you prescribe a carbapenem?

A

If pt is not allergic to PCN and has an anaerobic bacteria

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14
Q

Quinolones indications:

A

Lower respiratory tract infections
Bone and joint infections
Infectious diarrhea
Urinary tract infections
Skin infections
Sexually transmitted diseases except gonorrhea

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15
Q

Which two sulfanomides produce a synergistic affect and good for gram negatives? Indicated for which gram (-)?

A

Sulfamethoxazole combined with trimethoprim.

-Trimethoprim is the Dihydrofolate (FAH2) reductase inhibitor

Indications:

UTI -

PCP (New name: Pneumocystis jiroveci ) - haemophilus

OM

Chronic bronchitis of COPD

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15
Q

What does this pt have?

A

Exfoliative Dermitis

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17
Q

Identify the picture?

A

Gram (+)

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17
Q

Name the 1st Gen cephalosporins and routes

A

Cefadroxil (Duricef) (PO)
Cephalexin (Keflex) (PO)
Cefazolin (Kefzol) (IM/IV)

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18
Q

What is Phenazopyridine? What is it used for?

A

Prescribed in conjunction with an Ab for UTI and is a topical (bladder) analgesic

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18
Q

Bacteriodes Fragilis is a negative gram obligate anaerobe of the gut. If a Pt comes in for an abdominal [or colorectal] surgery which AB can you prescribe? why?

A

Cefoxitin (mefoxin) IV/IM

great for (-) gram anaerobes and as a surgical prophylaxis

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18
Q

Why would you Rx Clindamycin (Cleocin)?

A

Reserved for serious to life-threatening infections that cannot be treated with other Ab like Bacteriodes fragilis.

Cleocin vaginal for bacterial vaginosis (BV) or

Cleocin topical for acne

** carries a high risk of getting pseudomembranous colitis due to C. diff***

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19
Q

OM in children is treated by a macrolide and a sulfa. Name the two drugs, brand name, administration and dosage form

A

sulfisoxazole + erythromycin = Pediazole (PO) suspension

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20
Q

Name the Monobactam/route and explain why it is so unique.

A

Aztreonam (Azactam) with a narrow spectrum (IV/IM)

  • only covers **AEROBIC gram (-) **
  • excellent for Pseudomonas Aeruginosa anaerobic/aerobic
  • PCN allergy is not an absolute contraindication just use with caution
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21
Q

what are the adverse effects of cephalosporins?

A

simlar to PCN: hypersensitivity

Contraindicated if PCN reaction is urticaria or anaplylaxis

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22
Q

Name the natural Penicillans, brand and route

A

Penicillin G benzathine (Bicillin L-A) (IM)
Penicillin G potassium (Pfizerpen) (IV/IM)
Penicillin G procaine (IM)
Penicillin G sodium (IM/IV)
Penicillin V potassium (Pen VK) (PO)

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23
Q

Macrolides indications?

A

Pneumonia

Bronchitis

URI from Haemophilus influenzae

Sinusitis

OM

STDs

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24
Q

how are the sulfa drugs administered?

A

Microsulfon- PO

silver sulfadiazine (Silvadeen)- topical

sulfisoxazole (Pediazole)- PO

Sulfamethoxazole + Trimethoprim (Bactrim) - PO/IV

sulfamylon (Mafenide)- topical

sulfacetamide (sulamyd) - Opthalmic

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25
Q

What are the three basic shapes of bacteria?

A

Bacilli – Rod shape

Cocci – Spherical shape

Spirilla – Spiral shape

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27
Q

Name the tetracyclines, brand and route

A

Demeclocycline (Declomycin) (PO)
Tetracycline HCL (Sumycin) (PO)
Doxycycline (Doryx) (PO)
Minocycline (Minocin) (PO)
Tigecycline (Tygacil) (IV)

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28
Q

What does this pt have?

A

Toxic Epidermal Necrolysis (TEN)

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29
Q

When would you Rx Vancomycin PO?

A

Serious life-threatening Gram + infections resistant to PCN (i.e. MRSA)

Serious life-threatening Gram+ infections in PCN allergic patients

           Enterococci (resistance developing)

Pseudomembranous colitis from C. Diff that’s resistant/relapsing from Flagyl

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31
Q

Which bacteria does not stain but is still classified as + gram and why?

A

Mycoplasma because it has no cell wall

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31
Q

Name the 3rd gen cephalosporins, brand and route

A 
Cefpodoxime proxetil (Vantin) (PO) +
**Ceftriaxone (Rocephin) (IV/IM) +**
Ceftibuten (Cedax) (PO)
 Cefditoren pivoxil (Spectracef) (PO)

Cefotaxime (Claforan) (IV/IM) +
Ceftazidime sodium (Fortaz) (IV/IM)

Cefdinir (Omnicef) (PO)
Cefixime (Suprax) (PO) +

+ Currently Approved for GC

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32
Q

MOA of cephalosporins?

A

Bacteriocidal

Superior to PCN

divided into 5 generations

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34
Q

How to antibiotics contribute to resistance?

A

AB kills the bacteria SENSITIVE to it–> the few MUTATED (insensitive to drugs) bacteria continue to multiply and infect

*AB do NOT cause mutations but contribute to its “selective pressure” on mutated microbes*

microbes follow an “adapt or die” theory

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35
Q

DOC for pregnant woman with gonorrhea?

A

cephalosporins 3rd generation bc best for gram (-)

Ceftriaxon (rocephin)

Ceftazidime sodium (Fortaz)

Cefotaxime (Claforan)

Cefpodoxime proxetil (Vantril)

Cefixime (Suprex)

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36
Q

Why do gram negative bacteria stain red?

A

Cell wall loses its stain or IS decolorized by ETOH

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38
Q

Name the types of Antibiotics.

A

Penicillins

Cephalosporins

Sulfonamides

Macrolides

Tetracyclines

Aminoglycosides

Quinolones

Miscellaneous

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39
Q

Name the sulfa drugs

A

Sulfadiazines

Sulfamethoxazoles

Sulfisoxazoles

Sulfacetamide

Sulfamylon

41
Q

What do you see?

A

gram (-)

42
Q

Identify

A

MRSA - Methicillin Resistant Staph Aureus

due to nosocomial infections

44
Q

what are the two antibiotic spectrums of activity?

A

Narrow Spectrum and Broad Spectrum

45
Q

What are sulfonamides used for?

A

Mostly UTI but other indications are:

PCP,Shigellosis, Prophylaxis

46
Q

What are broad spectrum antibiotics?

A

antibiotics effective against a wide variety of infections

47
Q

Which gram bacteria usually causes bacteremia?

A

(-) gram bacteria (Salmonella, Klebsiella, Helicobacter, Legionella, Escherichia, Spirochaetes, Neisseria, Shigella, Moraxella, Proteus, Hemophilus, Yersinia, Pseudomonas)

48
Q

Which AB produces risk of tendon rupture? to which age population?

A

Quinolones

  • to pts over 60 and increased if they are taking corticosteriods
  • contraindicated to under 18 years old
48
Q

Which drug is good for C. difficile-associated bacteria?

A

Macrolide- Fidaxomicin (Dificid) PO

Metronidazole (flagyl) or as a last resort Vancomycin

50
Q

Carbapenems are contraindicated for which pts?

A

PCN allergic pts

51
Q

Identify the Penicillinase-resistant AB and routes.

A

Dicloxacillin (PO)
Nafcillin (IV)
Oxacillin (Bactocill) (IM/IV)

52
Q

quinolones is contraindicated for which pts and why?

A

kids under 18 due to risk of tendon rupture and pt with myasthenia gravis due to risk of exacerbation of muscle weakness

53
Q

Which drug turns your urine bright orange? What else can the drug stain? How much should you prescribe?

A
  • Phenazopyridine (Pyridium)
  • May stain contact lenses
  • Only prescribe enough for two days
55
Q

Names the Macrolides, brand and Routes

A

Erythromycin base (Eryc) (PO)
Erythromycin ethylsuccinate (E.E.S.) (PO)
Erythromycin stearate (Erythrocin) (PO)
Azithromycin (Zithromax) (PO/IV)
Clarithromycin (Biaxin) (PO)
Erythromycin lactobionate IV (Erythrocin IV)

55
Q

What is Pseudomembranous colitis? which drug carries a high risk of getting it?

A

Caused by bacterium Clostridium difficile (AKA C. diff colitis) due to an interruption of normal flora in colon

C. diff produces toxins → Severe diarrhea (may be bloody), High fevers, Abdominal cramping/pain, Prostration

caused by Clandamycin (Cleocin) PO/IV/IM

56
Q

Name some sulfamethoxazole and its route of administration?

A

Bactrim and Septra (PO/IV)

58
Q

How do bacteria develop resistance?

A

1-they can produce enzyme that deactivate the antibiotic

2-they can change cellular permeability to prevent the drug from entering the cell

3-they can alter transport systems to exclude the drug from active transport into the cell

4-they can alter binding sites on the membranes so they can no longer accept the drug

5-they alter binding sites on the ribosomes so they no longer accept the drug

6-they produce chemicals that act as an ANTOGONIST to the drug

60
Q

Which are your fixed does Extended- spectrum penicillins?

A

Ticarcillin + clavulanic acid [inhibits penicillinase] = Timentin (IV)
Piperacillin + tazobactam [inhibits penicillinase] = Zosyn (IV)

61
Q

Diagnose and give cause

A

Diaper Dermatitis from Candida (diaper rash from bacteria or yeast superinfection)

63
Q

What drug causes the reaction on the picture? And what is it?

A

Caused by sulfonamides

Steven-Johnson Syndrome: Severe to life-threatening hypersensitivity complex that affects the skin & mucus membranes -May occur in response to an illness but MORE OFTEN occurs in response to a drug

63
Q

Tetracyclines are the drug of choice for??

A

gram (-) Cholera, Rocky Mountain Spotted fever, Chlamydia, Lyme Disease

64
Q

Pt has P. aeruginosa and is allergic to PCN, which AB is the drug of choice?

A

Aminoglycoside

66
Q

Identify: Penicillan spectrum?

A

Kill a wide variety of bacteria → broad spectrum
AKA “beta-lactams”

68
Q

If you want to prevent infections secondary to burns, which drug would you use ?

A

silver sulfadiazine (Silvadeen)- topical or Sulfamylon Topical (Mafenide) [similar action to sulfadiazine]

69
Q

Which are your fixed dose Aminopenicillins?

A

Ampicillin + sulbactam [inhibits penicillinase] = Unasyn (IM or IV)

Amoxicillin + clavulanic acid [inhibits penicillinase] = Augmentin (PO)

70
Q

Name Sulfadiazines antibiotics and routes

A

sulfadiazine (Microsulfon) PO

silver sulfadiazine (Silvadeen) Topical

71
Q

MOA of tetracycline?

A

bacteriostatic

most administered PO except for Tygecyline (IV)

bind to ions ot form insoluble complexes

72
Q

What do you see?

A

Neisseria gonorrhoeae
Gram Negative Intracelluar Diplococci

73
Q

identify

A

Staphylococci

74
Q

Which AB have a beta-lactam ring in the center?

A

Penicillins, cephalosporins, monolactams and carbapenems

76
Q

Which drugs should** not** be** **given to pts with Mysthenia Gravis? (it’s contraindicated)

A

Quinolones and Ketolides- Telithromycin

77
Q

When would you give a prophylaxis?

A
  • if a Pt Travels to an area where an infectious disease is endemic
  • before a GI or GU surgery
  • for Known cardiac valve disease or prosthetic valves
  • for Known exposure to life-threatening or chronic infection [meningitis, TB]
  • before Invasive procedures
78
Q

Pregnant woman tests positive for Chlamydia- which is the best treatment?

A

(Macrolide)Azithromycin bc Tetracycline may harm the fetus

79
Q

Why do gram positive bacteria stain blue-violet?

A

Cell wall retains the stain or resists decolorization with ETOH

80
Q

What is good to treat an eye infection? Give generic and brand name.

A

Sulfacetamide Ophthalmic (Sulamyd)

82
Q

What color are gram negative bacteria when stained?

A

red

84
Q

Which test requires culture taken from an infected site then grown out on a agar plate? and why would you do this test?

A

culture and sensitivity- demonstrates which drugs the microorganism is sensitive to therefore helps choose THE BEST DRUG - great way to test various drugs at one time

85
Q

Why is 2nd Gen Cephalosporin better thn 1st gen?

A

Better gram (-) coverage, more potent , good coverage of anaerobic bateria

(-)Oxygen2 [(-) gram, lack Oxygen, 2nd gen]

86
Q

What are super infections?

A

Superinfection are often caused by broad spectrum antibiotics or chronic long-term Ab use

Normal flora typically protects against pathogenic microorganisms but with antibiotics they are destroyed–> opportunistic microbes proliferate

87
Q

A 25y/o male returns home from a holiday in the Far East and complains of 3 days of dysuria and a purulent discharge. You diagnose this to be a case of gonorrhea. Which of the following is an appropriate treatment?

A. Ceftriaxone IM

B. Penicillin G IM

C. Gentamicin IM

D. Piperacillin/tazobactam IV

E. Vancomycin IV

A

A- Ceftriazone IM (rocephin)

Most gonorrhea are resistant o PCN

gonorrhea is a gram (-) PCN G treat gram (+) and vancomycin is too strong

88
Q

In general, what are the adverse affects of antibiotics?

A

SHRuGiN’

Superinfections

Hypersensitivity reactions

Renal toxicity

Gastrointestinal (GI) tract toxicity

Neurotoxicity

89
Q

Which type of gram bacteria do carbapenems cover?

A

most beta lactamase gram + and gram - and anaerobic bacteria (including - Pseudomonas Aeruginosa anaerobic/aerobic)

90
Q

Children younger than 8 years of age should not receive tetracyclines, because these agents:

A. cause rupture of tendons

B. do not cross into the CSF

C. are not bactericidal

D. deposit in tissues undergoing calcification

E. can cause aplastic anemia

A

D. deposit in tissues undergoing calcification

Quinolones cause ruptures of tendons

91
Q

Which are your extended spectrum penicillins?

A

Ticarcillin
Piperacillin

92
Q

what can you prescribe to a pt with chlamydia who is allergic to PCN ?

A

Azithromycin (best for PCN allergic pts)

93
Q

Which AB can you give a pt with CF?

A

inhaled form of Azteonam (Cayston) [monobactam] or Tobramycin (Tobi podhaler) [aminoglycosides]

95
Q

Which drugs cover Pseudomonas and which is the drug of choice?

A

DRUG OF CHOICE: Ceftazidime Sodium (Fortaz) but any of the following work too:

Ticarcillin [extended spectrum penicillin] IV

Aztreonam (Azactam) IV/IM

or any of the carbapenem: Meropenem (Merrem) IV, Imipenem/cilastatin (Primaxin) IM/IV, Doripenem (Doribax) IV but not ertapenam (invanz) IV/IM

or an Aminoglycoside

96
Q

What is septicemia?

A
  • also known as bacteremia
  • is the presence of bacteria in the blood due to a failure of defense mechanisms
  • life threatening condition w/ high mortality rate
  • may progress to septic shock, multiple organ failure or death
97
Q

Under what conditions would you not do a culture and sensitivity test?

A

if the pt already started taking antibiotics

98
Q

What are the signs and symptoms for sepsis?

A
  • either high temp (fever) or a low body temp
  • leukocytosi >12,000 or leukopenia 10% bands (immature neutrophils)
  • tachycardia
  • Tachypnea
  • vomiting
100
Q

Name the gram (+) bacteria

A

Listeria

Staphylococcus

Streptococcus

Enterococcus

Clostridium

Corynebacterium

Mycoplasma *

101
Q

What are some adverse effects to prescribing sulfonamides?

A

*Photosensitivity- sensitive to the sun

*Toxic epidermal necrolysis (TEN)

*Steven-Johnson Syndrome

*Exfoliative dermatitis

Crystalluria

Toxic nephrosis

Urticaria

Aplastic anemia

(*pictures on pharm slides*)

102
Q

Describe the antibiotic MOA: Bacteriostatic

A

inhibits growth and reproduction of susceptible bacteria by causing death INDIRECTLY

103
Q

What factors should a clinician take into account when prescribing antibiotics?

A
  • identifying the right pathogen
  • selecting a drug that is the most effective with the lowest side effect specific to the pathogen and pt
  • least expensive drug
104
Q

Pt who test positive for STD Chlamydia should get which AB?

A

Z-pack (microlide) or Tetracycline

105
Q

What is the drug of choice for a pt with pseudomembranous Colitis?

A

Drug of choice is metronidazole (Flagyl) but if it fails then Vancomycin

106
Q

What is the MOA of penicillans?

A

Bactericidal → Inhibit cell wall synthesis

Bind to the PCN-binding protein inside the bacteria cell wall and disrupting cell wall synthesis leading to cell lysis.

107
Q

What does this pt have? Prob Caused by what?

A

Steven- johnson Syndrome probably caused by sulfonamides

108
Q

Name the Ab whose adverse effect is ototoxicity and nephrotoxicity AND it’s signs.

A

Aminoglycosides:

Warning Signs of Ototoxicity-
Dizziness
Tinnitus
Hearing loss

Warning Signs of Nephrotoxicity
Urinary casts
Proteinuria
Elevated BUN and serum creatinine levels

109
Q

Name the quinolones, brand and route

A

Ciprofloxacin (Cipro) (PO/IV)
Norfloxacin (Noroxin) (PO)
Ofloxacin (Floxin) (PO)
Gemifloxacin (Factive) (PO)
Levofloxacin (Levaquin) (PO/IV)
Moxifloxacin (Avelox) (PO/IV)

quinolones suffix is -floxacin

110
Q

Which drugs are good for community acquired pneumonia (CAP)?

A

5th Generation cephalosporin- Ceftaroline fosamil (Teflaro) IV (also good for skin/skin structure infections)

and Ketolides- Telithromycin (Ketek) PO

111
Q

Name the different types of Penicillins

A

Natural penicillins
Penicillinase-resistant penicillins
Aminopenicillins
Extended-spectrum penicillins

112
Q

Define: antibiotics

A

medications used to treat infections by susceptible bacteria. (bacteria that are not resistant)

113
Q

How can we prevent AB resistance?

A

Use it judiciously

114
Q

Can antibiotics cause a synergistic affect? If so, Give an example.

A

Yes, when combined (1+1=5), some diseases require multiple antibiotic therapy (i.e.TB)

synergistic: Bactrim or Septra (PO/IV) = sulfamethoxazole + Trimethoprim

115
Q

MOA of Macrolides

A

Bacteriostatic OR bacteriocidal

broad spectrum

used for PCN allergic pts

117
Q

Which AB can you prescribe for a pink eye?

A

none - pink eye is viral

118
Q

Which Penicillins have a bulky side group and what is it for? Is there a downfall to this bulky group?

A

Penicillinase- Resistant IOT protect the Beta lactam ring from penicillinases BUT it inhibits ability to penetrate gram (-)

119
Q

What color are gram positive bacteria when stained?

A

Gram positive bacteria appear blue-violet on Gram stain

120
Q

MOA of quinolones

A

Bactericidal

excellent oral absorption unlike aminoglycosides

covers both gram (+) and gram (-)

121
Q

Pt has P. aeruginosa and is allergic to PCN, which AB is the drug of choice?

A

Aztreonam (Azactam)

122
Q

A pt with a gunshot would to the abdomen, which has resulted in spillage of intestinal contents, is brought to the ER. Which AB would you select to effectively treat an infection due to Bacteriodes fragilis?

A. Aztrenam

B. clindamycin

C. gentamicin

D. Azithromycin

E. Doxycycline

A

B. Clindamycin

124
Q

Which drug is good for toxoplasmosis?

A

Sulfadiazine (Microsulfon) - PO

125
Q

Which AB is appropriate for a pt with mono and strep?

A

Any natural Penicillin, Cephalexin (keflex) PO (1st gen cepahlo with B-lactam ring) or erythromycin (macrolide- if pt is allergic to PCN) for the strep.

Mono is a virus (no AB for it) but if a pt also has strep, they will develop hypersensitivity to Ampicillan/Amoxicillan.

drug of choice is Cephalexin

126
Q

Which drug would you use to treat malaria?

A

Sulfadiazine (microsulfon) - PO in conjunction with other drugs

127
Q

Primary use of Penicillins are for which type of gram bacteria?

A

mainly Gram +

128
Q

name the 2nd generation cephalosporins

A

Cefaclor (Ceclor) (PO)
Cefprozil (Cefzil) (PO)
Cefoxitin (Mefoxin) (IM/IV)
Cefuroxime axetil (Ceftin) (PO)
Cefuroxime sodium (Zinacef) (IM/IV)
Cefotetan (Cefotan) (IM/IV)

Pharm 1- k (4 decks)

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