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Pharm Exam 4 > Other Beta Lactams > Flashcards

Other Beta Lactams Flashcards

1
Q

What is the broadest spectrum antibiotic currently available?

A

Imipenem/Cilastatin

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2
Q

What is the MOA of Cilastatin?

A

It is a Dyhydropeptidase Inhibitor:

Protects the parent drug from cleavage, so it does not get broken down into a nephrotoxic metabolite

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3
Q

What are some common adverse effects of Cilastatin?

A

N/V and Diarrhea

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4
Q

What are some LESS common adverse effects of Cilastatin?

A
  1. Eosinophilia
  2. Neutropenia
  3. **HIGH levels may provoke seizures
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5
Q

T or F: Imipenem/Cilastatin penetrates well into the tissues and CSF even when not inflamed.

A

True

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6
Q

What is the purpose of Imipenem/Cilastatin?

A

Serves as Empiric therapy until you find out what is causing the infection

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7
Q

What is Aztreonam?

A

A monobactam

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8
Q

What is specific about the structure of Aztreonam?

A

The beta lactam ring is not fused to another ring

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9
Q

What is the ONE job of Aztreonam?

A

Narrow spectrum:
Gram (-) rods only
Enterobacteria

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10
Q

Because Aztreonam is excreted via Kidney, i.e. urine, what should you be weary of?

A

Renal failure pts

This accumulates in the kidneys

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11
Q

T or F: Aztreonam is the one IV drug that is affordable.

A

False: Most IV drugs are expensive; Aztreonam is expensive!

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12
Q

How do you administer Aztreonam?

A

IM/IV

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13
Q

Are Cephs CIDAL or STATIC?

A

CIDAL

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14
Q

Is Vancomycin static or cidal?

A

Cidal

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15
Q

Structrally, what is Vancomycin?

A

Tricyclic Glycopeptide

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16
Q

Why would you use Vancomycin?

A

It is effective against Gram (+) resistant drugs

MRSA; MRSE

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17
Q

What is the use of Vancomycin restricted to?

A
  1. Life threatening C. dif infections that are antibiotic associated
  2. Life threatening Staph inf where the pt is allergic to B-lactam drugs
  3. Gram (+) resistant drugs
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18
Q

How would you administer Vancomycin in a life threatening C. dif infection that is antibiotic associated ?

A

PO

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19
Q

What other drug does Vancomycin act synergistically with?

A

Amino glycosides

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20
Q

If a pt is diagnosed with Streptococcal endocarditis, what can you use if they are allergic to PCN?

A

Vancomycin

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21
Q

Random question: If a pt is diagnosed with Enterococcal endocarditis, what can you use if there are no allergies?

A

PCN with Streptomycin

22
Q

A patient is seen with flushing “red man syndrome”; what agent caused this? And what is the red due to?

A

Vancomycin

The red is due to the histamine release.

23
Q

With increased plasma levels, what adv rx can you expect to see with Vancomycin? What increases the pts chance of getting this adv rxn?

A
  1. Ototoxicity

2. Renal failure (drug is not getting excreted so it accumulates in the ear)

24
Q

How is Vancomycin administered?

A

IV

25
Q

Structurally, what is Bacitracin?

A

It is a mixture of polypeptides that inhibit bacterial cell wall synthesis

26
Q

Is Bacitracin static or cidal?

A

static

27
Q

How is Bacitracin administered?

A

Topically

28
Q

Why is Bacitracin only administered topically?

A

Due to nephrotoxity potential

29
Q

T or F: Bacitracin is used against a wide variety of gram (-).

A

False: Bacitracin is used against a wide variety of gram (+) bugs

30
Q

Structurally, what is Polymyxin B Sulfate?

A

A basic polypeptide that acts like a cationic detergent to disrupt cell membrane of gram (-) bugs

31
Q

What are the 2 indications of Polymyxin B Sulfate?

A
  1. Resistant Gram (-) inf

2. Pseudomonas in cystic fibrosis

32
Q

How is Polymyxin B Sulfate administered?

A

Topically

33
Q

Why is Polymyxin B Sulfate given topically?

A

Extreme nephrotoxicity/neurotoxicity when given

34
Q

What other adverse effect is associated with Polymyxin B, besides Nephron/Neurotoxicity?

A

Respiratory paralysis:

due to neuromuscular blockade

35
Q

How is Daptomycin administered?

A

IV

36
Q

Which agent DEPOLARIZES the cell, disrupts the membrane function and inhibits DNA/RNA protein synthesis?

A

Daptomycin

37
Q

What drug is used as an alternative to Linezolid for resistant gram (+) including MRSA and VRE?

A

Daptomycin

38
Q

What is a critical limitation to Daptomycin?

A

Cannot be used with pneumonia patients

39
Q

Why is Daptomycin contraindicated in pneumonia?

A

Because it is deactivated by the pulmonary surfactants

40
Q

What should be monitored while taking Daptomycin?

A

Liver function

41
Q

What is an adv effect of Daptomycin?

A

Myalgia:

Additive with statins (discontinue if this occurs)

42
Q

In what event would you discontinue Daptomycin?

A

In the even the patient is experiencing myalgia

43
Q

What drug is used for complicated skin infections and bacteremia?

A

Daptomycin

44
Q

What drug is a lipoprotein derived from Vancomycin?

A

Telavancin

45
Q

How is Telavancin given?

A

IV

46
Q

What is the MOA of Televancin?

A

Similar to Vancomycin and Daptomycin?

47
Q

Which drug is used as an alternative to Linezolid for resistant gram (+) including MRSA and complicated skin infections?

A

Televancin

48
Q

Should you prescribe Telavancin to a pregnant patient?

A

Nope.

49
Q

What are some other critical adverse reactions of Telavancin ?

A
  1. Prolongs QT interval

2. Interferes with coagulation tests (PT and PTT)

50
Q

How does Cycloserine work?

A

Disrupts cell wall synthesis

Similar to B lactams

51
Q

What is Cycloserine used for?

A

Restricted for use of treatment of tuberculosis certain UTIs

52
Q

Is Cycloserine static or cidal?

A

Both

Pharm Exam 4 (10 decks)

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