Pharm PCN/Cephalosporin/Carbapenem Flashcards

1
Q

Natural PCNs (Drugs)

A

Penicillin G

Penicillin V

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2
Q

Natural PCNs (Spectrum)

A

Gram +, cocci and bacilli, some gram -

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3
Q

Penicillinase resistant PCN (Drugs)

A

Nafcillin, methacillin, cloxacillin, dicloxacillin, oxacillin

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4
Q

Penicillinase resistant PCN (Spectrum)

A

Staph. Aureus

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5
Q

Extended spectrum (Drugs)

A

Ampicillins, amoxicillin, bacampicillin

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6
Q

Extended spectrum (Spectrum)

A

Gram +/-, cocci and bacilli

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7
Q

Antipseudomonals (Drugs)

A

Ticarcillin, piperacillin, carbenicillin, mezlocillin

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8
Q

Antipseudomonals (Spectrum)

A

Gram (-) plus pseudomonas

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9
Q

Penicillin/Beta lactamase inhibitors (Drugs)

A

amoxicillin clavulanate (Augementin)
ampicillin/sulbactam (Unasyn)
piperacillin/tazobactam (Zosyn)
ticarcillin/clavulanate (Timentin)

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10
Q

1st generation cephalosporins (drugs)

A

“Cefa” “Cepha” “Cephra”

Except Cefaclor which is 2nd gen

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11
Q

2nd generation cephalosporins (drugs)

A

Cefuroxime, Cefoxitin, Cefotetan, Cefaclor

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12
Q

3rd generation cephalosporins (drugs)

A

“ime” “one” “ten”
Cefdinir
Moxalactam

Except Cefuroxime which is 2nd gen

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13
Q

4th generation cephalosporins (drugs)

A

“pi”

Cefepime, Cefepirole

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14
Q

5th generation cephalosporins (drugs)

A

“rol”

Ceftaroline

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15
Q

1st generation (spectrum)

A

Gram +, Ok Gram -, anaerobes +/- (not B. fragilis)

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16
Q

2nd generation (spectrum)

A

Gram +, Good Gram -, anaerobes +/-

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17
Q

3rd generation (spectrum)

A

Weak Gram +, Better Gram -, anaerobes +/-, ceftazidime active against pseudomonas

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18
Q

4th generation (spectrum)

A

Gram +, Best Gram -, anaerobes +/-, pseudomonas

19
Q

5th generation (spectrum)

A

Gram +, Gram -, anaerobes +/-, MRSA

20
Q

1st generation (Role)

A
  • S. aureus infections
  • Skin, soft tissue infections
  • Preoperative antibiotic prophylaxis for clean procedures
  • Uncomplicated, community acquired UTIs
21
Q

2nd generation (Role)

A
  • Surgical prophylaxis in GI surgery
  • PID
  • Community-acquired pneumonia
  • Otitis media
  • Sinusitis
  • Quinolone, TMP/SMX-resistant E. coli UTI
22
Q

3rd generation (Role)

A
  • Predominantly GRAM NEGATIVE AGENT
  • Community acquired pneumonia
  • ECF-acquired pneumonia where Pseudomonas is not suspected
  • UTIs with gram (-)
  • Meningitis
  • Gonorrhea

CEFTAZIDIME = ANTIPSEUDOMONAL

23
Q

4th generation (Role)

A

Overly broad

24
Q

5th generation (Role)

A

MRSA pneumonia?

Community acquired pneumonia (CAP)

Cellulitis with CANVAS 1 in CANVAS 2

25
Q

Procaine Pencillin

A

Formulation of Penicillin G

  • Delays peak serum and last 12 hours in serum and tissue
  • Common allergy to procaine (injection anesthetic)
26
Q

Benzathine Penicillin

A

Formulation of Penicillin G

  • Drug of choice for latent syphilis
  • Provides long lasting serum levels (15-30 days)
  • Not effective against CNS infections
27
Q

Ampicillin-sulbactam

A

Common name: Unasyn

Penicillin with Beta-lactamase

28
Q

Amoxicillin-clavulanate

A

Common name: Augmentin

Penicillin with Beta-lactamase

29
Q

Unasyn/Augmentin (spectrum)

A

Gram +: MSSA
Gram -
Anaerobes: B. fragilis

30
Q

Unasyn/Augmentin (Role)

A
  • Pneumonia
  • Intraabdominal infections
  • Skin and soft tissue infections
31
Q

Piperacillin-Tazobactam

A

Common name: Zosyn

Penicillin with beta-lactamase

32
Q

Piperacillin-Tazobactam (Spectrum)

A
  • MSSA
  • Beta-lactamase producing Enterobacteriaceae
  • B. fragilis
33
Q

Piperacillin-Tazobactam (Role)

A
  • Nosocomial pneumonia
  • Intra-abdominal infections
  • Complications infections
  • Pseudomonal infections
34
Q

Cephalosporins (adverse effects)

A
  • Stomach discomfort.
  • Nausea or vomiting.
  • Diarrhea.
  • Thrush (white fungus in the mouth), yeast infection, or other fungal infection.
  • Blood abnormalities.
  • Rash or itching
35
Q

Penicillin (adverse effects)

A
  • Oxacillin, nafcillin (Elevated AST/ALT, neutropenia, rash, allergic interstitial nephritis)
  • Ampicillin/amoxicillin (Rash, diarrhea)
36
Q

KPCs

A

K pneumoniae carbapenemase

Klebsiella and other Enterobacteriaceae produce carbapenemases, which are enzymes that hydrolyze the carbapenems

37
Q

Aztreonam (Role)

A

No cross reactivity if patient has a PCN allergy

Gram (-)
Antipseudomonal

38
Q

Aztreonam (Adverse effects)

A

Extremely expensive ($150/day)

39
Q

Imipenem (Adverse effects)

A

Rapid renal excretion leading to higher incidence of seizures in renal insufficiency patients (A dehydropeptidase inhibitor is added to try to reduce issue)

40
Q

Imipenem/Meropenem (activity)

A

Gram +
Gram (-)
Anaerobic activity

Quick resistance from Acinetobacter baumannii

41
Q

Ceftolozane/Tazobactam (indications)

A

Use reserved for multi-drug resistant Pseudomonas aeruginosa

42
Q

Ceftolozane/Tazobactam (disadvantages)

A

Expensive

43
Q

Ceftazidime/Avibactam (Indications)

A

Treatment of carbapenem-resistant Enterobacteriaceae that have Klebsiella producing carbapenemases activity

44
Q

Ceftazidime/Avibactam (Disadvantages)

A

Extremely expensive