antimicrobials FA

Question 1

how is penicillin V given ?

Answer 1

orally

Question 2

how is penicillin G given?

Answer 2

IV or IM

Question 3

MOA of pencillin G and V

Answer 3

bind PBPs and block transpeptidase cross-linking

Question 4

clinical uses of penicillins G and V?

Answer 4

mostly gram +s

Question 5

adverse effects of penicillins G and V ?

Answer 5

hypersensitivity reactions, direct Coombs + hemolytic anemia, drug-induced interstitial nephritis

Question 6

Resistance mechanism of bacteria against penicillin G and V?

Answer 6

Beta-lactamase cleaves the B-lactam ring OR mutations in PBPs

Question 7

What are the penicillinase-sensitive penicillins?

Answer 7

Amoxicillin, ampicillin, aminopenicillins

Question 8

MOA of penicillinase-sensitive penicillins?

Answer 8

same as penicillin

Question 9

clinical use of the aminopenicillins ?

Answer 9

extended spectrum - H influenza, h pylori, E coli, Listeria, Proteus, Salmonella, Shigella

Question 10

What should you combine the aminopenicillins with?

Answer 10

clavulanic acid to prevent destruction by Beta lactamases

Question 11

mechanism of resistance against the aminopenicillins?

Answer 11

penicillinase

Question 12

Penicillinase-resistant penicillins names

Answer 12

dicloxacillin, nafcillin, oxacillin

Question 13

MOA of penicillinase-resistant penicillins

Answer 13

same as penicillins

Question 14

clinical uses of dicloxacillin, nafcillin, oxacillin?

Answer 14

Narrow spectrum. S aureus

Question 15

adverse effects penicillinase-resistant penicillins

Answer 15

hypersensitivity reactions, interstitial nephritis

Question 16

mechanism of resistance against dicloxacillin, nafcillin, oxacillin

Answer 16

MRSA alters PBP target site

Question 17

Antipseudomonal penicillins names

Answer 17

piperacillin, ticarcillin

Question 18

MOA of pipercillin/ticarcillin

Answer 18

same as penicillin

Question 19

clinical use of pipercillin/ticarcillin

Answer 19

pseudomonas and gram - rods

Question 20

adverse effects of pipercillin/ticarcillin

Answer 20

hypersensitivity

Question 21

Cephalosporins MOA

Answer 21

Beta-lactams that inhibit cell wall synthesis

Question 22

names of 1st gen cephalosporins

Answer 22

cefazolin, cephalexin

Question 23

1st gen cephalosporins coverage

Answer 23

Gram + cocci + PEK (proteus mirabils, e coli, klebsiella)

Question 24

2nd generation cephalosporins names

Answer 24

cefaclor, cefoxtin, cefuroxime

Question 25

2nd generation cephalosporins uses

Answer 25

gram + cocci + HENS PEK (H influenza, Enterobacter aerogenes, Neisseria, Serratia marcescens, Proteus mirabilis, E coli, Klebsiella pneumoniae

Question 26

what are the 3rd generation cephalosporins?

Answer 26

ceftriaxone, cefotaxime, cefpodoxime, ceftazadine

Question 27

3rd generation cephalosporins clinical uses?

Answer 27

serious gram - infections including meningitis, gonorrhea, disseminated Lyme disease

Question 28

which 3rd gen cephalosporin has action against pseudomonas?

Answer 28

ceftazadime

Question 29

name the 4th gen cephalosporin

Answer 29

cefepime

Question 30

clinical uses of 4th gen cephalosporins

Answer 30

gram - organisms with increased activity against pseudomonas

Question 31

name of 5th gen cephalosporin

Answer 31

ceftaroline

Question 32

clinical uses of ceftaroline

Answer 32

broad gram + and gram - coveragine, covers MRSA and enterococcus feacalis

Question 33

does ceftaroline cover pseudomonas?

Answer 33

no

Question 34

adverse effects of cephalosporins

Answer 34

hypersensitivity reactions, autoimmune hemolytic anemia, disulfiram like reaction, vit K deficiency

Question 35

aminoglycosides and cephalosporins used together increase the risk of what?

Answer 35

nephrotoxicity

Question 36

mechanisms of resistance against cephalosporins?

Answer 36

cephalosporinases or structural change in PBPs

Question 37

What are the beta-lactamase inhibitors and what is their purpose?

Answer 37

clavulanic acid, avibactam, sulbactam, tazobactam | Added to penicillin antibiotics to prevent descrubtions by Beta-lactamase

Question 38

Name the carbapenems

Answer 38

Dorpenem, imipenem, meropenem, ertapenem

Question 39

What do you always administer carbapenems with?

Answer 39

Cilastin (inhibits renal dehydropeptidase I) to decrease inactivation of drug in renal tubules

Question 40

clinical uses of carbapenem

Answer 40

extended spectrum but use is limited to due serious side effects

Question 41

adverse effects of carbapenems

Answer 41

GI distress, rash, CNS toxicity (seizures) at high plasma levels

Question 42

Name a monobactam

Answer 42

aztreonam

Question 43

MOA of monobactams

Answer 43

bind to penicillin-binding protein 3

Question 44

monobactams are synergistic with what drug ?

Answer 44

aminoglycosides

Question 45

clinical use of monobactams?

Answer 45

gram - only

Question 46

monobactams are particularly useful for which pateints?

Answer 46

those with a penicillin allergy - no cross reactivity

Question 47

Vancomycin MOA

Answer 47

inhibits cell wall formation by binding D-Ala-D-Ala

Question 48

Vancomycin clinical use?

Answer 48

gram +s only - for serious multidrug resistant organisms

Question 49

adverse effects of vancomycin

Answer 49

nephrotoxicity, ototoxicity, thrombophlebitis, red man syndrome, dress syndrome

Question 50

MOA of resistance to vancomycin

Answer 50

amino acid modification