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Flashcards in Antimicrobials - First Aid Deck (198)
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1

Penicillin G and V (prototype Beta-lactams) MOA

Bind penicillin-binding proteins to block transpeptidase cross-linking of peptidoglycan.

They also activate autolytic enzymes.

2

Penicillin G and V Use

-mostly for gram-positive organisms
-also for N. meningitidis and T. pallidum

3

Penicillin G, V are bactericidal for...

gram-positive cocci and rods, gram-negative cocci and spirochetes.

4

Toxicity of Penicillin G, V

HSRs and hemolytic anemia

5

Resistance to Penicillin G, V

penicillinase in bacteria (a type of beta-lactamase) cleaves the beta-lactam ring

6

Ampicillin/Amoxicillin MOA

same as penicillin

7

Ampicillin/Amoxicillin Use

extended spectrum penicillins
-H. influenzae
-E. coli
-Listeria
-Proteus
-Salmonella
-Shigella
-enterococci

8

Ampicillin/Amoxicillin Toxicity

-HSRs
-rash
-pseudomembranous colitis

9

Ampicillin/Amoxicillin Resistance

-penicillinase

10

Oxacillin, Nafcillin, Dicloxacillin MOA

same as penicillin; penicillinase resistant because bulky R group blocks access of beta-lactamase

11

Oxacillin, Nafcillin, Dicloxacillin Use

S. aureus (narrow spectrum)

12

Oxacillin, Nafcillin, Dicloxacillin Toxicity

HSRs, interstitial nephritis

13

MRSA is resistant because of....

altered PBP target site.

14

Ticarcillin, Piperacillin MOA

same as penicillin

15

Ticarcillin, Piperacillin Use

extended spectrum; Pseudomonas and gram-negative rods

16

Beta-lactamse inhibitors are often...

added to penicillin antibiotics to protect the antibiotic from destruction by beta-lactamase.

(Clavulanic Acid, Sulbactam, Tazobactam)

17

Cephalosporins MOA

Beta-lactam drugs that inhibit cell wall synthesis but are less suceptible to penicillinases; bactericidal

18

Organisms typically not covered by cephalosporins are...

LAME:
-Listeria
-Atypicals
-MRSA
-Enterococci

(Exception: ceftaroline covers MRSA)

19

1st generation Cephalosporins Use

Cefazolin, Cephalexin
-gram positive cocci
-Proteus
-E. coli
-Klebsiella

20

Cefazolin is used prior to...

surgery to prevent S. aureus wound infections.

21

2nd generation Cephalosposrins Use

Cefoxitin, Cefaclor, Cefuroxime
-gram positive cocci
-H. influenza
-Enterobacter
-Neisseria
-Proteus
-E. coli
-Klebsiella
-Serratia

22

3rd genreation Cephalosporins Use

Ceftriaxone, Cefotaxime, Ceftazidime
-serious gram negative infections resistant to other beta-lactams
(Ceftriaxone for Neisseria and Ceftazidime for Pseudomonas)

23

4th generation Cephalosporins Use

Cefepime
-increased activity against pseudomonas and gram-positives

24

5th generation Cephalosporins Use

Ceftaroline
-broad gram positive and negative coverage
-including MRSA
-does NOT cover pseudomonas

25

Cephalosporins toxicity

-HSRs
-vitamin K deficiency
-increased nephrotoxicity of aminoglycosides

26

Aztreonam MOA

a monobactam; resistant to beta-lactamases; prevents peptidoglycan cross-linking by binding to PBP3

27

Aztreonam Use

gram-negative rods only; for penicillin allergic pts and those with renal insufficiency who cannot tolerate aminoglycosides

28

Carbapenems (4)

1. Imipenem
2. Meropenem
3. Ertapenem
4. Doripenem

29

Carpabenem (Imipenem) MOA

broad-spectrum, beta-lactamase reistant; always admisistered with Cilastatin (inhibitor of renal dehydropeptidase I) to decrease inactivation of the drug in the renal tubules

30

Clinical use of carbapenems

-gram positive cocci
-gram negative rods
-anaerobes