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Therapeutics Exam 2 - antibiotics:( > Beta Lactam Antibiotics pt 1 (penicillins) > Flashcards

Beta Lactam Antibiotics pt 1 (penicillins) Flashcards

1
Q

MOA of Beta Lactam antibiotics

A

interferes with bacterial cell wall synthesis during active multiplication causing death and resultant bactericidal activity against susceptible bacteria

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2
Q

what type of killing do beta lactam antibiotics exhibit?

A

time dependent killing

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3
Q

natural penicillins

A

Penicillin G
penicillin VK
penicillin benzathine/procaine

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4
Q

route of administration of
penicillin G
penicillin VK
penicillin bezathine/procaine

A

Pen G - IV
VK - oral
benzathine/procaine - IM

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5
Q

spectrum of activity for natural penicillins

A

most streptococci infections
mouth anaerobes (peprostreptococcus, prevotella, fusobacterium)
syphillis

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6
Q

avoid using natural penicillins when

A

strep pneumo
enterococcus

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7
Q

pharmacokinetics of natural penicillins

A

renally eliminated, wide distribution

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8
Q

ADR’s of natural penicillins

A

rash
anaphylaxis
fever

sometimes seizures due to renal insufficiency and
GI UPSET

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9
Q

what are some aminopenicillin names and RoA’s

A

ampicillin (IV/PO)
amoxicillin (PO only)

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10
Q

main uses of aminopenicillins (ampicillin and amoxicillin)

A

gram positive activity (step, mouth anaerobes)
ENTEROCOCCUS
STREP PNEUMO
gram negative: H. influenza, E. coli, proteus, salmonella, shigella

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11
Q

avoid using ampicillin and amoxicillin in which type of infections?

A

staph infections

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12
Q

do ampicillin and amoxicillin need to be dose adjusted?

A

yes, renally eliminated

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13
Q

where do aminopenicillins have good penetration?

A

sinusitis, lung, ear
useful for UTI’s

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14
Q

ampicillin and amoxicillin are drug of choice for which infections

A

listeria infections
enterococcus infections (only if susceptible)

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15
Q

ADRs of aminopenicillins (amoxicillin and ampicillin)

A

rash/allergic reactions
fever
seizures (secondary to renal insufficiency)

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16
Q

what are some aminopenicillin- beta lactamase inhibitor combinations? what are the ROA’s of them?

A

ampicillin + sulbactam (IV)
amoxicillin + clavulanate (PO)

17
Q

main uses for the aminopenicillin-BLI combo

A

gram positive ADDS MSSA
gram negative (sulbactam adds acinetobacter)
gut anaerobes: adds bacreroides fragilis (because of BLI)

18
Q

ADR of PCN-BLI combos

A

rash/allergic reactions
fever
seizures (due to renal insufficiency)
augmenten (amoxclav) increases GI side effects (diarrhea)

19
Q

how to lessen GI side effects of some PCN’s

A

take with food

20
Q

clinical pearls of amox-clav and amp-sul

A

treat infections caused by animal bites
more stable agains gram -

21
Q

what are the antipseudomonal penicillins and there RoA?

A

piperacillin

22
Q

spectrum of activity of piperacillin

A

gram positive
gram negative aeroSPACE
serratia
pseudomonas
acinetobacter
citrovacter
enterobacter/klebsiella aerogenes

23
Q

avoid using piperacillin/antipseudomonal PCN in what?

A

staphylococcal infections

24
Q

ADR of piperacillin

A

rash
SJS
C. difficile associated diarrhea
fluid adjustment (lots of sodium)
interstitial nephritis (check renal function)

25
Q

clinical pearls of piperacillin/antipseudomonal penicillins

A

only available as BLI combos

26
Q

antipseudomonal-BLI combinations and RoA

A

piperacillin + tazobactam

27
Q

main uses of piperacillin-tazobactam

A

gram positive - streptococcus and enterococcus
gram negative - aeroSPACE (serratia, pseudomonas, acinetobacter citrobacter, enterobacter)
gut anaerobe - bacteroides fragilis

28
Q

ADR piperacillin-tazobactam

A

rash
SJS
CDAD (c. dif associated diarrhea)
fever
interstitial nephritis (check renal function periodically)

29
Q

piperacillin - tazobactam is used for which hospital/healthcare associated infections?

A

MDR gram negative organisms
- febrile neutropenia
- SIRS/sepsis
- pneumonia (VAP/HAP/healthcare associated)
- UTI
- kidney infections
- intra-abdominal infections

30
Q

anti-staph PCN’s and their RoA’s

A

nafcillin (IV)
oxacillin (IV)
dicloxacillin (oral)

31
Q

main uses of anti-staphylococcal PCN’s

A

MSSA
group A strep

32
Q

which PCN is okay with renal problems?

A

oxacillin - adjust at CrCl <10
nafcillin - hepatically eliminated

33
Q

ADR of anti-staph PCN’s

A

rash
allergic reactions
fever
interstitial nephritis

34
Q

which PCN is generally limited to skin infections?

A

dicloxacillin

35
Q

which anti-staph PCN’s are preferred for systemic infections?

A

nafcillin and oxacillin

36
Q

which PCN’s treat systemic infections of bacteremia, endocarditis, osteomyelitis?

A

nafcillin and oxacillin

Therapeutics Exam 2 - antibiotics:( (7 decks)

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