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PHRM 865 > Beta Lactams > Flashcards

Beta Lactams Flashcards

(89 cards)

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1
Q

MOA of beta lactams

A

inhibit cell wall synthesis by binding to and inhibiting PBPs

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2
Q

resistance mechanisms of beta lactams

A

beta lactamase production
alteration in PBPs
decreased permeability of outer cell membrane

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3
Q

are beta lactams time dependent or concentration dependent?

A

time dependent
T>MIC

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4
Q

are beta lactams bactericidal or bacterostatic

A

bactericidal
(Except against enterococcus)

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5
Q

half life of beta lactams

A

<2 hours
(except: ceftriaxone, cefotitan, cefixime, ertapenem)

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6
Q

elimination of beta lactams

A

renal
(except: nafcillin, oxacillin, ceftriaxone, cefoperazone)

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7
Q

is there cross allergenicity with beta lactams?

A

yes except aztreonam

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8
Q

mechanisms of resistance penicillins

A

beta lactamases
altered PBPs
decreased penetration through outer cell membrane (gram negatives)

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9
Q

which bacteria make beta lactamase enzymes?

A

Gram +: staph aureus
Gram -: most, haemophilus, moraxella, neisseria, E. coli, Klebsiella, Enterobacter
Gram neg anaerobes: bacteroides

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10
Q

natural penicillins

A

penicillin G
benzathine penicillin
procaine penicillin
penicillin VK

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11
Q

penicillinase resistant penicillins

A

methicillin
nafcillin
dicloxacillin

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12
Q

aminopenicillins

A

ampicillin
amoxicillin

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13
Q

carboxypenicillins

A

ticaricillin

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14
Q

ureidopenicillins

A

pipericillin

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15
Q

beta lactamase inhibitor combo penicillins

A

amoxicillin-clavulaunate (Augmentin)
piperacillin-tazobactam (Zosyn)
ampicillin-sulbactam (Unasyn)

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16
Q

natural penicillins (Pen G, Pen V)
general spectrum

A

gram pos
gram neg cocci
anaerobes

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17
Q

penicillinase resistant (nafcillin, methicillin,dicloxacillin) general spectrum

A

gram pos
MSSA

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18
Q

aminopenicillins (amox and amp) general spectrum

A

gram pos
gram neg
anaerobes

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19
Q

carboxypenicillin (ticarcillin) general spectrum

A

gram neg aerobes only
pseudomonas aeruginosa

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20
Q

uriedopenicillin (piperacillin) general spectrum

A

gram pos
gram neg
anaerobes
pseudomonas aeruginosa
BDA (with Zosyn)

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21
Q

beta lactamase inhibitors general spectrum

A

gram pos
gram neg
anaerobes
below diaphragm anaerobes
MSSA (not used)

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22
Q

CSF penetration with penicillins

A

all penicillins will get in if max IV dose and inflamed meninges

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23
Q

which penicillins do not need renal dose adjustment

A

nafcillin
oxacillin

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24
Q

what dosage form for mild to moderate infections

A

oral

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25
which penicillins are IM
procaine pen G benzathine
26
best oral anti staph penicillin
dicloxacillin
27
which drug for syphilis
penicillin G
28
which penicillin for MSSA
nafcillin, dicloxacillin, oxacillin
29
which drug of choice for enterococcus
ampicillin, amoxicillin
30
which penicillin of choice for pseudomonas aeruginosa
piperacillin
31
augmentin uses
otitis media, sinusitis, bronchitis, lower respiratory tract infections, animal bites, human bites
32
Zosyn use
empiric therapy for hospital acquired pneumonia
33
adverse effects of penicillins
hypersensitivity seizures (renal insufficiency if no dose adjus leukopenia, neutropenia diarrhea w clauv interstitial nephritis phlebitits hypokalemia sodium overload
34
drugs to use in caution for pts with CHF or renal insufficiency due to high sodium content
aqueous sodium penicillin G nafcillin ticarcillin piperacillin (and Zosyn)
35
what is interstitial nephritis
abrupt increase in serum creatinine (sometime with eosinophilia)
36
which drugs more likely to cause interstitial nephritis
nafcillin, methicillin
37
1st generation cephalosporins
cefazolin cephalexin
38
2nd generation cephalosporins
cefuroxime cefoxitan cefotetan cefprozil
39
3rd generation cephalopsporins
ceftriaxone ceftazidime cefpodoxime cefoperazone
40
4th generation cephalosporins
cefepime
41
anti MRSA cephalosporin
ceftraroline
42
new miscellaneous cephalosporin
cefiderocol
43
beta lactamse inhibitor combo cephalosporins
cetolozane-tazobactam ceftazidime-avibactam
44
general spectrum of activity for generations of cephalosporins
1st gen - highest gram pos, lowest neg 4th gen - highest gram neg, lowest neg
45
which cephalosporins have the best activity out of all the cephalos
cefazolin cephalexin
46
which cephalosporins cover BDA
cephamycins 2nd gens (cefotetan, cefoxitan, cefmetazole)
47
which cephalosporin covers only gram negative
cefiderocol
48
which cephalosporins cover enterococcus
none, its a hole in the spectrum of these
49
cefazolin, cephalexin target organisms
MSSA
50
cefuroxime, cefprozil target organisms
MSSA (not used)
51
cefotetan, cefoxitin, cefmetazole target organisms
BDAs
52
ceftraixone target organisms
MSSA (not used) PRSP
53
ceftazidime target organisms
pseudomonas aeruginosa
54
cefepime target organsism
pseudomonas aeruginosa MSSA (not used)
55
ceftaroline target organisms
MRSA PRSP MSSA
56
cefiderocol target organisms
pseudomonas aeruginosa
57
ceftolozane-tazobactam and ceftazidime-avibactam target organisms
pseudomonas aeruginosa
58
which cephalosporins cover PRSP?
ceftriaxone (primary) ceftaroline cefepime
59
which cephalosporins cover MSSA
cephalexin, cefazolin 2nd, 3rd, 4th, ceftaroline (Not used)
60
which cephalosporins cover MRSA
ceftaroline
61
which cephalosporins cover pseudomonas
ceftazidime (primary) cefepime cefiderocol combos
62
which cephalosporins cover BDAs
cefoxitin cefotetan cefmetazole
63
which cephalosporins cover legionella
none, hole in spectrum
64
which cephalosporins penetrate the CSF?
cefuroxime
65
which cephalosporins do not require dose adjustment in renal insufficiency
ceftraixone cefoperazone
66
which cephalosporin is the only once daily dosing
ceftraixone
67
adverse effects of cephalosporins
hypersensitivity leukopenia, thrombocytopenia, neutropenia biliary sludging: ceftriaxone c. diff colitis nonconvulsive status epilepticus disulfuram, hypoprothombinemia
68
which drugs cause disulfuram reaction and hypoprothrombinemia
cefamandole cefotetan cefmetazole cefoperazone moxalactam (due to MTT side chain)
69
which cephalosporins can cause nonconvulsive status epilepticus in nephrotoxicity
cefepime ceftazidime cefiderocol
70
which cephalosporin should you avoid with calcium
ceftriaxone
71
can we use cephalosporins in PCN allergy>
if anaphylaxis - no if delated reaction - avoid first gens (side chain r1)
72
carbapenems
imipenem doripenem meropenem ertapenem meropenem-vabobactam imipenem-relebactam
73
monobactams
aztreonam
74
spectrum of activity of carbapenems general
most broad spectrum antibiotics
75
carbapenems with best gram positive activity
imipenem doripenem
76
carbapenems with best gram negative activity
meropenem doripenem
77
target organisms carbapenems
BDA MSSA (not used) pseudomonas aeruginosa (not erta) ESBL and Amp C producing KPC (combos)
78
which carbapenem does not cover pseudomonas
ertapenem
79
which drugs cover ESBL and Amp C
carbapenems
80
which drugs cover KPC
carbapenem combos
81
CSF penetration of carbapenems
meropenem only one
82
which carbapenems require dose adjustment in renal insuf
all of them
83
adverse effect of carbapenems
seizures
84
which drug is used with cilastatin
imipenem prevent breakdown of imipenem by DHP in kidney
85
what is cilastatin
DHP inhibitor used with imipenem
86
risks for CNS toxicity with carbapenems
CNS disorder (recent stroke, seizure, head trauma), high doses, renal insufficiency
87
aztreonam spectrum
no gram positive only gram negative pseudomonas
88
does aztreonam penetate the CNS?
yes
89

PHRM 865 (33 decks)

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