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Pcol2 > Beta-Lactams Part 2 of 2 - Characteristics of Beta-Lactam Subclasses & Adverse Events > Flashcards

Beta-Lactams Part 2 of 2 - Characteristics of Beta-Lactam Subclasses & Adverse Events Flashcards

1
Q

Aminopenicillins

A

amoxicillin and ampicillin

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2
Q

Antipseudomonal penicillins

A

ticarcillin and piperacilin

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3
Q

Oldest penicillins developed in the 1940s

A

Penicillin A-Sensitive

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4
Q

No activity against bacteria producing penicillinase enzymes

A

Penicillin A-Sensitive

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5
Q

Active against gram-positive pathogens, but limited use due to resistance

A

Penicillin A-Sensitive

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6
Q

Used rarely, e.g., for susceptible group A. streptococci, pneumococci, Treponema pallidum, Actinomyces spp.

A

Penicillin A-Sensitive

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7
Q

Active against penicillinase-producing bacteria, especially Staphylococci

A

Penicillinase-Resistant Penicillins

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8
Q

Drugs of choice for infections due to proven methicillin-susceptible Staphylococcus aureus (MSSA).

A

Penicillinase-Resistant Penicillins

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8
Q

Penicillin A-Sensitive (treatment) example

A

Treatment of “strep throat” (caused by Streptococcis pyogenes)
Treatment of syphilis
Treatment of pneumonia caused by penicillin-sensitive Streptococcus pneumoniae

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9
Q

Penicillinase-Resistant Penicillins drug example

A

Methicillin, oxacillin, dicloxacillin, nafcillin

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9
Q

methicillin susceptibility is tested in vitro using _________

A

oxacillin

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10
Q

(Penicillinase-Resistant Penicillins) used as oral choice

A

Dicloxacillin

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11
Q

IV choice for methicillin-susceptible S. aureus (MSSA)

A

Nafcillin

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12
Q

Penicillinase-Resistant Penicillins is active against

A

gram-positive cocci, including penicillinase

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13
Q

Do not use if suspect methicillin-resistant S. aureus (MRSA)

A

Penicillinase-Resistant Penicillins is active against

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14
Q

Extended Spectrum Penicillins (± BLI combos) drugs

A

Amoxicillin ± clavulanate
Ampicillin ± sulbactam
Ticarcillin ± clavulanate
Piperacillin ± tazobactam

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15
Q

Common BLI used in clinical practice: _________________

A

clavulanic acid, tazobactam, and sulbactam

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16
Q

Addition of ________________ to Extended Spectrum Penicillins (± BLI combos) extends activity to cover beta-lactamase-producing gram-negative bacilli

A

beta-lactamase inhibitors (e.g., clavulanate, tazobactam, sulbactam)

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16
Q

Extended Spectrum Penicillins (± BLI combos)
has broader activity against _______________ rods and anaerobes

A

gram-negative

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17
Q

Used for a wide range of infections

A

Extended Spectrum Penicillins (± BLI combos)

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18
Q

Extended Spectrum Penicillins (± BLI combos)
that have variable anti-pseudomonal activity

A

Ticarcillin and piperacillin

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19
Q

very commonly used in empiric treatment of severe, polymicrobial infections

A

Beta-lactam + BLI combos

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19
Q

Clinical Uses of Penicillins
Limited use for __________ Penicillins due to resistance.
Penicillinase-Resistant Penicillins for proven ________ infections.
Extended Spectrum Penicillins for _____ infections.

A
  • A sensitive;
  • MSSA
    -broader
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20
Q

Monobactams example

A

Aztreonam

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21
Q

Narrow-spectrum activity against gram-negatives only, including some P. aeruginosa

A

Aztreonams

22
Q

Only active against gram-negative bacilli

A

Aztreonams

23
Q

Aztreonams are often needs to be used in combination with _____________ in the context of empiric broad-spectrum _________ coverage for severe of polymicrobial infections

A

anti-gram positive agents; IV

24
Q

Safe for use in penicillin/cephalosporin-allergic patients

A

Aztreonams

25
Q

has MRSA activity, and it’s spectrum of activity is otherwise more similar to the 3rd generation

A

5th generation

26
Q

First Generation Cephalosporins

A

Cefazolin, cephalexin

27
Q

Narrow spectrum, mostly gram-positive coverage

A

First Generation Cephalosporins (Cefazolin, cephalexin)

28
Q

Limited gram-negative activity

A

First Generation Cephalosporins (Cefazolin, cephalexin)

29
Q

Used for mild skin infections and surgical prophylaxis

A

First Generation Cephalosporins (Cefazolin, cephalexin)

30
Q

Primarily for skin/soft tissue infection caused by suscpetible organisms (e.g., MSSA)

A

First Generation Cephalosporins (Cefazolin, cephalexin)

31
Q

Second Generation Cephalosporins

A

Cefaclor
Cefuroxime
Cefoxitin
Cefotetan

32
Q

Slightly more gram-negative activity with variable anaerobic activity

A

Cefaclor, Cefuroxime, Cefoxitin, Cefotetan (Second Generation Cephalosporins)

33
Q

2nd Gen Cephalosporins are active against some beta-lactamase-producing organisms such as __________ and ___________, but not _______

A

Klebsiella & H. influenzae; AmpC beta-lactamase)

34
Q

Used for mild community-acquired pneumonia (CAP)/sinusitis (e.g., cefuroxime) and other mild community-acquired infections

A

Cefaclor, Cefuroxime, Cefoxitin, Cefotetan (Second Generation Cephalosporins)

35
Q

Third Generation Cephalosporins

A

Ceftriaxone
Ceftazidime

36
Q

Expanded gram-negative coverage

A

Third Generation Cephalosporins (Ceftriaxone, Ceftazidime)

37
Q

Used for serious infections requiring IV therapy

A

Third Generation Cephalosporins (Ceftriaxone, Ceftazidime)

38
Q

Used for hospitalized community-acquired pneumonia (CAP), meningitis, neutropenic fever

A

Third Generation Cephalosporins (Ceftriaxone, Ceftazidime)

39
Q

the only 4th generation drug used clinically

A

Cefepime

40
Q

4th gen cephalosporins have better activity against _________________ and ______________ family

A

Pseudomonas aeruginosa; Enterobacteriaceae

41
Q

5th gen cephalosporins

A

Ceftaroline

42
Q

Very active against MRSA

A

Ceftaroline

43
Q

Ceftaroline is not active against

A

P. aeruginosa

44
Q

Restored activity against beta-lactamase-producing gram-negative pathogens

A

Cephalosporin + BLI Combinations

45
Q

a novel BLI that has activity against many beta-lactamases including many AmpC-producing pathogens

A

Avibactam

46
Q

Carbapenem drugs

A

-Imipenem-cilastatin
-Ertapenem
-Meropenem
-Doripenem

47
Q

deactivated by renal dehydropeptidases, thus is manufactured with a dehydropeptidase inhibitor called cilastain

A

Imipenem

48
Q

Carbapenem that is not active against P. aeruginosa or Acinetobacter spp.

A

Ertapenem

49
Q

Often reserved for severe infections thought to be polymicrobial or involving multidrug-resistant pathogens

A

Carbapenems

50
Q

Used for complicated intra-abdominal infections, nosocomial pneumonia, etc

A

Carbapenems

51
Q

last line of defence

A

carbapenem

52
Q

Beta-Lactams: Adverse Effects

A

-Hypersensitivity
-Gastrointestinal Events
-Renal Abnormalities (rare)
-Hematological Abnormalities (rare)
-Seizures (Rare)

53
Q

Hypersensitivity reaction of Beta lactams on 1-5% patients

A

rash

54
Q

Hypersensitivity reaction of Beta lactams on <0.05% patients

A

serious reactions (anaphylaxis)

55
Q

This ADE is less common between penicillins and cephalosporins

A

Hypersensitivity

56
Q

There is no cross-reaction with__________

A

aztreonam

57
Q

Beta lactams impose Possible risk of ___________-associated disease

A

C. difficile

Pcol2 (20 decks)

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