Cell Wall Inhibitors Flashcards by Nicholas Weber

Cephalosporins are not active against LAME

Listeria monocytogenes
Atypical bacteria
MRSA
Enterococcus

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Cephalosporin used in Orthopedic surgery because it penetrates bone

Cefazolin

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First generation cephalosporins high activity against? Specifically (3)

Gram positive cocci

Proteus mirabilis, E. coli, Klebsiella

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First generation cephalosporin used in URTIs and penicillin/sulfonamide resistant UTI

Cephalexin

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Surgical prophylaxis against gram positive bacteria

Cefazolin

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Do first generation cephalosporins enter CNS?

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First generation cephalosporins are eliminated primarily through

Glomerular filtration and tubular secretion

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First generation cephalosporins levels are increased in serum by

Probenecid

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Base compound extracted from fungus and modified attachments of various R groups of cephalosporins is called?

7-aminocephalosporanic acid

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Parenteral second generation cephalosporins (5)

Cefuroxime
Cefamandole
Cefoxitin
Cefotetan
Cefmetazole

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First generation cephalosporins

Which is parenteral? Which is oral

Parenteral - cefazolin

Oral - cephalexin, cefadroxil

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Spectrum of 2nd generation cephalosporins? HENPEcK

Hemophilus influenza, Enterobacter aerogenes, N. meningitidis, Proteus mirabilis, E. coli, Klebsiella

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2nd gen cephalosporins active against H influenzae (3)

Cefamandole
Cefuroxime
Cefaclor

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3 therapeutic uses of cephalosporins

Upper and lower RTIs
Anaerobic infections
Community-acquired pneumonia

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2nd gen cephalosporins to treat anaerobic infections (B fragilis) (3)

Cefoxitin
Cefotetan
Cefmetazole

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Oral Third generation cephalosporins (4)

Cefixime
Cefdinir
Cefibuten
Cefpodoxime proxetil

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Spectrum of third gen cephalosporins (4 specific)

Gram + cocci
HENPEcK
Pseudomonas
Serratia
Citrobacter
Providencia

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Agents of choice (2) for treatment of meningitis caused by pneumococci, meningococcal, H influenzae but not L. Monocytogenes

Cefriaxone and cefotaxime

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Third generation cephalosporins most active against P. Aeruginosa

Ceftazidime and Cefoperazone

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3rd gen cephalosporin for typhoid fever

Ciprifloxacin

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Only generation cephalosporin that can enter CNS? Except which drug?

3rd except Cefoperazone

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The excretion of Cefoperazone and ceftriaxone is mainly through?

The biliary tract and no adjustment is required in renal insufficiency

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Parental Fourth generation cephalosporins (2)

Cefepime, Cefpirome

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Cephalosporin active against methicillin-resistant staphylococci

Ceftaroline fosamil

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Cephalosporins of choice in pseudomonas infection (3)

Ceftazidime, Cefoperazone, Cefepime

Cephalosporins of choice in Gonorrhea

Ceftriaxone, Cefixime

Cephalosporins of choice in acute otitis media

Ceftriaxone

Majority of cephalosporins are administered via___

IV or IM

2nd gen cephalosporins active against B fragilis

Cefotetan Cefoxitin Cefmetazole

If a patient is allergic to penicillin, avoid cephalosporins, an alternative for Gram + consider____, for Gram - consider_____

Gram + = macrolides | Gram - = aztreonam

Nephrotoxicity from which cephalosporin specifically?

Cephaloridine

Oral second generation cephalosporins (2)

Cefaclor | Cefuroxime axetil

Doripenem and Meropenem have greater activity against ______aerobes and less activity against _____ than imipenem

More = gram - aerobes Less = gram +

Drug of choice for Enterobacter

Carbapenems

Name of Inhibitor of renal dehydropeptidase? Used specially with?

Cilastatin Imipenem

Cefepime is a ___ generation cephalosporin and has good activity against (6)

``` Pseudomonas Enterobacteriaceae S aureus S pneumoniae Hemophilus Neiserria spp ```

4 carbapenems D I E M

Doripenem Imipenem Ertapenem Meropenem

Carbapenems are administer via____

IV or IM

Which cephalosporins may cause bleeding due to hypoprothrombinemia? Because of what side chain? Administer _____ to correct the problem.

Cefoperazone, Cefamandole, Cefotetan, Cefmetazole Methylthiotetrazole side chain Administer VITAMIN K corrects problem

Red man syndrome is a type ___ hypersensitivity reaction

Type 1

Ertapenem is sometimes given with _____ to prevent irritation effects

1 % lidocaine

Given orally as back up drug for C. Difficile enterocolitis?

Vancomycin

Adverse effect of Imipenem

Seizures

Parenteral Third generation cephalosporins (4)

Cefotaxime Ceftriaxone Ceftazidime Cefoperazone

Monobactams are only given for ____ such as (3) administered via

``` Aerobic gram negative rods like H. Influenzae Pseudomonas Enterobacteria Administer via IV ```

Monobactams have no activity against _____ and ____

Gram + and anaerobes

Cephalosporins of choice in meningitis

Ceftriaxone, Cefotaxime

Which carbapenem should not be used for P aeruginosa

Ertapenem

Aztreonam has structural similarities to which 3rd generation cephalosporin?

Ceftazidime

What is the only Monobactam called?

Aztreonam

2 glycopeptide antibiotics

Vancomycin, teicoplanin

3 adverse effects of vancomycin

Red neck syndrome Ototoxicity Nephrotoxicity

Triple topical antibiotic

Bacitracin, polymyxin, neomycin

Vancomycin mechanism of action Bactericidal/Bacteriostatic?

Inhibition of synthesis of peptidoglycan binding to D-Ala-D-Ala terminus inhibiting transglycosylation Bactericidal

Vancomycin is Effective against MRSA because...

Does not bind to PBP

Spectrum of Vancomycin

Only Gran + Enterococcus MRSA

2 Adverse effects of daptomycin

Myopathy and allergic pneumonitis

Replacement of D-Ala-D-Ala to ____ leads to vancomycin resistance

D-Ala-D-Lactate

Vancomycin is ____(lipid/water) soluble; ____ absorbed orally

Water soluble; poorly absorbed orally

Vancomycin is used orally only for the treatment of antibiotic associated colitis caused by

C. difficile

Parenteral doses of vancomycin must be administered intravenously by ______

Slow IV infusion

Vancomycin does not enter ___ tissue

CNS

Vancomycin is primarily excreted by ____

Glomerular filtration

How to prevent red man syndrome from vancomycin (2 ways)

Prolong the infusion period (1-2 hrs) or pretreatment with antihistamines

What two protein inhibitors are used for treatment of vancomycin resistant organisms?

Linezolid | Quinupristin/Dalfopristin

Action of fosfomycin

Inhibits bacterial wall synthesis

Spectrum of fosfomycin

Gram + | Gram -

Daptomycin binds to cell-membrane via ____-dependent insertion of its ____ resulting in _____ of the membrane resulting in____

Calcium dependent; Lipid tail; Depolarization; Potassium efflux and rapid cell death

Vancomycin is used in combo with _____(3) for treatment of meningitis due to penicillin-resistant strains of pneumococcus

Cefotaxime Ceftriaxone or Rifampin

Is fosfomycin safe in pregnancy?

Yes

Vancomycin is used in combo with ___ to treat enterococcus endocarditis in a patient with penicillin allergy

Gentamicin

Cell Wall Inhibitors Flashcards

(71 cards)