EXAM ONE COVERAGE Flashcards

(134 cards)

1
Q

Skin Normal Flora

A
  1. Staphylococcus
  2. Streptococci
  3. Diptheroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Mouth Normal Flora

A
  1. Streptococci
  2. Neisseria Sp.
  3. Haemophilus Sp.
  4. Bacteroides Sp.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

GU Tract Normal Flora

A
  1. Enterobacterales
  2. Lactobacillus Sp.
  3. Staphylococci
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

GI Tract Normal Flora

A
  1. Enterobacterales
  2. Bacteroides Sp.
  3. Clostridium Sp.
  4. Streptococci
  5. Enterococci
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Staphylococci Aureus

A

Gram Pos Cocci
Coagulase +
Rapid Test = PNA-FISH
Can alter PBP to as form of resistance to beta-lactams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Staphylococci Epidermis

A

Gram Pos Cocci
Coagulase -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Streptococci Pneumoniae

A

Gram Pos DIPLOcocci
Alpha Hemolytic
Upper Respiratory Tract infection and Otitis Media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Streptococci Pyogenes

A

Gram Pos Cocci
Beta Hemolytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Enterococcus Faecalis

A

Gram Pos Cocci
Gamma Hemolytic
More Sensitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Enterococcus Faecium

A

Gram Pos Cocci
Gamma Hemolytic
More Resistant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Peptostreptococcus

A

Gram Pos Cocci
Anaerobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lactobacillus

A

Gram Pos Bacilli
Concomitant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diptheroids

A

Gram Pos Bacilli
Concomitant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clostridium Difficle

A

Gram Pos Bacilli
Anaerobe in GI Tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

E.Coli

A

Gram Neg Bacilli (enterobacterales)
Oxidase Negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Klebsiella Sp.

A

Gram Neg Bacilli (enterobacterales)
Oxidase Negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Proteus Sp.

A

Gram Neg Bacilli (enterobacterales)
Oxidase Negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Enterobacter Sp.

A

Gram Neg Bacilli (enterobacterales)
Oxidase Negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pseudomonas Aeruginosa

A

Gram Neg Bacilli
Oxidase Positive = highly resistant, death in a matter of days
Piperacillin or Ceftazidime has good activity against
Cefepime or Ceftolozane or Cefiderocol has excellent activity against

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Acinetobacter Sp.

A

Gram Neg Bacilli
Oxidase Negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Bacteroides Fragilis

A

Gram Neg Bacilli
Strict Anaerobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Moraxella Catarrhalis

A

Gram Neg DIPLOcocci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

N. Gonorrhae, Meningilidis

A

Gram Neg DIPLOcocci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Coagulase Properties

A

Differentiate between STAPH
+ = fibrinogen to fibrin = clots = need treatment
- = no action = rarely causes infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Hemolytic Properties
Differentiate between STREP
26
Oxidase Properties
Test gram NEG bacteria for specific electron oxidase pathway + = Pathogen
27
Oxidase Properties
Test gram NEG bacteria for specific electron oxidase pathway + = Pathogen
28
What are the 1st Generation Cephalosporins?
1. Cefazolin 2. Cefadroxil 3. Cephalexin
29
What are the 2nd Generation Cephalosporins?
1. Cefoxitin 2. Cefaclor 3. Cefuroxime
30
What are the 3rd Generation Cephalosporins?
1. Ceftazidime 2. Cefotaxime 3. Cefpodoxime 4. Ceftriaxone 5. Cefdinir
31
What are the 4th Generation Cephalosporins?
1. Cefepime
32
What are the 5th Generation Cephalosporins?
1. Ceftaroline 2. Ceftolozane
33
What are the Siderophore Cephalosporins?
1. Cefiderocol
34
Ceftolozane
5th Generation Treat Intra-Abdominal and UTIs Administered with Tazobactam Most POTENT Anti-Pseudomonal
35
Tazobactam
Beta-Lactamase Inhibitor Combo with Ceftolozane Heavily modified penAM backbone
36
Ceftazidime
Third Generation Improved stability against certain beta-lactamases Administered with AVIBACTAM
37
Avibactam
Broad Spectrum Inhibitory Activity against beta-lactamases Bridged BICYCLIC scaffold NON-BETA-LACTAM INHIBITOR Reversible mechanism of inhibition, recyclizes
38
Relebactam
Board spectrum inhibitory activity against beta-lactamases Bridged BICYCLIC scaffold Admin with Imipenem/Cilastatin
39
What are 2 Carbapenems and what can they be administered in combination with?
1. Thienamycin 2. Imipenem Admin with Cilastatin Sodium
40
Aztreonam Disodium
Monobactam
41
List clinically useful Carbapenems where the SULFA is located outside the ring?
1. Ertapenem 2. Doripenem 3. Meropenem
42
Vancomycin
Glycopeptide Narrow G+ Binds D-Ala-D-Ala, does not directly inhibit CMT IV/PO, PO= C.Diff TIME DEPENDENT antibiotic AEs: Nephrotoxicity, Ototoxicity, Infusion Related Effects
43
Dalbavancin
Second Generation LipoGLYCOPEPTIDE Gram Positive Bacteria: MRSA and MRSE MOA: DIMERIZES and Inserts LIPOPHILIC side chain into membrane Binds D-Ala-D-Ala ABSSSI IV once weekly 346 hr half life
44
Oritavancin
Semisynthetic lipoGLYCOPEPTIDE Gram Pos SKIN infections More active than Vanc for certain strains of C.Diff MOA: disrupts cell membrane, inhibits transglycosylation and transpeptidation 195 hr half life CAN BIND D-Ala-D-Lactate active against VRSA
45
Telavancin
LipoGLYCOPEPTIDE 9 hr half life IV QD AE: Nephrotoxicity and Teratogenic
46
Daptomycin
LipoPEPTIDE Narrow Gram + including MRSA and VRSA, last resort antibiotic MOA: lipid protein inserts into the bacterial cytoplasmic membrane where it aggregates and forms an ion-conducting channel 1: binds in a calcium dependent manner 2: oligomerizes, disrupts membrane 3: release of intracellular ions causes rapid cell death IV QD/Infusion AE: Muscular Toxicity DDI: STATINS
47
Linezolid
Oxazolidinone Narrow Gram +, MRSA, VRSA, Strep Pneumoniae, and VRE C-Ring provides great flexibility in SAR MOA: binds to the 23S portion of the 50S ribosomal subunit preventing the formation of the functional 70S initiation complex, intracellular target can bind in Gram + but CANNOT cross Gram - outer membrane BEST ORAL drug for MRSA Broken down in the liver = PO BID AE: bone marrow suppression, peripheral neuropathy DDI: MAOI monoamine oxidase inhibitor an SSRI
48
Tedizolid
Second Generation Oxazolidinone Narrow Gram +, MRSA, VRSA, Strep Pneumoniae, and VRE More potent against Staphylococci and Enterococci MOA: binds to 50S subunit, more affinity than Linezolid IV QD, transported by albumin AE: same as Linzeolid but less effects due to lower doses DDI: MAOI and SSRI
49
Streptogramins
Dalfopristin + Quinupristin = Macrolide Like MOA: Bind 50S subunit Always take in combination
50
Quinupristin
Streptogramin Narrow Gram +, last resort VRSA, VRE, MRSA MOA: binds MLSb on bacterial ribosome subunit IV/3-4x daily Metabolized in liver AE: muscular toxicity, infusion related reactions
51
Dalfopristin
Streptogramin Narrow Gram +, last resort VRSA, VRE, MRSA MOA: binds nearby site, increased affinity of Quinupristin for 50S subunit IV/3-4x daily Metabolized in liver AE: muscular toxicity, infusion related reactions
52
Lincosamides
MOA: Bind 50s subunit ONLY ACT ON GRAM POS, due to extremely polar structure
53
Clindamycin
Lincosamide Narrow Gram +, anaerobic gram + infections, penicillin allergy substitute, and some MRSA MOA: REVERSIBLY bind 50s subunit BETTER ORAL absorption and antimicrobial activity than Lincomycin EXCELLENT penetration in bone, abscesses, macrophages, NOT CNS AEs: increased risk for C.Diff (not sensitive to Clinda)
54
Sulfonamides
First Type: aniline substitute Second Type: PRODRUGS Third Type: Non-Alanine, no cleavage
55
Sulfanilamide
Newer versions have lower pKa vales to prevent Crystalluria MOA: replacement of PABA
56
Sulfamethoxazole
Sulfonamide BROAD spectrum, MRSA Good Oral absorption AE: nephrotoxicity, hyperkalemia, pancytopenia, photosensitivity, rash, SJS, epidermal necrolysis KERNICTERUS IN NEONATES
57
Dihydrofolate Reductase Inhibitiors
Trimethoprime will target dihydrofolate reductase to stop DNA/RNA synthesis
58
Trimethoprim
Dihydrofolate Reductase Inhibitor BROAD spectrum, MRSA Good Oral absorption AE: nephrotoxicity, hyperkalemia, pancytopenia, photosensitivity, rash, SJS, epidermal necrolysis KERNICTERUS IN NEONATES
59
Bactrim
Sulfamethozaole (sulfanilamide) + Trimethoprim DDI: WARFARIN, slowing drug metabolism
60
Mupirocin
Monocarboxylic Acid Class Narrow Gram + MOA: interrupting peptide-chain elongation, reversibly binds to bacterial isoleucyl-tRNA synthetase TOPICAL ONLY AE: allergic reactions, irritation
61
Teixobactin
MOA: binds to lipid II and lipid III cell wall peptidoglycan precursors Acts on GRAM POS: Staph Aureus, Enterococci Faecalis, and M. tuberculosis
62
Penicillin G
Parent Penicillin Narrow G+ Poor Oral absorption, Continuous IV Unstable in acidic environments
63
Penicillin V
Parent Penicillin Narrow G+ Oral absorption
64
Pen-VK
Acid Stable Form of Penicillin V Pen V + Potassium Salt
65
Parent Penicillin V and G
Short half life 30-60 mins Accumulate in renal insufficiency Rapid renal elimination Narrow G+
66
Oxacillin
Narrow G+ Penicillinase Resistant IV AE: hepatotoxicity
67
Methicillin
Prototype Renal toxicity No longer available
68
Nafcillin
Narrow G+ Penicillinase Resistant IV AE: interstitial nephritis, bone marrow suppression
69
Dicloxacillin
Narrow G+ Penicillinase Resistant Oral, take on empty stomach
70
MRSA Resistant to what?
Oxacillin, Nafcillin, and Dicloxacillin, and other B-Lactams
71
Ampicillin
Extended G+ Penicillinase Sensitive IV/PO, limited oral absorption affected by food
72
Amoxicillin
Extended G+ Penicillinase Sensitive PO, 100% absorption, no effect with food
73
Piperacillin
Extended G+, more gram- most extended of ALL penicillins Penicillinase Sensitive IV GOOD ACTIVITY against Pseudomonas Aeruginosa
74
Unasyn
Ampicillin + Sulbactam IV Broad Spectrum
75
Augmentin
Amoxicillin + Clavulanic Acid PO Broad Spectrum
76
Zosyn
Piperacillin + Tazobactam IV Broad Spectrum
77
Cefazolin
First Generation Extended G+ IV, longest half life in 1st gen DDI: Warfarin = increased anticoagulant effect
78
Cephalexin
First Generation Extended G+ PO Most widely used
79
Cefadroxil
First Generation Extended G+ PO, best absorbed after oral admin
80
Cefoxitin
Second Generation More Extended G+ Less Sensitive to Beta-Lactamases IV
81
Cefuroxime
Second Generation More Extended G+ Less Sensitive to Beta-Lactamases IV/PO
82
Cefaclor
Second Generation More Extended G+ Less Sensitive to Beta-Lactamases PO
83
Cefotaxime
Third Generation Broad Spectrum, Gram + and Enterobacteriaceae Rod Gram - Resistant to B-Lactamase Cross BBB IV First approved 3rd gen
84
Ceftriaxone
Third Generation Broad Spectrum, Gram + and Enterobacteriaceae Rod Gram - Resistant to B-Lactamase Cross BBB IV Most widely used, long half life AE: BILIRUBIN DISPLACEMENT
85
Ceftazidime
Third Generation Broad Spectrum, Gram + and Enterobacteriaceae Rod Gram - SENSITIVE to B-Lactamase Cross BBB IV, take in combo with AVIBACTAM HIGH ACTIVITY AGAINST P.Aeruginosa
86
Cefdinir
Third Generation Broad Spectrum, Gram + and Enterobacteriaceae Rod Gram - Resistant to B-Lactamase Cross BBB PO Can chelate with iron = stool discoloration
87
Cefpodoxime
Third Generation Broad Spectrum, Gram + and Enterobacteriaceae Rod Gram - Resistant to B-Lactamase CANNOT cross BBB PO
88
Cefepime
Fourth Generation Broad Spectrum Resistant to B-Lactamase Cross BBB Excellent activity against P.Aeruginosa AE: INCREASED risk of seizures
89
Ceftaroline
Fifth Generation Broad Spectrum Resistant to B-Lactamase NOT effective against P.Aeruginosa but EFFECTIVE against MRSA and VRSA (FDA approved)
90
Ceftolozane
Fifth Generation USE IN COMBO with Tazobactam Sensitive to B-Lactamase Broad
91
Cefiderocol
Siderophere Cephalosporin: forms a complex w/iron to cross gram- outer membrane Resistant B-Lactamase Narrow Gram - IV, last resort antibiotic for MDR gram -
92
Acinetobacter Baumannii
Gram Neg Rod Cefiderocol has excellent activity against
93
Imipenem
Carbapenem Extreme Broad Spectrim Resistant B-Lactamase IV, Metabolites can cause kidney damage AE: nephrotoxicity Can use in combo with Cilastatin and Relebactam
94
Meropenem
Carbapenem Extreme Broad Spectrim Resistant B-Lactamase IV, Resistant to dehydropeptidase Can use in combo with Vaborbactam to target MDR
95
Ertapenem
Carbapenem Extreme Broad Spectrim Resistant B-Lactamase IV, resistant to dehydropeptidase
96
Aztreobactam
Monobactam Narrow G- IV No cross-allergic reactions with other B-Lactams
97
ALL Penicillin AEs
CNS Excitation and Seizures at HIGH concentrations
98
ALL Cephalosporins AEs
Rash Cross Reactivity with penicillin allergy
99
ALL Carbapenems AEs
INCREASED risk of seizures Cross Reactivity with penicillin allergy
100
Beta-Lactamase Inhibitor + Aminopenicillin AEs
Diarrhea
101
Narrow G+ Penicillins
1. Penicillin G (IV/IM) 2. Penicillin V (PO empty stomach) 3. Oxacillin (IV) 4. Nafcillin (IV) 5. Dicloxacillin (PO empty stomach)
102
Extended G+ Penicillins
1. Ampicillin (IV, PO empty stomach) 2. Amoxicillin (PO) 3. Piperacillin (IV), P.Aeruginosa
103
Broad Spectrum Penicillins
1. Unasyn (IV) 2. Augmentin (PO) 3. Zosyn (IV)
104
Which beta lactams have the broadest spectrum?
Carbapenems
105
For CNS Symptoms which beta lactams are the most problematic?
Carbapenems
106
Lefamulin
Pleuromutilins Extended Gram +, MRSA, community pneumonia MOA: unique binding site on 50s bacterial ribosome, inhibit protein synthesis IV/PO AE: QT prolongation, teratogenic
107
Enterococcus vs Enterobacterales
Coccus = gram positive Bacterales = gram negative Entero = gut
108
Pen G, Pen VK Coverage
Gram + Narrow Gram Pos = Strep/S.Pneumo/E.Faecalis/Listeria Gram Neg = T.Pallidum Anaerobes = Gram +
109
Nafcillin, Oxacillin, and Dicloxacillin Coverage
Gram + Narrow Gram Pos = Staph/Strep/S.Pneumo
110
Ampicillin and Amoxicillin Coverage
Extended Gram + Gram Pos = Strep/S.Pneumo/E.Faecalis/Listeria
111
Unasyn and Augmentin Coverage
Broad Spectrum Gram Pos = Strep/S.Pneumo/Staph/E.Faecalis/Listeria Gram Neg = HENPEcK Anaerobes = +/-
112
Zosyn Coverage
Broad Coverage Gram Pos = Strep/Staph/E.Faecalis/Listeria Gram Neg = HENPEcK and Pseudomas Anaerobes = +/-
113
PEcK
Proteus E.Coli Klebsiella
114
HENPEcK
H.Influenzae Enterobacter Neisseria Proteus E.Coli Klebsiella
115
Cephalexin, Cefadroxil, and Cefazolin Coverage
Gram Pos = Staph, Strep, S.Pneumo Gram Neg = PEcK Anaerobe = Peptostrepto
116
Cefoxitin, Cefuroxime, and Cefaclor Coverage
Gram Pos = Staph, Strep, S.Pneumo Gram Neg = HENPEcK Anaerobes = Peptostrepto, Cefoxitin = GN
117
Cefdinir, Cefpodozime, Ceftriazone, Ceftazidime, and Cefotazime Coverage
Gram Pos = Staph, Strep, S.Pneumo (except Ceftaz) Gram Neg = HENPEcK (Ceftaz = pseudomonas) Anaerobes = Peptostrepto, Cefotax = GN
118
Cefepime Coverage
Gram Pos = Staph, Strep, S.Pneumo Gram Neg = HENPEcK and Pseudomonas Anaerobe = Peptostrepto
119
Ceftaroline +++ Ceftolozane/Taxo --- Coverage
Gram Pos = Staph, S.Pneumo, Ceftaro = Staph/MRSA Gram Neg = HENPEcK, Ceftolo = Pseudomonas Anaerobe = Peptostreto, Ceftolol = GN
120
Cefiderocol Coverage
Gram Neg = Enterics, Pseudomonas
121
What drugs can cover Pseudomonas?
1. Ceftazidime 2. Cefepime 3. Ceftolozane/Tazobactam 4. Cefiderocol 5. Zosyn 6. Imipenem 7. Meropenem 8. Aztreonam
122
Imipenem/Cilstatin Coverage
Gram Pos = Staph, Strep, S.Pneumo, E.Faecalis Gram Neg = HENPEcK, Pseudomonas Anaerobe = +/- Listeria
123
Meropenem Coverage
Gram Pos = Staph, Strep, S.Pneumo Gram Neg = HENPEcK, Pseudomonas Anaerobe = +/-
124
Ertapenem Coverage
Gram Pos = Staph, Strep, S.Pneumo, E.Faecalis Gram Neg = HENPEcK Anaerobe = +/-
125
Aztreonam Coverage
Gram Neg = Enterics, HENPEcK, and Pseudomonas
126
Vancomycin Coverage
Gram Pos = Strep, S.Pneumo, Staph, MRSA, E.Faecalis Anaerobes = Peptostrepto, Clostridia
127
Telavancin, Oritavancin, and Dalbavancin Coverage
Gram Pos = Strep, S.Pneumo, Staph, MRSA, E.Faecalis Anaerobes = Peptostrepto, Clostridia
128
Daptomycin Coverage
Gram Pos = Strep, S.Pneumo, Staph, MRSA, E.Faecalis, VRE Anaerobes = Peptostrepto
129
Linezolid and Tedizolid Coverage
Gram Pos = Strep, S.Pneumo, Staph, MRSA, E.Faecalis,VRE (Linezolid = Listeria) Anaerobes = Linezolid = Peptostrepto, Clostridia
130
Quin/Dalfopristin Coverage
Gram Pos = Strep, S.Pneumo, Staph, MRSA, E.Faecalis, VRE
131
Clindamycin Coverage
Gram Pos = Strep, S.Pneumo, Staph, MRSA, Anaerobes = Peptostrep
132
Bactrim Coverage
Gram Pos = Staph, MRSA, Listeria Gram Neg = Enterics
133
Mupirocin Coverage
Gram Pos = Strep, Staph, MRSA
134
What drugs cover VRE?
1. Daptomycin 2. Linezolid 3. Tedizolid 4. Quinupristin/Dalfopristin