general and beta lactams Flashcards by Christiana Antonio

an antibiogram shows what

susceptibility patterns

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characteristics of a gram positive organism

thick cell wall, stains purple

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characteristics of a gram negative organism

thin cell wall, stains pink

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characteristics of an atypical organism

no cell wall, no stain

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MIC

minimum inhibitory concentration

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explain the rationale of synergistically using aminoglycosides and beta lactams

beta lactams allow aminoglycosides to reach the intracellular target permitting a lower dose of aminoglycosides

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intrinsic resistance

resistance is natural to the organism

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selection pressure resistance

antibiotics kill only susceptible bacteria and leaves behind more resistant bacteria strains that multiply

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acquired resistance

bacterial DNA with resistant genes

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enzyme inactivation resistance

bacteria-produced enzymes break down the antibiotic

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high risk of CDI

broad spectrum penicillins and cephalosporins, quinolones, carbapenems, clindamycin* (BBW)

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bacteriostatic

inhibit bacterial growth

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bacteriocidal

kill bacteria

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hydrophillic agents

beta lactams, aminoglycosides, vancomycin, daptomycin, polymixins

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characteristics of hydrophilic agents

1-small VD = less tissue penetration; 2-renal elimination = drug accumulation & SE; 3-low intracellular conc = no atypical activity; 4-poor/mod bioavailability = IV:PO is NOT 1:1

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lipophilic agents

quinolones, macrolides, rifampin, linezolid, tetracyclines

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lipophilic agent characteristics

1-large VD = tissue penetration; 2-hepatic elim = DDIs & hepatotoxicity; 3-intracellular = atypical activity; 4-excellent bioavailability = IV:PO is 1:1

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spectrum of penicillins: natural, antistaphylococcal, aminopenicillines, extended-spectrum

Natural-strep/entero/gram+ anaerobes; Antistaphylococcal- strep/MSSA; Aminopenicillins- strep/enter/gram neg(HNPEK); Extended-spectrum- gram pos and neg(pseudamonas, CAPES)

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Penicillin G Benzathine BBW

not for IV use (must use IM); can cause cardiorespiratory arrest and death

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zosyn

pip/taz

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augmentin

amoxicillin/clavulanate

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unasyn

ampicillin/sulbactam

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penicillins contraindication

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CrCl<30 ml/min

what is the rationale behind using probenecid with penicillins

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probenecid can inc levels of beta lactams by interfering with renal excretion

t/f: all beta lactams enhance the anticoagulation effect of warfarin

f; all except nafcillin and diclozacillin

accumulation of penicillins put patients at inc risk of

seizure

first line tx for pharyngitis

penicillin VK

first line tx for AOM

amoxicillin, augmentin (also for nasal pharyngitis)

drug of choice for infective endocarditis prophylaxis before dental procedures

amoxicillin

drug of choice for syphilis

Penicillin G benzathine (G for george from grey's)

drugs that have exposure dependent dosing

vancomycin, macrolides, tetracyclines, polymixins

drugs that have time dependent dosing

beta lactams

drugs that have concentration dependent dosing

aminoglycosides, quinolones, daptomycin

the gram __(negative/positive)___ spectrum of cephalosporins ___(inc/dec)___ with each generation

negative; inc

cephalosporins have no activity against

enterococci and atypical organisms

first gen cephalosporins and which one(s) has IV formulation

cefazolin (IV), cephalexin, cephadroxil

second gen cephalosporins and which one(s) has IV formulation

IV: cefuroxime (also PO), cefotetan, cefoxitin; PO only: cefaclor, cefprozil

second gen cephalorsporins with gram negative anaerobe activity

cefotetan, cefoxitin

third gen cephalosporins and which one(s) has IV formulation

IV: ceftriaxone, cefotaxime, ceftazidime; PO: cefdinir, cefixime, cefpodoxime

third gen cephalosporin that covers pseudemonas

ceftazidime

fourth gen cephalosprin

cefepime

fifth gen cephalosporin

ceftaroline

only beta lactam that covers MRSA

ceftaroline

beta lactamase inhibitors may be used with cephalosporins to inc acitivty against

MDR gram negative rods

ceftriaxone contraindication

hyperbilirubinemic neonates, concurrent use with Ca-containing IV products in neonates <28 days (can form precipitates with Ca)

cefotetan warning

inc risk of bleeding/disulfram rxn if ingested with alcohol due to NMTT side chain

cephalosporin SE

seizures (renal accumulation), GI upset, diarrhea, rash/allergy, hemolytic anemia

ceftriaxone clinical pearl

no renal adjustments!

cephalosporin DDIs

separate from antacids; avoid H2RAs and PPIs

carbapenems are generally reserved for

MDR gram neg

ertapenam must only be diluted in

carbapenem major DDI

dec serum conc of valproic acid

invanz

ertapenem

ertapenem does not cover

pseudamonas, enterococcus, acinetobacter (PEA)

carbapenems do not cover

atypicals, VRE, MRSA, C diff, stentrophomonas

CAPES

citrobacter, acinetobacter, providencia, enterobacter, serratia

aztreonam spectrum

gram neg, CAPES, pseudamonas (no gram pos or anaerobic activity)

general and beta lactams Flashcards

(57 cards)