L10+11 - Cell Wall Inhibitors Flashcards by Ahmed Ahmed

State all old generation penicillins, their β-lactamase inhibitor, and their combination name

Amoxicillin - Clavulanic acid (Amoxiclav)
Ampicillin - Sulbactam (Sultamicillin)
Piperacillin - Tazobactam (Tazocin)

How well did you know this?

Not at all

Perfectly

Brand name of Amoxiclav

Augmentin

How well did you know this?

Not at all

Perfectly

Brand name of Sultamicillin

Unasyn

How well did you know this?

Not at all

Perfectly

Brand name of Tazocin

Zosyn

How well did you know this?

Not at all

Perfectly

State all new generation of penicillins and their β-lactamase inhibitors

Ceftazidime - Avibactam
Meropenem - Vaborbactam
Imipenem - Relebactam

How well did you know this?

Not at all

Perfectly

Which gram +ve bacteria can modify their PBP sites?

MRSA & Enterococci

How well did you know this?

Not at all

Perfectly

Which penicillin isn’t affected by food intake?

Amoxicillin

How well did you know this?

Not at all

Perfectly

Which penicillin is not excreted by kidneys?

Ceftriaxone

How well did you know this?

Not at all

Perfectly

Management of gas gangrene

1) Clean area
2) Administer 20M units of Penicillin G
3) Clindamycin daily

How well did you know this?

Not at all

Perfectly

Causative agent of gas gangrene?

Clostridium Perfringens

How well did you know this?

Not at all

Perfectly

RoA of Penicillin G

IV (not IM); IM painful w/o anesthesia

How well did you know this?

Not at all

Perfectly

Duration of Action of Penicillin G

Very short - 30 mins

How well did you know this?

Not at all

Perfectly

Causative agent of necrotizing fasciitis?

Streptococcus pyogenes

How well did you know this?

Not at all

Perfectly

Management of necrotizing fasciitis

1) Clean area
2) Administer 20M units of Penicillin G
3) Clindamycin daily

How well did you know this?

Not at all

Perfectly

Causative agent of cellulitis

Staphylococcus aureus & Streptococcus pyogenes

How well did you know this?

Not at all

Perfectly

Management of cellulitis

IV 20M units of penicillin G

How well did you know this?

Not at all

Perfectly

Causative agent of actinomycosis

Actinomyces israelii

How well did you know this?

Not at all

Perfectly

Management of actinomycosis

IV 20M units of penicillin G

How well did you know this?

Not at all

Perfectly

What is procaine

Local anesthetic

How well did you know this?

Not at all

Perfectly

Why is procaine sometimes coupled with penicillin G?

LA allows for IM injection
Acts as reservoir for drug; ↑ Duration of action (20 hours)

How well did you know this?

Not at all

Perfectly

Why is procaine penicillin G never administered IV?

Blocks Na+ channels of heart; arrhythmia
May cause other symptoms like dizziness/headache/seizures; due to rapid liberation of procaine toxicity

How well did you know this?

Not at all

Perfectly

Why is benzathine administered with penicillin G?

Increases its absorption and slows its release; ↑ Duration of action (4 weeks)

How well did you know this?

Not at all

Perfectly

Why is benzathine never administered IV and always IM?

Benzathine is associated with cardiopulmonary arrest = death

How well did you know this?

Not at all

Perfectly

What is benzathine penicillin G indicated for? With what doses?

Syphilis (2.4M units once every 1 week) & Rheumatoid Arthritis (1.2M units every 1 month)

How well did you know this?

Not at all

Perfectly

RoA of penicillin V

The only natural penicillin given ORALLY

Indication of penicillin V

Group A Streptococcus Tonsillitis & Pharyngitis (given penicillin V orally every 4 hrs)

Management of superinfection caused by penicillin

Rehydrate pt Discontinue penicillin with other drugs

How does ampicillin cause superinfection?

Not well absorbed; stays in GIT; kills normal flora; allows Clostridium difficile to grow; causes Pseudomonas colitis

Indication of ampicillin

Listeriosis Shigellosis (Bacillary dysetnery) Neonatal meningitis Infective endocarditis UTIs

Management of listeriosis

Administer IV Sultamicillin (2g every 6 hrs) with Gentamycin OR TMP/SMX in penicillin allergy

Management of shigellosis

Administer IV Sultamicillin (1g every 6 hours for 5 days) OR TMP/SMX in penicillin allergy

Management of neonatal meningitis

Empirical therapy with IV Sulatmicillin (1g every 6 hrs) with Cefotaxime

Causative agent of neonatal meningitis

Listeria monocytogenes

Causative agent of infective endocarditis

Enterococcus faecalis

Management of infective endocarditis

IV Sultamicillin (2g every every 6 hrs) with (Gentamycin or Ceftriaxone)

Causative agent of UTIs

E. coli

Management of UTIs

IV or Oral Sultamicillin (2g every 6 hrs)

Management of otitis media

Oral suspension amoxiclav (2.66mg/day or 4.27ml/day) three times a day

Causative agent of otitis media

Haemophilus influenzae

Causative agent of community-acquired pneumonia

Streptococcus pneumonia & Haemophilus influenzae (H. influenzae main causative)

Management of community-acquired pneumonia

Oral amoxiclav (3 times a day)

Causative agent of impetigo

Streptococcus pyogenes & Staphylococcus aureus

Management of impetigo

Oral amoxiclav (3 times a day) with topical ointment eg. Mupirocin or Fusidic acid

Causative agent of peptic ulcer

Helicobacter pylori

Management of peptic ulcers

Triple therapy: PPIs Clarythromycin Amoxicillin or Metronidazole

Prevention drug against infective endocarditis before dental surgery for pt with prosthetic valves

Amoxicillin

First line drug for acute sinusitis

Amoxicillin

Anti-staphylococcal aminopenicillins

Methicillin Cloxacillin Flucloxacillin

Main anti-pseudomonal penicillin + β-lactamaase inhibitor + RoA

Piperacillin with Tazobactam given IV

Causative agent of bacteremia

Pseudomonas aeruginosa & E. coli

Management of bacteremia

IV Piperacillin with tazobactam

Causative agent of pneumonia of gram -ve

Pseudomonas aeruginosa & Klebsiella pneumoniae

Managemet of pneumonia of gram -ve

IV Piperacillin with tazobactam

Causative agent of bacterial peritonitis

Pseudomonas aeruginosa & bacteroids fragilis

Management of bacterial peritonitis

IV Piperacillin with tazobactam

Causative agent of Nosocomial complicated UTIs

Pseudomonas aeruginosa & Enetrococcus faecalis

Management of Nosocomial complicated UTIs

IV piperacillin (pores in bacterial CW) with tazobactam & gentamicin (enter through these pores) given in different sites & IV syringes → piperacillin (-) and gentamicin (+) → combining causes inactive complex to form

Management of anaphylactic shock in cases of penicillin allergy

Maintain airways Epinephrine (IM) Antihistamines Hydrocortisone (immunosuppressant)

Cephalosporins are ineffective against which MOs?

MRSA (except 5th gen) Atypical bacteria (eg. Mycoplasma/Chlamydia/MTB) Listeria spp. & Legionella Enterococcus Clostridia spp.

Penicillins are ineffective against which MOs?

Strep pneumonia N. gonorrhea Staph aureus E. coli H. influenza P. aeruginosa

1st Generation cephalosporins

Cephalexin Cefazoline

Indications of cephalexin

Pharyngitis Mild G+ve UTIs

Cephalexin RoA

Orally

Indications of cefazoline

Pre-operative prophylaxis Infective Endocarditis & Bacteremia Prophylaxis against S. pneumonia

Causative agent of preoperative prophylaxis

MSSA & S. pyogenes

Causative agent of infective endocarditis & bactereima

S. pyogenes & MSSA

2nd gen cephalosporins

Cefaclor Cefoxitin & Cefotetan Cefuroxime

Cefaclor RoA

Oral

Spectrum of 1st gen cephalosporins

G+ve: S. pyogenes / S. aureus / S. pneumonia

Spectrum of 2nd gen cephalosporins

G+ve Bacteria G-ve: H. flu / E. coli

Indications of cefoxitin & cefotetan

Pre-operative gynecological prophylaxis → S. epidermis Peritonitis → Bacteroids fragilis

Indications of cefurixime

Community Acquired Pneumonia → S. pneumonia & H. flu Otitis media → H. flu Septicemia → E. coli

Cefazoline Adverse effects

Reduces coagulation with its anti-vitamin K → causes bleeding Measure INR

L10+11 - Cell Wall Inhibitors Flashcards

(74 cards)