micro drug

Question 1

Penicilin G is in what form

Answer 1

IV and IM form

Question 2

Penicilin V is in what form

Answer 2

oral

Question 3

B lactam antibodies

Answer 3

penicillin

Question 4

mechanism of penicillin

Answer 4

D-Ala-D-ala sturctural analog

Question 5

bind penicillin binding proteins (transpepidates)
block transpeptidase cross linkning of peptidoglycan in cell wall
activates autolytic enzymes

Answer 5

penicillin G, V

Question 6

Penicillin is mostly used for

Answer 6

gram + organisms

Question 7

Can be used for gram - (mainly n meningitids) and spirochetes (mainley t. pallidum)

Answer 7

penicllin G

Question 8

SE of penicillin G, V

Answer 8

hypersensitivy reactions, direct Coombs + hemolytic anemia

Question 9

Penicillin G, V is bactericidal for

Answer 9

gram + cocci
gram + rods
gram - cocci
spirochetes
also penicillinase sensitivte

Question 10

resistance to penicllin G, V

Answer 10

penicillinase in bacteria ( type of B lactamase) cleaves B-lactam ring

Question 11

penicillinase sensitive penicillins

Answer 11

amoxicillin, ampicillin, aminopenicllins

Question 12

Which has great oral bioavailibty, amoxicillin or ampicillin

Answer 12

amoxicillin

AmOxicillin = greater Oral bioavability

Question 13

extended spectrum penicillin use

HHELPSS

Answer 13

H. influenzae, H. pylori, E. coli, Listeria, proteus mirablis, Salmonella, Shigella + enterococci

HHELPSS

Question 14

SE of penicillinase sensitive penicllins

Answer 14

hypersenstiivity reactions; rash; pseudomembranous colitis

Question 15

Resistance to penicillinase sensitive penicllin

Answer 15

penicillinase in bactera cleaves b lactam rings

Question 16

dicloxacillin, nafcillin, oxacillin

Answer 16

penicillanse resistant penicillins

Question 17

why are penicillinase ressistant penicillins resistant

Answer 17

bc bulky R group blocks access of B lactamase to B lactam ring

Question 18

use of penicillinase resistant penicillins

Answer 18

S. auerus (except MRSA; resistant bc of altered penicilin binding protein target site)

Question 19

SE of penicillinase resistant penciilins

Answer 19

hypersensitivyt reactions, interstitail nephritis.

Question 20

Antipseuodomanl penicillins include

Answer 20

piperacillin, ticarcillin

Question 21

Use of antipseudomanl penicillins

Answer 21

pseudomonas spp. and gram - rods; susceptible to penicillinase ; use w b lactamase inihibtors

Question 22

se of antipseudomonal penicillins

Answer 22

hypersensitivty reactions

Question 23

B lactamase inhibitors

CAST

Answer 23

clauvulanic acid
avibactam
sulbactam
tazobactam

Question 24

purpose of b lactamase inhibiors

Answer 24

often added to penicillin antibiotics to protect atnbioitc destruction by b lactamase inhbitors

Question 25

B lactam drugs that inhibit cell wall synthesis but are less susible to penicillinases

Answer 25

cephalosporins

Question 26

organisms typically not covered by 1swts-4th generation cephalosporins are LAME:

Answer 26

listeria atypicals (chlamydia, mycoplasma) MRSA Enterococci

Question 27

1st gen cephalosporins

Answer 27

cefazolin, cephalexin

Question 28

use of cefazolin, cephalexin

Answer 28

gram + cocci, Proteus mirabils, E. Coli, Klebsiella pneumoniae

Question 29

what is used prior to surgery to prevent S aureus wound infection

Answer 29

Cefazolin

Question 30

2nd generation cephalosporins

Answer 30

cefaclor, cefoxitin, cefuroxime

Question 31

2nd gen cephalosporins use

Answer 31

``` gram + cocci, H. influenzae, enterobacter aerogenes, neisseria spp serratia marcescens proteus mirabilis E coli Eklebsiella pneumoniae ```

Question 32

3rd gen cephalosporins

Answer 32

ceftriaxone, cefotaxime, cefpodoxime, ceftazidime

Question 33

use of 3rd gene cephalosporins

Answer 33

serious gram - infectiosn resistant to other B lactams

Question 34

which cephalosporisn can cross BBB

Answer 34

3rd gene

Question 35

ceftriaxone use

Answer 35

meningitis, gonorrhea, disseminated lyme disease

Question 36

ceftzidime use

Answer 36

pseudomonas

Question 37

4th gen cephalosporins

Answer 37

cefepime

Question 38

use of 4th gene cephalosporins

Answer 38

gram - organisms, with increase acitivyt against pseudomonas and gram + organisms

Question 39

5th gen cephalsoproin

Answer 39

ceftaroline

Question 40

use of ceftarolien

Answer 40

broad gram + and gram - organism ocverage;

Question 41

unlike 1st -4th generation cephalosproisn; ceftaroline covers

Answer 41

Listeria, MRSA, enteroccocccus faecalils, but does not cover pseudomonas

Question 42

SE of cephalosporins

Answer 42

hypersenstiivty reacitosn, automminue hemolytic anemai, disulfiram like reaction, vit K deficiency, low rate of cross reactivty even in penicilin allergicp atients car

Question 43

increases nephorotoxixyt of aminoglycosides

Answer 43

cephalosporins se

Question 44

carbapenems include

Answer 44

impipenem, meropenem, ertapenem, doripenem

Question 45

broad specturm B lactamase resistant carbapene

Answer 45

imipenem

Question 46

imipenem is always administerd w

Answer 46

cilastatin

Question 47

cilastatin is an inhibiotr of

Answer 47

renal dehydropeptidase I

Question 48

why is cilstatin given with imipenem

Answer 48

to decrease inactionvat of drug in renal tubules

Question 49

use of carbapenems

Answer 49

gram + cocci, gram - rods and anerogbes | wide spectrum but signficiatn side effects limit use to life threatening infections or after other drugs have failed.

Question 50

which carbapenem has a decrease risk of seizures and is stable to dehydropeptidase I

Answer 50

meropenem

Question 51

SE of carbapenem

Answer 51

GI distress, skin rash, CNS toxicity (seizures) at high plasma levels

Question 52

monobactams drug

Answer 52

aztreonam

Question 53

mechanism of monobactam

Answer 53

less susceptible to B lactamases. prevents peptidoglycan cross linkign by binding to penicillin binding protien 3; synergistic with aminoglycosides. no cross allergencitiy w penicllins

Question 54

use of monobactams

Answer 54

gram - rods only - no activity against gram _ rods or anearobes. for penicillin allergic patients as well and those w renal insufficeincy who cannot tolerate amnoglcyosodies

Question 55

SE of monobactams

Answer 55

nontoxic; occaisonal Gi upset

Question 56

vancomycin mechansim

Answer 56

inhibits cell wall peptidocyglycn formation by binding D-ala D ala portion of cell wall precursors;

Question 57

vancomycin are not susceptible to b lactamases

Answer 57

true

Question 58

Vancomycun use

Answer 58

gram + bugs only - serious multidrug resistant organsism, including MRSA, S. epidermidis sensitive , ENterococcus species and C. dificile

Question 59

bacteriostiact against C. dificle

Answer 59

vancomycin

Question 60

bactericidal agaisnt most otehr bacteria

Answer 60

vancomyicn

Question 61

SE of vancomycin

Answer 61

``` NOT nephrotoxicity ototoxicty trhombophelbiits diffuse flushing - red man syndrome (largely preventable by pretreatmetn w anti histamines and slow infusion rat ```

Question 62

mechanism of reistiance in vancomycin

Answer 62

occurs in bacteria (enteroccucus) via amino acid modificiation of D-Ala D-Ala to D Ala D-Lac