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Flashcards in Penicillins Deck (46)
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1

*For what conditions is bactericidal antibiotic therapy required? (4 dz’s)

- Meningitis - Endocarditis - Osteomyelitis - Febrile neutropenia

2

Bactericidal or bacteriostatic? Cell wall formation/synthesis inhibitors are in general _____________. Nucleic acid synthesis inhibitors are ___________. Protein synthesis inhibitors tend to be ____________. Metabolic inhibitors are usually ______________.

Cell wall formation/synthesis inhibitors are in general bacteriocidal. Nucleic acid synthesis inhibitors are bacteriocidal. (exception: aminoglycosides) Protein synthesis inhibitors tend to be bacteriostatic. Metabolic inhibitors are usually bacteriocidal.

3

What are the 3 key concepts to consider regarding infection when considering antibiotic tx?

- Severity - Site - Organism

4

What are the 6 key concepts to consider regarding the host when considering antibiotic tx?

- Allergies - Age - Pregnancy - Renal/hepatic function - Drug interactions (w/theirs) - Underlying disease

5

What are the 7 key concepts to consider regarding the drug when considering antibiotic tx?

- Predicted activity/measured susceptibility - Clinical efficacy - “Drug of choice” - PK and tissue penetration - PD (need cidal?) - Side Effects - Cost

6

What are the 2 groups of natural PCNs?

PCN G and PCN VK (oral)

7

What are the 4 types of penicillinase-resistant penicillins?

Nafcillin, oxacillin, methacillin, dicloxacillin

8

What are the 2 aminopenecillins?

Ampicillin and amoxicillin

9

What is the name of the carboxypenicillin?

Ticarcillin (not avail.)

10

What is the name of the ureidopenicillin?

Piperacillin

11

Name 4 beta-lactamase inhibitor-combo treatments. (just the overall drug names)

- Unasyn - Timentin - Zosyn - Augmentin

12

Are PCNs time- or conc-dependent killing?

- Time-dependent

13

What group does PCNs have synergy w/?

Aminoglycosides (against Enterococcus spp., Staphylococcus spp., viridans strep, and gram-negative bacteria)

14

PCNs distribute throughout body tissues/fluids except for these 3 sites:

Eye, prostate, and uninflammed CSF.

15

*What 5 things are natural PCNs commonly used for treating, besides the organisms previously mentioned? (extra stuff that's on slides but not blue)

- Actinomyces - Bacillus anthracis (anthrax) - Endocarditis prophylaxis - Prevention of rheumatic fever

16

What type of infections (not organisms) are amino-PCNs used to treat?

- Respiratory tract infections - Pharyngitis - Sinusitis - Otitis media - Bronchitis - UTIs

17

Although not clinically available, what types of conditions do ticarcillin and pipercillin typically treat?

Hospital-acquired infections

18

The beta-Lactamase Inhibitor Combination treatment Augmentin is typically used to treat what sx?

Sinusitis, otitis media, upper and lower respiratory tract infections, human or animal bite wounds (similar to amino-PCNs)

19

The beta-Lactamase Inhibitor Combination treatments Unasyn, Zosyn, Timentin are typically used to treat what major types of infections?

- Polymicrobial infections - Empiric therapy for febrile neutropenia or hospital-acquired infections (Zosyn)

20

MoA of all beta-lactams? - Cidal or static?

Inhibit cell wall synthesis by binding and thus inhibiting PBPs. Inhibits final transpeptidation step of peptidoglycan synthesis. - Bactericidal

21

*Most beta-lactams are eliminated by the ___________. *What are the exceptions? (don't forget cephalosporins)

Kidneys - Nafcillin, oxacillin, dicloxacillin (PRPs) - Ceftriaxone (cephalosporin) - Cefoperazone (cephalosporin)

22

What are the beta-lactam mechs of resistance? (Which is most important?)

Beta-lactamase enzymes (most important; cephalosporins are less susceptable), PBP alteration, decreased membrane penetration

23

2 eg's of organisms that inhibit beta-lactams via beta-lactamase are:

- PRSP - MRSA

24

What 2 drugs are contained in Unasyn?

Ampicillin-sulbactam

25

What 2 drugs are contained in Timentin?

Ticarcillin-clavulanate

26

What 2 drugs are contained in Zosyn?

Piperacillin-tazobactam

27

What 2 drugs are contained in Augmentin?

Amoxicillin-clavulanate

28

What is the route of administration of PCN G, aqueous form? Benzathine salt form? Procaine form?

- Aqueous: IV - Benzathine: IM - Procaine: IM

29

What is the route of administration for PCN VK?

PO (acid stable)

30

Which of the 4 penicillinase-resistant penicillins can be given orally?

Dicloxacillin