Pharm PCN/Cephalosporin/Carbapenem

Question 1

Natural PCNs (Drugs)

Answer 1

Penicillin G

Penicillin V

Question 2

Natural PCNs (Spectrum)

Answer 2

Gram +, cocci and bacilli, some gram -

Question 3

Penicillinase resistant PCN (Drugs)

Answer 3

Nafcillin, methacillin, cloxacillin, dicloxacillin, oxacillin

Question 4

Penicillinase resistant PCN (Spectrum)

Answer 4

Staph. Aureus

Question 5

Extended spectrum (Drugs)

Answer 5

Ampicillins, amoxicillin, bacampicillin

Question 6

Extended spectrum (Spectrum)

Answer 6

Gram +/-, cocci and bacilli

Question 7

Antipseudomonals (Drugs)

Answer 7

Ticarcillin, piperacillin, carbenicillin, mezlocillin

Question 8

Antipseudomonals (Spectrum)

Answer 8

Gram (-) plus pseudomonas

Question 9

Penicillin/Beta lactamase inhibitors (Drugs)

Answer 9

amoxicillin clavulanate (Augementin)
ampicillin/sulbactam (Unasyn)
piperacillin/tazobactam (Zosyn)
ticarcillin/clavulanate (Timentin)

Question 10

1st generation cephalosporins (drugs)

Answer 10

“Cefa” “Cepha” “Cephra”

Except Cefaclor which is 2nd gen

Question 11

2nd generation cephalosporins (drugs)

Answer 11

Cefuroxime, Cefoxitin, Cefotetan, Cefaclor

Question 12

3rd generation cephalosporins (drugs)

Answer 12

“ime” “one” “ten”
Cefdinir
Moxalactam

Except Cefuroxime which is 2nd gen

Question 13

4th generation cephalosporins (drugs)

Answer 13

“pi”

Cefepime, Cefepirole

Question 14

5th generation cephalosporins (drugs)

Answer 14

“rol”

Ceftaroline

Question 15

1st generation (spectrum)

Answer 15

Gram +, Ok Gram -, anaerobes +/- (not B. fragilis)

Question 16

2nd generation (spectrum)

Answer 16

Gram +, Good Gram -, anaerobes +/-

Question 17

3rd generation (spectrum)

Answer 17

Weak Gram +, Better Gram -, anaerobes +/-, ceftazidime active against pseudomonas

Question 18

4th generation (spectrum)

Answer 18

Gram +, Best Gram -, anaerobes +/-, pseudomonas

Question 19

5th generation (spectrum)

Answer 19

Gram +, Gram -, anaerobes +/-, MRSA

Question 20

1st generation (Role)

Answer 20

• S. aureus infections
• Skin, soft tissue infections
• Preoperative antibiotic prophylaxis for clean procedures
• Uncomplicated, community acquired UTIs

Question 21

2nd generation (Role)

Answer 21

• Surgical prophylaxis in GI surgery
• PID
• Community-acquired pneumonia
• Otitis media
• Sinusitis
• Quinolone, TMP/SMX-resistant E. coli UTI

Question 22

3rd generation (Role)

Answer 22

• Predominantly GRAM NEGATIVE AGENT
• Community acquired pneumonia
• ECF-acquired pneumonia where Pseudomonas is not suspected
• UTIs with gram (-)
• Meningitis
• Gonorrhea

CEFTAZIDIME = ANTIPSEUDOMONAL

Question 23

4th generation (Role)

Answer 23

Overly broad

Question 24

5th generation (Role)

Answer 24

MRSA pneumonia?

Community acquired pneumonia (CAP)

Cellulitis with CANVAS 1 in CANVAS 2

Question 25

Procaine Pencillin

Answer 25

Formulation of Penicillin G - Delays peak serum and last 12 hours in serum and tissue - Common allergy to procaine (injection anesthetic)

Question 26

Benzathine Penicillin

Answer 26

Formulation of Penicillin G - Drug of choice for latent syphilis - Provides long lasting serum levels (15-30 days) - Not effective against CNS infections

Question 27

Ampicillin-sulbactam

Answer 27

Common name: Unasyn Penicillin with Beta-lactamase

Question 28

Amoxicillin-clavulanate

Answer 28

Common name: Augmentin Penicillin with Beta-lactamase

Question 29

Unasyn/Augmentin (spectrum)

Answer 29

Gram +: MSSA Gram - Anaerobes: B. fragilis

Question 30

Unasyn/Augmentin (Role)

Answer 30

- Pneumonia - Intraabdominal infections - Skin and soft tissue infections

Question 31

Piperacillin-Tazobactam

Answer 31

Common name: Zosyn Penicillin with beta-lactamase

Question 32

Piperacillin-Tazobactam (Spectrum)

Answer 32

- MSSA - Beta-lactamase producing Enterobacteriaceae - B. fragilis

Question 33

Piperacillin-Tazobactam (Role)

Answer 33

- Nosocomial pneumonia - Intra-abdominal infections - Complications infections - Pseudomonal infections

Question 34

Cephalosporins (adverse effects)

Answer 34

- Stomach discomfort. - Nausea or vomiting. - Diarrhea. - Thrush (white fungus in the mouth), yeast infection, or other fungal infection. - Blood abnormalities. - Rash or itching

Question 35

Penicillin (adverse effects)

Answer 35

- Oxacillin, nafcillin (Elevated AST/ALT, neutropenia, rash, allergic interstitial nephritis) - Ampicillin/amoxicillin (Rash, diarrhea)

Question 36

KPCs

Answer 36

K pneumoniae carbapenemase Klebsiella and other Enterobacteriaceae produce carbapenemases, which are enzymes that hydrolyze the carbapenems

Question 37

Aztreonam (Role)

Answer 37

No cross reactivity if patient has a PCN allergy Gram (-) Antipseudomonal

Question 38

Aztreonam (Adverse effects)

Answer 38

Extremely expensive ($150/day)

Question 39

Imipenem (Adverse effects)

Answer 39

Rapid renal excretion leading to higher incidence of seizures in renal insufficiency patients (A dehydropeptidase inhibitor is added to try to reduce issue)

Question 40

Imipenem/Meropenem (activity)

Answer 40

Gram + Gram (-) Anaerobic activity Quick resistance from Acinetobacter baumannii

Question 41

Ceftolozane/Tazobactam (indications)

Answer 41

Use reserved for multi-drug resistant Pseudomonas aeruginosa

Question 42

Ceftolozane/Tazobactam (disadvantages)

Answer 42

Expensive

Question 43

Ceftazidime/Avibactam (Indications)

Answer 43

Treatment of carbapenem-resistant Enterobacteriaceae that have Klebsiella producing carbapenemases activity

Question 44

Ceftazidime/Avibactam (Disadvantages)

Answer 44

Extremely expensive