UNIT 11: INTRO TO ANTIMICROBIALS Flashcards
(120 cards)
1
Q
Enumeration
Narrow-Spectrum Penicillins (2)
A
Penicillin G
Penicillin V
2
Q
Enumeration
Antistaphylococcal penicillins (4)
Very-Narrow Spectrum
A
Cloxacillin, dicloxacillin
Nafcillin
Oxacillin
Methicillin
Isoxazolyl Penicillins
3
Q
Enumeration
Extended-spectrum penicillins (3)
Wider-Spectrum
A
Aminopenicillins (Ampicillin, Amoxicillin)
Carboxypenicillins (Carbenicillin, Ticarcillin)
Ureidopenicillins (Piperacillin)
4
Q
Enumeration
Aminopenicillins (2)
A
Ampicillin
Amoxicillin
5
Q
Enumeration
Carboxypenicillins (2)
A
Carbenicillin
Ticarcillin
6
Q
Piperacillin is what type of Penicillin?
A
Ureidopenicillins
7
Q
First-generation cephalosporins (6)
A
Cefazolin
Cefadroxil
Cephalexin
Cephalothin
Cephapirin
Cephradine
8
Q
Second-generation cephalosporins (9)
A
Cefaclor
Cefamandole
Cefonicid
Cefuroxime
Cefprozil
Loracarbef
Ceforanide
Cefotetan
Cefoxitin
9
Q
Third-generation cephalosporins (12)
A
Cefoperazone
Cefotaxime
Ceftazidime
Ceftizoxime
Ceftriaxone
Cefixime
Cefpodoxime proxetil
Cefdinir
Cefditoren
Pivoxil
Ceftibuten
Moxalactam
10
Q
Fourth-generation cephalosporins (1)
A
Cefepime
11
Q
Cephalosporin–β-lactamase inhibitor combinations (2)
Effective against gram (-) infections
A
Ceftolozane-tazobactam
Ceftazidime-avibactam
12
Q
Siderophore Cephalosporin
A
Cefiderocol
13
Q
Cephalosporins Active Against Methicillin-Resistant Staphylococci (1)
A
Ceftaroline fosamil
14
Q
Carbapenems (4)
A
Ertapenem
Imipenem
Meropenem
Doripenem (not available in USA)
15
Q
Drugs with a monocyclic β-lactam ring
A
Monobactams
16
Q
Enumeration
Glycopeptides (5)
A
Vancomycin
Teicoplanin
Telavancin
Dalbavancin
Oritavancin
DOT TV
17
Q
The following are glycopeptides, EXCEPT:
Vancomycin
Teicoplanin
Telavancin
Daptomycin
Dalbavancin
Oritavancin
A
Daptomycin
Daptomycin is a lipopeptide
18
Q
Drugs that inhibit the growth/replication, or kill microrganisms
A
Antimicrobials
19
Q
Types of antimicrobials (5)
A
Antibacterial
Antifungal
Antiviral
Anti-protozoal
Anti-parasitic
20
Q
First-line drug for syphillis
A
Benzathine Penicillin G
21
Q
Penicillin G is the drug of choice for infections caused by:
A
Streptococci
Meningococci
Enterococci
Penicillin-susceptible pneumococci
Non-B-lactamase-producing staphylococci
Spirochetes (Treponema pallidum)
Actinomyces
Non-B-lactamase-producing Gram (-) anaerobic organisms
22
Q
Oral form of penicillin, indicated only in minor infections due to poor bioavailability
A
Penicillin V
23
Q
Most active of oral B-lactam antibiotics against pneumococci
A
Aminopenicillins (ampicillin & amoxicillin)
24
Q
Given orally to treat:
Bacterial sinusitis
Otitis
Lower respiratory tract infections
A
Amoxicillin
25
Effective for **shigellosis**
Ampicillin
26
**Ampicillin** is effective against serious infections including: (5)
Anaerobes
Enterococci
L. monocytogenes
E. coli
Salmonella sp.
27
**Ampicillin** is **not active** against:
Klebsiella sp.
Enterobacter sp.
P. aeruginosa
Citrobacter sp.
Serratia marcescens
Indole-positive Proteus species
Gram (-) aerobes
28
Resistant agents of **Penicillin G**:
Penicillin-Resistant S. pneumoniae (PRSP) strains
S. aureus
N. gonorrhoeae
29
Used for **oropharyngeal infections**
Penicillin V
30
Developed to broaden spectrum of penicillins against gram (-) pathogens, including **Pseudomonas aeruginosa**
**Carboxypenicillins** (carbenicillin, tricarcillin)
31
Active against **Gram (-) bacilli**:
**Klebsiella pneumoniae**
**Pseudomonas aeruginosa**
**Ureidopenicillin** (piperacillin)
32
Available only as co-formulation with **tazobactam**
**Ureidopenicillin** (piperacillin)
33
**Antipseudomonal B-lactams** used in combination with **Ureidopenicillin** due to P. aeruginosa developing resistance (2)
Aminoglycoside
Fluoroquinolone
34
**B-lactamase inhibitors** used in combination with Ampicillin, Amoxicillin, Piperacillin, and Ticarcillin (3)
Clavulanic acid
Sulbactam
Tazobactam
35
**B-lactamase inhibitors** extends the activity of penicillins against:
B-lactamase-producing strains of **S. aureus**
B-lactamase-producing **Gram-negative bacteria**
36
**Degradation products** of penicillins and products of alkaline hydrolysis
Antigenic determinants
| Penicilloic acid
37
Associated with **neutropenia**
Nafcillin
38
Causes **hepatitis**
Oxacillin
39
Causes **interstitial nephritis**
Methicillin
40
Associated with **pseudomembranous otitis**
Ampicillin
41
Associated with **skin rashes**
Ampicillin
42
Caused by large doses of **oral penicillins**
GI disturbances
| Nausea, vomiting, diarrhea
43
When combined with **vancomycin**, associated with greater incidence of **acute kidney injury**
Piperacillin-tazobactam
44
Generation of Cephalosporins effective against:
**Gram (+) *cocci***
**E. coli**
**Klebsiella pneumoniae**
**Proteus mirabilis**
**Anaerobic cocci** (peptococci, peptostreptococci)
1st Generation
45
**1st Generation Cephalosporins** are not effective against:
**Gram (-) cocci**
**Enterococci**
**MRSA**
Most **gram (-) rods**
Methicillin-resistant strains of **staphylococci**
**Pseudomonas aeruginosa**
Indole-positive **Proteus species**
**Enterobacter sp.**
**Serratia marcescens**
**Citrobacter sp.**
**Acinetobacter sp.**
46
Drug of choice for **surgical prophylasxis**
Cefazolin
| 1st Generation
47
Effective for serious staphylococcal infections such as **bacteremia**
Cefazolin
48
Suitable for **urinary tract infections** and **staphylococcal** or **streptococcal** infections, including cellulitis or soft tissue absess
Oral cephalosporins
49
A **heterogenous group** with individual differences in activity, pharmacokinetcs, and toxicity
**2nd Generation** Cephalosporins
50
2nd Generation Cephalosporins effective against **Haemophilus influenzae** but NOT Serratia and Bacteroides fragilis (2)
Cefuroxime
Cefaclor
51
2nd Generation Cephalosporins effective against **Bacteroides fragilis** and **Serratia** but NOT Haemophilus influenzae (2)
Cefoxitin
Cefotetan
52
# True or False
2nd Generation Cephalosporins are active against **enterococci** and **P. aeruginosa**
False
| No member is active
53
# True or False
2nd Generation Cephalosporins can be used to treat **Enterobacter** infections
False
| Should not be used
54
2nd Generation Cephalosporin effective against **extended-spectrum B-lactamases** produced by **E. coli** and **Klebsiella sp.**
Cefoxitin
55
# 2nd Generation
Most commonly used oral cephalosporin
Cefuroxime axetil
56
2nd generation cephalosporins used to treat **mixed anaerobic infections** such as: (2)
Peritonitis
Diverticulitis
Pelvic inflammatory disease
Cefoxitin
Cefotetan
57
# 2nd Generation
Used to treat **community-acquired pneumonia**
Cefuroxime
58
**2nd Generation Cephalosporins** are effective against: (4)
| Extended gram (-) activity
Klebsiella
H. influenzae
Bacteroides fragilis
Serratia
59
**2nd Generation Cephalosporins** are NOT effective against: (2)
Enterobacter
P. aeruginosa
60
**3rd Generation Cephalosporins** are effective against: (4)
Citrobacter
Serratia
Providencia
Pseudomonas
61
The only 3rd Generation Cephalosporin effective against **P. aeruginosa**
Ceftazidime
62
3rd Generation Cephalosporins are NOT effective against:
Enterobacter
63
3rd Generation Cephalosporins less active against **pneumococci** and **S. aureus** (2)
Cefixime
Ceftibuten
64
Generation of Cephalosporins that penetrate body fluids and tissues well, and can reach **cerebrospinal fluid**
3rd Generation
65
# 3rd Generation Cephalosporins
____ combined with ____ is the preferred regimen for treating most **gonococcal infections**
Intramuscular Ceftriaxone + azithromycin
66
The only 3rd Generation Cephalosporin excreted through the **biliary tract**
Ceftriaxone
67
The only penicillin excreted through the **billiary tract**
Nafcillin
68
# 3rd Generation
Most active cephalosporins against **penicillin-non-susceptible strains** of **pneumococci** (2)
Ceftriaxone
Cefotaxime
69
# 3rd Generation
Approved for treating **meningitis** caused by pathogens such as: (2)
**Pneumococci**
**Meningococci**
**H. influenzae**
**Enteric Gram-negative rods** (except *L. monocytogenes*)
Ceftriaxone
Cefotaxime
70
# 3rd Generation
Recommended for **empirical therapy** of serious infections caused by penicillin-non-susceptible strains of pneumococci (2)
Ceftriaxone
Cefotaxime
71
The only available **fourth generation** cephalosporin
Cefepime
72
**4th generation cephalosporins** are effective against: (6)
P. aeruginosa
Enterobacteriaceae
Methicillin-susceptible S. aureus (MRSA)
S. pneumoniae
Haemophilus sp.
Neisseria sp.
73
Valuable for treating **Enterobacter infections** due to good activity against most penicillin-resistant strains of streptococci
Cefepime
| 4th Generation
74
Commonly used empirically in patients with **febrile neutropenia**
Cefepime
| 4th Generation
75
First-beta-lactam antibiotic approved in the USA with activity against **MRSA**
| Prodrug of **ceftaroline**
Ceftaroline fosamil
76
Used **off-label** to treat bacteremia, endocarditis, and osteomyelitis
Ceftaroline
77
**Ceftolozane-tazobactam** and **Ceftazidime-avibactam** are effective against:
P. aerugnosa
AmpC and extended-spectrum B-lactamase-producing Enterobacterieae
78
**Ceftolozane-tazobactam** and **Ceftazidime-avibactam** are combined with ____ when treating complicated **intra-abdominal infections**
Metronidazole
79
Effective for **carbapenemase-producing organisms**
Ceftazidime-avibactam
80
**Ceftolozane-tazobactam** and **Ceftazidime-avibactam** are NOT effective against:
Organisms producing **metallo-B-lactamases**
81
Patients with history of **penicillic anaphylaxis** should avoid which generations of cephalosporins?
1st and 2nd generation
82
Cephalosporins that may cause hypoprothrombinemia and bleeding disorders (4)
Cephalosporins containing a **methylthiotetrazole group**:
Cefa**mandole**
Cef**metazole**
Cefo**perazone**
Cef**otetan**
83
Drugs with a **monocyclic B-lactam ring**
Monobactams
84
**Monobactams** are effective against:
**Aerobic Gram-negative organisms** (including *P. aeruginosa*)
85
**Monobactams** are NOT effective against:
Gram-positive bacteria or anaerobes
86
# Monobactams
Can be given to **penicillin-allergic patients** without reaction
Aztreonam
87
Beta-lactamase Inhibitors (4)
Clavulanic acid
Sulbactam
Tazobactam
Avibactam
| CATS
88
**Beta-lactamase Inhibitors** are most effective against:
**Ambler class A B-lactamases** produced by:
Staphylococci
H. influenzae
N. gonorrhoeae
Salmonella
Shigella
Escherichia coli
Klebsiella pneumoniae
89
Non-B-lactam B-lactamase inhibitor active against **Ambler class A**, **Ambler class C**, and some **class D** B-lactamases
Avibactam
90
Active against B-lactamase-producing **S. aureus** and **H. influenzae** but not against **Serratia**
Ampicillin-Sulbactam
91
# Trrue or False
**Piperacillin-Tazobactam** is active against **P. aeruginosa**
False
92
Carbapenem effective against:
Gram-negative rods (P. aeruginosa)
Gram-positive organisms
Anaerobes
Imipenem
93
Imipenem is NOT active against:
Enterococcus faecium
MRSA
Clostridium difficile
Burkholderia cepacia
Stenotrophomonas maltophilia
94
Inactivates **Imipenem**, resulting in low urinary concentrations
Dehydropeptidases
95
An inhibitor of renal dehydropeptidase, administered with **Imipenem** for clinical use against **pneumonia** and **sepsis**
Cilastatin
96
Clinical use:
Streptococcal infections
Meningococcal infections
Neurosyphilis
Penicillin G
| Narrow-spectrum Penicillin
97
Clinical use:
Skin and soft tissue infections
Urinary tract infections
Surgical prophylaxis
Cefazolin
| 1st Generation Cephalosporin
98
Clinical use:
Infections caused by **aerobic, Gram-negative bacteria** in patients with **hypersensitivity** to penicillins
Aztreonam
| Monobactam
99
Clinical use:
Serious infections such as **pneumonia** and **sepsis**
Imipenem-cilastatin
100
Intravenous carbapenem, stable to renal dehydropeptidase, lowers incidence of **seizures**
Meropenem
101
Clinical use:
Infections caused by **Gram-positive bacteria** including **sepsis**, **endocarditis**, and **meningitis**
**C. difficile colitis**
Vancomycin
102
Narrow-Spectrum Penicillins
**Penase-susceptible**
(2)
Penicillin G
Penicillin V
103
Narrrow-Spectrum Penicillins
**Penase-resistant**
(2)
Nafcillin
Oxacillin
104
Monobactam active only against **Gram-negative bacteria**:
Klebsiella
Pseudomonas
Serratia spp
Aztreonam
105
Novel cyclic lipopeptide fermentation product of **Streptomyces roseusporus**
Daptomycin
106
Active against **vancomycin-resistant** strains of **enteroccoci** and **S. aureus**
Daptomycin
107
Binds to the cell membrane via **calcium-dependent insertion** of its lipid tail
Daptomycin
108
Can cause **myopathy**
Daptomycin
109
Inhibits the cytpolasmic enzyme **enolpyruvate transferase**
Fosfomycin
110
Fosfomycin is active against:
Both gram-positive and gram-negative organisms
111
Approved for use against **uncomplicated lower urinary tract infections** in women
Fosfomycin
112
**Cyclic peptide mixture** obtained from the **Tracy strain** of *Bacillus subtilis*
Bacitracin
113
Inhibits cell wall formation by interfering with **dephosphorylation**
Bacitracin
114
An antibiotic produced by **Streptomyces orchidaceous**
Cycloserine
115
Almost exclusively used to treat **tuberculosis** caused by strains of *Mycobacterium tuberculosis* resistant to **first-line agents**
Cycloserine
116
Causes serious **dose-related CNS toxicity** with headaches, tremors, acute psychosis, and convulsions
Cycloserine
117
An antibiotic isolated from **Amycolatopsis orientalis**
Vancomycin
118
Inhibits cell wall synthesis by binding to the **d-Ala-d-Ala terminus** of nascent peptidoglycan pentapeptide
Vancomycin
119
Synergistic with vancomycin against **Enterococcus faecium** and **Enterococcus faecalis** strains (2)
Gentamicin
Streptomycin
120
Combined with vancomycin as an alternative regimen for treating **enterococcal endocarditis** in patients with **serious penicillin allergy**
Gentamicin
