Term
| What is the MOA for penicillins & cephalosporins? |
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Definition
1.Attach to penicillin binding proteins
2.inhibit transpeptidase - which usually cross links peptide side chains of bacterial cell wall
3.Acivates autolysins |
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Term
| What are the mechanisms of resistance for Penicillin's & cephalosporins? |
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Definition
1. Altered Protein binding protein
2. Altered porin sites
3. B - lactamases/ penicillinases (most common method of resistance) |
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Term
| Which bacteria changes the structure of porins to gain resistance to penicillin's & cephalosporins? |
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Definition
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Term
Which bacteria activates B- lactamases to gain resistance to penicillins and cephalosporins? |
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Definition
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Term
| WHich bacteria changes the penicillin binding protein structure to gain resistance to penicillins & cephalosporins? |
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Definition
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Term
What can be given to prolong the duration of cephalosporins & penicillin's?
how does it work? |
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Definition
| Probenecid - decreases renal tubular secretion of penicillin's & cephalosporins |
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Term
| WHat can be given to block the action of penicillinases/ B-lactumases? |
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Definition
| Clavulanic acid & Sulbactam |
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Term
| What can be given to synergistically enhance the action of penicillins? |
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Definition
| Aminoglycosides (separate IV lines) |
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Term
Name the narrow spectrum Penicillins
- B- lactumase sensitive/resistance |
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Definition
Penicillin G
Penicillin V
Sensitive |
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Term
What is the DOC for Treponema pallidum (aka Syphilis)
what can be given if Pt has allergy to this drug? |
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Definition
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Term
Name the very narrow spectrum penicillins
B- lactumase sensitive/ resistant?
Use?
Specific ADR? |
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Definition
Nafocillin
Methicillin
Oxacillin
Resistant
Known/ suspected styphylococci infection (not MRSA)
Interstitial nephritis |
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Term
Name the broad spectrum penicillins?
B- lactumase sensitive/ resistant? |
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Definition
Amoxacillin
Ampicillin
Sensitive |
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Term
Ampicillin
1.class of penicillin
2. Specific Use?
3.Specific ADR |
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Definition
1. borad spectrum (B-lactumase sensitive)
2. H. infulenza, E.coli,
3. Maculopapular rash |
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Term
Name the Extended action penicilins?
Specific action? |
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Definition
Ticarcillin
Piperacil
Gram -ve rods
Pseudomonas aeruginosa |
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Term
| What are the general ADR's of penicillins? |
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Definition
Hypersensitivity reactions (types 1 - 4)
Cross- allelrgenicity
superinfection |
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Term
| Which penicillins have a specific ADR of Interstitial nephritis? |
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Definition
Methicillin
Naficillin
Oxacillin
(type 3 immune complex hypersensitivity reaction) |
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Term
| What are the hypersensitivity reactions for penicillins? |
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Definition
Type I - IgE mediated - anaphylaxis
Type II - IgM & IgG mediated - Vasculitis, neutropenia, +ve Coombs test
Type III - Immune complex - Interstitial nephritis
Type IV - T-cell mediated - maculopapular rashes, Stevens- JOhnson syndnrome |
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Term
| What is the DOC for Enterobacter? |
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Definition
Imipenem
Meropenem
Carbepenem
Ertapenem
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Term
What are the uses of
Imipenem,
Meropenem
Carbepenem
Ertapenem
B-Lactumase sensitive/resistant? |
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Definition
RESERVE DRUGS - hospital agents for empiric use
RESISTANT |
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Term
| What is Imipenem given with & why |
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Definition
| Cilastatin, which inhibits its rapid metabolism by renal dehydropeptidase |
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Term
| What are the ADR's of the -'penem's? |
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Definition
| CNS - seizures, confusion, encephalopathy |
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Term
Name the Monobactums?
Spectrum of action? |
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Definition
Aztreonam
Gram -ve rods ONLY
** can be used with penicillins and cephalosporins as there is no cross allergenicity! |
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Term
|
Definition
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Term
| Name the first generation cephalosporins |
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Definition
Cefazolan (PE)
Cephalexin (oral)
(ZOLALEX) |
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Term
| What the the spectrum of action of the 1st generation cephalosporins? |
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Definition
E.coli
K.pneumoniae
Proteus Mirabilis
surgical prophylaxis
gram +ve (only)
PEcK |
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Term
| Name the 2nd generation cephalosporins |
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Definition
Cefaclor
Cefoxitin
Cefotetan
Cefuroxime
Cefamandole |
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Term
| WHat is the spectrum of action of the 2nd generation cephalosporins |
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Definition
Extended gram -ve
HENPeK
H.infulenziae
Enterobacter aerogenes
Nisseria
Proteous mirabilis
K.pneumoniae
E.coli |
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Term
| Which is the only cephalosporin that enters the CSF/ BBB from the 2nd generation drugs? |
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Definition
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Term
What cephalosporins are used to treat BActeriodes Fragilis?
What generation? |
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Definition
2nd generation
Cefoxitin
Cefotetan
3rd generation
Ceftizoxime |
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Term
Which cephalosporin is used to treat H. influenzae?
Which generation? |
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Definition
Cefaclor
Cefamandole
Cefuroxime
2nd Generation |
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Term
| Name the 3rd generation cephalosporins |
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Definition
Cefixime
Cefoperazone
Cefotaxime
Ceftazidime
Ceftizoxime
Ceftriaxone |
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Term
Which cephalosprins present anti pseudomonal activity?
generation? |
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Definition
Ceftazidime
Cefoperazone
3rd generation |
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Term
What is the DOC for Gonnorrhea?
generation? |
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Definition
Cefixime
Ceftriaxine
3rd generation |
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Term
DOC for ottitis media?
generation? |
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Definition
Ceftriaxone
3rd generation |
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Term
| What is the spectrum of action of 3rd generation cephalosporins |
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Definition
Resistant to B-lactumase
Crosses BBB
increased activity against gram -ve |
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Term
What is the DOC for s.typhi
What generation? |
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Definition
3rd generation
Ceftriaxone
Cefoperazone |
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Term
| Name the 4th generation cephalosporins |
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Definition
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Term
| What is the spectrum of action of the 4th generation cephalosporins? |
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Definition
Gram +/-
crosses BBB
RESERVE DRUGS! |
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Term
What is the DOC for menengitis?
what generation? |
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Definition
Ceftoaxime
Ceftriaxime
*AX to head* |
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Term
What is the only oral cephalosporin?
What generation? |
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Definition
|
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Term
| What are the organisms that are resistant to cephalosporins? |
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Definition
LAME
Listeria monocytogenes
Atypicals (chlamidya, mycoplasma)
MRSA
Enterococci |
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Term
| What are the general ADR's of cephalosporins? |
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Definition
Hypersensitivity
Cross allergenicity (between penicillins and cephalosporins)
Superinfections
|
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Term
| Cephalosporins have cross reactivity with what other drugs? |
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Definition
| Aminoglycosides - nephrotoxicity |
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Term
| What is contraindicated with specific cephalosporins which ones & why? |
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Definition
Alcohol - dusulfam like reaction
Cefotetan
Cefoperazone
Cefamandole |
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Term
| What is the MOA of vancomycin? |
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Definition
Binds to D-ala-D-ala muramyl pentapeptide
Hinders the TRANSGLYCOSYLATION reactions involved in elongation of peptidoglycan chains |
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Term
| What bacterial infections is vancomycin the DOC for? |
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Definition
MRSA
Penecillin resistant pneumococci
C.defficile
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Term
How is resistance aquired to vancomycin?
Which bacterias show this resistance? |
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Definition
Decreased affinity of the drug for the binding site, as D-ala is replaced by D-lactate
Enterococci - VRE & VRSA |
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Term
| What are the ADR's associated with vancomycin |
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Definition
Nephrotoxicity
Ototoxicity
Thrombophlebitis
Red Man Syndrome - increased histamine release - give antihistamine! |
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