Term
Which classes of antibiotics prevent bacterial cell wall synthesis by binding to and and inhibiting cell wall transpeptidases? |
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Definition
penicillins, cephalosporins, carbapenems, monobactams |
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Term
Which drugs inhibit cell wall synthesis by binding to the D-ala D-ala terminus of nascent peptidoglycan? |
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Definition
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Term
Which drugs bind to cell membrane, causing depolarization and rapid cell death? |
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Definition
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Term
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Definition
prevent bacterial cell wall synthesis by binding to and and inhibiting cell wall transpeptidases |
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Term
What are the effects of penicillins, cephalosporins, carbapenems and monobactams? |
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Definition
rapid bactericidal activity against susceptible bacteria |
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|
Term
What are the clinical applications of Pcn G? |
|
Definition
streptococcal infections, meningococcal infections, neurosyphilis |
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Term
What drug can be used for streptococcal infections, meningococcal infections, and neurosyphilis? |
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Definition
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Term
Name the drug: IV, rapid renal clearance (half life 30min) so requires frequent dosing every 4 hr, Tox: immediate hypersensitivity, rash seizures |
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Definition
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Term
Which drug can cause immediate hypersensitivity, rash and seizures? |
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Definition
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Term
How does PCN V compare to PCN G? |
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Definition
oral, low systemic levels limit widespread use |
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|
Term
which penicillin is taken orally and reaches low systemic levels which limit widespread use? |
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Definition
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Term
How do benzathine PCN and procaine PCN compare to PCN G? |
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Definition
intramuscular, long-acting formulations |
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|
Term
which PCNs can be given intramuscularly and have long-acting formulations? |
|
Definition
benzathine and procaine PCN |
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Term
How do nafcillin and oxacillin compare to PCN G? |
|
Definition
IV, added stability to staphylococcal B lactamase, biliary clearance |
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Term
Which PCNs are given IV, have added stability to staphylococcal B lactamase and biliary clearance? |
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Definition
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Term
How do ampicillin, amoxicillin, ticaricillin and piperacillin compare to PCN G? |
|
Definition
greater activity against gram-negative bacteria, addition of B-lactamase inhibitor restores activity against many B-lactamase-producing bacteria |
|
|
Term
Which PCNs have greater activity against gram-negative bacteria, addition of B-lactamase inhibitor restores activity against many B-lactamase-producing bacteria |
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Definition
ampicillin, amoxicillin, ticarcillin, piperacillin |
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Term
What are the 1st gen cephalosporins? |
|
Definition
cefazolin, cephalexin, etc |
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|
Term
cefazolin, cephalexin are which generation? |
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Definition
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|
Term
Which cephalosporins are 2nd gen? |
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Definition
Cefuroxime, cefotetan, cefoxitin |
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|
Term
Cefuroxime, cefoxitin, cefotetan are which generation? |
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Definition
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Term
Ceftriaxone, cefotaxime, ceftazidime are which generation? |
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Definition
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|
Term
Name the 3rd gen cephalosporins |
|
Definition
Ceftriaxone, cefotaxime, ceftazidime |
|
|
Term
|
Definition
prevents bacterial cell wall synthesis by binding to and inhibiting cell wall transpeptidases |
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Term
What are the clinical applications for cefazolin? |
|
Definition
skin and soft tissue infections, urinary tract infections, surgical prophylaxis |
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|
Term
Which drug is used for skin and soft tissue infections, urinary tract infections, surgical prophylaxis |
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Definition
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|
Term
name the drug: IV admin, renal clearance (half life 1.5 hr), dosed every 8h, poor penetration into CNS, tox: rash, drug fever |
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Definition
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|
Term
Which drug can cause rash and drug fever? |
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Definition
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|
Term
How does cephalexin compare to cefazolin? |
|
Definition
oral, 1st gen, skin and soft tissue infections and UTI |
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|
Term
name the cephalosporin: oral, 1st gen, skin and soft tissue infections and UTI |
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Definition
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|
Term
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Definition
oral and IV, 2nd gen, improved activity for pneumococcus and H flu |
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|
Term
Name the cephalosporin: oral and IV, 2nd gen, improved activity for pneumococcus and H flu |
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Definition
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|
Term
Describe cefotetan / cefoxitin |
|
Definition
IV, 2nd gen, activity against Bacteroides fragilis allows for use in abdominal/pelvic infections |
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|
Term
Name the cephalosporin: IV, 2nd gen, activity against Bacteroides fragilis allows for use in abdominal/pelvic infections |
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Definition
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|
Term
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Definition
IV, 3rd gen, mixed clearance with long half life (6hrs), good CNS penetration, many uses including pneumonia, meningitis, pyelonephritis, and gonorrhea |
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|
Term
name the cephalosporin: IV, 3rd gen, mixed clearance with long half life (6hrs), good CNS penetration, many uses including pneumonia, meningitis, pyelonephritis, and gonorrhea |
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Definition
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Term
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Definition
IV, 3rd gen, similar to ceftriaxone but clearance is renal and half life is one hour |
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|
Term
name the cephalosporin: IV, 3rd gen, similar to ceftriaxone but clearance is renal and half life is one hour |
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Definition
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|
Term
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Definition
IV, 3rd gen, poor gram-positive activity, good activity against pseudomonas |
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|
Term
name the cephalosporin: IV, 3rd gen, poor gram-positive activity, good activity against pseudomonas |
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Definition
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|
Term
Name a 4th gen cephalosporin |
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Definition
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|
Term
|
Definition
IV, 4th gen, broad activity with improved stability to chromosomal B-lactamase |
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|
Term
name the cephalosporin: IV, 4th gen, broad activity with improved stability to chromosomal B-lactamase |
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Definition
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Term
What are the investigational cephalosporins that are administered IV, are active against methicillin resistant staphylococci, and have broad gram-negative activity? |
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Definition
ceftobiprole, ceftaroline |
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|
Term
What type of drug is imipenem-cilastatin? |
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Definition
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|
Term
imipenem-cilastatin: MOA? |
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Definition
prevents cell wall synthesis by binding and inhibiting transpeptidases |
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|
Term
What are the applications for imipenem-cilastatin? |
|
Definition
serious infections such as pneumonia and sepsis |
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|
Term
Name the drug: IV, renal clearance (half life 1 hr), dosed every 6-8hr, component of drug prevents hydrolysis by renal dehydropeptidase, tox: seizures especially in renal failure or with high doses |
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Definition
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|
Term
Why is cilastatin added to imipenem-cilastatin? |
|
Definition
to prevent hydrolysis by renal dehydropeptidase |
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|
Term
which drug can cause seizures especially in high doses? |
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Definition
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|
Term
What drug is used for serious infections such as pneumonia and sepsis? |
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Definition
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|
Term
Describe meropenem / doripenem |
|
Definition
IV, similar activity to imipenem, stable to renal dehydropeptidase, lower incidence of seizures |
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|
Term
name the drug: IV, similar activity to imipenem, stable to renal dehydropeptidase, lower incidence of seizures |
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Definition
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|
Term
|
Definition
IV, longer half life allows for once-daily dosing, lacks activity versus pseudomonas and acinetobacter |
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|
Term
name the drug: IV, longer half life allows for once-daily dosing, lacks activity versus pseudomonas and acinetobacter |
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Definition
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|
Term
What type of drug is aztreonam? |
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Definition
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|
Term
|
Definition
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|
Term
|
Definition
binds and inhibits cell wall transpeptidases |
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|
Term
What are the clinical applications for aztreonam? |
|
Definition
infections caused by aerobic, gram negative bacteria in pts with immediate hypersensitivity to PCNs |
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|
Term
Which drug is used for infections caused by aerobic, gram negative bacteria in pts with immediate hypersensitivity to PCNs |
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Definition
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|
Term
How is aztreonam given? How is it cleared? Is there cross allergenicity with PCNs? |
|
Definition
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|
Term
|
Definition
inhibits cell wall synthesis by binding D-ala D-ala terminus of nascent peptidoglycan |
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|
Term
How do the effects of vancomycin compare to B-lactam abx? |
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Definition
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|
Term
What are the clinical applications for vancomycin? |
|
Definition
infections caused by gram positive bacteria including sepsis, endocarditis and meningitis, C difficile colitis (oral formulation) |
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|
Term
which drug is used for infections caused by gram positive bacteria including sepsis, endocarditis and meningitis, C difficile colitis (oral formulation) |
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Definition
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|
Term
Name the drug: Oral and IV, renal clearance (6 hr half life), tox: red man syndrome, nephrotoxicity uncommon |
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Definition
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|
Term
|
Definition
IV, similar to vanco except long half life permits once daily dosing |
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|
Term
Name the drug: IV, similar to vanco except long half life permits once daily dosing |
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Definition
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|
Term
|
Definition
IV, very long half life 6-11d, once weekly dosing, more active than vanco |
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|
Term
name the drug: IV, very long half life 6-11d, once weekly dosing, more active than vanco |
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Definition
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|
Term
|
Definition
IV, dual MOA results in improved activity against bacteria with reduced susceptibility to vancomycin |
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|
Term
name the drug: IV, dual MOA results in improved activity against bacteria with reduced susceptibility to vancomycin |
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Definition
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|
Term
What type of drug is daptomycin? |
|
Definition
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|
Term
|
Definition
binds cell membrane, causing depolarization and rapid cell death |
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|
Term
what are the effects of daptomycin compared to vanco |
|
Definition
more rapidly bactericidal |
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|
Term
What are the clinical applications for daptomycin? |
|
Definition
infections caused by gram positive bacteria including sepsis and endocarditis |
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|
Term
Name the drug: IV, renal clearance (half life 8hr), once daily dosing, inactivated by pulmonary surfactant so cannot be used to treat pneumonia, tox: myopathy, should monitor CK levels |
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Definition
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|
Term
which drug is inactivated by pulmonary surfactant? |
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Definition
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|
Term
which drug causes myopathy? |
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Definition
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|
Term
Aminopenicillins offer better coverage of... |
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Definition
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|
Term
penicillinase-resistant PCNs are also called... |
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Definition
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|
Term
Anti-pseudomonal PCNs include which groups? |
|
Definition
carboxy and ureidopenicillins and monobactams |
|
|
Term
describe the coverage for cephalosporins |
|
Definition
Resistant to beta-lactamase, broad spectrum of G+ and G- |
|
|
Term
PCN G is acid ____, so it can be given ____. |
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Definition
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|
Term
PCN V is the oral form of ... |
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Definition
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|
Term
Name the aminopenicillins. How does their spectrum compare to PCN G? Why? Are they sensitive to b-lactamases? |
|
Definition
ampicillin and amoxicillin, broader spectrum with better killing of G-, they can penetrate the outer membrane better and bind transpeptidases better, yes they are still sensitive to b-lactamase |
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|
Term
The G- bacteria killed by aminoPCNs include ______ and other enterics. However, resistance has developed and many enteric G- bacteria have acquired _____ and are resistant. |
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Definition
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|
Term
Both ampicillin and amoxacillin can be taken ____, but amoxicillin better absorbed this way. |
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Definition
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|
Term
IV ampicillin is commonly used with other ABX like aminoglycosides (gentamicin) for broad gram-_____ coverage |
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Definition
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|
Term
What are the penicillinase-resistant penicillins? What do they kill? How are they given? |
|
Definition
methicillin, nafcillin, oxacillin, Staph aureus, only IV |
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|
Term
Naficillin is the DOC for... |
|
Definition
serious staph aureus infections, like cellulitis, endocarditis, sepsis |
|
|
Term
The clocks were ticking. It was only a matter of time before the ORAL beta-lactamase resistant PCNs were discovered. They are... |
|
Definition
cloxacillin, dicloxacillin, flucloxacillin |
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|
Term
cloxacillin, dicloxacillin and flucoxacillin are not good against gram-_____ bacteria, they are used for gram-____ bacteria, especially those that produce _______, like _______ |
|
Definition
negative, positive, penicillinase, staph aureus |
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|
Term
Pt has infected skin wound. He most likely has _____ or _______. Would treating with PCN G, V or ampicillin work? Why or why not? |
|
Definition
staph aureus or group A beta-hemolytic strep, those would not cover penicillinase-producing Staph. Treating with a penicillinase-resistant agent (meth, ox, naf) would, and if you give an oral abx (clox, diclox, fluclox) you can send him home with an Rx and don't have to care for him around the clock |
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|
Term
CarboxyPCNs and ureidoPCNs are what type of PCN? What are they good for? |
|
Definition
anti-pseudomonal PCN, expanded G- rod coverage especially against pseudomonas, also active against anaerobes and G+ bacteria |
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|
Term
Pseudomonas was so tricky we needed James Bond to help. His tools include a special CAR, a trained TICK, and a PIPE bomb. What are the anti-pseudomonal PCNs? |
|
Definition
carbenicillin and ticaricillin (carboxyPCNs), piperacillin, mezlocillin, azlocillin (ureidoPCNs) |
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|
Term
Like ampicillin, the anti-pseudomonal penicillins are frequently combined with ______ to double up the pseudomonas killing |
|
Definition
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|
Term
anti-pseudomonal ABX are sensitive to ________, and thus most _______ infections are resistant |
|
Definition
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|
Term
What are the b-lactamase inhibitors? |
|
Definition
clavulonic acid, sulbactam, tazobactam |
|
|
Term
The generations of cephalosporins are based on... |
|
Definition
activity against gram+ and gram- |
|
|
Term
With each generation of cephalosporins, the drugs get better in which ways? |
|
Definition
Increasingly able to kill G-, increasingly resistant to b-lactamases, increasingly potent |
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|
Term
The newer (3rd gen) cephalosporins are less effective against... |
|
Definition
gram + organisms like staph and strep |
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|
Term
MRSA is resistant to all cephalosprorins because it has changed... |
|
Definition
the structure of its PBP (transpeptidase). The enterococci are also resistant to cephalosporins |
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|
Term
FA, FAM, FUR, FOX, TEA - what is this? |
|
Definition
2nd gen cephs - cefamandole, cefaclor, cefuroxime, cefoxitin, cefotetan |
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|
Term
around 10% of pts with allergy to PCN will also have allergy to... |
|
Definition
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|
Term
How are first gen cephs used? |
|
Definition
Excellent G+ coverage, so used as alternative to PCN for staph and strep infections. Surgeons love to use them before surgery to prevent infection from skin |
|
|
Term
2nd gen cephalosporins cover more gram-____ rods. Cefuroxime is a good agent for CAP because it has good coverage against ____ and ____. |
|
Definition
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|
Term
3 second gen cephalosporins have good coverage against anaerobes, making them good for abd/pelvic infections, aspiration pneumonia, and colorectal surgery prophylaxis. Which are they? |
|
Definition
cefotetan, cefoxitin, cefmetazole - the fox met the anaerobic bug for tea |
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|
Term
In general, what are 3rd gen cephalosporins good for? |
|
Definition
Multi-drug resistant aerobic G- organisms that cause nosocomial pneumonia, meningitis, sepsis and UTIs |
|
|
Term
Which is the only cephalosporin that's good against pseudomonas? |
|
Definition
|
|
Term
What is special about ceftriaxone? |
|
Definition
best CSF penetration, first line drug for meningitis in neonates, kids and adults. Also given IM for gonorrhea as more of these bugs have been resistant to tetracycline and PCN, pneumonia and pyelonephritis |
|
|
Term
What bugs are still resistant to imipenem? |
|
Definition
MRSA, some pseudomonas, mycoplasma |
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|
Term
Imipenem is ____ to beta-lactamases. It is very small and can pass through porin channels to the _____ space. There, it can interact with _____. |
|
Definition
stable, periplasmic, transpeptidase |
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|
Term
inipenem can cause what types of reactions? It also lowers the threshold for what? |
|
Definition
|
|
Term
Aztreonam - what's it good for? |
|
Definition
it is a monobactam, good for AEROBIC GRAM NEGATIVE only, kills the tough ones like Pseudomonas |
|
|
Term
can you use aztreoname in PCN-allergic pts? |
|
Definition
|
|