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DIT: gram + tx
Treatments for gram positive bacteria
| Question | Answer |
|---|---|
| What is the role of penicillinase inhibitors (=beta lactamase inhibitors) | The enhace the spectrum of penicillin drugs by protecting them from destruction by beta lactamases (penicillinases) |
| Beta lactamase inhibitors | (CAST) Clavulinic Acid, Sulbactam, Tazobactam |
| Bind penicillin-binding proteins | penicillins |
| blocks transpeptidase cross-linking of cell wall | penicillins |
| activate autolytic enzymes | penicillins |
| Which has a greater oral bioavailability - amoxicillin or ampicillin? | Amoxicillin |
| What are the clinical uses for ampicilin and amoxicillin? | Gram positive and (HELPS) Haemophilus, e Coli, Listeria, Proteus, Salmonella |
| aminopenicillins | ampicillin and amoxicillin |
| penicillinase resisitant penicillins | methicillin, nafcillin, dicloxacillin |
| Syphillis tx | Penicillin G |
| UTI tx | aminopenicillins |
| Pseudomonas | Ticarcillin, carbenicillin, piperacillin |
| Neonatal infection | Ampicillin w/ gentamycin |
| Cephalexin, Cefazolin | 1st G cephalosporins |
| Cefprozil | 2nd G cephalosporins |
| Cefdinir, Ceftriaxone | 3rd G cephalosporin |
| Which cephalosporin has the longest half life? | Ceftriaxone |
| What is a disulfiram-like reaction? | Flushing, sweating, nausea, HA, HTN due to inhibition of acetaldehyde dehydrogenase and accumulation of aldehyde. |
| What causes a disulfiram-like reaction? | certain cephalosporins, ANTABUSE, metronidazole, 1st G sulfonylureas, procarbazine |
| Clinical uses of 1st G cephalosporins | G+ cocci + (PECK) Proteus, E. Coli, Klebsiella |
| Clinical uses of 2nd G cephalosporins | G+ cocci + (HEN PECK) H flu, Enterobacter, Neisseria, Proteus, E. Coli, Klebsiella |
| Clinical uses of 3rd G cephalosporins | Ceftriaxone - meningitis and gonorrhea Ceftazidime - pseudomonas |
| Clinical uses of 4th G cephalosporin | broad spectrum. pseudomonas, G+, G- |
| What is the mechanism of action for aztreonam | Binds to PBP3 and inhibits cell wall synthesis. |
| Aztreonam | Gram negative rods only |
| What drug is always administered with ipipenem? | Cilastatin |
| How does Cilastatin assist Imipenem? | It decreases inactivation in renal tubules |
| Against what other organisms are Imipenem and Meropenem effective? | Enterobacter, Anaerobes, G+ cocci, G- rods |
| Side effects of Vancomycin? | NOT (nephrotoxic, ototoxic, teratogenic) |
| How does Vancomycin resistance occur | AA change of D-ala D ala to D-ala D lac |
| Clinical use of Vancomycin | Serious, multidrug resistant G+ organisms like MRSA and Cdiff |
| Can cause "red man" syndrome | vancomycin |
| Next step in tx of otitis media if resistan to amoxicillin | Augmentin |
| Prophylaxis against bacterial endocarditis | Penicillin V |
| Increases the nephrotoxicity of aminoglycosides | cephalosporins |
| Aminoglycoside pretender | Aztreonam |
| Inpatient Tx for MRSA | Vancomycin |
| Sufficient for the treatment of syphillis | Penicillin G |
| Single dose tx for gonorrhea | Ceftriaxone |
| Hospitalized pt with new Gram+ cocci in clusters in blood | vancomycin |
| broad spectrum coverage for appendicitis | Imipenem/Cilistatin |
| Treatment for C diff colitis | vancomycin |
Created by:
kayjames
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