5118317
Description
Flashcards by Amaal Salhieh, updated more than 1 year ago
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Created by Amaal Salhieh
about 8 years ago
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| Question | Answer |
| List the beta lactam agents | Penicillin Beta-lactam/Beta-lactamase inhibitors Cephalosporins Carbapanems Monobactam |
| Baseline chemical structure of beta lactam | 4 member ring surrounded by 5 member ring -Penicillin -Beta-lactamase inhibitors -Carbapanems |
| Cephalosporins structure | 4 member ring + 6 member ring |
| Monobactam structure | Just 4 member ring |
| How do PCN work? | Disrupting cell wall synthesis |
| PCN resistance | -production of beta-lactamase -alteration in PBP -decreased permeability |
| What is the primary method of excretion of PCN? | Via Renal |
| What PCNs are not excreted via renal? How are they excreted? | -Piperacillin, -Oxacillin, -Nafcilin Via biliary excretion |
| Plain penicillin | Streptococci (A, B, C, G) & Syphilis |
| Oxacillin/Nafcillin | Streptococci (A,B,C,G) & staphylococci (Doesn't include MRSA) |
| Ampicillin | -Has an additional side chain -Reasonable gram negative -E.coli, hemophalus influenza, Listeria, enterococcus -Has some resistance built up towards it |
| Piperacillin | -Pseudomonas, other gram negative, enterococcus |
| Drug of choice for enterococcus | Ampicillin |
| Adverse effects of PCN | Allergic Reactions Bone Marrow Effects Interstitial Nephritis Seizures |
| Allergic Reactions of PCN | Anaphylaxis (almost immediately) Immediate hypersensitivity (hours to day) Delayed hypersensitivity (7-10 days after) |
| List the BL/BLase Inhibitor Combinations | Amoxicillin/Clavulanic Acid (Augmentin) Ampicillin/Sulbactam (Unasyn) Ticarcillin/Clavulanic Acid (Timentin) Piperacillin/Tazobactam (Zosyn) |
| Augmentin | amoxicillin & clavulanic acid |
| Unasyn | Ampicillin & Sulbactam |
| Timentin | Ticarcillin & Clavulanic Acid |
| Zosyn | Piperacillin & Tazobactam |
| BL/BLAI drugs work best against what type of bacteria? | anaerobes and gram negative bacteria |
| How does BL/BLAI work? | Inhibitor binds irreversibly to Beta-lactamase |
| How do cephalosporins work? | -Disrupt cell wall synthesis -Resistance mechanisms similar to penicillin |
| CEPHS resistance | -Similar to penicillin -production of beta-lactamase -alteration in PBP -decreased permeability |
| CEPHS excretion | Renal mainly |
| What CEPH is not excreted by the main way, and by what method is it? | Ceftriaxone Biliary excretion |
| CEPH generation pattern | 1st - more active against gram positive, very small |
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