Term
| What is the mechanism of PNC? |
|
Definition
| binds to the transpepsidase and acylates it |
|
|
Term
| What are the two mechanisms for PNC resistance? |
|
Definition
alters PNC binding protein (MRSA, PRSP)
B-lactamase |
|
|
Term
| How is the B-lactamase resitance in PNC transfered from bacteria to bacteria? |
|
Definition
|
|
Term
| What are the anti-staphlococcal PNC? |
|
Definition
Methacillin
Naficilling
Oxacillin
Cloxacillin
Dicloxacillin |
|
|
Term
| What anti-staphlococci PNC are cleared by hepatic system (4)? |
|
Definition
Nafcillin
Oxacillin
Cloxicillin
Dicloxicillin |
|
|
Term
| What are 3 adverse effects of PNC? |
|
Definition
|
|
Term
| What does meticillin cause in the kidney? |
|
Definition
| Acute Interstitial Nephritis |
|
|
Term
| What type of PNC is PNC G? |
|
Definition
|
|
Term
| How must PNC G be administered, why? |
|
Definition
| IV b/c is inactivated by GI |
|
|
Term
What is the drug of choice for non-resistent Staph?
However what is the problem? |
|
Definition
PNC G
95 % of staph is resistent |
|
|
Term
| What other antibiotics are included when a bacteria is said to be MRSA? |
|
Definition
|
|
Term
| What two drugs other than PNC G is Staph Aureus 95% resistant to? |
|
Definition
|
|
Term
| Which is more potent amoxicillin or ampicillin? |
|
Definition
|
|
Term
What can be added to amoxicillin to make it more active against staph, gram -, and anaerobes?
What is it called? |
|
Definition
Amoxicillin +clavulanic acid
Augmentin |
|
|
Term
| What do B-lactamase inhibitors increase activity against when given with an extended spectrum PNC? |
|
Definition
|
|
Term
| What is the mechanism of action of cephalosporins? |
|
Definition
| they prevent the transpeptidase from creating cell wall crosslink |
|
|
Term
| What tpe of resistance is found with cephalosporins? |
|
Definition
| plasma mediated B-lactamase |
|
|
Term
| What drug allergy does not allow one to recieve cephalosporins? |
|
Definition
|
|
Term
| What are the uses for 1st generation cephalosporin? |
|
Definition
|
|
Term
| What are two examples of 1st generation cephalosporins? |
|
Definition
cephalexin (Keflex)
cefazolin |
|
|
Term
| What is a drug in the glycopeptide class? |
|
Definition
|
|
Term
| What is the side effect of Vancomycin if it is administered to quickly? |
|
Definition
|
|
Term
| What is vancomycin mechanism of action? |
|
Definition
| binds to the alanine ends of the cross link by electrostatic force and prevents the crosslink from forming |
|
|
Term
What is the mechanism of resitance for vancomycin?
How is the resistance transmitted? |
|
Definition
the bacteria becomes resistant by changing the terminal alanine to a lactic acid
an entire gene cluster (VAN A) is transmitted opposed to a plasma mediated single gene like in B-lactamase |
|
|
Term
How is vancomycin administered for C-diff?
Why? |
|
Definition
oral
b/c it will stay on the enterocytes and will not be absorbed |
|
|
Term
| How is vancomycin administered for systemic infections? |
|
Definition
|
|
Term
| True/False: Vancomycin should be used for first line treatment in methicillin sensitive bacteria? |
|
Definition
|
|
Term
| Why should Vancomycin not be used for methicillin sensitive bacteria? WHat should be used? |
|
Definition
b/c it is not as strong as a PNC due to the electrostatic forces opposed to PNC ability to acylate the transpeptidase
Nafcillin should be used |
|
|
Term
| How is Vancomycin cleared? |
|
Definition
|
|
Term
| What does vancomycin cause if administered with other drugs toxic to this organ? |
|
Definition
|
|
Term
| What drug is in the class of lipopeptides? |
|
Definition
|
|
Term
| What type of infections cannot be treated with daptomycin? Why? |
|
Definition
| Pneumonia b/c it binds the surfactant |
|
|
Term
| What is a possible side effect of daptomycin but is often not seen when it is given in lower doses? |
|
Definition
|
|
Term
| What is the mechanism of action of daptomycin? |
|
Definition
|
|
Term
| True/False Daptomycin is a first line drug of choice. |
|
Definition
| False, it is often saved when others fail |
|
|
Term
| What is daptomycin great in treating? |
|
Definition
|
|
Term
| What is the drug in the class of oxazolidinones? |
|
Definition
|
|
Term
| What is the MOA of Linezolid? |
|
Definition
|
|
Term
| What antibiotics are 30s ribosome inhibitors? (3) |
|
Definition
tetracyclines
Aminoglycosides
Glycylglycines |
|
|
Term
| What six bacteria are teh oxazolidinones active against? |
|
Definition
Staph
Strep
Enterococci
Gram positive anerobes
corynebacteria
Listera monocytogens |
|
|
Term
| What is the primary use for linezolid? |
|
Definition
|
|
Term
| What side effect do you need to monitor in linezolid patients? |
|
Definition
|
|
Term
| What is the name of the drug in the class of streptogramins? |
|
Definition
Synercid
Quinupristin-dalfopristin |
|
|
Term
| What is synercid used for? (3) |
|
Definition
|
|
Term
| What are the adverse effects of synercid? (2) |
|
Definition
phlebitis
arthralgia-myalgia |
|
|
Term
| What drug causes arthralgia-myalgia and phelbitis? |
|
Definition
|
|
Term
| WHat type of administration is need for synercid due to a specific side effect? |
|
Definition
| central line because of phelbitis |
|
|
Term
| What drug is in the glycylglycine class? |
|
Definition
|
|
Term
| What is the MOA of tigeglycine? |
|
Definition
|
|
Term
| What is important about tigeglycine when comparing it to tetracycline? |
|
Definition
| it does not have the efflux resistance like tetracycline nor the altering of 30s ribosome site |
|
|
Term
| How must tigecycline be administered? |
|
Definition
|
|
Term
| What are the adverse effects of tigeglycine? |
|
Definition
N/V sometimes severe especially in young otherwise healthy patients
|
|
|
Term
| Who can you not give tigeglycine to? (2) |
|
Definition
pregnant
children under 8 |
|
|
Term
| What are the uses of Glycylglycine? (3 bacterias and one medical situation) |
|
Definition
MRSA
VRE
Gram -
post op wounds |
|
|
Term
| What are the three macrolides? |
|
Definition
Erythromycin
Azithromycin
Clarithromycin |
|
|
Term
| What is the MOA of the macrolides? |
|
Definition
|
|
Term
| Are the macrolides bacteriastatic or cidal? |
|
Definition
|
|
Term
| What are the two mechanisms of resistance for erythromycin? |
|
Definition
| efflux and altering of the ribosome binding site (erm-erythromycin ribosomal methylase) |
|
|
Term
| What allergy patients are macrolides great for? |
|
Definition
|
|
Term
| What three bacteria are increasing resistance to erythromycin? |
|
Definition
group A strep
staph
pneumococci |
|
|
Term
| What drug are 40% of the people in buffalo that have staph resistant to? |
|
Definition
|
|
Term
| What are two adverse effects of erythromycin? |
|
Definition
General GI: N/V/D
inhibits cytochrome P450 |
|
|
Term
| What is clarithromycin better against than erythromycin? (2) |
|
Definition
| haemophilus and moraxella |
|
|
Term
| TRUE/FALSE: the macrolides show crossresistance to one another |
|
Definition
|
|
Term
| Why is clarithromycin better tolerated than erythromycin? |
|
Definition
|
|
Term
| What is another name for azithromycin? |
|
Definition
|
|
Term
| Which macrolid is slowly released from tissues and therefore can be given once a day for a shorter duration? |
|
Definition
|
|
Term
| What is azithromysin less active than erythromycin and clarithromycin against? |
|
Definition
|
|
Term
| What drug falls in the lincomycin class? |
|
Definition
|
|
Term
| What is the leading cause of C. Diff/dose? |
|
Definition
|
|
Term
| What is the leading cause of C.diff in general? |
|
Definition
|
|
Term
What is the mechanism of action of clindamycin (lincomycin)?
is it bacterialstatic or cidal |
|
Definition
|
|
Term
| Which drug interferes with the 50s ribosome aminoacyl translocation? |
|
Definition
|
|
Term
| What type of MRSA is clindamycin often used for? |
|
Definition
|
|
Term
| What two drugs are often given for necrotizing faciitiis and why? |
|
Definition
clindamycin because it can prevent toxin prduction
PNC b/c 15% of Group A strep is resistant to clinda |
|
|
Term
| What drug allergy patients can be treated with clindamycin? |
|
Definition
|
|
Term
| What is the common marker for CA-MRSA? |
|
Definition
|
|
Term
| What does USA 300 database indicate? |
|
Definition
|
|
Term
| What is Ceftibiperzole? What will it be used for? WHy is it useful for this bacteria? |
|
Definition
a new 5th generation cephalosporin
Used in MRSA patients
It binds PBP2
|
|
|
Term
| What gene does staph carry the PBP2 on? |
|
Definition
|
|
Term
| What does SCCmec code for? |
|
Definition
|
|
Term
| What is CA-MRSA often mistaken for? |
|
Definition
|
|
Term
What is the best treatment for CA-MRSA?
Why? |
|
Definition
clindamycin
b/c it makes the worried doctor be able to sleep at night since it will treat group A strep just in case CA-MRSA is not the cause |
|
|
