Term
| Classification of antimicrobials |
|
Definition
cell wall synthesis
protein synthesis inhibitors
metabolic and nuclear acid inhibitors
cell membrane active |
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Term
|
Definition
| kills sensitive organism so that the number of viable organisms falls rapidly after exposure to the drugs |
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Term
|
Definition
| inhibits the growth of bacteria but DOESN'T kill it |
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Term
| If the etiology of an organism is known, it is best to use...... |
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Definition
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Term
| Decreased Accumulation of Drug |
|
Definition
-may result from increased efflux or decreased uptake of the drug
-increased efflux is often mediated by membrane protein that transports the drug out of the bacterial cells
-decreased uptake results from altered porins. |
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Term
| Selection of the Antimicrobial Drug for the host depends on |
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Definition
pregnancy
allergy
immune status
abscess
foreign body
renal/hepatic impairment |
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Term
| Selection of Antimicrobial Drugs based upon 2 factors |
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Definition
| Host factors and Drug Characteristics |
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Term
| Drug Characteristics for selection of antimicrobial drugs |
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Definition
antimicrobial spectrum vs culture results
pharmocokinetic properties
adverse effect profile
cost
conveniece |
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Term
aminoglycoside+.........= for eneterococci
(synergistic) |
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Definition
| ampicillin and Penicillin G |
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Term
Aminoglycoside+........= for gram (-) bacilli
(synergistic) |
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Definition
| Broad spectrum penicillin or cephalosporin |
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|
Term
antistaph penicillin+........for staph
(synergistic) |
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Definition
|
|
Term
aminoglycoside+..........=for enterobacteriaceae
(antagonistic) |
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Definition
|
|
Term
Broad Spectrum penicillin+............=
for strep pneumoniae
(antagonistic) |
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Definition
|
|
Term
| Single Infection exceptions |
|
Definition
penicillin+aminoglycoside for P.aeruginosa
sulfamethoxazole+trimethoprin
-both inhibit sequential steps in folate synthesis (synergistic) |
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Term
|
Definition
| usually are treated with aminoglycoside+metronidazol or clindamycin |
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Term
| nosocomial infections usually require |
|
Definition
| empiric treatment with vncomycin and aminoglycoside or cephalosporin for gram (-) bacilli |
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Term
|
Definition
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Term
|
Definition
give before a procedure such as dental
(endocarditis) and surgery |
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|
Term
| patients with valvular heard disease are given....prior to dental procedures to prevent the development of bacterial endocarditis |
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Definition
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Term
| Cytoplasmic Membrane of Bacteria |
|
Definition
found in both gram positive and gram negative
contains transport proteins
contains enzymes required for synthesis of cell wall |
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Term
|
Definition
-composed of peptidoglycan
-much thicker in gram (+)
-protects the bug from osmotic lysis
-maintains the shape
-synthesized during replication
-principle of selective toxicity |
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Term
|
Definition
-found in gram negative only
-composed of lipopolysacchrides and porins
-LPS comprises the endotoxin responsible
for septic shock
-polymixins act as detergens to disrupt both the outer and cytoplasmic membranes
- |
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Term
|
Definition
1.penicillin
2.cephalosporins
3.monobactams
4.carbapenems
5. beta-lactam inhibitors |
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Term
Penicillins-
narrow spectrum |
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Definition
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Term
| Antistaphlococcal penicillin |
|
Definition
1. methicillin
2. Nafcillin
3. Dicloxacillin |
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Term
| extended spectrum penicillins |
|
Definition
1. amoxicillin
2. ampicillin
3. piperacillin
4. Tiracillin |
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Term
|
Definition
1. half life is 30 min to an hr and half
2. Beta-Lactam ring fused to a thiazolidone ring
3. Acid stable and labile |
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Term
|
Definition
must be given parenterally
Pen. H piperacillin and ticarcillin |
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Term
|
Definition
are safe to take orally
1. amoxicillin
2. dicloxacillin
3. penicillin V |
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Term
| Penicillins are eliminated by........which is inhibited by....... |
|
Definition
kidneys (active tubular secretion)
probenecid |
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Term
|
Definition
| Inhibits active renal tubular secretion |
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Term
Narrow Spectrum Penicillins
-Good coverage for |
|
Definition
meningococcus
streptococcus
syphilis |
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Term
| antistaphylococcal penicillin for infection of |
|
Definition
1. skin, heart and bone
2. MRSA |
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Term
| Extended Spectrum Penicillin |
|
Definition
1. Strep
2. E.Coli
3. H.Flu
4. Listeria Monocytogenes |
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Term
|
Definition
1. Beta-lactamase enzymes
2. Efflux pump
3. Altered penicillin binding proteins
4. Altered porins |
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Term
| Bacteria Resistance to Penicillin |
|
Definition
| most pneumococci, gonococci, and staph |
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Term
| Penicillins are dispensed as |
|
Definition
| units 1 million units=0.6 gm |
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Term
| Adverse effects of Penicillins |
|
Definition
most common for hypersensitivity
breakdown products are highly antigenic
hypersensitivity causes hives and anaphylaxis
interstitial nephritis
serum sickness
hepatitis
seizures |
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Term
|
Definition
| inflammation of the spaces between the kidney tubules, causing improper filtration of the blood. |
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Term
|
Definition
1. an acid stable form of penicillin which can be taken orally
2. indicated for the outpatient treatment of streptococcal pharyngitis
3. should be given on an empty stomach |
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Term
|
Definition
| drug of choice for infection caused by strep meningoccoci, not beta lactamase-producint staph, bacillus anthracis, clostridium species, actinomycins and gram (-) anaerobic organisms |
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Term
| Benzathine penicillin G provides sustained low level coverage for...this long of time |
|
Definition
|
|
Term
| Procaine penicillin G provides sustained levels for approx |
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Definition
|
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Term
| Penicillin G Summary...Class |
|
Definition
| Beta Lactam, narrow spectrum |
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Term
| Penicillin G Summary....Mech of action |
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Definition
| cell wall synthesis inhibitor |
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Term
| Penicillin G summary....Ind |
|
Definition
| strep, meningococci and spirochetes |
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Term
| Penicillin G Summary....Contra |
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Definition
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Term
| Penicillin G Adverse effects |
|
Definition
| anaphylaxis, serum thickness, seizures |
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Term
| Antistaphylococcal Penicillins |
|
Definition
1. Methicillin
2. Nafcillin
3. Cloxacillin
4. Dicloxallin
5. Oxacillin |
|
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Term
Antistaphylococcal Penicillins
sole indicator for use against... |
|
Definition
| beta lactamase producing staphlococci |
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Term
| Methicillin is not longer used because of its |
|
Definition
|
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Term
|
Definition
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Term
| Dicloxacillin Mechanism of action |
|
Definition
| cell wall synthesis inhibitor |
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Term
|
Definition
| used to treat penicillin resistant strains of staph |
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Term
|
Definition
|
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Term
| Dicloxacillin adverse effects |
|
Definition
|
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Term
| Drug of Choice for Treatment of Listeria Monocytogenesis |
|
Definition
|
|
Term
|
Definition
ampicillin and amoxicillin
amoxicillin can be taken orally absorbed better than ampicillin
these drugs in general retain the spectrum of activity of penicillin G but have enhanced activity against gram negative |
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Term
|
Definition
| a broad spectrum aminopenicillin |
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Term
| amoxicillin mech of action |
|
Definition
| cell wall synthesis inhibitor |
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Term
|
Definition
| Strep, H. Flu, and E.Coli |
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Term
|
Definition
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Term
| Amoxicillin..adverse reaction |
|
Definition
| rash and anaphylaxis, serum sickness and seizures |
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Term
| Amoxicillin has an adverse reaction (rash) in |
|
Definition
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Term
|
Definition
These extend the ampicillin spectrum to include P. aeruginosa and enterbacter species.
Ticarcillin is available by itself and in a fixed combination with clavalante |
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Term
|
Definition
| Extended spectrum antipseudomonal carboxypenicillins |
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Term
|
Definition
|
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Term
|
Definition
| pseudomonos aeruginosavand other aerobic gram negative bacilli |
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Term
|
Definition
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Term
| Ticarcillin Adverse effects |
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Definition
| same as other penicillins |
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Term
|
Definition
| piperacillin, mezlocillin, and azlocillin resemble ticarcillin except they are active against selected gram negative bacilli such as Klebsiella pneumoniae |
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Term
| Beta Lactamase Inhibitors |
|
Definition
-Resemble the Beta lactam molecule. Have minimal antibiotic activity
they are potent inhibitor of beta lactamases and can protect PCN. for inactiviation by these enzymes
suicide inhibitors
clavulanic acid, sulbactam |
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Term
|
Definition
| an infection that is commonly seen among infants who have meningitis and/or sepsis and can only be treated with ampicillin |
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
beta lactam antibiotic that are more stable and less antigenic than penicillins
cell wall synthesis inhibitor
excreted renally except for the ceftraxone and cefoperazone
adverse effects are minimal toxicity may cross react with PCN allergy |
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Term
| Ceftriaxone and cefoperazone are excreted... |
|
Definition
| by the liver and have a longer half life |
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Term
| cephalosporins bacterial resistance |
|
Definition
| more resistant to beta lactamase than PCN. Resistance to Gram negative beta lactamase increase with each generation |
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Term
| 1st generation cephalosporins |
|
Definition
-mainly gram positive, very limited to gram negative
-cefadroxil, cefazolin, cephalexin, cephalothin, cephapirin and cephradine |
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Term
|
Definition
| used primarily for skin and soft tissue infections and uncomplicated UTI's |
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Term
| 1st generation cephalosporins |
|
Definition
-good activity against most streptococci and Methacillin Resistant staph.
-also active against a few gram negative enteric bacilli E.coli and Klebsiella |
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Term
|
Definition
-essentially the only first generation parenteral cephalosporin still in use
-drug of choice for surgical prophylaxis
-doesn't penetrate the meninges and shouldnt be used for meningitis. |
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Term
| 2nd generation cephalosporins |
|
Definition
-same as Gen 1st for gram (positive) but increases activity against gram negative
-treatment of Resp. Track Infection and otitis media
-good H.Flu coverage |
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Term
|
Definition
2nd generation
-can be taken orally and parenterally
-used to treat community acquired pneumonia |
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Term
| Cefoxitin, Cefotetan and Cefmatazole can be used in mixed |
|
Definition
| anaerobic infections such as peritonitis and diverticulities |
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Term
| 3rd generation cephalosporins |
|
Definition
| -greater activity against gram negative bacilli, H.flu and gonococci |
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Term
|
Definition
| hepatic excretion which allows for once daily dosing |
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Term
|
Definition
-indicated for serious infections of the lower resp. tract, CNS GU bones and joints
-2 or 3 per day
-3rd generation |
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Term
| 4th Generation cehalosporins (cefepime) |
|
Definition
-active against a big percentage of gram negative and drug resistant strept.
-primary indicated for the treatment of infections due to multi-drug resistant bacteria |
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Term
|
Definition
under evaluation for use against MRSA in complicated skin and skin structure infections
-IV twice daily
-renally eliminated |
|
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Term
| cephalosporins-adverse effects |
|
Definition
-5-10 percent incidense of cross reactivity with PCN allergy
-can cause hypoprothrombinemia and bleeding disorders
-with alcohol, disulfram like rxn |
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Term
|
Definition
| aztreonam a monocyclic beta lactam |
|
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Term
|
Definition
a monocyclic beta lactam
-cell wall synthesis
-active against money gram negative bacilli, 90 percent P. aeruginosa
-may cause seizures and leukopenia |
|
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Term
|
Definition
1. doripenem
2. ertapenem
3. imipenem
4. meropenem
used for treatment of gram negative resistant bacteria and for serious infections of nosocomial origin. |
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Term
carbapenems
drug interactions |
|
Definition
| may reduce serum valproic acid levels to subtherapeutic resulting in loss of seizure control |
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Term
| carbapenems adverse effects |
|
Definition
-nausea vomitting diarrhea skin rash and rxns at infusion site
-too much imipenem in patients with renal failure may lead to seizures
-imipenem-usually the cause of adverse effects
-patients allergy to pcn, might be allergic to this |
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Term
|
Definition
-narrow spectrum of activity than others
-approved for IV once daily
-Treatment of complicated UTI intra-abd infection, skin and community pneumonia
NOT empiric for nosocomial |
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Term
Impenem-Cilastatin (primaxin)
class |
|
Definition
|
|
Term
Imipenem-Cilastatin (primaxin)
Mechanism |
|
Definition
| cell wall synthesis inhibitor |
|
|
Term
Imipenem-Cilastatin (primaxin)
Ind |
|
Definition
Bacteriacidal to a wide range of gram positive and gram negative organisms, including many aerobic and anaerobic gram negative bacilli
-indicated for serious life threatening infection |
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Term
|
Definition
-Inhibits cell wall synthesis by preventing peptidoglycan elongation and cross-linking
-active against gram positive bacteria
-Used to treat MRSA
-adverse effect
Red man syndrome caused by histamine release when given too quickly |
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Term
|
Definition
| Glycopeptide that is a cell wall synthesis inhibitor (not a beta lactam) |
|
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Term
| Vancomycin (contra and adverse) |
|
Definition
administered parenterally and excreted renally
contra
-allergy to vancomycin
adverse
-nephrotoxicity
-ototoxicity
-red man syndrome |
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Term
|
Definition
| inhibits the step of cell wall synthesis in which the disaccharide precursor is added to the growing peptido-glycan chain |
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Term
|
Definition
staph or enetrococcal endocardidtis etc, infections caused by methacillin resistant organisms.
occasionally used to threat C.Def. Given orally for this indication. |
|
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Term
|
Definition
-Not available in US
-similar to vancomycin
-may be given IM
-once daily dosing |
|
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Term
|
Definition
-inhibits very early stage of bacterial cell wall synthesis
-structurally unrelated to any other antibiotic
-active against gram positive or gram negative organisms
-approved for use a single 3g dose for the treatment of uncomp. UTI
-safe in pregnancy |
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Term
|
Definition
-gram positive coverate
-unique mech of action which results in no cross-resistance with other antimicrobial drug
-markedly nephrotoxic, only topical application |
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Term
|
Definition
| cell wall synthesis inhibitor |
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Term
|
Definition
| blocks cell wall peptidoglycan synthesis by blocking the regeneration of the lipid carrier molecule |
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Term
|
Definition
| active against gram positive used topically for minor skin infections |
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Term
|
Definition
| -nephrotoxic if used systemically, |
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Term
|
Definition
-gram positive and negative activity, but used only for TB infections
-Adverse effect
dose related CNS toxicity w/ headache tremors, acute psychosis and seizures |
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Term
|
Definition
| Bacterial enzymes involved in cross-linking of linear peptidoglycan chains, the final step in cell wall synthesis |
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Term
| Chemotherapy is based on the principle of |
|
Definition
|
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Term
|
Definition
| more toxic to the invader than the host: property of useful antimicrobial drugs |
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Term
|
Definition
| chains of polysaccharides and polypeptides that are cross linked to form the bacterial cell wall |
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Term
| Penicillin-binding proteins |
|
Definition
| bacterial cytoplasmic membrane proteins that act as the initial receptors for penicillins and other Beta lactam antibiotics |
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Term
|
Definition
-pulmonary surfactant antagonizes daptomycin and should not be used to treat pneumonia
-it can cause mopathy. Monitor creatine phosphokinase levels |
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Term
|
Definition
-A cell wall inhibitor that is a cyclic lipopetide
-Binds to and depolarizes the cell wall causing K efflux and rapid cell death
Same spectrum as Vancomycin except active against Vancomycin Resistant staph and enterococci. |
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