Term
| Broad spectrum: meaning, use, examples |
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Definition
| Kills many groups of bacteria; use when identity of pathogen unknown, carbapenems, cephalosporins, tetracyclines, chloramphenicol, fluorquinolones) |
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Term
| Narrow spectrum: meaning, use and why, examples |
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Definition
| kills one or a few groups of bacteria; use when identity of pathogen known, why: protects bacteria that breaks down polysacharides in intestine (diarrhea if not digested), that produce vitamin K (bleeding if killed) and colon bacteria (if killed allows pathogenic bacteria to move in); penicillin, glycopeptides, monobactams?, lincosamides) |
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Term
| Bactericidal? Bacteriostatic and contraindication? Combination therapy? |
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Definition
| Cidal: Kills bacteria; static: inhibits bacteria growth and immune system kills (don't use if px has compromised immune system e.g. HIV); Use cidal drugs together and static drugs together (cidal drugs require bacteria to be actively proliferating and not inhibited). |
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Term
| Categories of antibacterial cell wall inhibitors |
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Definition
| beta lactams and non beta lactams |
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Term
| Categories of beta lactams |
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Definition
| penicillin, cephalosporin, carbapenems, monobactams |
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Term
| Categories of anibacterial drugs? |
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Definition
| Cell wall inhibitors, cell membrane inhibitors, inhibitors of DNA synthesis and inhibitors of protein synthesis |
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Term
| Category of inhibitors of bacteria DNA synthesis |
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Definition
| fluoroquinolones (broad-3rd Gen) |
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Term
| Categories of bacterial inhibitors of protein synthesis |
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Definition
| Tetracylines (static, broad); aminoglycocides (cidal); lincosamides (narrow); macrolides; chloramphenicol (static, broad) |
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Term
| Antibacterial drug side effects |
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Definition
1) Diarrhea from A) Pseudomembranous colitis/C. difficile colonization (tx: metronidizole [DOC], vancomycin) B) ingestion of carbohydrates (not absorbed)C) agonism of duodenum motilin receptors that promote peristaliss (macrolides, erthromycin)
2) increased risk of bleeding from A) inhibition of 2C9 (warfarin action up) by macrolides, chloramphenicol or fluoroquinolines B) Sulfonamides (displace warfarin from albumin, increase warfarin action) C)NMTT structure of Cephalosporins (interferes with hepatic synthesis of vitamin K dependent factors)
3) Avoid FCATS during pregnancy (fluoroquinolones, chloramphenicol, aminoglycosides, tetracyclins, sulfonamides) |
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Term
| 4 methods of antibiotic resistance |
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Definition
| efflux pump, antibiotic altering enzyme, antibiotic degrading enzyme (beta lactamase), altered target (PBP or porin structure) |
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Term
| Gram positive: cell membrane/wall structure; staining? |
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Definition
| cell wall contains peptidoglycan, surrounding plasma membrane; iodine stains purple |
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Term
| Gram negative: cell membrane/wall structure; staining? |
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Definition
| cell wall separate, contains porins, and surrounds peptidoglycan layer, which surrounds plasma membrane; iodine doesn't stain, but counterstains pink |
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Term
| Meningitis antibiotic quality? 1st line tx? 2nd line tx? not used for tx? |
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Definition
| Must pass thru blood-brain barrier; 1st: cefotaxim, cefriaxome, ceftazidime (cephalosporins that pass bbb during infection); 2nd: chloramphenicol (if allergy, always passes bbb); no: sulfonamides, trimethoprim (pass bbb but menigitidis resistant to) |
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Term
| categories of penicillins |
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Definition
| natural, antistaph, extended spectrum, antipseudomonal |
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Term
| beta lactams mode of action, cidal or static, resistant bacteria, elimination, ADR; types of resistance |
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Definition
| disrupt penicillin binding proteins (PBP) that crosslink chains via transpeptidation; bactericidal; Chlamydia and mycoplasm are resistant (no peptidoglycan cell wall); renal elimination (through PSOASS, retain with probencid except oxacillin/nafcillin); hypersensitivity: rash, broncospasm, urticaria (hives), anaphylactic shock -> cross allergenicity (if allergic to one, allergic to others); beta lactamase/change in PBP/Porin |
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Term
| penicillins category, spectrum, cidal/static, bbb passage, ending, structural note |
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Definition
| beta lactams; narrow; cidal; bbb passage during infection; -cillin; thiazolidine ring |
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Term
| cephalosporin category, spectrum, cidal/static, prefix, structural notes |
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Definition
| beta lactams; broad; cidal; cef/ceph; dihydrothiazine, if NMTT structure than 1) interferes with synthesis of vit. K dependent factors and increases bleeding 2) disulfiram like (blocks acetaldehyde dehydrogenase -> hangover symptoms with alcohol) |
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Term
| carbapenems category, spectrum, cidal/static, -ending, structural note, beta lactamase and probenecid effect? |
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Definition
| synthetic beta lactams; broad(est) spectrum; cidal; -penem ; thiazolidine (but lacks sulfur); beta lactamase resistant, not probenecid sensitive |
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Term
| imipenem category, coadministered with (why?) |
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Definition
| carbapenem; cilastatin (inhibits renal dehydropeptidase I, nephrotoxic without) |
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Term
| monobactams category, spectrum, cidal/static, structural note, beta lactamase and probenecid effect? SE? |
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Definition
| synthetic beta lactam; narrow? (G - rod only); cidal; b lactam ring only; beta lactamase resistant and not probencid sensitive; less pronounced |
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Term
| Cephalosporin 1st gen, 3rd gen, 4th gen, all gens; tx for (with which drugs)? |
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Definition
| 1G: beta lactamase sensitive, affects gram +; 3G: beta lactamase resistant, affects gram -; 4G affects gram +/-; all gens affect strep; meningitis tx (caused by N. meningitidis), use cefotaxim, cefriaxome, ceftazidime) |
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Term
| natural penicillins beta lamtamase sensitivity, examples, treatment for (drugs used)? |
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Definition
| sensitive; G, V; tx of siphyllis (trep. pallidum/a spiracheta)using depot forms: penicillin G procaine or benzathine |
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Term
| antistaph/oxipenicillins common root; beta lamtamase sensitivity, examples, treatment for (exception)? |
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Definition
| -ox-; resistant; methicillin, nefcillin, oxacillin, cloxacillin; tx for staphylococcus (except MRSA: Methicillin resistant Staph [PBP -> PBP2] which requires vancomycin) |
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Term
| extended spectrum/aminopenicillans prefix, beta lamtamase sensitivity, examples, mode of action, treatment for? |
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Definition
| amp-; sensitive (use beta latamase inhibitor); ampicillin; water soluble, goes thru porin; tx for G - rods (E. Coli, H. Influenzae, Salmonella) and G + Listeria |
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Term
| antipseudomonal: beta lamtamase sensitivity, examples, mode of action, treatment for? |
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Definition
| sensitive (use beta lactamas inhibitors); carbenicillin, ticarcillin, piperacillin; doesn't require porins; tx for G - rods esp. pseudomonas aeroginosa (green/cyan toenail [rusted copper]) also: Flu, E. coli and enterbacter |
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Term
| beta lactamase inhibitors |
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Definition
| sulbactum; carulonate; tazobactum |
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Term
| categories of non beta lactams |
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Definition
| vancomycin (glycopeptides) and bacitracin |
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Term
| vancomycin category, spectrum, cidal/static, mode of action, bbb passage, tx for? resistant bacteria? SE? Alternative drug? |
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Definition
| non beta lactam; narrow (staph); cidal; disrupts polymerization of NAG/NAM complexes via transglcosylation, binds to D-Ala, D-Ala ending of NAM capping it; passes bbb during infection; tx for pseudomembranous colitis (C. difficile), MRSA (staph); VRSA (staph) and VRE (D-Ala to D-lactone) are resistant; SE Redman syndrome (nonspecific degranulation of mast cells -> flushing), ototoxicity and nephrotoxicity); Alt drug: Teicoplanin (less SE's and longer 1/2 life |
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Term
| bacitracin category, mode of action |
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Definition
| non beta lactam; works on NAM (N-acetyl muramic acid) and NAG (N-acetyl glucosamine) precursors of cell wall in cytoplasm |
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Term
| Daptomycin mode of action, use, spectrum, cidal/static, structure, tx for? |
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Definition
| Ca dependent cell membrane inhibitor that binds to membrane causing rapid depolarization which inhibits DNA, RNA and protein synthesis; kills gram + bacteria without lysis; narrow?; cidal; cycliclipopeptide; tx for cSSSI (complicated skin/skin structure infections) |
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Term
| Bacteria that causes meningitis |
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Definition
| N. meningitidis (young adults), H. influenza (toddlers), Streptococcus pneumoniae (elderly) |
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