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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 |