Cephalosporins
What do PCN and cephalosporins have in common? (2)
work by the same MOA and are beta lactams
What are prescribed drugs are tetracyclines known to interact with?
oral contraceptives
(also calcium supps, antacids, magnesium-containing laxatives, and iron supps)
What are two downsides of broad spectrum ABX?
hint: homeostasis and viral infections
1) they vastly affect normal flora
2) they do the most to facilitate the emergence of drug resistant bacteria
What are nosocomial infections?
healthcare-associated infections such as CAUTIs, MRSA, VRE
What are sulfonamides and Nitrofurantoin commonly used for?
uncomplicated UTIs
How do cephalosporins work? What type of bacteria do they target?
(half credit for answering 1 of the 2)
bind to PBPs and disrupt cell wall synthesis --> causing bacterial lysis
gram positive and gram negative; depends on what generation
Which ABX is most associated with pseudomembranous colitis superinfection?
Clindamycin
(pseudomembranous colitis superinfection --> aka C-diff)
What is group of broad spectrum PCNs called? Give two common examples
hint: these three all start with a
What is empiric therapy drug selection based on? (2 things)
hint: no culture yet
ABX therapy before we know what the "bug" is. But if the infection is severe enough, empiric therapy is started with an ABX based on:
1) clinical evaluation and 2) knowledge of microbes which most likely caused the infection
Which two classes of ABX are known to cause for interval prolongation?
Name the three 1st generation cephalosporins we have to know and if they are resistant to beta lactamases
Cefazolin, Cefadroxil, and Cephalexin
they are not, they die :(
Which labs do we need to monitor closely when a patient is receiving Macrolides? Ex: Erythromycin
AST/ALT --> hepatotoxic effects
What are carbapenems, penicillins, and cephalosporins administered with for greater effectiveness?
beta-lactamase inhibitors
ex: Amoxicillin + clavulanic acid(b-lac inhibitor) = Augmentin
Which classes of drugs are NOT safe during pregnancy?
Category D - Fluoroquinolones, Aminoglycosides, Tetracyclines, Bactrim
Don't Forget About The Babe
What three types of Gram Positive bacteria do we need to remember?
Staphylococcus, Streptococcus, enterococcus
Name the only fourth and fifth generation cephalosporins we need to know
Cefepime (4) - broad spectrum
Cetraoline (5) - MRSA
What are two things you need to monitor closely for with Vancomycin and Aminoglycosides?
nephrotoxicity and ototoxicity
Which broad spectrum ABX are a good option for PCN allergy patients?
DOUBLE POINTS: what bacteria does this class cover?
monobactams - due to different structure with only a single beta lactam ring
kills Gram (-) aerobes
Name the four drugs that are typical treatment for tuberculosis
Rifampin, Isoniazid, Pyrazinamide, Ethamutol
RIPE
Which four classes (or common drugs) work by inhibition of bacterial wall synthesis?
PCN, cephalosporins, carbapenems, Vancomycin
Name the four third generation cephalosporins we need to know and their main indication
hint: same indication
ceftriaxone, ceftazidime, cefotaxime, and cefpodoxime
indication - pneumonia
What is the difference between a side effect versus a true allergy to PCN?
(or really any drug)
side effect - PREDICTABLE, dose-related, can affect anyone
allergy - unpredictable, NOT dose related, antibody/T-cell mediated
What is a particularly toxic broad spectrum drug that is used when safer alternatives are ineffective/contraindicated?
DOUBLE POINTS: name two adverse effects
Chloramphenicol
adverse effects: GI effects, reversible bone marrow depression, gray syndrome, fatal aplastic anemia, peripheral neuropathy
What are two important (and somewhat unique) adverse effects to watch for with use of fluoroquinolones?
ex: Ciprofloxacin and Levofloxacin
QT interval prolongation, tendon rupture, CNS effects such as dizziness/confusion
Name at least 3 ABX that act against MRSA
Vancomycin, Ceftaroline (5th gen ceph.), Telavancin, Linezolid, Dalfopristin/Quinupristin, Daptomycin