Term
What factors at the site of infection can affect antimicrobial therapy? |
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Definition
Presence of Pus Presence of Hemoglobin pH Anaerobic conditions Presence of foreign body |
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Term
What antimicrobials site of action is on DNA gyrase? |
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Definition
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Term
What antimicrobials site of action is on Protein Synthesis, 30S inhibitors? |
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Definition
Aminoglycosides Tetracyclines |
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Term
What antimicrobials site of action is on Protein synthesis, 50S inhibitors? |
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Definition
Macrolides Clindamycin Linezolid |
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Term
Why is Combination Chemotherapy used? |
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Definition
Mixed Bacterial Infections Unknown etiology when can't wait for results Drug Synergy Prevent Resistance Permit Lower dose |
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Term
Increased export of which drug from cells creates resistance? |
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Definition
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Term
What drug do Beta-lactamases inactivate? |
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Definition
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Term
What drug is inactivated by phosphorylation, acetylation? |
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Definition
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Term
How is resistance achieved to Sulfonamides/trimethoprim? |
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Definition
Alternative and salvage metabolic pathways |
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Term
What class of Penicillins is effective against G+ cocci and bacilli, some G-, and spirochetes? |
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Definition
Natural penicillins
Penicillin G - parenteral
Penicillin V - oral |
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Term
What specific orgainisms are the Natural Penicillins effective against? |
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Definition
Streptococcus Neisseria gonorrhoeae Treponema pallidum |
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Term
What class of penicillins is effective against Beta-lactamase-producing staph? |
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Definition
Anti-staphylococcal Nafcillin - parenteral |
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Term
What class of penicillins is effective against G+ cocci and bacilli, some G- cocci, rods, and bacilli, and spirochetes? |
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Definition
Extended Spectrum Ampicillin - parenteral/oral Amoxicillin - Oral |
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Term
What specific organisms are amoxicillin effective against? |
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Definition
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Term
What are the Extended spectrum Penicillins not resistant to? |
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Definition
Broad Spectrum Beta-lactamases in G- organisms |
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Term
What enzymes do penicillins bind to that is required for cell wall synthesis? |
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Definition
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Term
How are penicillins metabolized and excreted? |
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Definition
Hepatic enzyme metabolism Renally excreted |
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Term
What penicillins need to be supplemented following hemodialysis? |
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Definition
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Term
What is MRSA usually resistant to? How should it be treated? |
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Definition
Usually resistant to: cephalosporins erythromycin tetracycline Treat With: Vancomycin |
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Term
What are the prophylactic uses of penicillins? |
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Definition
Exposure to gonorrhea, syphilis Prevention of recurrence of rheumatic fever Patients with valvular hear disease undergoing surgery |
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Term
What adverse reaction is frequent with augmentin in Children but can occur with all penicillins? |
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Definition
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Term
What adverse reaction is more common with ampicillin after oral dose? |
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Definition
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Term
What penicillin can cause adverse effects on plasma electrolyte concentrations? |
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Definition
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Term
What penicillin causes dose related renal impairment? |
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Definition
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Term
What patients are at higher risk for neurotoxicity when taking penicillins? |
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Definition
Patients with reduced renal function |
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Term
What penicillins more commonly cause hypersensitivity reactions? |
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Definition
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Term
What was developed to be effective in patients allergic to penicillins? |
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Definition
cephalosporin (but MRSA is usually resistant to it) |
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Term
What drugs can be used in place of penicillin for a person who is acutely allergic to penicillin? |
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Definition
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Term
What are the 4 generations of Cephalosporins? |
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Definition
1st - Cefazolin 2nd - Cefoxitin 3rd - Ceftriaxone, Cefotaxime 4th - Cefapime |
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Term
What is the progression of the cephalosporin generations? |
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Definition
Broadening in G- susceptibility Decreased activity against G+ Increased resistance to B-lactamase Increased capability to enter CSF |
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Term
What generation of cephalosporins has a similar spectrum to ampicillin, G+ cocci, and many G- bacilli? |
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Definition
First Generation Cefazolin |
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Term
What Cephalosporin has less G+ activity and is effective against H. influenza and B. fragilis? |
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Definition
Second Generation Cefoxitin |
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Term
What cephalosporin is effective againts Enteric G-, and is reserved for very serious infections? |
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Definition
Third Generation Cefotaxime, Ceftriaxone
Crosses Blood Brain Barrier |
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Term
T/F No current cephs have activity for entercocci or ORSA |
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Definition
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Term
What cephalosprins penetrate to CSF sufficiently to be useful for meningitis? |
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Definition
3rd Generation Cefotaxime & ceftriaxone |
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Term
What cephalosporin is used to treat bacteremia? |
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Definition
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Term
What cephalosporin is the only one that does not have to be supplemented following hemodialysis? |
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Definition
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