Alternatives- PHARM 2

robbypowell's version from 2016-09-20 01:37

Some (but not all) Cephalosporin questions

Question Answer
What Cephalosporin crosses the CNS and is used to treat MENINGITIS?Cefuroxime (maybe same as cephotaxime)
Cephalosporin sidechain for antibacterial activity R1
Cephalosporin sidechain for Modification of metabolism & kineticsR2
Which generation is the specific Cephalosporin drug, Cephalexin?1st gen
What Cephalosporin generation?: Cefamandole, Cefaclor, Lorbacef2nd gen
What Cephalosporin generation is Cefotaxime3rd (crosses CSF, good w pseudomonas, sometimes IV)
What Cephalosporin generation is Cefepime4th (IV, expensive, broad spectrum)
This Cephalosporin generation is mainly effective against Gram + bacteria1st (Cephalexin)
This Cephalosporin Generation has No activity against enterococci1st (Cephalexin)
This generation of Cephalosporins is especially Beta lactamase sensitive1st (e.g. Cephalexin)
Cephalosporin generations given for Pseudomonas infection (depending on severity)3, 4 (4 being more sever)
Cephalosporin Generations given for Penicillin resistant strep pneumoniae3, 4
Cephalosporin generation given for MRSA, enterococci4
This Cephalosporin Gen is Like ALWAYS, like you know, given IV ... DUH!4 (3 is regularly)
Cross-over reaction of penicillin allergy with Cephalosporins ___ %20%
Maculopapular rash, increased liver fxn, stop hemostasis, alcohol interolance are adverse reactions of what antibiotic class?cephalosporin adverse rxns
Cephalosporins excreted by the _____kidney
______ lesions, penicillin cross allergy, and increased _____ function are adverse effects of cephalosporinsMaculopapular; Liver
______ intolerance and inhibited hemostasis ((hypoprothrombinemia... what a mouthful) are adverse effects of cephalosporinsAlcohol
(Major or Minor) ______ determinants of penicillinic acid degradation are responsible for allergic rxn to beta-lactam drugs**MINOR** (it was on the quiz, it could be on the test too)
T/F: Pt with mild chain rxn to penicillins or positive skin test to major antigenic determinant can be given cephalosporin with reasonable safetyTrue
T/F: Patients with mild reaction to penicillins or pos skin test to major antigenic determinant should not be given Cephalosporins as they will cause an allergic responseFalse (it is "reasonably safe")
Decision to switch a patient with a mild allergy to penicillin to cephalosporin is made on the basis of a ____ testSKIN (give major determinant of penicillin ... and ceph doesn't have that in common)

Which classes of antibiotics

Question Answer
Highly specific to PBP2carbapenems
Imipenem, Meropenemcarbapenems
Wide spectrum, Beta lactamase resistant, cross rxn penicillin, MRSAcarbapenems
this penicillin alternative has No thiazolidine ringMonobactam
These antibiotics seem pretty useless... but at least they lack cross-resistance with penicillinMonobactams (limited to aerobic gram negative, Beta lactamase sensitive, only injection, but at least it lack cross rxn penicillin)
Erythromycin, Clarithromycin, AzithromycinMacrolides
target 50S ribosomal subunit of bacteriaMacrolides & Clindamycin
target 30S ribosomal subunit of bacteriaTetracycline & Aminoglycosides (BRUH!)
Microsomal enzyme inhibitorErythromycin & Clarithromycin
this Macrolide is special. it causes less GI problemsClarithromycin
Liver-bile-urine to excreteErythromycin
Liver & or Kidneys to excreteClarithromycin
antibiotics used to treat OsteomyelitisClindamycin, Fluoroquinolones
Inhibits carboxypeptidaseVancomycin
Very effective through IV... but orally has poor absorptionVancomycin
antibiotic used to treat Protozoal infectionMetronidazole
antibiotic used to treat ANUGMetronidazole
this class causes a Disulfuram like action when taken with alcohol (vomit) (aka Barfing)Metronidazole (Acetylaldehyde)
this class antibiotics cause Metal taste in your mouth... (vampires rejoice!)Metronidazole (vampires are Metrosexuals... just like Varun according to Dr Karp... but they don't eat egg white spinach omelettes)
Nitro group gets reduced to metabolites that damage DNAMetronidazole
Increased CNS toxicity with Theophyine or NSAIDsFluoroquinolones
Adverse reactions for heart problem patientsFluoroquinolones

further questions (LOL we're only getting started)

Question Answer
this class of antibiotics (a penicillin alternative) is isolated from the fungus Acremonium chrysogenumCephalosporins
T/F: Cephalosporins are a B-Lactam drugTrue (and so inhibit cell wall synthesis)
T/F: Cephalosporins inhibit Bacterial DNA synthesisFalse (B-Lactam drug... inhibit cell wall synthesis)
Cephalosporins inhibit what?Cell wall synthesis (like B-Lactam drugs)
Are Cephalosporins absorbed well orally?Yes
Which specific cephalosporin is used to treat MENINGITIS because it can penetrate the CSF?**Cefuroxime**
Cephalosporins structure: a ______ ring and ________ ringB-Lactam ring & DIHYDROTHIAZINE ring (6 membered ring)
Cephalosporins have a B-Lactam ring & DIHYDROTHIAZINE ring... Dihydrothiazine is a _____ (#) membered ring6 membered ring
What enzymes do cephalosporins (like penicillins) target in order to inhibit cross-linking of peptidoglycan?transpeptidases & carboxypeptidases
Cephalosporin is a _____ nucleus with 2 side chains: R1 (antibiotic action) & R2 (kinetic modifier)Cepham nucleus (w/ 2 side chains: R1 & R2)
What class of drugs has a Cepham nucleus with 2 side chains?Cephalosporins (B-Lactam)
Different "generations" (classifications) of Cephalosporins are classified on the basis of their ______ activityAntimicrobial (GM+, GM-, pseudomonas, or wide spectrum)
What is the main First generation Cephalosporin?Cephalexin (also "main drug for orofacial infections")
What Cephalosporin is taken orally for soft tissue infection and surgical/endocarditis prophylaxis?Cephalexin(Gen1) (main drug for orofacial infection)
T/F: Cephalexin has the same dosage and regimen as PenicillinTrue
What is the half-life of Cephalexin (First Gen Cephalosporin)1 hour
Are Second generation Cephalosporins used commonly in dentistry?No (b/c mainly effective against Gram neg... which app isn't as big a concern in our realm)
What is the main second generation Cephalosporin?Cefamandole
Azithromycin is excreted by the ______Liver

Which cephalosporin generation?

Question Answer
drugs: Cefamandole, cefaclor, & lorbacefGen 2 (mainly GM-, more resistant to B-lactamse than Gen 1, rarely used in dentistry)
Taken orally for soft tissue infections caused by GM+ bacteria (mainly staph & strep)Gen 1 (Cephalexin)
drug: CephalexinGen 1 (GM+, soft tissue infections esp., B-Lactamase sensitive, taken orally)
VERY EXPENSIVE (apparently because of its broad spectrum)Gen 4 (e.g. Cefepime)
CefepimeGen 4 (expensive, broad spectrum, always IV route)
Generally taken parenterally for serious GM- bacteria infection (specifically effective against GM-) Gen 3 (cefotaxime)
Very sensitive to Beta-LactamaseGen 1 (Cephalexin... ; Gen 2-4 are resistant to B-Lacatamase)
Should patients with history of systemic penicillin reaction be given Cephalosporins?NO (unless specifically called for in life threatening situation such as meningitis and anaphylaxis antidote is available)
cefotaximeGen 3 (serious GM- infection, crosses CSF)
CefamandoleGen 2 (GM- effective, only mild effect against anaerobes)

B-Lactam antibiotics that are not penicillin or cephalosporin

Question Answer
imipenem & meropenem are drugs of what B-Lactam class?Carbapenems
this class has wide antibiotic spectrum but is highly specific for PBP2 of GM+ and GM-Carbapenems
this class is broken down by B-Lactamase (bacterial defense enzyme) but lacks cross-allergic rxn with penicillin entirelyMonobactams
structure of this B-Lactam antibiotic class is a monocyclic B-lactam AB with no thiazolidine ringMonobactams
are Carbapenems cross-allaergenic with penicillin?yes
are Monobactams cross-allergenic with penicillin?no

and other antibiotics still

Question Answer
What are the 3 Macrolide drugs?erythromycin, clarithromycin & azithromycin
this group Acts by binding to 50S ribosome unit → inhibit RNA-dependent protein synthesis by blocking translocationMacrolides (Clindamycin does too.. but its not a macrolide)
more effective against strep and staph than the other 2 MacrolidesAzithromycin
A Z pack is 6 tabs of 250 mg of what antibiotic?Erythromycin
BEST ALTERNATIVE for B-lactam allergic patient for acute orofacial infec***Macrolides***
cholestatic hepatitis and cardiac arrhythmia are contraindications for what class of antibiotics?Macrolides
This drug has less GI problems associated with it than Erythromycin does and is mostly effective against GM+ anaerobesClarithromycin
What class antibiotics is used for Treating acquired bacterial pneumonia, chronic sinusitis, & asthma complications?Macrolides
T/F: Clindamycin is a macrolideFalse (part of another family called Lindomycins)
T/F: Clindamycin, unlike Erythromycin, Azithromycin, and Clarithromycin, is not a macrolideTrue (Its a Lindomycin... which is a diff family)
What is the 1st and 2nd most preferred AB for dental infection/fever especially if pt is systemically allergic to penicillin?Macrolides (1st choice) or Clindamycin(2nd)
This antibiotic is known especially for its ability to penetrate into bonesClindamycin (and thus is great for Osteomyelitis)
This antibiotic acts synergistically with cephalosporins and aminoglycosidesVancomycin
Vancomycin is great against Gram _____Gram Pos (esp strep and staph... including MRSA!)
not an antibiotic... but anti-abuse drugs given for alcoholicsDisulfiram
Metallic taste and disulfiram-like interaction with alcohol (vomiting) are side-effects of this antibiotic**Metronidazole**
used to treat ANUG, anaerobic bacteria (staph) , and MAINLY PROTOZOAL infections**Metronidazole**
drug that Has a nitro group that gets reduced to metabolies that damage bacterial DNA**Metronidazole**
nausea, neutropenia, pancreatitis, pseudomembranous colitis and alcohol intolerance are side-effects of what antibiotic?**Metronidazole**
these antibiotics are a Fluorine derivative of nalidixic acidFluoroquinolones
___-floxacin named antibiotics are of what class?Fluoroqunilones
most common Fluoroquinolone antibiotic drug?Ceprofloxacin
what class is the drug Ceprofloxacin?Fluoroquinolone
First drug of Fluoroquinolone class, but had undesirable CNS stimulant effects and rapid development of bacterial resistanceNalidixic acid
dosage of Cipro (Ceprofloxacin, a Fluoroquinolone)250-500 mg BID
dosage of Levaquin (levofloxacin, a Fluoroquinolone)250, 500, or 750 mg, QD (1x/d)
dosage of Avelox (moxifloxacin, Gen 4 Fluoroquinolone)400 mg, QD
This class of antibiotics has interactions with anti-arrhythmia drugsFluoroquinolones
_____ is used to prolong the effects of FluoroquinolonesCimetidine
this class of antibiotics is used against UTIs, STDs (mainly syphilis and gonorrhea), GI infections, resp tract infec, bone/joint infections (including osteomyelitis)Fluoroquinolones
this class of antibiotics has side-effects of nausea, headaches, CNS side effects such as seizures and delirium (this is why gen 1 isnt used any more)Fluoroquinolones
this class of antibiotics has side-effects of Tendon rupture, arthralgia and joint swelling, renal crystals and prolonged QT interval (causes heart attack for patients with heart problems)Fluoroquinolones

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