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55 Cards in this Set
- Front
- Back
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what is the key component of bacterial cell walls?
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peptidoglycan
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how thick is the wall in gram + bacteria and where is the peptidoglycan?
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thicker
peptidoglycan forms a layer over the cell membrane |
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how thick is the wall in gram - bacteria and where is the peptidoglycan?
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thinner
peptidoglycan is located in the periplasmic space |
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what is the MOA of all penicillins?
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all work by binding to transpeptidase to prevent peptidoglycan from being formed
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what are 2 natural penicillins?
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Pencicillin G and penicillin K
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what bacteria are the natural penicillins good against? (5)
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strep
staph (not MRSA) enterococcus anaerobes T. palladium (syphillus) |
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how is penicillin G administered
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IV or IM
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what is the advantage of IM penicillin G over IV?
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IV has a shorter half life
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how is penicillin G excreted?
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renal
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what is IV penicillin G used for? (2)
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endocarditis
neurosyphillis |
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what is IM (benzathine) penicillin G used for? (3)
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primary
secondary tertiary syphillis |
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What is IM (aqeous procaine) penicillin G used for? (1)
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alternative for syphillis
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How is pencicillin V administered and why?
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orally because it is more stable in stomach acid
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how is penicillin V excreted?
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renal and fecal
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what are 2 uses for penicillin V?
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strep pharyngitis
dental infections |
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how to anti-staph penicillins work?
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the beta-lactam ring is altered to protect against beta-lactamase
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what are 3 antistaph penicillins?
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Nafcillin
oxacillin dicloxacillin |
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how is nafcillin and oxacillin administered?
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IV
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where are nafcillin and oxacillin metabloized?
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liver
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how is dicloxacillin administered?
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orally
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how is dicloaxacilin excreted?
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renal and extra-renal, therefore no dose adjustment is necessary
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what are the indications for anti-staph penicillins? (3)
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mainly used for staph (but not MRSA)
Gram-positives no enterococcus |
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what are 4 typical conditions treated with anti-staph penicillins? (4)
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endocarditis
cellulitis osteomyelitis bacteremia |
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how to aminopenicillins work?
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more lipophilic so the can enter gram negatives but still affected by beta lactamases
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what are 2 aminopenicillins?
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amoxicillin
ampicillin |
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what are 2 advantages of amoxicillin over ampicillin?
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slightly more active against specific gram -
better absorption that ampicillin |
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how is amoxicillin administered?
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orally
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how is amoxicillin excreted?
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renal
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what are 2 primary uses for amoxicillin?
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otitis media
prophylactic for endocarditis |
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how is ampicillin administered?
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orally and IV
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how is ampicillin excreted?
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renal
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what is ampicillin used to treat? (2)
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listeria meningitis
sensitive enterococcus |
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how do beta-lactamase inhibitors work?
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suicide inhibitors that bind preferentially to beta-lactams to do their job
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what are 3 beta-lactamase inhibitors?
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clavulanic acid
sulbactam tazobactam |
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what are 2 beta-lactamase + aminopenicillin combinations?
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unasyn = ampicillin + sulbactam
augmentin = amoxicillin + clauvulanic acid |
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what 5 bacterias can beta-lactamase inhibitors + aminopenicillins be used for?
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strep
staph (not MRSA) enterococcus anaerobes lesser gram-negatives |
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what 5 conditions are beta-lactamase inhibitors + aminopenicillins used for?
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strep
staph (not MRSA) enterococcus anaerobes gram-negatives (not including pseusamonas) |
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what are extended-spectrum penicillins mainly used for?
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pseudamonas
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what bacteria does extended-spectrum penicillin cover? (4)
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strep
staph (not MRSA) enterococcus most gram negatives |
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what are 2 extended-spectrum penicillins?
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piperacillin
ticarcillin |
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what are 2 combination extended-spectrum penicllins?
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zosyn = piperacillin + tazobactam
timentin = clavulanic acid + clavulanic acid |
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how are extended spectrum penicillins administered?
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IV only
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what are 6 indications of extended spectrum pencillins?
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nosocomial pneumonia
cellulitis intra-abdominal infections bacteremia febrile neutropenia complicated UTI |
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if a bacteria is beta-lactamse positive, what 2 anti-microbials will it destroy at the very least?
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penicillins and cephalosporins
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what are carbapenems stable against?
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all types of beta-lactamases so you don't need beta-lactamase inihibitors
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what are 4 carbapenems?
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imipenem
meropenem doripenem ertapenem |
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what must imipenem be attached to and why?
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imipenem-cilastatin
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what are imipenem, meropenem, and doripenem mainly used to treat?
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gram-negatives
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what is the limited coverage of ertapenem? (3)
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does not treat enterococcus, pseudomonas, or acinetobacter
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what is the advantage to ertapenem?
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it has a longer half life so it can be given as a once daily dose
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why is ertapenem useful for home-health care?
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it can be given once daily as an IM
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how are carbapenems administered?
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IV
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what is the main adverse effect of carbapenems?
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seizures - even with appropriate dosage, seizures may occur
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what patients should you not use carbapenems in? (2)
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any seizure history
CNS infection |
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what carbapenem is the worst CNS agitator?
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imipenem
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