Therapeutics Id Bergman Test Questions – Flashcards

Beta Lactam Antibiotic

Only effective against Beta Hemolytic, Groups A and B Streptococcus

DOC for syphilis

Beta Lactam

Anti-Staph Drug

DOC for MSSA

Beta Lactam

Anti-Staph Drug

DOC for MSSA

Beta Lactam

Anti-Staph Drug

DOC for MSSA

Beta Lactam

• Aminopenicillin Drug
• Designed against G- organisms --> not effective anymore because of Beta-Lactamase produced by enteric G- bacteria
• Effective against Alpha Hemolytic Streptococcus (S. pneumoniae, Viridans group)
• Effective against Enterococcus faecalis in the blood --> give IV

Beta Lactam

• Aminopenicillin Drug
• Designed against G- organisms --> not effective anymore because of Beta-Lactamase produced by enteric G- bacteria
• Effective against Alpha Hemolytic Streptococcus (S. pneumoniae, Viridans group)

Beta Lactam

• Anti-Pseudomonal Drug
• Effective against Enteric bacteria (E. coli, Klebsiella) and Pseudomonas aeruginosa
• Drug is still susceptible to Beta Lactamase so it is usually combined with Ticarcillin

Beta Lactam

• Anti-Pseudomonal Drug
• Effective against Enteric bacteria (E. coli, Klebsiella) and Pseudomonas aeruginosa
• Drug is still susceptible to Beta Lactamase so it is usually combined with Piperacillin

Beta Lactamase Inhibitor

• Usually combined with Ampicillin (Ampicillin/Sulbactam)
• Inhibits beta lactamase so the antibiotic can work on bacteria
• Improved activity against organisms that produce beta-lactamase such as:

1. Staphylococcus aureus

2. Enteric G- Bacteria (E. coli, Klebsiella)

3. Respiratory G-

4. Anaerobes

Beta Lactamase Inhibitor

• Usually combined with Amoxicillin and Ticarcillin
• Inhibits beta lactamase so the antibiotic can work on bacteria
• Improved activity against organisms that produce beta-lactamase such as:

1. Staphylococcus aureus

2. Enteric G- Bacteria (E. coli, Klebsiella)

3. Respiratory G-

4. Anaerobes

Beta Lactamase Inhibitor

• Usually combined with Piperacillin
• Inhibits beta lactamase so the antibiotic can work on bacteria
• Improved activity against organisms that produce beta-lactamase such as:

1. Staphylococcus aureus

2. Enteric G- Bacteria (E. coli, Klebsiella)

3. Respiratory G-

4. Anaerobes

Beta Lactam

• 1st Generation Cephalosporin
• Administered IV
• Effective against MSSA, Beta Hemolytic Group A and B Strep.
• Prophylaxis prior to surgery to prevent infections from skin flora

Beta Lactam

• 1st Generation Cephalosporin
• Administered PO
• Effective against MSSA, Beta Hemolytic Group A and B Strep.
• Same spectrum of activity as Cefazolin

Beta Lactam

• 2nd Generation Cephalosporin
• Administered IV and PO
• Effective against Alpha Hemolytic Strep. (Streptococcus pneumoniae, Viridans), Respiratory G- cocci (H. influenzae)
• Used in COPD
• However, not DOC for any infection?

Beta Lactam

• 2nd Generation Cephalosporin (Cephamycin)
• Administered IV
• Effective against Enteric bacteria (E. coli, Klebsiella) and Anaerobes (Clostridium, Bacteroides, Peptostreptococcus)
• Prophylaxis prior to surgery to prevent intra-abdominal infections
• Does not have good G+ activity

Beta Lactam

• 2nd Generation Cephalosporin (Cephamycin)
• Administered IV
• Effective against Enteric bacteria (E. coli, Klebsiella) and Anaerobes (Clostridium, Bacteroides, Peptostreptococcus)
• Prophylaxis prior to surgery to prevent intra-abdominal infections
• Does not have good G+ activity

Beta Lactam

• 3rd Generation Cephalosporin
• Administered IV
• Effective against Alpha Hemolytic Strep. (S. pneumoniae, Viridans group), Enteric bacteria (E. coli, Klebsiella)
• Very commonly used in hospital setting, plus QD dosing
• Not for newborns --> excreted biliary, not well developed in newborns

Beta Lactam

• 3rd Generation Cephalosporin
• Administered IV
• Effective against Alpha Hemolytic Strep. (S. pneumoniae, Viridans group), Enteric bacteria (E. coli, Klebsiella)
• Commonly used in hospital setting
• Not for newborns --> excreted biliary, not well developed in newborns

Beta Lactam

• 3rd Generation Cephalosporin
• Administered IV
• Effective against Enteric bacteria (E. coli, Klebsiella), Pseudomonas aeruginosa
• G- activity

Beta Lactam

• 4th Generation Cephalosporin
• Administered IV
• Effective against Alpha Hemolytic Strep. (S. pneumoniae, Viridans group), Enteric bacteria (E. coli, Klebsiella), Pseudomonas aeruginosa
• Sounds good to have all 3 covered but usually one will not need that kind of coverage

Beta Lactam

• 5th Generation Cephalosporin 
• 1st Beta Lactam with MRSA activity
• Has pseudomonas activity

Beta Lactam

• 5th Generation Cephalosporin 
• 1st Beta Lactam with MRSA activity

Beta Lactam

• Carbapenem
• Activity against Enteric bacteria (E. coli, Klebsiella), Pseudomonas aeruginosa, Anaerobes (Clostridium, Bacteroides, Peptostreptococcus)
• DOC for Extended Spectrum Beta Lactamase (produced by E. coli and Klebsiella)

Beta Lactam

• Carbapenem
• Activity against Enteric bacteria (E. coli, Klebsiella), Pseudomonas aeruginosa, Anaerobes (Clostridium, Bacteroides, Peptostreptococcus)
• DOC for Extended Spectrum Beta Lactamase (produced by E. coli and Klebsiella)

Beta Lactam

• Carbapenem
• Activity against Enteric bacteria (E. coli, Klebsiella), Pseudomonas aeruginosa, Anaerobes (Clostridium, Bacteroides, Peptostreptococcus)
• DOC for Extended Spectrum Beta Lactamase (produced by E. coli and Klebsiella)

Beta Lactam

• Carbapenem
• Activity against Enteric bacteria (E. coli, Klebsiella), Anaerobes (Clostridium, Bacteroides, Peptostreptococcus), Streptococcus
• Does NOT cover Pseudomonas aeruginosa (different from other carbapenem drugs), Enterococcus, or A. baumanii
• Advantage over other carbepenems is it is QD dosing, but it has a narrower spectrum
• Used for plain G- Enterics
• DOC for Extended Spectrum Beta Lactamase (produced by E. coli and Klebsiella)

Beta Lactam

• Monobactam (only one ring)
• Similar to ceftazidime
• Activity against enterics (Not ESBLs), Pseudomonas aeruginosa

• Inhibits ribosomes
• Penetrates G- cell walls
• Does not work by itself against G+
• Works in synergy with beta lactams to target G+ bacteria
• IV Only
• A good back up when bacteria is resistant to beta lactam antibiotics

Aminoglycoside

• Not effective by themselves because of poor tissue penetration, but OK in urine (eliminated renally)
• Administered IV
• Synergy for Enterococcus, Staphylococcus aureus
• Double coverage for potentially resistant enteric G- bacteria, Pseudomonas aeruginosa

Aminoglycoside

• Not effective by themselves because of poor tissue penetration, but OK in urine (eliminated renally)
• Administered IV
• Synergy for Enterococcus, Staphylococcus aureus
• Double coverage for potentially resistant enteric G- bacteria, Pseudomonas aeruginosa

Aminoglycoside

• Not effective by themselves because of poor tissue penetration, but OK in urine (eliminated renally)
• Administered IV
• Synergy for Enterococcus, Staphylococcus aureus
• Double coverage for potentially resistant enteric G- bacteria, Pseudomonas aeruginosa

• Effective against resistant G- bacteria and G- bacteria that produce carbopenamase
• Last line of defense against resistant Pseudomonas aeruginosa and A. baumanii
• Also found in double and triple antibiotic ointment (neosporin) --> works well topically
• Also administered IV
• Toxic side effects

• Polymyxin E
• Effective against resistant G- bacteria and G- bacteria that produce carbopenamase
• Last line of defense against resistant Pseudomonas aeruginosa and A. baumanii
• Also found in double and triple antibiotic ointment (neosporin) --> works well topically
• Also administered IV
• Toxic side effects

Sulfonamide

• Effective against Staphylococcus aureus and community acquired MRSA
• Effective against G- enterics, especially UTIs (PK) --> eliminated renally
• Not the greatest against Strep. anymore

• Synergy for MRSA
• Resistance develops if used by itself so use in combo
• CYP P450 inducer

Macrolide

• More commonly used because well tolerated and fewer drug interactions
• first class with atypical coverage
• Z pack used commonly in resp. infections
• Effective against S. pneumoniae, H. influenzae, atypicals
• Concentration dependent

Tetracycline

• Time dependent, bacteriostatic --> longer courses, more frequent dosing
• Similar to macrolides in that it is effective against S. pneumoniae, H. influenzae, atypicals
• Has the added coverage of minor MRSA infections
• Not as common as macrolides

Fluoroquinolones

• Only used against G- bacteria (Enterics and Pseudomonas aeruginosa) and Atypicals
• Good oral bioavailability (the only oral class that has activity against P. aeruginosa)
• Poor against G+

Fluoroquinolones

• Effective against Streptococcus spp., G- bacteria (Enterics and Pseudomonas aeruginosa), Atypicals
• Good oral bioavailability (the only oral class that has activity against P. aeruginosa)

Fluoroquinolones

• Effective against Streptococcus spp., Enterics, Atypicals
• No activity against Pseudomonas aeruginosa but gains the activity against anaerobes (Clostridium, Bacteroides, Peptostreptococcus)

• Effective against S. aureus, including MRSA (esp. in children)
• Effective against Beta Hemolytic Group A and B Streptococcus and Strep. pneumoniae
• Effective against anaerobes

• DOC for most anaerobic infections (Clostridium, Bacteroides, Peptostreptococcus)
• Better activity against anaerobes than moxifloxacin

• Effective against all G+ except VRE
• DOC for MRSA infections but cure rates still not good
• Very effective against bacteremia (endocarditis)
• Has poor tissue penetration --> if patient has MRSA in lungs, cannot use Vanco

• MRSA agent
• First drug for VRE
• Not effective against E. faecalis
• Side effects limits usefulness --> not used clinically

• MRSA agent
• Effective against VRE
• Good tissue penetration --> can be used for MRSA pneumonia
• Not useful for bacteremia
• Use caution long term and with SSRIs

• MRSA agent
• essentially the opposite of linezolid (can be used for bacteremia, not for pneumonia)
• QD and approved for endocarditis

• MRSA agent
• similar to vancomycin and daptomycin -- has MOA of both
• Good for pneumonia, not approved yet for bacteremia
• Also covers anaerobes and G- other than P. aeruginosa