MIC 541-Exam 4- Antimicrobials IV-4

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MIC 541-Exam 4- Antimicrobials IV-4
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2013-04-14 17:03:48
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MIC 541 Exam Antimicrobials IV
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MIC 541-Exam 4- Antimicrobials IV-4
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  1. Augmentin is used for what mainly?
    Ear infections (Daycares/small children)
  2. Clavulanate causes what side effect?
    Increased GI activity (causes diarrhea)
  3. Clavulanate induces what?
    Causes organism to produce higher levels of B-lactamase that it does not inhibit
  4. Zosyn is used rarely (T/F)?
    False, it is used commonly in hospitals for serious infections
  5. Zosyn has many issues of resistance?
    False
  6. What B-lactamases are controlle with B-latamse inhibitors?
    • B-lactamses of:
    • Staphylococci
    • Hsemophilus
    • N. gonorrhoeae
    • many of Enterobacteriaceae
  7. B-lactamase inhibitors are effective against all B-lactamases (T/F)?
    False
  8. What are no B-lactamse inhibitors active against?
    Amp-C beta-lactamases
  9. What antibiotic is used for bite wounds?
    Augmentin
  10. What aspect of inhibitor combinations is not ideal?
    dissimilar pharmacokinetics
  11. Why are pharmacokinetics important to inhibitor combinations?
    One need not be excreted before the other
  12. What is a superinfection?
    Destruction of normal flora allowing for resistant strains to proliferate
  13. Under what conditions would you develop a superinfection?
    High doses of Penicillins
  14. Superinfections are common (T/F)?
    False
  15. What were the tree rare adverse effects discussed in class for Penicillin?
    • CNS toxicity
    • Hematologic issues
    • Hepatic issues
    • What percent of the population is allergic to Penicillins?
    • 1%
  16. How are severe allergic reactions to penicillins treated?
    With epinephrine injection
  17. Cephalosporins are different from Penicillins how?
    They have a six membered ring attached to the B-lactam ring (not five) and several substituents
  18. Why are there more options for chemically altering Chephalosporins that Penicillins?
    There are more substituents
  19. Why are there more Cephalosporins than penicillins?
    More substituents to alter
  20. Methoxy group attached to the B-lactam ring indicates what type of B-lactam?
    Cephamycins
  21. What is the difference between Cephalosporins and Cephamycins?
    • Produced by different organisms
    • Cephamycins have a methoxy group attached to the B-lactam ring
  22. Carbacephems are in what group?
    Cephalosporins
  23. Cephalosporins and Cephamycin are as good as Penicillin (T/F)?
    No
  24. Cephalosporins are grouped in what way?
    By generations
  25. What are examples of 1st generation cephaolsporins?
    • Cefazolin
    • Cefaclor
  26. What characteristic was noted in class about 1st generation cephalosporins?
    Relatively narrow spectrum
  27. What group of cephalosporins are relatively narrow spectrum?
    1st generation
  28. What characteristics in class were noted about 2nd generation cephalosporins?
    They are of intermediate spectrum
  29. What is an example of a 2nd generation cephalosporin?
    Cefuroxime
  30. What characteristic was noted in class about 3rd generation cephalosporins?
    Broader spectrum with some Pseudomonas activity
  31. What is an example of a 3rd generation cephalosporin?
    Ceftazidime
  32. What is characteristic of a 4th generation cephalosporin?
    • broader spectrum
    • more resistant to chromosomally mediated B-lactimases
  33. What is an example of a 4th generation cephalosporin?
    Cephepime
  34. What generation of cephalosporins are of intermediate spectrum?
    2nd generation
  35. what generation of cephaolosporins of a broader spectrum and hae some pseudomonas activity?
    3rd generation
  36. What generation of Cephalosporins are of a broader spectrum and are more resistant to chromosomally mediated b-lactamases?
    4th generation
  37. What generation of cephalosporins does Cefazolin and cefaclor belong to?
    First generation
  38. What generation of cephalosporins does cefuroxime belong to?
    2nd generation
  39. What generation of cephalosporins does ceftazidime belong to?
    3rd generation
  40. What generation of cephalosporins does cefepime belong to?
    4th generation
  41. Ceftazidime has good activity against what particular bacteria?
    Pseudomonas
  42. There is cross-allergy between what two antibiotic groups?
    Penicillins and Cephilosporins (5-15%)
  43. What rate of cross-allergy is there between Penicillins and cephalosporins?
    5-15%
  44. A person with a penicillin allergy has a 5-15% chance of having an allergy to what other antibiotics?
    Cephalosporins
  45. What options do you have if you have a patient with a severe penicillin reaction, what alternate options do you have?
    • Give a cephalosporin (if you need a cidal drug)
    • Use a non-beta-lactamase drug
  46. Under what conditions would you use a non-betalactamase drug or use cephalosporins only if you need a cidal antibiotic?
    If the patient has had a severe penicillin reaction
  47. How long after administration will a life threatening reaction to a cephalosporin is going to occur?
    30 minutes
  48. In what time frame will a cross-allergy to cephalosporin occur?
    Later than 30 minutes
  49. Penicillin reactions are mediated with what antibody type?
    IgE
  50. What should you do if you need to give a patient a cephalosporin who has a serious penicillin allergy?
    Wait 30 minutes with the patient with epinephrine and tracheostomy tube
  51. Under what conditions would you site with a patient with a tracheostomy tube and epinephrine for 30 minutes?
    Giving a cephalosporin to a patient with a sever penicillin allergy
  52. Allergic reactions to cephalosporins that occur much later are or are not life-threatening?
    not- life threatenting
  53. What way can you administer a cephalosporin to a patient with a penicillin allergy to minimize the reaction?
    Give them a quarter dose first
  54. What administration routes are available for Cephalosporins?
    • Oral
    • Parenteral

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