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Clin Pod Med Exam II > 35/36: Antibiotics - Smith > Flashcards

35/36: Antibiotics - Smith Flashcards

1
Q

spectrum of activity for Pen G

A
  • Streptococcus Group A and B
  • Group D Streptococcus (enterococcus)
  • Anaerobes, except Bacteroides
  • Gonococci
  • Staphylococcus less than 10%
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2
Q

often used for ear infections

A

amoxicillin/ampicillin

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3
Q

spectrum of activity for amoxicillin/ampicillin

A
  • Streptococcus, including Group D
  • Some gram negative coverage (E. coli, H. influenzae, P. mirabilis, Salmonella and Shigella)
  • Most Staphylococcus resistant
  • Bacteriostatic unless combined with Aminoglycoside
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4
Q

CONDM antibiotics

A

Semi-synthetic penicillins

  • Cloxacillin
  • oxacillin
  • nafcillin
  • dicloxaillin
  • methicillin

(penicillinase-resistant)

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5
Q

Where is nafcillin metabolized

A

liver

- covers staph, except MRSA

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6
Q

extended-spectrum penicillins and beta-lactamase inhibitors common combinations

A
  • Ticarcillin / Clavulanic Acid (Timentin)
  • Ampicillin / Sulbactam (Unasyn)
  • Amoxicillin / Clavulanic Acid (Augmentin)
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7
Q

which drugs have a high sodium load?

A
  • ticarcillin/clavulanic acid (timentin) [120 mg/g sodium load]
  • ampicillin/sulbactam (unasyn)
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8
Q

*** do two 250 mg augmentin oral tabs = 1 500 mg augmentin tab

A

NO

  • because all pills contain 125 mg of clavulanic acid
  • too much clavulanic acid causes GI side effects
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9
Q

how does unasyn compare to timentin?

A
  • more active against gram + than timentin

- less active against gram - than timentin

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10
Q

describe the different generations of cephalosporins

A

First Generation-Better activity against gram positive cocci

Second Generation-Less activity against gram positive, but more activity against gram negative organisms

Third Generation-Even less activity against gram positive, more activity against gram negative organisms

Fourth Generation-Best of both worlds (gram + and - )

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11
Q

common oral 1st gen cephalosporin

A

cephalexin (keflex, keftab, keflet)

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12
Q

common parenteral 1st gen cephalosporin

A

cefazolin (ancef, kefzol)

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13
Q

classify this drug: cephradine (anspor, velosef)

A

1st or 2nd gen cephalosporin

- not super common

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14
Q

20% pen-allergic patients are also allergic to…

A

cephalosporin

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15
Q

drug of choice for surgical prophylaxis

A

cefazolin

- 2g 30 min before surgery

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16
Q

elimination of ceftriaxone

A

biliary elimination

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17
Q

drug of choice for n. gonorrhea ***

A

ceftriaxone

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18
Q

longest half-life of any cephalosporin

A

ceftriaxone

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19
Q

gram + diplococcus is typically …

A

n. gonorrhea

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20
Q

elimination of cefoperazone

A

biliary elimination

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21
Q

elimination of cefepime

A

renal excretion

22
Q

polymicrobial infection with renal insufficiency first choice

A

cefepime (4th gen cephalosporin)

23
Q

why is cilastatin added to imipenem?

A
  • imipenem is destroyed in kidney; cilastatin inhibits renal enzymes preventing degradation
24
Q

“gorillamycin”

A

imipenem/cilastatin (primaxin)

- very broad spectrum

25
Q

indications fro invanz/ertapenem [carbapenem]

A

anaerobic (gas gangrene, etc)

26
Q

name the aminoglycosides

A

gentamicin (garamycin)
tobramycin (nebcin)
amikacin (amikin)

27
Q

spectrum of activity for aminoglycosides

A
    • Gentamicin best activity against Serratia
    • Tobramycin best activity against P. aeruginosa
    • Amikacin reserved for organisms resistant to other two
28
Q

adverse reactions aminoglycosides

A

nephrotoxicity
ototoxicity
neuromuscular blockade

29
Q

aminoglycosides are always infused over _____ minutes

A
  • 30

- neuromuscular blockade is risk with rapid admin

30
Q

what do you do when peak is high and trough is normal?

A

Peak high and trough normal - decrease dose

Peak low and trough normal - increase dose

Peak normal and trough high - increase time

Peak normal and trough low - decrease time

31
Q

name the most common anti-anaerobic agents

A

metronidazole (flagyl)

clindamycin (cleocin)

32
Q

adverse rxn metronidazole

A 
metallic taste
disulfiram reaction (alcohol reaction)
33
Q

treatment of pseudomembranous colitis

A 
#1 metronidazole (oral) or #2 vancomycin (oral) 
*** never put pt on anti-GI motility drug if they have this condition (want the bad to come out)
34
Q

causes pseudomembranous colitis (antibiotic associated diarrhea)

A

clindamycin (because doesn’t work against c. diff)

35
Q

metabolism of metronidazole

A

liver

- clindamycin is also metabolized by liver

36
Q

can kill MRSA, MRSE, and enterococci

A

vancomycin

37
Q

red man syndrome

A
  • adverse effect of vancomycin
  • should give over 45-60 min to prevent
  • peak less than 30ml/min and trough less than 10 ml/min
38
Q

turns body fluids red (contact lenses) and a rash

A

rifampin

39
Q

only use for oral vancomycin

A

pseudomembranous colitis

40
Q

used for TB

A

rifampin

- always in combo with other drugs

41
Q

name the quinolones we might use

A
  • CIPROFLOXACIN (CIPRO)
  • LEVOFLOXACIN (LEVAQUIN)
  • TROVAFLOXACIN (TROVAN) (only life-threatening infections)
42
Q

does ciprofloxacin cover streptococcous?

A

no

  • Excellent coverage against gram negative organisms, including Pseudomonas
  • Mild Staphylococcus and no Streptococcus coverage
43
Q

adverse reactions with cipro/ciprofloxacin

A
  • Theophylline and derivatives (caffeine) will be potentiated
  • Antacids and Fe will decrease absorption
  • Cartilage degeneration and tendon rupture (*do not use on juvenille pts - premature growth plate closure)
44
Q

which antibiotic might cause an achilles tendon rupture?

A

quinolones class

45
Q

Similar indications as Ciprofloxacin (Cipro), but dosage is once a day

A

levaquin

46
Q

what is bactrim?

A

trimethoprim/sulfamethoxazole

1:5 ratio

47
Q

Mame the macrolides

A
    • Erythromycin (e-mycin, ees, erythrocin)
    • Azithromycin (zithromax/ z-pak)
    • Clarithromycin (biaxin)
48
Q

Z-PAK?

A

Azithromycin 5 days of therapy
2 - 250 mg first day
1 each day from days 2 through 5

49
Q

can macrolides be used for pen-allergic pts?

A

yes

50
Q

Drug of choice borrelia burgdorferi/ lyme disease

A

tetracyclines

51
Q

Side effects of tetracycline

A

sun sensitivity and graying of teeth

52
Q

why is linezolid a good drug?

A
  • no dose adjustment for renal impairment

- works against Strep. D (VRE), Staph. aureus (MRSA), Staph. epidermidis (MRSE), Pasteurella multocida

Clin Pod Med Exam II (9 decks)

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