8.1 Antibacterials and Antimicrobials Flashcards
What is the DOC for enterobacter infection and extended spectrum B-lactamase producing gram negatives?
Carbapenems
Imipenem & Meropenem
Which carbapenem forms a potentially nephrotoxic metabolite, which can lead to seizures (high levels)
Imipenam
Which drug is given ONLY for gram negative aerobic rods? (including pseudomonas)
Aztreonam (Monobactam)
What is the best way of delivering Aztreonam for cystic fibrosis patients?
Inhalation
Which drug is active against gram positive only, and is effective against multi drug resistant organisms?
Vancomycin
What is the mechanism of Vancomycin?
Binds D-Ala-D-Ala terminus of nascent peptidoglycan pentapeptide -> inhibition of cell wall synthesis & peptidoglycan polymerization
How does Vancomycin gain resistance?
Modication of the binding site: lactate replaces Ala
What drug does one give in combination with an aminoglycoside for empirical treatment of infective endocarditis?
Vancomycin
How does one give Vancomycin for treatment of Staphylococcal enterocolitis or antibiotic associated C. Diff?
Orally
What are the adverse effects of Vancomycin? (3)
1) Red man syndrome (infusion related flushing over face and upper torso)
2) Ototoxicity (Drug accumulation)
3) Nephrotoxicity (drug accumulation) (esp with aminoglycoside combination)
Which drug is effective against V-RSA, and is effective only against other gram positive organisms?
Daptomycin
Daptomycin is not effective against what?
Pneumonia (mucus produced inactivates)
What is the MOA of Daptomycin?
Bingd to cell membrane via calcium-dependent insertion of lipid tail, which results in depolarization of cell membrane with K+ efflux -> cell death
What is the pharmacokinetics of Daptomycin?
IV only
What is the most important adverse effect of Daptomycin?
Myopathy due to elevated creatine phosphokinases (discontinue use of statins as they have the same effect)
