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Pharmacology (clin med Q2) > antibiotic classes > Flashcards

antibiotic classes Flashcards

1
Q

Name the major classes of ABX (6)

A

Betalactams, Fluoroquinalones, Macrolides, Tetracyclines, Lincomycins, Sulfonamides

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2
Q

Name the “Miscellaneous” classes/ABX (7)

A

Nitrofurantoin, Metronidazole, Rifamycin, Aminoglycosides, Vancomycin, Linezolid, Daptomycine

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3
Q

3 Subdivisions of Penicillins

A

Penicillin G derivatives, Anti-Staphylococcal Penicillins, Extended Spectrum Penicillins

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4
Q

2 Subclasses of Betalactams

A

Penicillin deritatives and cephalosporins

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5
Q

Pen G derivatives (4)

A

Pen G, Pen C, Ampicillin, Amoxicillin

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6
Q

Pen G works on:

A

Most GP, susceptible staphylococcus and streptococcus pyogenes, enterococcus (GP), [limited GN]

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7
Q

4 indications for use of Pen G derivatives (Amp, Amox, Pen G, Pen V)

A
  1. Uncomplicated OTM (Amoxicillin)
  2. pre-partum group beta strep prophylaxis (Amp)
  3. Sub-acute Bacterial Endocarditis prophylaxis (Pen V)
  4. H. pylori (amox)
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8
Q

Anti-Staphylococcus Pen drugs (5)

A

Dicloxacillin, Cloxacillin, Nafcillin, Methicillin

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9
Q

What is MRSA due to? (resistance)

A

overuse of penicillins, mainly anti-staph

Methicillin Resistant Staph Aureus

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10
Q

4 indications for anti-staph penicillins

A
  1. coagulase neg staph
  2. MSSA
  3. Beta-lactamase producing strep
  4. bacterial endocarditis
    (infx d/t susceptible strains of staphylococcus)
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11
Q

What is a broadened spectrum agent?

A

it utilizes an “add on” beta lactamase inhibitor that is added onto the penicillin

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12
Q

3 broad spectrum Penicillins

A

Augmentin, Unasyn, Zosyn

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13
Q

4 “super” penicillins (broad spec and extended spec)

A

Ticarcillin, mezlocillin, azlocillin, piperacillin

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14
Q

What are the Super pens good for?

A

Both BL and non-BL GP & GN, some anaerobes

*serious infections, hospital setting, all IV

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15
Q

3 (negative) things to think about when using Penicillins:

A
  1. secreted by kidneys: look at renal function!
  2. high rates of hypersensitivity (anaphylaxis)
  3. increasing BL resistance
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16
Q

3 indications for penicillins in general:

A
  1. pediatric indications (amoxicillin)
  2. Specific indications (UTIs that that don’t respond to bactrim)
  3. inpatient indications (broadened spectrum, serious infxn)
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17
Q

Cephalosporin 1st generation drugs (3)

A

cefazolin, cephalexin, cefadroxil

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18
Q

Cephalosporin 2nd generation drugs (2)

A

Cefoxitin, Cefuroxime

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19
Q

Cephalosporin 3rd generation drugs (2)

A

ceftriaxone, cefpodoxime

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20
Q

Cephalosporin 4th generation drugs (1)

A

cefipime

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21
Q

what are 1st gen cephalosporins good for? (2)

A

most non-BL producing GP, non-BL producing GN aerobes

alternative to pen G for pediatrics, SSTs

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22
Q

what are 2nd gen cephalosporins good for? (2)

A

GN, GP (slightly less than 1st gen), anaerobes

clean-contaminated surgeries

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23
Q

what are 3rd gen cephalosporins good for? (2)

A

GP, GN

severe OTM, CAP, NOT prophylaxis in surgery d/t no anaerobic coverage

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24
Q

what are 4th gen cephalosporins good for?

A

GP, GN (better BL-producing organism resistance than 3rd gen)
*limited to clinically serious infections (inpatient)

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25
Q

Fluoroquinalones (5)

A

Ciprofloxacin, Ofloxacin, Levofloxacin, Moxifloxacin, Gtifloxacin (-“ofloxacins”)

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26
Q

2 good things about FQs

A
  • available in both IV and Po; and dosing conversion in 1:1

- broad spec; good for empirical tx of common comm. acquired infxns

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27
Q

4 clinical issues with FQs

A
  • not useful for CNS infxns
  • reduced absorption with cations (can not take with antacids)
  • not for pregnant or kiddos (bone growth issues)
  • growing resistance
  • not good for pt’s with impaired renal function (dose and check CrCl frequently)
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28
Q

What are FQs good for treating?

A
  • Staphylococcus, GN
  • minimal activity against streptococcus (Levo and Moxi are the exceptions) and anaerobes (moxifloxacin is the exception)
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29
Q

3 Macrolide ABXs

A

Erythromycin, Azythromycin (zithromax), clarithromycin (biaxin)

30
Q

What are macrolides good at getn’?

A

susceptible GP, atypical coverage (mycoplasma, legionella, chlamydia)

31
Q

clinical indications of Macrolides

A

CAP
atypical pneumonia (mycoplasma, legionella)
chlamydia
susceptible URIs

32
Q

clinical issues with macrolides

A
  • resistance: take home: DO NOT use macrolide if pt has recent hx of macrolide use
  • emerging resistance of streptococcus
33
Q

Tetracyclines (4)

A

tetracycline
doxycycline
minocycline
tigecycline

34
Q

what are tetracyclines used to treat?

A

GP &GN areobes, anaerobes

35
Q

clinical indications for tetracyclines? (4)

A 
rickettsial infxns (lyme, RMSF)
chlamydia alternative (doxy)
secondary infxns to acne vulgarus (mino)
serious infections (+ sensitivity to Tige)
36
Q

clinical issues of tetracyclines (2)

A

contraindicated for pregnant and kiddos (bone growth)

bad for GI flora

37
Q

Lincomycins (1)

A

clindamycin

38
Q

what does clindamycin treat? (2)

A

GP aerobes

anaerobes!!

39
Q

clinical indications for clindamycin?

A 
Gut/GI/GU anaerobic infections
GP infections (streptococcus, staphylococcus that are sensitive)
40
Q

clinical issues with clindamycin?

A

BAD for GUT (enterocolitis is a major side effect)

resistance with GP

41
Q

Sulfonamide abx (6)

A 
sulfamethoxazole
trimethoprim
SMX/TMP (Bactrim)
sulfaisoxazole
sulfadiazine
silver sulfadiazine (silvadene)
42
Q

Spectrum of coverage for Sulfa drugs (2):

A

GP and GN

43
Q

clinical indications for sulfa drugs (4)

A

pediatric URI
PCP pneumonia (for immunocompramised pts=bactrim)
bacterial infections secondary to burns (topical)
ocular infections

44
Q

clinical issues with sulfa:

A

resistance

SEVERE side effects (rash, anemias, SJS)

45
Q

Nitrofurantoin indication:

A

alternative for uncomplicated UTI (d/t GN aerobes liek E. coli, klebsiella, proteus)

46
Q

clinical issues with nitrofurantoins:

A

-not good for pt’s with impaired renal function (not toxic, just doesn’t work)

47
Q

Metronidazole indications:

A 
antiprotozoal (trichamonas) and antimicrobial
anaerobic species (helicobacter, bacteroides, c. Diff)
48
Q

antibiotic Rifamycin in class

A

rifampin

49
Q

spectrum of activity/ indications for rifampin (3):

A

susceptible GP (a few GN)
TB (mycobacterial) in combo with other agents
meningitis (goes in CNS rapidly)

50
Q

draw backs of rifampin:

A

hepatotoxic
numerous drug interactions
resistance
makes you pee orange… but who really cares?

51
Q

Aminoglycosides (4):

A

gentamicin
tobramycin
spectinomycin
amikacin

52
Q

spectrum of activity for aminoglycosides:

A

GN aerobic

synergistic effect on GN infections that are tough to tx

53
Q

bad things about aminoglycosides (2):

A

renal and ototoxic (hearing loss)

54
Q

Vancomycin is structurly similar to….

A

aminogylcosides

55
Q

mode of administration of vancomycin:

A

IV only (unless treating a GI infection)

56
Q

spectrum of activity for vancomycin (3)

A

GP
MRSA!!!!
Metronidazole resistant c. Diff

57
Q

clinical issues with Vancomycin

A

oto and renal toxic

58
Q

Antibiotic in oxalininone class:

A

linezolid (zyvox)

59
Q

spectrum of activity for zyvox (3)

A

GP aerobes
MRSA!!
VRE!!
(primarily used for inpatients with MRSA/VRE)

60
Q

drawbacks of zyvox/linezolid

A

$$$$$$

significant drug/food interactions (seritonin, caetcholamines, cheese and wine)

61
Q

Daptomycin spectrum of activity/ indication

A 
MRSA! 
MSSA/anti-staphylcoccal
VRE (?)
most GP
(indicated for serious GP infections of hospitalized pts; bacteremia, SSTs)
62
Q

drawbacks of Daptomycin

A

only IV, too big and complicated
$$$$- reserved for pts that are not responding to other tx
not indicated for pts w/ pneumonia, even if caused by MRSA

63
Q

Daptomycin : the good things

A

VERY bacericidal

benign side effect profile

64
Q

what are bactericidal abx dependent on?

A

concentation

65
Q

what are bacteriostatic abx dependent on?

A

time/host dependent (the pt’s immune system needs to be functioning)

66
Q

bacteriostatic classes (5):

A 
(MALTS)
Macrolides
Amineogylcosides
Lincomycins
Tetracyclines
Sulfonamides
67
Q

Bactericidal classes/drugs (5):

A 
Betalactams
Fluoroquinolones
Vancmycin
Rifamycin
daptomycin
68
Q

What ABX treat gram Neg? (1 drug, 2 classes)

A

Cipro (only FQ for GN), Aminoglycocides, nitrofurantoin

69
Q

What Abxs treat both GN and GP? (4 drugs, 3 classes)

A

piperacillin, ticarcillin, rifampin, metronidazole

2nd-4th gen cephalosporins
FQ
Sulfonamides

70
Q

which ABX treat gram positive?(4 classes/sub classes, 4 drugs)

A

Pen G, Anti-Staph, 1st gen Cephalosporins, tetracyclines

clindamycin, zyvox, daptomycin, vancomycin

Pharmacology (clin med Q2) (2 decks)

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