Antibiotic portion Flashcards
what is it called when you use a drug that is most likely to treat an organism BEFORE you have the lab results back?
empiric therapy
Which type of antibiotic susceptibility (bacteriostatic/bacteriocidal) is defined as STOPPING the growth of bacteria, limiting its spread until the body’s immune system can attack the pathogen?
Bacteriostatic
which type of susceptibility is defined as KILLING the bacteria directly, and preferred only for very ill patients?
Bacteriocidal
what is the enzyme released by bacteria that can lyse the activity of penicillin?
Beta lactamase
What is the coverage for Natural penicillins?
gram positive cocci, gram negative cocci, gram positibe bacilli, spirochetes, gas gangrene, syphilis
What is the drug of choice for gram (+) bacilli LISTERIA?
Ampicillin
When clavulanic acid is added to Ampicillin, what is now covered?
MSSA, more gram negative, and some anaerobes.
What are the extended spectrum penicillins?
Amoxicillin
Ampicillin
Which cephalosporin is best to give to someone with renal dysfunction?
Ceftriaxone - it is not renally eliminated
True or false: Dicloxacillin, oxacillin, and Nafcillin are antistaphylococcals, so they cover MRSA
FALSE - the antistaphylococcal penicillins do NOT cover MRSA
Which cephalosporin is typically used pre-surgery due to its long half life?
Cefazolin
Which cephalosporin can penetrate bone?
Cefazolin
Which of these does NOT have a B-lactam ring? Carbapenems Monobactams Penicillin Vancomycin
Vancomycin
What is extremely important to monitor when administering Vancomycin?
serum drug concentrations (aka Troughs)
What organisms does Vancomycin cover?
gram positive, MRSA, MRSE, enterococcus, C.diff (only PO!)
Why shouldn’t you administer daptomycin to a patient with a pneumonia infection?
It is inactivated by pulmonary surfactants
This medication is a good choice for treating UTIs (bacteria), as it distributes well to the kidneys/bladder
Fosfomycin
Which Carbapenem does NOT cover pseudomonas?
Ertapeneum
Coverage of carbapanems?
gram negative
gram positive
pseudomonas
Coverage of Amoxicillin/Ampicillin
gram positive
gram negative
(ampicillin drug of choice for LISTERIA)
coverage antistaphylococcals?
gram positive, but
NOT MRSA
coverage natural penicillins
gram positive
gram negative
coverage antipseudomonals
pseudomonas
gram negative
Which cephalosporin covers MRSA?
5th gen - ceftaroline
which cephalosporins have pseudomonas coverage?
3rd generation CEFTAZIDIME
4th generation Cefepime
5th generation Ceftaroline
monobactam med name and its coverage?
Aztreonam, covers gram negative and PSEUDOMONAS
vanco coverage
gram positive (b-lactam resistant)
MRSA (treatment of choice)
C.diff (po only)
Daptomycin coverage
gram positive
MRSA
VRE
When do you NEVER use Daptomycin and why?
pneumonia, the surfactant inactivates it. Use telavancin
Telavancin converage
gram positive
MRSA
VRE
(last choice for hospital acquired pneumonia)
Fosfomycin coverage
bacteria; e. coli and e. faecalis
Polymixin coverage
gram negative
pseudomonas
LAST CHOICE DRUG!!!!
which tetracycline is best to use in renal impairment?
doxycycline
tetracycline coverage
gram positive gram negative anaerobes atypicals (almost everything.....EXCEPT MRSA and VRE)
you are supposed to take the tetracyclines on an empty stomach, EXCEPT for ______, which you take with food.
tetracycline
are tetracyclines safe for pregnancy?
NO - crosses placenta and breast milk
Glycylcycline (Tigecycline) coverage
MRSA
VRE
which 4 bacterium does tigecycline NOT cover?
Morganella, proteus, providencia, pseudomonas
is Tigecycline good for a bloodstream infection?
no - it has high volume of distribution
Aminoglycosides coverage
gram negative
pseudomonas
are aminoglycosides (tobramycin, gentamycin, streptomycin) safe for pregnancy?
no - crosses placenta
Macrolides/ketolides coverage
gram positive and atypicals
which macrolide is often used for urethritis?
azithromycin
metronidazole coverage
anaerobic only - C. Diff treatment of choice
quinupristin/dalfopristin coverage
gram positive
VRE
e. faecium
what does quinupristin/dalfopristin NOT cover?
E. faecalis
Linezolid coverage
MRSA
VRE
gram positive….the BIG GUNS! save for high need
Fidaxomicin coverage
NARROW!
gram positive aerobes and anaerobes
Chloramphenicol coverage
BROAD!
spirochetes, chlamydia, anaerobes
what happens with high doses of chloramphenicol?
binds mitochondrial ribosome, causing bone marrow toxicity
Clindamycin
gram positive
MRSA
anaerobes
Do you use clindamycin for UTI infections?
NO - it doesn’t distribute there
which class of antibiotics have a large PAE?
aminoglycosides
what is a benefit of high doses of erythromycin?
gastric smooth muscle contractions, may help move food (therapeutic)
gray baby syndrome is associated with what antibiotic?
chloramphenicol
fluoroquinolone coverage
gram negative
gram positive
atypicals
which fluoroquinolone has the best pseudomonas coverage?
ciprofloxacin
which fluoroquinolones are considered the “respiratory” ones?
Lexofloxacin
Moxifloxacin
fluoroquinolones do not cover…
syphilis
gonorrhea
what can happen if you administer fluoroquinolones with pregnancy?
can cause cartilage erosion (also risk of tendon rupture in adults)
what do you need to be careful of when prescribing fluoroquinolones; another concern for collateral infection
c. diff
all of the fluoroquinolones are renally eliminated except which one?
Moxifloxacin - eliminated by the liver
