Antibiotics

Question 1

Penicillin G/Penicillin V

Answer 1

Natural penicillins; G (IV only), V (PO only), renal elimination; Streptococci, enterococci, treponema pallidum (Syphillis)

Question 2

Nafcillin/Oxacillin

Answer 2

Antistaphylococcal penicillins; Penicillinase-resistant (bulky R group that inhibits b-lactamases); Nafcillin (AE phlebitis); MSSA streptococci

Question 3

Ampicillin/Amoxicillin

Answer 3

Aminopenicillins susceptible to b-lactamases but improved gram - activity; ampicillin (IV,PO) amoxicillin (PO); Strep, enterococci, GNR (non b-lactamase), listeria, H.pylori

Question 4

Piperacillin

Answer 4

Antipseudomonal penicillil (Ureidopenicillin); IV, renal and biliary elimination; AE: thrombocytopenia, Same as aminopenicillin + pseudomonas, used for HAP, sosocomial infections

Question 5

Beta Lactam/beta lactamase inhibitors

Answer 5

Piperacillin/Tazobactam; Ampicillin/Sulbactam; Amoxicillin/Clavulanate

Question 6

Cefazolin/Cephalexin

Answer 6

1st gen cephalosporins; renal elim; No CNS penetration; MSSA Strep some GNR; surgical prophylaxis, cellulitis, UTI

Question 7

Cefuroxime

Answer 7

2nd gen cephalosprorin; better Gram - coverage including neisseria; URTI, gonnorrhea

Question 8

Ceftriaxone/cefotaxime/ceftazidime

Answer 8

3rd gen cephalosporin; worse antistaph but better antistrep activity (except ceftazidime); better gram -; active against Pseudomonas aeruginosa; meningitis, CAP/HAP, lyme disease, SSSIs, UTIs, febrile neutropenia

Question 9

Cefepime (IV only)

Answer 9

4th gen cephalosporin; MSSA, strep, GNR and Pseudomonas

Question 10

Ceftaroline (IV only)

Answer 10

5th gen cephalosporin; Anti MRSA (not useful against pseudomonas); susceptible to B-lactamase; SSSI, CAP

Question 11

Aztreonam (IV only)

Answer 11

Monobactam; GNR + psuedomonas; (Cross reactive with ceftazidime); Used in pt w/ allergies to other b lactams

Question 12

Imipenem/cilastatin; meropenem/doripenem/ertapenem (all IV only)

Answer 12

Carbapenem; Higher incidence of seizures; ESBL producing GNR; nosocomial infection, mixed aerobic/anaerobic infection

Question 13

Vancomysin

Answer 13

Glycopeptide (binds to terminal D-ala-D-ala chain of peptidoglycan; time dependent; gram + aerobes/anaerobes including MRSA; Do not kill b-lactam susceptible staph as quickly as b-lactams

Question 14

Telavancin

Answer 14

Lipoglycopeptide; Bind terminal D-ala-D-ala and disrupts cell membrane function; cSSSIs; studied in HAP

Question 15

Bacitracin

Answer 15

Peptide antibiotic; interferes with dephosphorylation of bactoprenol pyrophophated, disrupting translocation

Question 16

Fosfomycin

Answer 16

Cell-wall synthesis; simple UTIs

Question 17

Daptomycin

Answer 17

Cyclic lipopeptides; insert into cell membrane of gram + organism leading to cation release, bactericidal

Question 18

Daptomycin

Answer 18

Conc dependent (inactivated by surfactant); bacteremia, skin and soft tissue infections.  
MOA: inserts into cell membrane or gram + organisms leading to cation leaking out, depolarization and cell death, 
Can cause rhabdomyolysis from increase in creatine kinase

Question 19

Colistin

Answer 19

Polymyxin; binds to cell membrane of gram - disrupting permeability
Gram - , mar strains, pseudomonas, klebsiella
Nephrotoxicity common
Prophylaxis off pneumonia in colonized CF pts