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antibiotics Flashcards

1
Q

Gentamicin*

A 
Aminoglycoside (IV)
gram neg. + pseudomonas
traditional dosing= 1-3mg/kg/dose (IBW unless obese)
--> CrCl>60mL/min= q8h
extended interval= 4-7mg/kg
AE: neurotoxicity, ototoxicity
monitor trough/peak
peak 5-10, trough <2
synergy for endocarditis (gram positive)
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2
Q

Tobramycin*

A 
Aminoglycoside (IV)
gram neg. + pseudomonas
traditional dosing= 1-3mg/kg/dose (IBW unless obese)
--> CrCl>60mL/min= q8h
extended interval= 4-7mg/kg
AE: neurotoxicity, ototoxicity
monitor trough/peak
peak 5-10, trough <2
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3
Q

Amikacin*

A 
Aminoglycoside (IV)
gram neg + pseudomonas
traditional dosing= 5-7mg/kg/dose
--> CrCl>60mL/min= q8h
extended interval= 15-20mg/kg
AE: neurotoxicity, ototoxicity
peak 20-30, trough <5
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4
Q

Amoxicillin (+/- cavulanate)

A

Amoxil, Augmentin (PCN)
gram + (strep, enterococci)
Clavulanate= gram - (PEK), h.flu, MSSA, anaerobe
dosing= 8-12 hrs (PO)
AE: rash, acute interstitial nephritis, increased LFTs
reduce dose/extend interval in renal impairment
refrigerate augmentin susp

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5
Q

Ampicillin (+/- sulbactam)

A

Unasyn (PCN)
gram + (strep, enterococci)
sulbactam= gram neg. (PEK), H.flu, NSSA, anaerobe
dosing= q6h (ampicillin= PO/IV, sulbactam (IV)
AE: rash, acute interstitial nephritis, increased LFTs
reduce dose/extend interval in renal impairment
compatible with NS only

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6
Q

Penicillin

A

Pen VK, Bicillin L-A (PCN)
gram + (strep)
VK= q6-8hrs (PO), G= q4-6h (IM/IV)
AE: rash, acute interstitial nephritis, increased LFTs
reduce dose/extend interval in renal impairment
VK on empty stomach (refrigerate susp)

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7
Q

Nafcillin*

A 
PCN 
gram + (strep, MSSA)
dosing= 1-2g q4-6h (IV)
AE: rash, acute interstitial nephritis, increased LFTs
NO dose adjustment in renal impairment
VESICANT
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8
Q

Cefazolin

A

Kefzol (1st gen. cephalosporin)
staph + PEK
IV/IM (250-2,000mg q8h)
AE: rash, acute interstitial nephritis, increased LFT, seizure with accumulation
cross reactivity with PCN allergy
decrease dose/extend interval in renal impairment

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9
Q

Cephalexin

A

Keflex (1st gen. cephalosporin)
staph + PEK
PO (250-1,000mg q6h)
AE: rash, acute interstitial nephritis, increased LFT, seizure with accumulation
cross reactivity with PCN allergy
decrease dose/extend interval in renal impairment

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10
Q

Cefuroxime

A

Ceftin, Zinacef (2nd gen. cephalosporin)
staph + HNPEK
PO/IV/IM (250-1,500mg q8-12h)
AE: rash, acute interstitial nephritis, increased LFT, seizure with accumulation
cross reactivity with PCN allergy
decrease dose/extend interval in renal impairment

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11
Q

Cefotetan*

A

2nd gen. cephalosporin
staph +HNPEK + ANAEROBES (b. fragilis)
IV/IM (1-2g q12h)
AE: rash, acute interstitial nephritis, increased LFT, seizure with accumulation
cross reactivity with PCN allergy
decrease dose/extend interval in renal impairment
–> increased risk of hypothrombinemia (bleeding) and disulfiram with alcohol (NMTT side chain)

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12
Q

Cefoxitin*

A

2nd gen. cephalosporin
staph +HNPEK + ANAEROBES (b. fragilis)
IV/IM (1-2g q6-8h)
AE: rash, acute interstitial nephritis, increased LFT, seizure with accumulation
cross reactivity with PCN allergy
decrease dose/extend interval in renal impairment

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13
Q

Cefdinir*

A

3rd gen. cephalosporin
staph/strep + HNPEKS
PO (300mg q12h/600mg QD)
AE: rash, acute interstitial nephritis, increased LFT, seizure with accumulation
cross reactivity with PCN allergy
decrease dose/extend interval in renal impairment

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14
Q

Ceftazidime

A

Fortaz, Tazicef (3rd gen. cephalosporin)
staph/strep + HNPEKS + PSEUDOMONAS
IV/IM (1-2g q8-12h)
AE: rash, acute interstitial nephritis, increased LFT, seizure with accumulation
cross reactivity with PCN allergy
decrease dose/extend interval in renal impairment

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15
Q

Ceftriaxone

A

Rocephin (3rd gen. cephalosporin)
staph/strep + HNPEKS
IV/IM (1-2g q12-24h)
AE: rash, acute interstitial nephritis, increased LFT, seizure with accumulation
cross reactivity with PCN allergy
NO DOSE ADJUSTMENT IN RENAL IMPAIRMENT
–> biliary sludging (avoid co-administration with Ca soln)

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16
Q

Cefipime

A 
Maxipime (4th gen. cephalosporin)
staph/strep + HNPEKS + CAPES
IV/IM (1-2g q8-12h)
AE: rash, acute interstitial nephritis, increased LFT, seizure with accumulation
cross reactivity with PCN allergy
dose adjustment in renal impairment
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17
Q

Ceftaroline

A 
Teflaro (5th gen. cephalosporin)
Gram + (MRSA)
IV (600mg q12h)
AE: rash, acute interstitial nephritis, increased LFT, seizure with accumulation
cross reactivity with PCN allergy
dose adjustment in renal impairment
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18
Q

Imipenem/Cilastatin

A

Primaxin (carbapenem)
Gram +, gram - (pseudomonas), anaerobic
IV (250-1,000mg q6-8h)
AE: CNS, SEIZURE, increased LFTs
reduce dose/extend interval in renal impairment
PCN cross-reactivity
–> decreases concentrations of valproic acid

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19
Q

Meropenem

A

Merrem (carbapenem)
Gram +, gram - (pseudomonas), anaerobic
IV (500-2,000mg q8h)
AE: CNS, seizure, increased LFTs
reduce dose/extend interval in renal impairment
PCN cross-reactivity
–> decreases concentrations of valproic acid

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20
Q

Ertapenem

A 
Invanz (carbapenem)
Gram +, Gram -, anaerobes
NO PSEUDOMONAS
IV/IM (1,000mg QD)
AE: CNS, seizure, increased LFTs
reduce dose/extend interval in renal impairment
PCN cross-reactivity
--> decreases concentrations of valproic acid
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21
Q

Doripenem

A

Doribax (carbapenem)
Gram +, gram - (pseudomonas), anaerobic
IV (500mg q8h)
AE: CNS, seizure, increased LFTs
reduce dose/extend interval in renal impairment
PCN cross-reactivity
–> decreases concentrations of valproic acid

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22
Q

Ofloxacin

A 
Floxin-otic (fluoroquinolone)
gram -, gram +
PO (200-400mg q12h)
AE: tendon rupture, neuropathy, QT prolongation, seizure/CNS, hypoglycemia, photosensitivity
extend interval in renal impairment
avoid in children/pregnancy
separate from antacids
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23
Q

Ciprofloxacin

A

Cipro (FQ)
gram -, gram+, PSEUDOMONAS
PO/IV (250-750mg PO/200-400mg IV 8-12h)
AE: tendon rupture, neuropathy, QT prolongation, seizure/CNS, hypoglycemia, photosensitivity
extend interval in renal impairment
avoid in children/pregnancy
separate from antacids
–> oral susp= no NG/feeding tube, no refrigeration
–> can give IR tabs via feeding tube (separate from meal)
–> P-gp substrate, strong 1A2 inhibitor

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24
Q

Levofloxacin

A 
Levaquin (FQ)
gram -, gram+, PSEUDOMONAS, ATYPICAL
respiratory FQ
PO/IV (250-750mg QD)
AE: tendon rupture, neuropathy, QT prolongation, seizure/CNS, hypoglycemia, photosensitivity
extend interval in renal impairment
avoid in children/pregnancy
separate from antacids
--> soln= empty stomach, room temperature
--> renal clearance
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25
Q

Moxifloxacin

A 
Avelox, Vigamox- opth (FQ)
gram -, gram+, ATYPICAL, ANAEROBE
IV/PO (400mg QD)
AE: tendon rupture, neuropathy, QT prolongation, seizure/CNS, hypoglycemia, photosensitivity
NO RENAL DOSE ADJUSTMENT
avoid in children/pregnancy
separate from antacids
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26
Q

Azithromycin

A

Zithromax (macrolide)
gram + (strep), gram - (HNM), atypical (legionella, chlamydia, mycoplasma, mycobacterium)
upper/lower resp. tract, sexually transmitted infection
PO/IV (PO ZPak, IV 250-500mg QD)
AE: QT prolongation, hepatotoxicity, increased LFTs
no dose adjustment in renal impairment
susp= no refrigeration
minimal drug interactions

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27
Q

Clarithromycin

A

Biaxin (macrolide)
gram + (strep), gram - (HNM), atypical (legionella, chlamydia, mycoplasma, mycobacterium)
upper/lower resp. tract, sexually transmitted infection
PO (250-500mg PO q12h or 1g PO QD)
AE: QT prolongation, hepatotoxicity, increased LFTs
decrease dose in renal impairment (50% if CrCl <30)
take with food
susp= no refrigeration
3A4 substrate and INHIBITOR

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28
Q

Erythromycin

A

E.E.S, Ery-tab, Erythrocin (macrolide)
gram + (strep), gram - (HNM), atypical (legionella, chlamydia, mycoplasma, mycobacterium)
upper/lower resp. tract, sexually transmitted infection
PO/IV (q6-12h)
AE: QT prolongation, hepatotoxicity, increased LFTs
no renal dose adjustment
refrigerate EES susp
erythromycin powder stable @ RT
3A4 substrate and INHIBITOR

29
Q

Doxycycline

A

Vibramycin, Oracea, Doryx, Monodox, Atridox, Adoxa (Tetracycline)
gram + (broad), Gram - (resp.), spirochetes, rickettsial, anthrax, syphillis, acne, chlamydia, malaria
USE: MRSA (mild skin infection), VRE (UTI)
PO/IV (100mg q12h)
–> Oracea= empty stomach
AE: photosensitivity, nephrotoxicity, DRESS rash, bone marrow suppression
NO dose adjustment in renal impairment
separate from antacids
avoid in children <8 and pregnancy
avoid with retinoic acids (pseudotumor cerebri)
IV:PO= 1:1
susp= no refrigeration
enhance neuromuscular blockin agent, warfarin
decrease effectiveness of PCN

30
Q

Minocycline

A

Minocin, Dynacin, Solodyn (tetracycline)
gram + (broad), Gram - (resp.), spirochetes, rickettsial, anthrax, syphillis, acne, chlamydia, malaria
USE: skin infection, acne
PO/IV (50-100mg q12-24h)
AE: photosensitivity, nephrotoxicity, DRESS rash, bone marrow suppression
NO dose adjustment in renal impairment
separate from antacids
avoid in children <8 and pregnancy
avoid with retinoic acids (pseudotumor cerebri)
enhance neuromuscular blockin agent, warfarin
decrease effectiveness of PCN

31
Q

Tetracycline

A

Tetracycline
gram + (broad), Gram - (resp.), spirochetes, rickettsial, anthrax, syphillis, acne, chlamydia, malaria
–> rarely used (in H.pylori Tx)
PO (250-500mg q6h)
take on empty stomach
AE: photosensitivity, nephrotoxicity, DRESS rash, bone marrow suppression
–> extend interval in renal impairment
separate from antacids
avoid in children <8 and pregnancy
avoid with retinoic acids (pseudotumor cerebri)
3A4 substrate and inhibitor
enhance neuromuscular blockin agent, warfarin
decrease effectiveness of PCN

32
Q

Sufamethoxazole/Trimethoprim

A 
Bactrim, septra (Sulfonamides)
gram + (MRSA), gram - (H-PEK, enterobacter, shigella, salmonella), opportunistic pathogens (nocardia, pnsumocystis, toxoplasmosis)
PO/IV
--> UTI= 1 DS tab BID x3 days
--> PCP prophylaxis= 1 DS or SS tab QD
CI in sulfa allergy
AE: skin reactions (SJS, TEN), crystalluria, photosensitivity, hyperkalemia, hypoglycemia, increased LFTs, CNS, QT prolongation
Avoid in pregnancy @ term (kernicterus, spinal cord defects)
use caution in G6PD deficiency
IV= store @ RT, dilute with D5W only
susp= RT
reduce dose in renal impairment
IV:PO= 1:1
2C8/9 inhibitor (warfarin)
33
Q

Vancomycin

A 
Vancocin
gram + (MRSA), c.diff
MRSA= 15-20mg/kg q8-12h IV
C.diff= 125-500mg QID x10-14 days PO
AE: red man syndrome, nephrotoxicity, ototoxicity
monitor trough (10-20
extend interval in renal impairment
34
Q

Linezolid

A 
Zyvox (oxazolidinone)
gram + (MRSA, VRE faecium/faecalis)
USE: pneumonia, SSTI, VRE
PO/IV (600mg q12h)
AE: HA, diarrhea, taste alteration, increased LFT/pancreatic enzymes, neuropathy
weak MAOI (avoid tyramine-containing foods)
IV:PO= 1:1
no adjustment in renal impairment
susp= room temp
35
Q

Quinupristin/Dalfopristin

A 
Synercid (streptogramin)
gram + (MRSA, VRE faecium)
USE: complicated SSTI
IV (7.5mg/kg q8-12h)
AE: arthralgias/myaglias, infusion reaction, hyperbilirubinemia, CPK elevation
no adjustment in renal impairment
D5W only, refrigerate after reconstitution
weak 3A4 inhibitor
36
Q

Daptomycin

A

Cubicin (cyclic lipopeptide)
gram + (MRSA, VRE faecium/faecalis)
USE: complicated SSTI, staph bloodstream (endocarditis)
IV (4-6g/kg QD)
AE: myopathy, eosinophilic pneumonia, GI upset, increased CPK/myopathy, increased LFT
extend interval in renal impairment (q48h)
cannot use for pneumonia
only mix with NS
false elevation in PT/INR

37
Q

Telavancin

A 
Vibativ (lipoglycopeptide)
derivative of Vanco
gram + (MRSA)
USE: complicated SSTI, HA-pneumonia
IV (10mg/kg QD)
AE: nephrotoxicity, QT prolongation, red man syndrome, metallic taste, N/V, increased SCr
fetal risk (Category C)
reduce dose/extend interval in renal impairment
MedGuide admin.
38
Q

Aztreonam

A 
Azactam (monobactam)
Gram - (pseudomonas)
IV (500-2,000mg q6-12h)
AE: increased LFTs, N/V/D, rash
reduce dose in renal impairment
safe in PCN allergy
39
Q

Colistimethate

A

Colistin (polymixin Abx)
gram - (pseudomonas)
USE: MDR gram-neg pathogen
IV (2.5-5mg/kg/day divided in 2-4 doses)
AE: nephrotoxicity, neurologic disturbances
reduce dose/extend interval in renal impairment

40
Q

Tigecycline

A

Tygacil (Minocycline derivative)
gram + (MRSA, VRE), gram -, anaerobe, atypical
use LAST LINE (complicated SSTI/intraabdominal, CAP)
IV (100mg x1 then 500mg q12h)
BBW= increased risk of death
AE: hepatotoxicity, photosensitivity, increased LFTs
avoid in children <8 and pregnancy
no adjustment in renal impairment
decrease dose in severe hepatic impairment
avoid in bloodstream infection

41
Q

Clincamycin

A 
Cleocin
gram +, anaerobes
PO/IV
AE: SJS, increased LFTs, C.DIFF
no adjustment in renal impairment
42
Q

Metronidazole

A 
Flagyl
anaerobes, protozoal
PO/IV
--> c.diff= 500mg TID x10-14 days
AE: GI upset, metallic taste, furry tongue, darkened urine, CNS
no adjustment in renal impairment
ER tabs= empty stomach
IV:PO= 1:1
avoid in 1st trimester
avoid alcohol (disulfiram)
3A4 and 2C9 inhibitor
43
Q

Rifaximin*

A

Xifaxan
structurally related to rifampin
USE: traveler’s diarrhea, hepatic encephalopathy prevention
PO (200-550mg BID-TID)
AE: flatulence, GI, rash, peripheral edema
not for systemic infection
no adjustment in renal impairment

44
Q

Nitrofurantoin

A 
Macrodantin, Macrobid, Furadantin
USE: uncomplicated UTI
macrodantin= QID PO (QD prophylaxis)
macrobid= BID PO
AE: pulmonary toxicity (long-term), hepatotoxicity/neuropathy (rare), N/HA, darkened urine
Category B (CI @ term)
CI when CrCl<60
45
Q

Fidaxomicin

A 
Dificid
USE: c.diff
AE: N/V, abdominal pain, GI bleed
not for systemic infection
no adjustment in renal impairment
46
Q

Rifampin

A

Rifadin, Rifamate (isoniazid), Rifater (INH/pyrazinamide)
USE: TB
PO (empty stomach)
AE: increased LFT, GI upset, rash, orange-red discoloration of fluids, flu-like syndrome
CYP INDUCER

47
Q

Isoniazid

A 
Rifamate (isoniazid), Rifater (rifampin/pyrazinamide)
USE: TB
PO (empty stomach)
AE: HA, GI upset, increased LFT, peripheral neuropathy, lupus-like syndrome, hyperglycemia, hepatitis, agran/thrombocytopenia/anemia
pyridoxime (Vit B6)= reduce neuropathy
avoid in liver disease
CYP inhibitor
avoid tyramine-containing foods
increase folic acid, niacin, and Mg
48
Q

Pyrazinamide

A

Rifater (rifampin/INH)
USE: TB
PO (empty stomach)
AE: GI upset, malaise, hepatotoxicity, arthralgias, hyperuricemia/gout
extend interval if CrCl <30
fatal hepatotoxicity with rifampin (monitor)

49
Q

Ethambutol

A

Myambutol
USE: TB
PO (2-3x/week)
AE: optic neuritis

50
Q

Streptomycin*

A

USE: TB
PO (2-3x/week)
AE: neurotoxicity, nephrotoxicity, neuromuscular blockage/respiratory paralysis
extend interval for CrCl <50

51
Q

Bedaquiline

A 
Sirturo
USE: MDR-TB
PO (QD--> 3x/week)
AE: QT prolongation, increased risk of death, chest pain, increased LFTs
Take with food
52
Q

Amphotericin B

A

Lipid formulations= Abelcet, AmBisome (antifungal)
broad spectrum= yeast, mold, dimorphic fungi
AE: fever, chills, malaise, rigors, hypokalemia, hypomagnesemia, nephrotoxicity, anemia, hypotension/hypertension
Ambisome= back/chest pain with 1st dose
D5W only
lipid formulations= decreased nephrotoxicity
infusion related reaction (premedicate= APAP/NSAID, Benadryl, Merperidine, Fluid bolus)

53
Q

Ketoconazole

A

Nizoral, Ketodan, Extina, Xologel (azole antifungal)
USE: androgen-related disorders
AE: hepatotoxicity, increased LFTs, QT prolongation, hypertriglyceridemia, hypokalemia
hepatic clearance
CYP 3A4 inhibitor
pH dependent absorption

54
Q

Fluconazole

A

Diflucan (azole antifungal)
yeast (candida albicans, cryptococcus), dimorphic fungi
IV/PO (100-800mg QD)
AE: increased LFTs, QT prolongation, hypertriglyceridemia, hypokalemia
CNS penetration (fungal meningitis)
IV:PO= 1:1
CYP 3A4 inhibitor (not hepatically cleared)

55
Q

Voriconazole

A

VFEND (azole antifungal)
yeast, dimorphics, ASPERGILLOSIS (DOC), mold
IV/PO (q12h)
AE: QT prolongation, increased LFTs, visual changes, increased SCr, CNS, photosensitivity
avoid direct sunlight and driving at night
avoid IV formulation for CrCl <50
take on empty stomach
CYP3A4 inhibitor
CYP substrate (2C9, 2C19, 3A4)*** (michaelis-menten kinetics)

56
Q

Posaconazole

A

Noxafil (azole antifungal)
yeast, dimorphics, aspergillosis, mold, MUCORMYCOSIS, ZYGOMYCOSIS
PO (6-12h)
must be taken with full meal
AE: QT prolongation, increased LFTs, hypokalemia
CYP 3A4 inhibitor

57
Q

Caspofungin

A

Cancidas (echinocandin)
USE: systemic candida infection
IV (QD)
do not mix with dextrose
AE: increased LFTs, hypotension, fever, diarrhea, hypokalemia, hypomagnesemia, rash
no dose adjustment in renal impairment (few DI’s)
+ cyclosporine= hepatotoxicity (reduce dose)

58
Q

Micafungin

A

Mycamine (echinocandin)
IV (candidemia 100mg QD, esophageal 150mg QD)
AE: increased LFTs, hypotension, fever, diarrhea, hypokalemia, hypomagnesemia, rash
no dose adjustment in renal impairment (few DI’s)

59
Q

Terbinafine

A

Lamisil (antifungal)
PO (250m in 1-2 divided doses)/topical
AE: taste disturbances, systemic lupus exacerbation, HA, skin rash, increased LFTs
strong CYP 2D6 inhibitor (SSRIs)

60
Q

Oseltamivir

A 
Tamiflu (antiviral)
PO (Tx 75mg BID x5d, prophylacis 75mg QD x10d)
AE: CNS, vomiting
start within 48 hrs of symptoms
decrease frequency for CrCl <30
61
Q

Acyclovir

A

Zovirax (antiviral)
USE: HSV, VZV
PO/IV (IBW in obese patients), topical
AE: thrombocytopenic purpura/hemolytic uremic syndrome, renal impairment, malaise, HA/N/V/D, increased LFTs/SCr/BUN, neutropenia
infuse over 1 hr (min) + hydration (prevent renal damage)
full glass of water (PO)
extend interval in renal impairment

62
Q

Valacyclovir

A 
Valtrex (antiviral)
prodrug of acyclovir
USE: HSV, VZV
PO (500-1,000mg QD-TID)
AE: thrombocytopenic purpura/hemolytic uremic syndrome, renal impairment, malaise, HA/N/V/D, increased LFTs/SCr/BUN, neutropenia
full glass of water
extend interval in renal impairment
63
Q

Valganciclovir

A

Valcyte (antiviral)
prodrug of ganciclovir
USE: CMV (DOC), HSV, VZV
PO (450-900mg QD-BID)
TAKE WITH FOOD
AE: myelosupression, fever, N/V/D, anorexia, thrombocytopenia, neutropenia, leukopenia, anemia, increased SCr, seizure (rare)
extend interval and reduce dose in CrCl <60

64
Q

Atovaquone/Proquanil

A 
Malarone (antimalarial)
PO (QD)
initiation 1-2 days, D/C 7 days
AE: increased LFTs
take with food or milk
avoid prophylaxis when CrCl <30
65
Q

Mefloquine

A 
Lariam (antimalarial)
PO (qWeek)
initiation 1-2 weeks, D/C 4 weeks
DOC for resistance
AE: seizure, neuropsychiatric effects, loss of balance/dizziness, GI upset, chills, tinnitus
take with food and 8oz. water
66
Q

Quinine

A

Qualaquin (antimalarial)
PO (q8h)
must be given with doxy, tetracycline, clindamycin
AE: QT prolongation, SJS/TEN, visual changes, hypoglycemia
avoid in G6PD deficiency

67
Q

Chloroquine

A

Aralen (antimalarial)
PO (qWeek)
initiation 1-2 weeks, D/C 4 weeks
AE: retinopathy, QT prolongation, GI upset, visual disturbances, hair loss, myopathy/neuropathy, psoriasis exacerbation

68
Q

Primaquine*

A 
(antimalarial)
PO (QD)
initiation 1 day, D/C 7 days
USE: p.vivax
AE: agran, anemia
avoid in G6PD deficiency (hemolytic anemia)

NAPLEX (5 decks)

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