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Dr. Freschi antibiotics Brett > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q 
Primaxin: Gorillamycin
What is it?
MOA?
Coverage?
Doseage?

Risk:

A
  • Imipenem and cilastatin (inhibits dehydropeptidase)
  • bind PCN binding proteins inhibiting cell wall synthesis
  • Coverage: very broad spectrum of activity, serious systemic infections, for use with very resistant bugs

500mg IV q6h

High risk of seizures

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2
Q 
Meropenem
What is it?
MOA?
Coverage?
Doseage?
A
  • A carbapenem
  • binds PCN binding proteins to inhibit cell wall synthesis
  • Coverage: strep, pseudomonas, bacteroides
  • 500mg IV q8: 1g IV q8
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3
Q 
Invanz
What is it?
MOA?
Coverage?
Doseage?
A

Ertapenem

  • binds PCN binding proteins to inhibit cell wall synthesis
  • Coverage: MSSA, Strep, Aerobes. Used for moderate-severe foot infections

DOES NOT COVER PSEUDO

Dose: 1g IM/IV qday

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4
Q 
Gentamicin
What is it?
MOA?
Coverage?
Doseage?

Side effects?

A

an Aminoglycoside

  • Protein synthesis inhibitor, binds irreversibly to 30S
  • Covers: serratia
  • Dose: 1-1.7mg/kg IM/IV q8

Side effects: ototoxicity, nephrotoxicity

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5
Q 
Tobramycin
What is it?
MOA?
Coverage?
Doseage?
A

an aminoglycoside

  • Protein synthesis inhibitor, binds irreversibly to 30S
  • Covers pseduo aeruginosa

Dose: 1-1.7mg/kg IM/IV q8

Side effects: ototoxicity, and nephrotoxicity

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6
Q 
Amikacin
What is it?
MOA?
Coverage?
Doseage?
A

An aminoglycoside

  • protein synthesis inhibitor, binds irreversibly to 30S
  • reserved for organisms resistant to gentamycin and tobramycin

Dose: 7.5 mg/kg IM/IV q12h

Side effects: ototoxicity and nephrotoxicity

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7
Q

Penicillin G

  • MOA
  • Coverage
  • Doseage
A

MOA: acts on penicillin binding protein to inhibit cell wall synthesis

-Coverage: anaerobes, Strep, nonpenicillinase staph, nonpenicillinase gonococci

Dose: 1.2-40million units IM or IV qd

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8
Q

Penicllin V

  • MOA
  • Coverage
  • Doseage
A

acts on penicillin binding protein to inhibit cell wall synthesis

Coverage: anaerobes, strep, nonpenicillinase staph, and nonpenicillinase gonococci

Dose: 250-500 mg po qd

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9
Q

Ampicillin

  • MOA
  • Coverage
  • Doseage
A

acts on penicillin binding protein to inhibit cell wall synthesis

-coverage: E.coli, P.mirabilis, Shigella , Salmonella, bacteroides, enterococci

Dose: 250-1000mg PO, IM, IV q4-6

COverage

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10
Q

Amoxicillin

  • MOA
  • Coverage
  • Doseage
A

MOA: acts on penicillin binding protein to inhibit cell wall synthesis

Coverage: E.coli, P.mirabilis, Shigella, Salmonella, bacteroides, enterococci

Dose: 250-500mg PO TID

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11
Q

Dicloxacillin/Cloxacillin

  • MOA
  • Coverage
  • Doseage
A

MOA: acts on penicillin binding protein to inhibit cell wall synthesis

Coverage: DOC for MSSA

Dose: 250-500mg po bid/qid oral

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12
Q

Nafcillin

  • MOA
  • Coverage
  • Doseage
A

MOA: acts on penicillin binding protein to inhibit cell wall synthesis

Coverage: DOC for MSSA

Dose 1-2grams IV q4-q6

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13
Q

Oxacillin (Bactocill)

  • MOA
  • Coverage
  • Doseage
A

MOA: acts on penicillin binding protein to inhibit cell wall synthesis

  • Dose: 250-500mg IV/IM q4-6
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14
Q

Timentin

  • Makeup
  • MOA
  • Coverage
  • Doseage

What to look out for?

A

Ticarcillin/clavulonic acid

MOA: acts on penicillin binding protein to inhibit cell wall synthesis

Coverage: covers pseudo

Dose: 3.1gm IV q4-6

Watch for increased NA levels

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15
Q

Zosyn

  • Makeup
  • MOA
  • Coverage
  • Doseage
A

Piperacillin/tazobactam

MOA: acts on penicillin binding protein to inhibit cell wall synthesis

Coverage: covers pseudo

Dose: 3.375-4.5 grams IV q8

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16
Q

Unasyn

  • Makeup
  • MOA
  • Coverage
  • Doseage
A

ampicillin/sulbactam

MOA: acts on penicillin binding protein to inhibit cell wall synthesis

Indicated for polymicrobial diabetic foot infections

Dose: 1/5-3.0 grams IV q6

DOC MSSA

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17
Q

Augmentin

  • Makeup
  • MOA
  • Coverage
  • Doseage
A

amoxicillin/clavulonic acid

MOA: acts on penicillin binding protein to inhibit cell wall synthesis

COverage: gram+ and bacteroides

Dose: 875 gm oral BID

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18
Q

Which Penicillins are hepatically cleared (4)

A

Mezlocillin, Azlocillin, Nafcillin, Piperacillin

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19
Q

First generation Cephalosporins (3)

A

Cephalexin, Cefadroxil, Cefazolin

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20
Q 
Cephalexin
Brand name 
MOA
Coverage
Doseage
A

Keflex

MOA: acts on penicillin binding proteins to inhibit cell wall synthesis

Covers: more Gram +
DOC for staph

Dose: 250mg-500mg PO BID

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21
Q 
Cefadroxil
Brand name 
MOA
Coverage
Doseage
A

Duricef

MOA: acts on penicillin binding proteins to inhibit cell wall synthesis

Coverage: more Gram +
DOC for staph

Dose: 30mg/kg/day PO BID

22
Q 
Cefazolin
Brand name 
MOA
Coverage
Doseage
A

Ancef

MOA: acts on penicillin binding proteins to inhibit cell wall synthesis

Coverage: more Gram +
DOC for staph

Dose 2 grams IV prior to surgery

23
Q

Second generation cephalosporins (2)

A

Cefaclor, and Cefuroxime

24
Q 
Cefaclor
Brand name 
MOA
Coverage
Doseage
A

Ceclor

MOA: acts on penicillin binding proteins to inhibit cell wall synthesis

Coverage: similar Gram + as 1st generation.
More upper resp coverage

Dose:250-500mg PO q8

25
Q 
Cefuroxime
Brand name 
MOA
Coverage
Doseage
A

Ceftin

MOA: acts on penicillin binding proteins to inhibit cell wall synthesis

Coverage: simmilar Gram + as 1st generation.
More upper resp coverage

Dose: 250-500mg PO BID

26
Q

Third generation Cephalosporins (3)

A

Ceftriaxone, ceftazidime, cefdinir

27
Q 
Ceftriaxone
Brand name 
MOA
Coverage
Doseage
A

Rocephin

MOA: acts on penicillin binding proteins to inhibit cell wall synthesis

Coverage: less gram + than previous gen. But now more gram negative.

Empiric/ DOC for neisseria-septic joint

Dose: 1-2grams IV q day

28
Q 
Ceftazidime
Brand name 
MOA
Coverage
Doseage
A

Fortaz

MOA: acts on penicillin binding proteins to inhibit cell wall synthesis.

Coverage: less gram + than previous generations but now more gram -. COVERS PSEUDO

Dose: 1gram IV/IM BID

29
Q 
Cefdinir
Brand name 
MOA
Coverage
Doseage
A

Omnicef

MOA: acts on penicillin binding proteins to inhibit cell wall synthesis

Coverage: less gram + than previous generations but now more gram -.
USED BY internal med

Dose: 300mg PO BID

30
Q

Fourth gen Cephalosporin

A

Cefepime

31
Q 
Cefepime
Brand name 
MOA
Coverage
Doseage
A

Maxipime

MOA: acts on penicillin binding proteins to inhibit cell wall synthesis

Coverage: Similar Gram + to 1st gen and Gram - similar to 3rd gen. INCLUDING PSEUDO
Similar coverage to zosyn

Dose: 2g IV BID

32
Q

Fifth generation Cephalosporin (1)

A

Ceftaroline

33
Q 
Ceftaroline
Brand name 
MOA
Coverage
Doseage
A

Teflaro

MOA: acts on penicillin binding proteins to inhibit cell wall synthesis

Coverage: broad spectrum similar to fourth gen and active against MRSA.

Dose: 600 mg IV BID

34
Q 
Ciprofloxacin
Brand name 
MOA
Coverage
Doseage

What to be weary of

A

Cipro

MOA: inhibit bacterial DNA topoisomerase (gyrase)

Coverage: Gram-.
DOC-pseudo

Dose:250-750mg PO BID
OR 200-400mg IV BID

Be careful: active people, open growth plates, supplements will decrease absorption

35
Q 
Levofloxacin 
Brand name 
MOA
Coverage
Doseage

What to be weary of

A

Levaquin

MOA: inhibit bacterial DNA topoisomerase (gyrase)

Coverage: empiric antibiotic, mainly Gram-

Dose: 250-500mg PO/IV

Be careful: active people, open growth plates, supplements will decrease absorption.

36
Q 
Moxifloxacin
Brand name 
MOA
Coverage
Doseage

What to be weary of

A

Avelox

MOA: inhibit bacterial DNA topoisomerase (gyrase)

Coverage: empiric oral antibiotics. Covers everything but those that are resistant. Better anaerobic coverage in diabetic foot infections.

Dose: 400mg qd PO

Be careful: active people, open growth plates, supplements will decrease absorption.

37
Q

Macrolides (3)

A

Azithromycin, clarithromycin, erythromycin

38
Q

Erythromycin

MOA

Coverage:

Doseage:

Metabolism:

A

MOA: inhibit protein synthesis by binding to 50 S subunit

Coverage: S.pyogenes, S.pneuomonia, S. aureus.
Chlamydia, gonorrhoeae, syphilis.

Campylobacter

Dose: 250-500mg PO BID
Max: 4g daily

Metabolized by the liver

39
Q

Azithromycin

MOA

Coverage

Doseage

A

MOA: inhibit protein synthesis by binding to 50s subunit.

Coverage:

  • S.aureus
  • S.pyogenes
  • Strep agalactiae

Dose:

  • 500mg PO day 1
  • 250mg qday 2-5
40
Q

Clarithromycin

Brand name

MOA

Coverage

Doseage

A

Biaxin

MOA: inhibit protein synthesis by binding to the 50s subunit.

Coverage:

  • Staph aureus
  • S.pyogenes
  • Mycoplasma, chlamydia, mycobacteria

Dose: 250mg PO BID

41
Q

Tetracyclines

MOA

Coverage

Contraindications

A

MOA: act on 30 S subunit of bacterial ribosome inhibiting translation

Coverage: broad spectrum
active against community MRSA

Contraindicated in pregnancy

42
Q

Clindamycin

Brand name

MOA:

Coverage:

Doseage

Metabolism

A

Cleocin

MOA: inhibits protein synthesis through 50s ribosome subunit

Coverage: most gram positives and anaerobes.
-including bacteroides fragilis

Dose:
–foot infections: 300-450mg tid PO

–osteo due to MRSA: 600mg tid po

Metabolized by liver

43
Q

Metronidazole

Brand name

MOA

Coverage

Doseage

A

flagyl

MOA: binds to DNA and disrupts its structure

Coverage: anaerobes (gram+ and gram-)

Dose: 500mg TID PO

44
Q

Trimethoprim-sulfamethoxazole

Brand name:

MOA:

Spectrum of activity:

Dosing:

Caution?

A

Bactrim

MOA: inhibit bacterial synthesis of THF

Spectrum of activity: aerobic G+ and G-
-DOC for community acquired MRSA

Dosing:
-TMP/SMX: 80mg/400mg or 160mg/ 800mg

Caution for people with folate deficiency

45
Q

Daptomycin

Brand name :

MOA:

Spectrum of activity:

Dosing

A

Cubicin

MOA: depolarizes bacterial membranes, inhibits protein, DNA and RNA synthesis

Spectrum of activity: MSSA, MRSA and VRE.
DOC for MRSA infection when vanco is not allowed

Dosing:
Skin infections: 4mg/kg IV qday

46
Q

Tigecycline

Brand name:

MOA:

Spectrum of activity:

Dosing:

Side effects

A

Tygacil

MOA: binds 30s inhibiting protein synthesis

Spectrum: very broad.

  • MRSA,MRSE, PRSP, and VRE
  • multi-drug resistant organisms

Dose: start at 100mg IV and 50mg IV q12h

Side effects: high seizure rates

47
Q

Vancomycin

Brand name:

MOA:

Spectrum:

Dosing:

Peaks and troughs

A

Vancocin

MOA: binds to the building blocks (NAG and NAM) of peptidoglycan to inhibit cell wall synthesis

Spectrum:
-DOC: for MRSA
Also covers enterococcus and Strep

Dosing:
-Oral:125mg and 250mg

-IV: 1g q12 hours (slow infusion over 1 hour)

Must measure peaks and troughs with administration. (10-20mL is normal)

Red man syndrome is treated with diphenhydramine

48
Q

Rifampin

Brand name:

MOA:

Spectrum

Dosing:

Common Side effects

A

Rifampicin

MOA: inhibition of DNA-dependent RNA polymerase leading to suppression of RNA synthesis and cell death

Spectrum:

  • TB
  • Endocarditis
  • Hansen Disease
  • Anthrex

Dosing: 300mg-600mg PO/IV

Side effects: reddening of the mucosa. As well as urine, sweat, saliva or tears

49
Q

Linezolid

Brand name

MOA

Spectrum of activity

Dosing:

A

Zyvox

MOA: binds at the P site at the ribosomal 50S subunit

Spectrum:

  • VREF
  • Hospital acquired pneumonia
  • endocarditis
  • anthrax

Dosin: 600mg PO/IV q12 hours

50
Q

Synercid

Brand name

MOA:

Spectrum of activity

Dosing

Black box:

A

Quinupristin/dalfopristin

MOA: synergistic

Dalfopristin: binds to the 23 S portion of the 50S ribosomal subunit to change the conformation of it. This will enhance the binding of quinupristin by 100.

Quinupristin: binds to nearby site on 50S ribosomal subunit to prevent elongation of peptide

Spectrum:

  • MRSA
  • VRA/VRE

Dosing: 7.5mg/kg q8h

Black box for being advanced so quickly through FDA approval.

Dr. Freschi antibiotics Brett (3 decks)

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