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Boc G - Infections > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

The gram positive bacterias usually end in US, OC, ER and UM (sound masculin) except which one?

A
  • Listeria spp
  • Nocardia spp
  • Gemella spp
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2
Q

Gram negative bacterias usually end in A or ER except which one?

A
  • Proteus spp
  • Haemophilus spp
  • Acinetobacter spp
  • Bacteroides spp
  • Vibrio spp
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3
Q

Which b-lactams cross the BBB appreciably?

A

–Penicillin IV (high dose)

–Ampicillin IV (high dose)

–Third generation cephalosporins IV (high dose)

–Cefepime

–Carbapenems

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4
Q

Adverse reactions of All b-lactams?

A

–GI upset

–Diarrhea (b-lactamase inhibitors; cefixime/Suprax)

–Drug induced neutropenia

–Seizures

–Anaphylaxis

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5
Q

Why are Carbapenems used?

A

BROAD SPECTRUM: Like BROAD SPECTRUM b-lactams/b-lactamase inhibitor combinations

  • Gram-positives (MSSA), gram-negative, anaerobes
  • Usually resistant to b-lactamases
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6
Q

Do Cephalosporins work against Gram-positive Enterococcus spp / Listeria spp?

A

Non

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7
Q

Which generation of Cephalosporins works againts gram-negative Pseudomonas spp / Campylobacter spp?

A

3rd (Only ceftazidime) and 4th

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8
Q

Penicillins and b-lactamase inhibitors are used against what bacteria?

A
  • S. aureus
  • Most gram-positive organisms including Enterococcus and Listeria spp
  • Most gram-negative respiratory pathogens (Haemophilus and Moraxella spp)
  • Most gram-negative enteric bacteria
  • Most anaerobes (gram-positive and gram-negative)
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9
Q

What can you use against Pseudomonas spp?

A

Timentin and Pip/tazo (Penicillins and b-lactamase inhibitors)

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10
Q

S. aureus choice of antibiotic?

A

Cloxacillin

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11
Q

E Coli choice of antibiotic?

A

Ampicillin IV

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12
Q

Pseudomonas aeruginosa choice of antibiotic?

A

–Ticarcillin

–Piperacillin

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13
Q

Which type of antibiotic is time dependant?

A
  • Beta-lactam group (Penicillins and their derivatives)
  • Macrolides and ketolides
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14
Q

Type of antibiotic that is concentration dependant?

A

aminoglycosides

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15
Q

Which antibiotics have such good bioavailability that po = IV availability?

A

–Clindamycin po = IV

–Fluoroquinolones po = IV

–Septra po = IV

–Tetracyclines po = IV

–Metronidazole po = IV

–Linezolid po = IV

LIMITED BY GI TOLERANCE AND ABSORPTION

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16
Q

Which b-lactams have activity against MSSA?

A

–Cloxacillin po/IV (and methicillin)

– b-lactam/b-lactamase combinations (po/IV)

–1st and 2nd generation cephalosporins po/IV

•3rd generation IV NOT that good – just OK

–Cefepime

–Carbapenems

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17
Q

Which b-lactams have activity against Pseudomonas spp?

A

–Ticarcillin and Piperacillin (IV)

–Timentin and Pip/tazo (IV)

–Ceftazidime (IV)

–Cefepime (IV)

–Carbapenems (IV)

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18
Q

Which b-lactams have activity against anaerobes?

A

–Penicillin (po/IV)

–All b-lactam/b-lactamase combinations (po/IV)

–Carbapenems (IV)

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19
Q

What is the Antibacterial spectrum of Vancomycin?

A

Gram-positive including anaerobic gram-positive

Very good activity against Clostridium difficile (oral treatment)

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20
Q

Pharmacological key points of Vancomycin?

A
  • BBB penetration, mainly with inflammation
  • Need higher levels to penetrate BBB, bone and cartilage, heart tissue
  • Need higher levels when dealing with MRSA
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21
Q

Adverse reactions of Vancomycin?

A

Nephrotoxicity: Usually with accumulation (high trough levels)

When administered over short period (<1 hr): Histamine release (Red-man syndrome)

22
Q

What is the antibacterial spectrum of Macrolides/Ketolides?

A

Gram-positives

  • S. pneumoniae (if S)
  • Group A Streptococcus (if S)

Gram-negatives

  • Campylobacter spp
  • Bordetella pertussis

Atypical bacteria

  • Mycoplasma spp, Chlamydia spp, Clamydophila spp

Non-tuberculous mycobacteria

  • Clarithromycin, azithromycin
23
Q

Do macrolides cross the BBB?

A

Non

24
Q

What is the Antibacterial spectrum of Aminoglycosides?

A

GRAM-NEGATIVE

25
Q

Adverses effects of Aminoglycosides?

A
  • Renal toxicity (high accumulated levels)
  • Vestibular and cochlear toxicity (long period, irreversible)
  • Muscular blockade (never give if NMD)
26
Q

What are the 3 important types of Fluoroquinolones?

A
  1. Ciprofloxacin po/IV (Cipro)
  2. Levofloxacin po/IV (Levaquin): “The respiratory quinolone”
  3. Moxifloxacin po (Avelox)
27
Q

What is the Antibacterial spectrum of Fluoroquinolones?

A

À PARTIR DE LA DEUXIÈME GÉNÉRATION

  • S. pneumoniae
  • MSSA
  • Enteric gram negative rods
  • Pseudomonas spp
  • Atypicals
28
Q

What is the Antibacterial spectrum of Sulfonamides?

A

Gram-positive and gram-negative:

  • Enterobacteriaceae
  • Shigella
  • S.maltophilia (PARASITE)
  • B.cepacia
  • Chlamydia
  • Nocardia
  • Pneumocystis jeroveci
  • Toxoplasma
    ** NOT ENTEROCOCCUS
29
Q

What is the Antibacterial spectrum of Cyclines?

A
  1. Minocycline: topical for acne
  2. Tetracyclines: gram-negative enteric rods, anaerobes, atypical bacteria
  3. Tigecycline: gram-negative enteric rods, gram-positive, anaerobes, atypical
30
Q

What is the mechanisms of action of Clindamycin?

A
  • Inhibition of protein synthesis
  • Bacteriostatic time-dependent activity
31
Q

What is the Antibacterial spectrum of Clindamycin?

A

ONLY gram-positive:

  • S.pneumoniae
  • S aureus
32
Q

What are the Adverse reactions of Clindamycin?

A
  • May cause moderate diarrhea
  • Associated with C.difficile colitis
33
Q

What is the Antibacterial spectrum of Metronidazole (Flagyl)?

A
  • ANAEROBES: vaginosis
  • parasites
  • anti-inflammatory in bowel
34
Q

Why is used Rifamycins?

A
  • TB
  • Post-exposure prophylaxis:
  • N. meningitides (meningitis and/or meningococcemia)
  • H. influenzae (meningitis)
35
Q

What is the adverse effect of Rifamycins?

A
  • MAJOR drug interactions between Rifampin and Rifabutin: both are metabolized in the liver and induce CYP-450 enzymes
  • Coloration of fluids
36
Q

What is the antibiotic of choice for non-complicated cystitis treatment and UTI prophylaxis?

A

Nitrofurantoin

37
Q

What are the antibiotics specifically used for multiresistant gram-positive bacteria?

A
  • Oxazolidinones: Linezolid
  • Streptogramins: Quinipristin/Dalfopristin
  • Daptomycin
  • Ceftaroline for MRSA
38
Q

What are the adverse reaction sof Linezolid?

A
  • Risk of thrombocytopenia
  • Inhibitor of monoamine oxydase
39
Q

What should absolutely be avoided when using Flagyl antibiotic?

A

ALCOHOL

40
Q

What are the empiric antibiotics for a febrile neonate?

A

Ampicillin IV + Gentamicin IV

± third generation cephalosporin for meningitis (Cefotaxime IV)

41
Q

What are the empiric antibiotics for a febrile baby (1-3 months old)

A

Ampicillin IV + Gentamicin IV

Ampicillin IV + Vancomycin IV + third generation cephalosporin for meningitis (Ceftriaxone IV)

42
Q

What is the treatment of Cystitis UTI?

A

TMP/SMX (Septra) for 3 days

OR

Quinolone (Cipro) also for 3 days

43
Q

What is the treatment of Pyelonephritis UTI?

A

Ampicillin (to cover possible enterococcus) and aminoglycoside (To cover gram negatives: Genta/Tobra)

Oral of IV depending of severity

44
Q

What is the treatment of Gonorrhoeae?

A

Combination:

  • Ceftriaxone (intra-muscular) x 1 dose, or Cefixime (by mouth) x 1 dose
  • Azithromycin x 1 dose
45
Q

What is the treatment of Chlamydia?

A

Azithromycin (oral) x 1 dose or doxycycline

46
Q

What is the treatment of Trichomonas vaginalis (flagella)?

A

Metronidazole (Flagyl)

47
Q

What is the treatment of Syphilis​?

A
  • Primary, Secondary or early latent: Penicillin IM x 1
  • Late latent or latent of unknown duration; teritary: Penicillin IM weekly x 3 doses
  • Neurosyphilis: Penicillin IV for 10-14 days
48
Q

What is the antibiotic of choice against Enterococcus anaerobes?

A

Fluroquinolones 4th generation

49
Q

Best treatment of endocarditis?

A
  1. Nafcillin (beta lactam)
  2. Aminoglycoside
50
Q

Best treatment of endocarditis with prostethic valve infection?

A
  1. Nafcillin (beta lactam)
  2. Aminoglycoside
  3. Vancomycin
51
Q

Treatment of choice of S. Aureus osteomyelitis?

A

Cloxacilin or Cefazolin

OR VANCOMYCIN IF METHICILLIN RESISTANT

Boc G - Infections (7 decks)

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