antibiotics Flashcards
Name the naturally occurring PCNs and their ROI.
Penicillin VK (PO) Penicillin G (IV or IM)
Name the Anti-staphylococcal PNCNs.
Dicloxacillin (PO)
Nafcillin (IV)
Oxacillin (IV)
Name the Aminopenicillins
Amoxicillin (PO)
Ampicillin (IV)
Name the Antipseudomonal penicillins
Piperacilline (IV)
Ticarcillin
Name the two Beta-lactamase/PNCN combo
Zosyn (antipseudomonal)
Unasyn (anti-Acinetobacter)
what are first line abx in tx MSSA?
Dicloxacillin (PO)
Nafcillin (IV)
Oxacillin (IV)
(Anti-staphylococcal PNCNs)
what would we use to tx Syphilis ?
Pen G
*only PCN doesn’t require renal dosing??
Dicloxacillin
Nafcillin
Oxacillin
describe the coverage of Anti-Staphylococcal
PCNs (diclox, naf, oxa)
GREAT MSSA COVERAGE
Broader gram + coverage
gold standard for tx of listeria
ampicillin
what would you prescribe Amoxicillin for?
Otitis media
UTIs/URIs
Meningitis (ampicillin)
describe coverage for ampicillin/amox
PCN + added Gram negative coverage (E. coli, H. flu, salmonella)
Enterococcus
Listeria and Shigella (Ampicillin preferred)
β-lactam + β-lactamase Inhibitors include zosyn and unasyn among others, which of the 2 is equivalent to augmentin PO?
unasyn
β-lactam + β-lactamase Inhibitors include zosyn and unasyn among others, which of the 2 is used to tx P. aeruginosa?
zosyn
β-lactam + β-lactamase Inhibitors include zosyn and unasyn among others, which of the 2 is used to tx Acinetobacter?
unasyn
what would you use to tx Human bites + Animal Bites
augmentin
Name the 1st gen cephs?
Cefazolin (Ancef) (IV)
Cephalexin (Kelfex) (PO)
Cefadroxil (Duracef) (PO
Name the 2nd gen cephs (2A)
Cefuroxime (Ceftin)
Cefaclor
Cefprozil
Name the 2nd gen cephs (2B)
Cefoxitin
Cefotetan
Name the 3rd gen cephs
Anti-pneumococcal Cefotaxime Ceftriaxone Cefixime Cefpodoxime
Antipseudomonal
Ceftaz
name 4th gen cephs
Cefepime IV
name 5th gen cephs
Ceftaroline IV
name the abcx prescribes SECOND line for MSSA infection?
1st gen cephs
Cefazolin (Ancef) (IV)
Cephalexin (Kelfex) (PO)
Cefadroxil (Duracef) (PO
what would we use 1st gen cphs to tx?
Skin infections SECOND line for MSSA SSTI UTI Pre-op abx
Out of the cephalosporins what would tx?
Respiratory tract infections
Sinusitis, otitis, etc
2nd gen (2A)
Cefuroxime (Ceftin)
Cefaclor
Cefprozil
Out of the cephs what covers:
Skin infections
MRSA / VRSA
VSE
CeftarolineIV (5th gen)
gram +/- aerobes
out of the cephalosprins which cover pseudomonas?
3rd gen antipseudo -> ceftaz
4th gen -> Cefepime (IV)
name the Anti-pneumococcal cephs
Cefotaxime
Ceftriaxone
Cefixime
Cefpodoxime
what would we prescribe for tx of Gonorrhea ?
Gonorrhea (ceftriax)
what would we prescirbe if their was an infection due to b. fragillis
2B
Cefoxitin
Cefotetan
what ceph covers: gram -
Abdominal infections
GYN infections
includes b.fragilis !!
Cefoxitin
Cefotetan
what could we use ceftaz to tx
HA pneumonia
what would we use to tx Neutropenic fever
Cefepime (Maxipime)
name the carbapenems
Primaxin (imipenem/cilastatin)
Meropenem
Doripenem
Ertapenem
Drug of choice for ceftriaxone-resistant E. coli
carbapenems:
Primaxin (imipenem/cilastatin)
Meropenem
Doripenem
Ertapenem
Name ADRs of carbapenems
Highest risk of seizures
Carbapenem resistant Enterobacteriaceae (CRE)
Expensive
coverage of carbapenems
gram +/- aerobes
name things carbapenems tx:
Ceftriaxone resistant E. coli Klebsiella ESBL Complicated UTI Intraabdominal infection
name coverage of vanco
Gram (+) aerobes & anaerobes
what are indications for using vanco IV
Hospital acquired pneumonia Skin infections (MRSA)
why would you usevanco PO?
tx C. diff - PO
name ADRs of vano
Red-man syndrome
Ototoxicity/ nephrotox
C/I in corn hypersensitivity
Dosing renal & weight adjusted
what is VERY important in putting in your order when dosing vanco
TDM of trough – order 30 min before 4th dose
Name the tetracyclines
Doxycycline (IV or PO)
Tetracycline
Minocycline
indications for tetracyclines:
Respiratory tract infections
Skin infections (MRSA)
Tick-bourne infections
coverage of tetracyclines
Strep
Staph (MSSE, MRSA)
Neisseria sp. (gram (-))
Atypicals (ex. lyme. Mycoplasma, chlamydia)
ADRs of tetracyclines
CI in children under 8 avoid in pregnancy Drug intx w/ Ca, Fe, Mg Al Metabolized in liver GI sensitivity Photosensitivity
what class of dugs has Black box warning for causing tendinopathies (elderly and young)
FQs
what classes of drugs decrease seizure threshold and should be avoided in pts who experience seizures?
FQs
Carbapenems
FQs can tx UTIs EXCEPT:
Moxifloxacin (no gram-)
FQs can tx resp. tract infections EXCEPT
Ciprofloxacin (no gram +)
indications for prescribing FQs
UTI (except moxi)
Respiratory tract infections (except cipro)
Intrabdominal infections
Osteomyelitis
drug class w/ ADRS including: Hypoglycemia/hyperglycemia Delirium in the elderly (mental status change) QTc prolongation
FQs
coverage of FQs
Gram (+) (except cipro)
Gram (-) (except moxi)
Atypical – chlamydia, legionella, mycoplasma
Enterobacteriaceae – H.flu M. cat, Niserria
which class of abx is known to have EXCELLENT atypical coverage?
FQs
what FQs could we use to tx M. tuberculosis
moxi
levo
whoch abx has an ADR of possible causing C. Difficile/ diarrhea
clinda
what abx could we use to tx NF
clinda
coverage of clinda
Strep
Staph (MSSA, MRSA)
Gram (+) anaerobes – w/ PSN allergy
name some indications for prescribing clinda
Skin infections (CA-MRSA) Dental infections Respiratory tract infections Nec fash Pregnant women colonized w/ MRSA
name macrolide abx
Azithromycin (IV or PO)(Z-pak)
Erythromycin (IV or PO)
tx of AOM, pharyngitis in PCN allergy
macrolide (azith/eryth)
coverage of macrolides
Group A strep
GNR – H. flu, M/ cat, Neisseria
Atypicals – chlamydia, legionella, m. pneumonia
what class of abx are NEVER USED for: SEPSIS, urine or soft tissue infections
macrolide
ADRs of macrolides
QTc prolongation (risk of sudden cardiac death) Liver metabolized
macrolides are used to tx respiratory tract infections, pharyngitis in PCN allergy and what else? (2 things)
Chlamydia
Travelers diarrhea
what abx is indicated for coverage of
Anaerobes (b. fragilis + c. diff)
Parasites
Metronidazole (flagyl)
FIRST line for tx of c. diff
Metronidazole (flagyl)
indications to prescribes Metronidazole (flagyl)
Intra-abdominal infections
C. diff – FIRST line
Vaginosis
____________ is often added to other abx when treating intraabdominal infections
Metronidazole (flagyl)
ADRs of Metronidazole (flagyl)
Should not take with alcohol (disulfiram-like reaction)
GI intolerance
Metallic taste
periph. neuropathy