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Pharm/Pharmacotherapeutics I > Antibiotics in Pulmonary Diseases > Flashcards

Antibiotics in Pulmonary Diseases Flashcards

1
Q

Cell Wall Synthesis Inhibitors

A

For organisms that need peptidoglycan
MOA: bind D-ala-D-ala portion preventing peptidoglycan synthesis (Ex: vancomycin); bind to Penicillin Binding Protein and prevent peptidoglycan cross-linking (Ex: beta lactams)

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2
Q

Protein Synthesis Inhibitors

A

mnemonic (Buy AT 30 CCEL at 50)
30S: Aminoglycosides, Tetracyclines
50S: Chloramphenicol, Clindamycin, Erythromycin (macrolides), Linezolid

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3
Q

DNA Topoisomerase Inhibitors

A

MOA: Inhibit II & IV
Ex: fluoroquinolones

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4
Q

Mechanisms of Bacteria Resistance

A

Beta-lactams: beta lactamases, carbapenemases, MRSA has altered Penicillin Binding Proteins (PBP)

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5
Q

Beta Lactams Adverse Effects

A

Hypersensitivity, Type I IgE reactions, rash, hemolysis

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6
Q

Chlamydiophyla

A

Atypical
Technically gram -
Covered by FQ, macrolides, clindamycin, chloramphenicol, tetracyclines

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7
Q

Haemophilus influenzae

A

Typical
Gram - rod
Covered by: aminopenicillins, piperacillin, carbapenems, aztreonam, FQ, cephalosporins, GNATS, macrolides, tetracyclines, TMP/SMX

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8
Q

Klebsiella

A 
Typical
Gram - rods
Primarily nosocomial 
Alcoholics
Covered by: 3rd Gen cephalosporins (ceftriaxone), FQ, piperacillin, carbapenems
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9
Q

Legionella

A

Atypical
Gram - rod but doesn’t stain w/ common reagents!
Covered by: FQ, macrolides, SMX/TMP, tetracyclines

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10
Q

Mycoplasma pneumoniae

A

Atypical (no peptidoglycan wall)
Most common atypical
Covered by: FQ, macrolides, tetracyclines, tigecycline

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11
Q

Pseudomonas aeruginosa

A

Typical
Gram - rods
Covered by: Piperacillin/tazobactam, imipenem, aztreonam, FQ (cipro, levo), GNATS

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12
Q

Staph aureus (MSSA)

A

Typical
Gram + cocci
Coveredy by: antistaph penicillins, amoxicillin-clavulanate, carbapenems, FQ, GNATS, macrolides, tetracyclines, vancomycin, SMX/TMP

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13
Q

Staph aureus (MRSA)

A

Typical
Gram + cocci
Covered by: Tetracyclines, Vancomycin, SMX/TMP, FQ (community acquired only)

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14
Q

Strep pneumoniae

A

Typical
Gram + cocci
Covered by: beta lactams, FQ (not cipro!!!), clindamycin, macrolides, tetracyclines, vancomycin, TMP/SMX

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15
Q

Acute pharyngitis

A 
Viral in 80-95%
Reserve abx for confirmed GABHS
Penicillin or amoxicillin
1st gen cephalosporin for minor allergy
Clindamycin for severe allergy
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16
Q

Acute Bacterial Rhinosinusitis

A 
Abx given when:
persistent & not improving > or = 10 days
Severe (> or = 3-4 days) or worsening
Typically Strep pneumo or H. influenzae
Treat with Amoxicillin-clavulanate
17
Q

Kids allergic to penicillin

A

Give Cefixime plus Clindamycin with non type I reaction

Give Levofloxacin if type I hypersensitivity

18
Q

CAP in Adults

A

Typicals: S. pneumo, H. influenzae, viruses (influenza A and B, adenovirus, RSV, parainfluenza), atypicals: M. pneumo, C. pneumo

19
Q

CAP (inpatient non-ICU)

A

S. pneumo, M. pneumo, C. pneumo, H. influenzae, Legionella, aspiration, viruses

20
Q

CAP (inpatient ICU)

A

S. pneumo, S. aureus, legionella, gram negative bacilli, H. influenzae

21
Q

Empiric Therapy (outpatient)

A

Healthy: macrolide or doxycycline
Comorbidities: resp FQ + macrolide

22
Q

Empiric Therapy (inpatient non-ICU)

A

Resp FQ + macrolide

23
Q

Empiric Therapy (inpatient ICU)

A

Beta-lactam + azithromycin or resp FQ

24
Q

Empiric Therapy (Pseudomonas risk)

A

Piperacillin/tazobactam + cipro or levo

Pip/taz + aminoglycoside and azithromycin

25
Q

Empiric Therapy (CA-MRSA risk)

A

Add vancomycin or linezolid

26
Q

HAP and VAP

A

Often caused by gram negative bacilli (Klebsiella, E. coli, Pseudomonas)

27
Q

CAP in Babies

A

Up to 1 month: vaginal flora, group B strep, H. flu, E. coli

Prescribe: Ampicillin/sulbactam, cephalosporin, or carbapenem

28
Q

CAP in Babies

A

1-3 months: atypicals, S. aureus, S. pneumo

Prescribe: azithromycin, SMX/TMP

29
Q

CAP in Kids (outpatient)

A

Usually viral
Amoxicillin is first line for healthy, immunized kids
Macrolide for atypicals

30
Q

CAP in Kids (inpatient)

A

S. pneumo
If susceptible, use Ampicillin or Pen G for immunized kids
Ceftriaxone for non-immunized

31
Q

Vancomycin Adverse Effects

A

Nephrotoxic, ototoxic, red man syndrome

32
Q

Aminoglycosides Adverse Effects

A

Nephrotoxic, neuromuscular blockade, ototoxic, teratogenic

33
Q

Tetracyclines Adverse Effects

A

GI distress, chelation in teeth & bone, inhibition of bone growth, photosensitivity, contraindicated in pregnancy

34
Q

Macrolides Adverse Effects

A

GI, prolonged QT interval, hepatotoxic

35
Q

Fluoroquinolones Adverse Effects

A

Photosensitivity, chelation, QT prolongation, tendinitis

Phototoxicity: The Sun Fries (tetracyclines, sulfonamides, fluoroquinolones)

Pharm/Pharmacotherapeutics I (3 decks)

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