Antimicrobial Summaries

Question 1

IV only cell wall inhibitors

Answer 1

Pen G, Piperacillin (anti-pseudomonal w/ Tazo), Vancomycin (unless C. diff), Carbapenems

Question 2

Significant adverse reactions of Penicillins

Answer 2

Type 1 reaction (rare), superinfection caused by Amoxicillin

Question 3

Cell wall inhibitors with renal excretion

Answer 3

Penicillins (almost all), Cephalosporins (almost all), Carbapenems, Vancomycin. Virtually every cell wall inhibitor is renally excreted.

Question 4

Pharmacokinetics of Macrolides

Answer 4

Good oral admin. Concentrate in lungs.

Question 5

Adverse reactions of Macrolides

Answer 5

Drug-drug interactions due to inhibition of CYP450 by erythromycin and clarythromycin.

Question 6

Spectrum/uses of Tetracyclines

Answer 6

Broad spectrum, CA-MRSA, Good activity vs atypical organisms chlamydia, mycoplasma

Question 7

Adverse reactions of Tetracyclines

Answer 7

Abnormal bone/tooth development in children, Possible fungal superinfection, Drug-Drug interactions with metal cations

Question 8

Pharmacokinetics of clindamycin

Answer 8

Penetrates into bone

Question 9

Spectrum of clindamycin

Answer 9

Gram + cocci (Pen alternative), anaerobes (NOT C diff), CA-MRSA

Question 10

Significant adverse reactions of clindamycin

Answer 10

Severe diarrhea, pseudomembranous colitis

Question 11

Pharmacokinetics of aminoglycosides

Answer 11

IV/IM, Accumulates in kidney/inner ear, Renal excretion

Question 12

Significant adverse reactions of aminoglycosides

Answer 12

Vestibular and auditory toxicity, nephrotoxicity, requires routine monitoring of Cp levels

Question 13

Spectrum/uses of aminoglycosides

Answer 13

Narrow spectrum, gram - aerobes (E. coli, pseudomonas)

Question 14

Pharmacokinetics of fluoroquinolones

Answer 14

Good oral or IV, Cipro & Levo = renal excretion

Question 15

Spectrum of fluoroquinolones

Answer 15

DNA gyrase inhibition, extended spectrum, Cipro = excellent gram- (pseudomonas, UTIs), Levo = Gram +/- (Respiratory, UTIs)

Question 16

Adverse reactions of fluoroquinolones

Answer 16

Possible superinfections (C diff), possible DDI with antacids.

Question 17

Pharmacokinetics and spectrum of nitrofurantoin

Answer 17

Rapid GI absroption, rapid renal excretion, urinary antiseptic, 1st line agent in UTI, Damages bacterial DNA

Question 18

Pharmacokinetics and spectrum of metronidazole

Answer 18

Good oral, damages bacterial DNA, Effective agains anaerobic bacteria (C diff) and protozoa, causes Antabuse -like reaction against alcohol.