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NAPLEX > Antimicrobials > Flashcards

Antimicrobials Flashcards

1
Q

Gentamicin

A

Class: Aminoglycosides

TD: 1-2.5 mg/kg/dose
EID: 4-7mg/kg/dose

IV, IM, ophthalmic, topical

Renal: Q8H (CrCl >60), Q12H (40-60), Q24H (20-40), or PRN (

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2
Q

Tobramycin

A

Class: Aminoglycosides

TD: 1-2.5 mg/kg/dose
EID: 4-7mg/kg/dose

IV, IM, ophthalmic, inhaled (TOBI)

Renal: Q8H (CrCl > 60), Q12H (40-60), Q24H (20-40), PRN (

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3
Q

Streptomycin

A

Class: Aminoglycosides

Dosing: 15 mg/kg IM Q24H (max 1g)
25-30 mg/kg IM 2-3x Qwk
(max 1.5g)

Renal: Q24-72H (CrCl 10-50), Q72-96H
(

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4
Q

Amikacin

A

Class: Aminoglycosides

TD: 5-7.5 mg/kg/dose
EID: 15-20 mg/kg/dose

IV, IM

Renal: Q8H (CrCl >60), Q12H (40-60), Q24H (20-40), PRN (

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5
Q

Natural Penicillins

A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal (except Enterococci)

Coverage: Strep (DOC for Group A), some Enterococcus, PO anaerobes, Syphilis; minor Staph (

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6
Q

Penicillin V

A

Pen VK
Class: Natural Penicillins

Dosing: 125-500 mg PO Q6H

Tablet, suspension

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, taste disturbance, rash, BMS, AIN, C.diff infection, seizures (accumulation)

Tablet taken on empty stomach
Suspension should be refrigerated

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7
Q

Aminoglycosides

A

MOA: 30S & 50S subunit binding that inhibits protein synthesis
Concentration-dependent killing
Peak/AUC
Bactericidal

Coverage: Gm (-) species; Gent/Strepto provide synergy for Gm (+) infections when combined with Beta lactams or Vanc

BBW: neurotoxicity, nephrotoxicity, fetal harm (Category D)

Monitoring: Hartford Nomogram (extended interval dosing)

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7
Q

Penicillin G

A

Benzathine (Bicillin L-A) & Procaine (Bicillin C-R)
Class: Natural Penicillins

Dosing: 1.2-2.4 MU IM
Frequency varies on indication

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

BBW: can cause cardiorespiratory arrest or death if given IV

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8
Q

Penicillin G (Aqueous)

A

Pfizerpen-G
Class: Natural Penicillins

Dosing: 2-4 MU IV Q4-6H

Renal dose adjustments

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

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9
Q

Aminopenicillins

A

MOA: inhibits transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal (except Enterococci)

Coverage: Strep, Enterococcus (DOC), Listeria, and limited Gm (-)
No MSSA, Klebsiella,
Moraxella, or SPICE A
E. faecium usually resistant

Pregnancy Category B

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10
Q

Amoxicillin

A

Amoxil, Trimox, Moxatag
Class: Aminopenicillins

Dosing: 250-500 mg PO Q8H
500-875 mg PO Q12H
775 mg XR PO Q24H

Tablet, chewable, capsule, suspension

Renal dose adjustments

DOC: AOM, H. pylori, IE ppx

SE: hypersensitivity (inc. anaphylaxis), taste disturbance, GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

PO suspension refrigerated for taste; stable 14D at RT
Moxatag taken w/in 1 hour of meal end
PO bioavailability 75-90%

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11
Q

Amoxicillin/Clavulanate

A

Augmentin, Augmentin XR, Amoclan
Class: Aminopenicillin/Beta-lactamase

Coverage: anaerobes
No SPICE A

Dosing: 500 mg PO TID
875 mg PO BID
2g XR PO BID

Tablet, chewable, suspension

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), taste disturbances, GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

CI (XR only): hx of cholestatic jaundice, hepatic dysfunction, or CrCl

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12
Q

Ampicillin

A

Class: Aminopenicillins

Dosing: 250-500 mg PO Q6H
1-2g IV Q4-6H

IV, IM, capsule, suspension

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), taste disturbance, GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

PO on empty stomach (1H prior/2H after)
IV only compatible in NS; stable at RT for 8H

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13
Q

Ampicillin/Sulbactam

A

Unasyn
Class: Aminopenicillin/Beta-lactamase Inhibitor

Coverage: anerobes, Acinetobacter
No SPICE

Dosing: 1.5-3G IV Q6H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

Only compatible in NS

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14
Q

Antistaphylococcal Penicillins

A

MOA: inhibits transpeptidation in cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal (except Enterococci)

Coverage: MSSA (DOC) & Strep
No MRSA or Coag (-) Staph

Pregnancy Category B

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15
Q

Nafcillin

A

Class: Antistaphylococcal Penicillins

Dosing: 1-2g IV/IM Q4-6H

IV, IM

No renal dosing adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, hepatitis/increased LFTs, BMS, AIN, C.diff infection, seizures (accumulation)

Most tolerated in class (better for long-term therapy)

Vesicant (tx: hyaluronidase & cold packs)

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16
Q

Oxacillin

A

Class: Antistaphylococcal Penicillins

Dosing: 250-2000 mg IV Q4-6H

No renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, hepatitis/increased LFTs, BMS, AIN, C.diff infection, seizures (accumulation)

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17
Q

Dicloxacillin

A

Class: Antistaphylococcal Penicillins

Dosing: 125-500 mg PO Q6H

No renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, taste disturbances, rash, hepatitis/increased LFTs, BMS, AIN, C.diff infection, seizures (accumulation)

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18
Q

Ureidopenicillins
&
Carboxypenicillins

A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing
Bactericidal (except Enterococci)

Coverage: MSSA, Strep, Gm (-) organisms inc. SPICE A, anaerobes (d/t beta-lactamase inhibitors)

Pregnancy Category B

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19
Q

Piperacillin/Tazobactam

A

Zosyn
Class: Ureidopenicillin/Beta-lactamase

Coverage: anerobes, SPICE A
No MRSA, VRE, Coag (-) Staph,
atypicals (CML), ESBLs

Dosing: 3.375-4.5g IV Q6-8H
Extended infusion dosing

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

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20
Q

Ticarcillin/Clavulanic Acid

A

Timentin
Class: Carboxypenicillin/Beta-lactamase Inhibitor

Coverage: anerobes, Stenotropomonas, SICE A
No Pseudomonas or
Enterococci

Dosing: 3.1g IV Q4-6H

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

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21
Q

Penicillin Drug Interactions

A

Probenecid: reduced PCN renal elimination

Methotrexate: increased [MTX]

Tetracyclines (& bacteriostatic agents): reduced PCN effectiveness by slowing bacterial growth

Mycophenolate: reduced active metabolites d/t impaired enterohepatic recirculation

Warfarin: increased INR (except Dicloxacillin & Nafcillin)

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22
Q

1st Generation Cephalosporins

A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal

Coverage: MSSA, minor Strep, Proteus, E.coli, Klebsiella (PEK)

BBW: PCN cross-reactivity

Pregnancy Category B

23
Q

Cefadroxil

A

Class: 1st Generation Cephalosporins

Dosing: 500-1000 mg PO Q12H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

24
Q

Cefazolin

A

Ancef, Kefzol
Class: 1st Generation Cephalosporins

DOC for severe MSSA infections in PCN allergic patients

Dosing: 1-1.5g IV/IM Q8H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

25
Q

Cephalexin

A

Keflex
Class: 1st Generation Cephalosporins

Dosing: 250-1000 mg PO Q6H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

26
Q

2nd Generation Cephalosporins

A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal

Coverage: MSSA, Strep, Haemophilus, Neisseria (HNPEKS)

BBW: PCN cross-reactivity

Pregnancy Category B

27
Q

Cefaclor

A

Class: 2nd Generation Cephalosporins

Dosing: 250-500 mg PO Q8H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

28
Q

Cefotetan

A

Class: 2nd Generation Cephalosporins

Coverage: anaerobes (B. fragilis has high resistance rates), reduced Gm (+)

Dosing: 1-2g IV/IM Q12H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

N-methylthiotetrazole (NMTT) side chain causes hypoprothrombinemia & disulfiram-like reaction

29
Q

Cefoxitin

A

Class: 2nd Generation Cephalosporins

Coverage: anaerobes, reduced Gm (+)

Dosing: 1-2g IV/IM Q6-8H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

30
Q

Cefprozil

A

Class: 2nd Generation Cephalosporins

Dosing: 250-500 mg PO Q12H-24H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

31
Q

Cefuroxime

A

Ceftin, Zinacef
Class: 2nd Generation Cephalosporins

Dosing: 250-1500 mg Q8-12H

PO, suspension, IV, IM

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

Suspension taken with food

32
Q

3rd Generation Cephalosporins

A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal

Coverage: Strep, minor Staph, Serratia (HNPEKS), enteric Gm (-) rods

BBW: PCN cross-reactivity

Pregnancy Category B

33
Q

Cefdinir

A

Omnicef
Class: 3rd Generation Cephalosporins

Dosing: 300 mg PO Q12H
600 mg PO Q24H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

34
Q

Cefditoren

A

Spectracef
Class: 3rd Generation Cephalosporins

Dosing: 200-400 mg PO Q12H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

Tablets take with food

35
Q

Cefixime

A

Suprax
Class: 3rd Generation Cephalosporins

Dosing: 400 mg PO div Q12-24H

Tablets, chewable

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

Chewable tablets contain phenylalanine

35
Q

Cefotaxime

A

Claforan
Class: 3rd Generation Cephalosporins

Dosing: 1-2g IV/IM Q4-12H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

36
Q

Cefpodoxime

A

Class: 3rd Generation Cephalosporins

Dosing: 100-400 mg PO Q12H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

36
Q

Ceftazidime

A

Fortaz, Tazicef
Class: 3rd Generation Cephalosporins

Coverage: Gm (-) inc. Pseudomonas
           No Gm (+) or anaerobes

Dosing: 1-2g IV/IM Q8-12

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

37
Q

Ceftibuten

A

Cedax
Class: 3rd Generation Cephalosporins

Dosing: 400 mg PO Q24H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

Take suspension on empty stomach

38
Q

Ceftriaxone

A

Rocephin
Class: 3rd Generation Cephalosporins

Dosing: 1-2g IV/IM Q12-24H

No renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)
CNS toxicity (encephalopathy, AMS, seizures)

CI: hyperbilirubinemic neonates, concurrent use of Ca-containing IVs in neonates

39
Q

4th Generation Cephalosporins

A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal

Coverage: Strep, minor Staph, HNPEKS, & SPICE A, weak anaerobes

BBW: PCN cross-reactivity

Pregnancy Category B

41
Q

Cefepime

A

Maxipime
Class: 4th Generation Cephalosporins

Coverage: Weak anaerobes
No Enterococcus

DOC neutropenic fever

Dosing: 1-2g IV/IM Q12-24H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)
CNS toxicity (encephalopathy, AMS, seizures)
42
Q

5th Generation Cephalosporins

A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal

Coverage: Staph (inc. MRSA), VRSA, Strep, Enterococcus (inc. VRE), HNPEKS
No ESBL or Pseudomonas

BBW: PCN cross-reactivity

Pregnancy Category B

44
Q

Ceftaroline fosamil

A

Teflaro
Class: 5th Generation Cephalosporins

Dosing: 600 mg IV Q12H

Renal: 400 mg (CrCl 30-50), 300 mg (15-30), 200 mg (

45
Q

Ceftolozane/Tazobactam

A

Zerbaxa
Class: 5th Generation Cephalosporin/Beta-lactamase Inhibitor

Dosing: 1.5g IV Q8H

Renal: 750 mg (CrCl 30-50), 375 mg (15-29)

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

Indications: complicated intra-abdominal infections & UTIs

46
Q

Cephalosporin Drug Interactions

A

Probenecid: reduced PCN renal elimination

Warfarin: increased INR by inhibition of Vit K-dependent clotting factors

48
Q

Carbapenems

A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal

Coverage: Gm (+), Gm (-) inc. SPICE A & ESBLs
No atypicals, MRSA, VRE,
Stenotropomonas

BBW: PCN cross-reactivity, CNS adverse effects (seizures, AMS)

Pregnancy Category B/C (Imipenem)

49
Q

Imipenem/Cilastatin

A

Primaxin
Class: Carbapenem/DHP-1 Inhibitor

Dosing: 250-1000 mg IV Q6-8H

SE: hypersensitivity (inc. anaphylaxis), rash, GI upset, BMS, seizures (accumulation)

Highest risk of seizures with renal impairment

50
Q

Meropenem

A

Merrem
Class: Carbapenems

Dosing: 500-2000 mg IV Q8H

Renal: Q12H (CrCl 26-50), 1/2 dose Q12H (10-25), 1/2 dose Q24H (

51
Q

Ertapenem

A

Invanz
Class: Carbapenems

Coverage: no Pseudomonas or Acinetobacter

Dosing: 1g IV/IM Q24H

Renal: 500 mg (CrCl

52
Q

Doripenem

A

Doribax
Class: Carbapenems

Dosing: 500 mg IV Q8H

Renal: 250 mg (CrCl 30-50), 250 mg Q12H (11-29)

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, seizures (accumulation)

Increased mortality/decreased cure rate in HCAP/VAP- do not use

57
Q

Carbapenem Drug Interactions

A

Probenecid: reduced PCN renal elimination

Depakote: decreased [VPA] lessens seizure control

58
Q

Monobactams

A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal

Coverage: Gm (-) inc. Pseudomonas
         No Gm (+)

Pregnancy Category B

Can be used in PCN allergic patients

59
Q

Aztreonam

A

Azactam IV, Cayston
Class: Monobactams

Dosing: 500-2000 mg IV Q6-12H

Renal: 50% normal (CrCl 10-30), 25% (

62
Q

Fluoroquinolones

A

MOA: inhibits topoisomerase IV & II (DNA gyrate) & prevents DNA supercoiling, promoting breakage of double-stranded DNA

Coverage: Gm (+), Gm (-), atypicals
Respiratory FQ (G/L/M):
enhanced Strep & atypical
C/L: Pseudomonas

BBW: tendon inflammation/rupture, QT prolongation, peripheral neuropathies, CNS effects, photosensitivity

Pregnancy Category C

Caution with use in children

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