"Big Guns" ...100% sensitive and specific for.... Flashcards
What % of Bactrim is absorbed orally?
85%
What % of Ampicillin is absorbed orally?
50%
Can Ampicillin achieve therapeutic levels in CSF?
Yes, if meninges inflamed
How is Bactrim excreted?
In the urine. Hence, this is a good drug for UTI
Where is Bactrim metabolized?
Liver
Is Bactrim available IV?
Yes
In addition to Grey Baby Syndrome, what is another possible rare, but serious adverse effect to Chloramphenicol?
Aplastic anemia
Which generations of cephalosporins penetrate into CSF?
3 and 4 (except cefoperazone and perhaps cefixime. Cefuroxime achieves CSF levels but 3rd gen agents preferred because of greater penetration and more rapid sterilization)
Most penicillins are excreted by
the kidneys. Renal impairment requires adjustment
1/2 life of PCNs in adults with normal renal function?
30 to 90 mins
The beta lactam/beta lactamase inhibitors diffuse into most body tissues, with the exception of
brain and CSF
Most of the oral and parenteral cephalosporins are excreted by the kidney, with the exception of
Ceftriaxone (eliminated by the liver)
Cephalosporins: bactericidal or bacteriostatic?
time- dependent bactericidal
Distribution of aztreonam?
Aztreonam distributes well into most tissues, with a volume of distr. of 0.16 L/kg. Penetration into CSF is increased in the presence of inflamed meninges
Aztreonam is excreted____
primarily unchanged by glomerular filtration. Dosage adjustments are necessary in pts with renal insufficiency
Aztreonam has activity against which gram-positive organisms?
None! Aztreonam has virtually no activity against GP orgs
This drug is a reasonable substitute for the aminoglycosides in treating GN infections in pts at high risk for toxicity
Aztreonam
Distribution of carbapenems?
They are widely distributed into most tissues, with an approx. volume of distribution of 0.25 L/kg. Penetration into the CSF varies and depends on the degree of meningeal inflammation
Are any of the carbapenems available PO?
No
Carbapenems are excreted_____
primarily by urinary excretion of unchanged drug
Carbapenems: bactericidal or bacteriostatic?
time-dependent bactericidal (much like other beta lactams)
Ertapenem has no activity against _________ or ______
Pseudomonas aeruginosa; Acinetobacter sp
Neurotoxicity is a well known adverse event of this group of antibiotics, characterized by seizure activity
Carbapenems
Which of the carbapenems is most likely to cause a seizure?
Imipenem
A pt with a seizure disorder needs a carbapenem. Which one is the first one you would consider?
Meropenem or doripenem
Probenecid increases the half life of the penicillins, many beta lactams, and these carbapenem drugs
Meropenem and doripenem (a similar interaction with imipenem occurs, but to a lesser degree)
Fluoroquinolones: Bactericidal or bacteriostatic?
Bactericidal - Concentration dependent killing effect
Distribution of the fluoroquinolones?
Distribute well into most tissues (approx. 1.5 to 6.1 L/kg) and fluids EXCEPT THE CNS!
All fluoroquinolones undergo renal elimination with the exception of
moxifloxacin
The macrolides are metabolized via the _____ and excreted _______
liver; in the urine
Your pt has renal failure, and needs a macrolide. Which of the macrolides require dosage adjustment?
Clarithromycin (Biaxin) and erythromycin
