cardiopulmonary infections - antimicrobials Flashcards
pleuromutilin w/ unique MOA, only indication is CAP in pts w/ normal lungs when other drugs are ineffective
lefamulin, IV
tetracycline useful in combo w/ b-lactam for CAP in those who cannot tolerate a macrolide, low pH can cause local damage
doxycycline
Important consideration when toxic drugs requiring monitoring are administered IV over short periods of time 9ie 30 min); in the case of gentamicin with irreversible effects on bacterial ribosomes, the concentration needs to be high enough to reliably exert those effects but low enough as indicated by the—- to allow for the toxic drugs to exit the host cells (eg proximal tubules, vestibulocochlear hair cells) where they can exert deleterious effects
trough
gen of cephalosporins esp useful in CAP bc of its wide spectrum against G+/- bacteria and stability in the presence of b-lactamase
third
enzyme inhbited by linezolid, responsible for rather unusual adverse effects for an antibiotic including serotonin syndrome
MAO
orally administered 2nd gen cephalosporin
cefaclor
how many weeks must pass w/ daily drug admin for most endocarditis tx regimens
4 weeks
an orally active and inexpensive ergosterol synthesis inhbibitor, and drug of choice for yeast infections has no activity agaisnt molds
fluconazole
among the 3rd gen antibiotics administered orally to treat community acquired pneumonia, also is among the cephalosporins that increases INR
cefditoren
- Common invasive fungal mold infection, especially in neutropenic pts where it can manifest as fever, chest pain, sob, etc. or just fever with imaging evidence of pulmonary nodules? Can cause a chronic slowly progressive pulmonary disease w. pulmonary infiltrates and cavities
aspergillus
a 2nd generation cephalosporin given parenterally and also orally as its axetil prodrug
cefuroxime
overgrowth of this anaerobe can occur in the Gi tract when broad spectrum antibiotics are administered, leads to severe diarrhea, can be a major problem in healthcare facilities, and has a worrisome mortality rate
c. difficile
has a high affinity for ergosterol leading to pre-formation in fungal cell membrane, standard tx for many severe invasive fungal infections byt multiple significant adverse effects
amphotericin B
notable among the cephalosporins for being only agent eliminated by the liver rather than kidneys
ceftriaxone
yeast that is the most common fundal cause of endocarditis; initial therapy is liposomal and amophotericin B +/- flucytosine or a high dose of an echinocandin
candida
vaccine against a broader range of S. pneumoniae serotype, but does not elicit a satisfactory immune response in those younger than 2 yo. Recommended for those over 65 and younger people who smoke
pneumovax 23
- Broad-spectrum orally active class of drugs w/ activity against gram – bacteria; current agents now also target gram + bacteria
fluoroquinolones
- Type of pneumonia seen more often in the very young, elderly and in its more severe forms in those who are immune compromised
viral
notable among the 3rd gen cephalosporins for having activity against pseudomonas
ceftazidime
- Was a drug of choice for aspiration pneumonia due to its spectrum of activity that includes most anaerobic bacteria (eg abundant in oral cavity); frequent cause of C. difficile colitis on exam questions
clindamycin
- At least 6 of these are required to pass with regular drug administration for successful treatment of tb, contributes to adherence challenges
6 months
- S. pneumoniae vaccine admin to newborns at 2,4,6 and 12-15 mo of age and sometimes to those >age 65
prevnar 13
Member of the newer echinocandin class of antifungal agents with excellent activity against invasive yeast infections, it also has few adverse effects especially when compared to amphotericin B
micafungin
3rd gen fluoroquinolone, “respiratory”activity but also useful against Pseudomonas
levofloxacin
