DPT Antibiotics II

Question 1

Linezolid: class, static/cidal, MOA, admin

Answer 1

oxazolidinone. static. binds 50S. PO or IV

Question 2

Linezolid coverage

Answer 2

VRE, MRSA, MSSA, penicillin resistant pneumonia. Can’t help with MRSA in the bloodstream. Is good for VRE, including meningitis.

Question 3

Linezolid side effects

Answer 3

thrombocytopenia, MAO-inhibition (beware serotonin sickness). Fatal lactic acidosis if used > 6 wks. Very expensive.

Question 4

What are the quinilones? How do they work? static/cidal

Answer 4

ciprofloxacin, levofloxacin, moxifloxicin. These are cidal abx that work by inhibiting DNA gyrase and topoisomerase.

Question 5

Ciprofloxacin: uses and administration

Answer 5

gram negatives, including psuedomanas, anthrax, mycoplasma, mycoplasma, legionella, chlamydia, bartonella. Iv or PO
used for pseudomonas coverage impirically, UTIs, prostatitis, traveler’s diarrhea, bartonella henselae, CF prophylaxis

Question 6

ciprofloxacin: side effects

Answer 6

GI, photosensitivity, QT prolongation, tendon rupture. worsening of myasthenia gravis, C diff superinfection.

Question 7

levofloxicin and moxifloxicin: class, uses

Answer 7

quinolones. used to treat MSSA, some MRSA, pneumococcus, vancomysin sensitive enertococcus, GAS, aerobes if not serious, pseudomonas, and other cipro-susceptible bugs. Moxi doesn’t get into the urine, so it can’t be used to treat a UTI.
used for community acuqired pneumonia, mixed soft tissue infections, drug resistant TB (Moxi)

Question 8

Side effects of levofloxicin and moxifloxacin

Answer 8

GI, photosensitivity, QT prolongation, especially with Moxi. tendon rupture. C diff superinfection

Question 9

TMP-SMX: class and MOA. static/cidal.

Answer 9

aka Bactrim (or septra)
folate inhibitor drug combo: TMP inhibits dihydrofolate reductase, and SMX inhibits dihydropteroate synthase  (PABA analogue).  static.

Question 10

TMP-SMX: uses, admin

Answer 10

PO and IV

Used for uncomplicated UTI, nocardiosis, pneumocystis jiroveci, listeriosis.

used for GAS, listeria, shigella, H flu, clamydia trachomatis, pneumocystis (this is important). some strep and resp. anaerobe coverage.

Question 11

TMP-SMX side effects

Answer 11

hypersensitivity, including stevens-Johnson. hyperkalemia, hemolytic anemia in G6PD deficient pts. hyperbilirubinema, so not given in last month of pregnancy (causes kernicteris)

Question 12

metronidazole: MOA, static/cidal

Answer 12

aka Flagyl. unclear MOA- maybe ROS generation. cidal

Question 13

uses of metronidazole:

Answer 13

CNS access, so use for abscesses, meningitis, brain abscesses, endocarditis, bacterial vaginosis, C diff, trichonisis, giardia, E hystolytica, rosacea, H pylori. First line for anaerobes.
covers anaerobes, giardia, entamoeba histolyca, h. hyloria, trichomonas vaginitis. Does NOT cover aerobes.

Question 14

administration of metronidazole

Answer 14

PO, IV, topical, vaginal, rectal

Question 15

metronidazole side effects

Answer 15

strong disulfram rxn (no alcohol!)

GI upset, metallic taste, interactions with coumadin

Question 16

Daptomycin: uses

Answer 16

MRSA bacteremai and right sided endocarditis. VRE. Don’t use it for pneumonia. Also no CNS access.
covers aerobic and facultative aerobic gram positives, VRE, MRSA, coag neg staph, GAS, pnemonococcus.

Question 17

daptomycin side effects

Answer 17

muscle weakness with a rise in CPK. don’t combine with statins. maybe eosinophilic pneumonitis?

Question 18

daptomycin: admin and MOA

Answer 18

pore-forming. cidal. IV.