Exam 2: Bacteria And Antibiotics Flashcards
What are the time-dependent, minimal/moderate persistent effect antibacterial? (5)
Cephalosporins
Penicillins
Carbapenems
Macrolides
Oxazolidiones
What are the concentration-dependent, prolonged-persistent effect antibiotics? (2)
Aminoglycosides
Quinolones
What are the time-dependent, prolonged persistent effect antibiotics? (3)
Vancomycin
Azithromycin
Tetracycline
What are the dosing GOALS for time-dependent min./mod. effect drugs? (4)
Prolonged infusion time
Continuous infusion
Shorter dosing interval
Increase dose
What is the dosing GOALS for time-dependent prolonged effect drugs? (1)
Optimize SAFE dose
What are the dosing GOALS for concentration-dependent prolonged effect drugs? (2)
Extended interval dosing
Maximize SAFE dose
What is the KEY PARAMETER for time-dependent min/mod. effect antibiotics?
%T>MIC
What are the KEY PARAMETERS for concentration -dependent prolonged effect antibiotics? (2)
Cmax:MIC
AUC:MIC
What is the KEY PARAMETER for time-dependent prolonged effect antibiotics?
AUC:MIC
What are the PK alterations that occur when the infection site is blood? (2)
Increased Vd and CL
What is the PK alteration that occur when the infection site is the lungs?
Impaired permeability
What is the PK alteration that occur when the infection site is bone?
Impaired permeability
What is the PK alteration that occur when the infection site is the CNS?
Impaired permeability
How do you optimize the dosing regimen of a blood infection? (2)
Add a loading dose
Increase the dose frequency
How do you optimize the dosing regimen of a lung infection? (1)
Increase the dose
How do you optimize the dosing regimen of a soft tissue infection? (1)
Increase the dose ONLY in OBESITY
How do you optimize the dosing regimen of a bone infection? (2)
Increase dose
Increase duration of therapy
(Remember, bone infections are very serious, usually require MRI!)
How do you optimize the dosing regimen of a CNS infection? (1)
Maximize dose
What are the antibiotics WITHOUT renal dosing? (12)
Ceftriaxone
Linezolid
Tigecycline
Clindamycin
Oxacillin
Moxifloxacin
Metronidazole
Azithromycin
Nafcillin
Doxycycline
Erythromycin
Dalfopristin/quinupristin
CLT COMMANDED
What is the resistance mechanism for ciprofloxacin?
Genetic materials are obtained externally (ie. plasmids)
What is the resistance mechanism for vancomycin?
Decreased permeability of cell wall (harder for drug to permeate)
What is the resistance mechanism for Linezolid?
Ribosomal protection
Is Staph. aureus Gram positive or negative?
Positive
Is S. pyogenes Gram positive or negative?
Positive
Is Pseudomonas [aeruginosa] Gram positive or negative?
Negative
What two bacteria do the later generations of cephalosporins cover that the earlier generations don’t?
Pseudomonas
MRSA (cefepime specifically)
What are the 4 classes of beta lactam antibiotics we should know?
Penicillins
Cephalosporins
Carbapenems
Monobactams
Are penicillins bacteriostatic or bactericidal? What classes of bacteria do they usually cover?
Bactericidal
Gram + aerobes, Enterococci, MSSA
*Piperacillin covers Pseudomonas
*combos cover Gram-neg anaerobes
Are cephalosporins bacteriostatic or bactericidal? What classes of bacteria do they usually cover?
Bactericidal
Gram positive aerobes, MSSA
Later gens cover pseudomonas and MRSA (cefepime)
What classes of bacteria do carbapenems usually cover?
Gram positive aerobes
Gram-negative aerobes
Pseudomonas
- exception: ertapenem
** good against extended-spectrum beta-lactamases (ESBLs)
Are aminoglycosides bacteriostatic or bactericidal? What classes of bacteria do they usually cover?
Bactericidal
Gram positive (Gentamicin only, in combo with cell wall active agent)
Which aminoglycoside is the most active against Pseudomonas?
Amikacin
Are tetracyclines bacteriostatic or bactericidal? What classes of bacteria do they usually cover?
Bacteriostatic
**mainly cover atypicals
Also cover Gram + aerobes, MSSA, enterococcus, some MRSA
Are macrolides bacteriostatic or bactericidal? What classes of bacteria do they usually cover?
Bacteriostatic
Gram + aerobes, **atypicals
No Pseudomonas, Gram - anaerobe or MRSA coverage
Is lincosamides [clindamycin] bacteriostatic or bactericidal? What classes of bacteria does it usually cover?
Bacteriostatic
MSSA/Gram + aerobes, some MRSA, some Gram - anaerobes
No Pseudomonas/atypicals coverage
Are fluoroquinolones bacteriostatic or bactericidal? What classes of bacteria do they usually cover?
Bactericidal
Gram + aerobes (Moxifloxacin), Gram - aerobes (Ciprofloxacin), atypicals
Are glycopeptides [VANCOMYCIN] bacteriostatic or bactericidal? What classes of bacteria do they usually cover?
Bactericidal
Gram + aerobes, MRSA, Enterococci
NO pseudomonas, gram - anaerobe, atypical activity
Is daptomycin indicated for pneumonia? What is the main bacteria it is used for?
No! Low pulmonary penetration
Mainly used for MRSA
Is TMP/SMX bacteriostatic or bactericidal? What classes of bacteria does it usually cover?
Bacteriostatic
Gram + aerobes, MRSA, P. carinii
Are nitroimidazoles/metronidazole bacteriostatic or bactericidal? What classes of bacteria do they usually cover?
Bactericidal
**Gram + and - anaerobes!
Are oxazolidinones [linezolid] bacteriostatic or bactericidal? What classes of bacteria do they usually cover?
Bacteriostatic
Gram + aerobes, MRSA, Enterococci
