Exam 2: Bacteria And Antibiotics

Question 1

What are the time-dependent, minimal/moderate persistent effect antibacterial? (5)

Answer 1

Cephalosporins
Penicillins
Carbapenems
Macrolides
Oxazolidiones

Question 2

What are the concentration-dependent, prolonged-persistent effect antibiotics? (2)

Answer 2

Aminoglycosides
Quinolones

Question 3

What are the time-dependent, prolonged persistent effect antibiotics? (3)

Answer 3

Vancomycin
Azithromycin
Tetracycline

Question 4

What are the dosing GOALS for time-dependent min./mod. effect drugs? (4)

Answer 4

Prolonged infusion time
Continuous infusion
Shorter dosing interval
Increase dose

Question 5

What is the dosing GOALS for time-dependent prolonged effect drugs? (1)

Answer 5

Optimize SAFE dose

Question 6

What are the dosing GOALS for concentration-dependent prolonged effect drugs? (2)

Answer 6

Extended interval dosing
Maximize SAFE dose

Question 7

What is the KEY PARAMETER for time-dependent min/mod. effect antibiotics?

Answer 7

%T>MIC

Question 8

What are the KEY PARAMETERS for concentration -dependent prolonged effect antibiotics? (2)

Answer 8

Cmax:MIC
AUC:MIC

Question 9

What is the KEY PARAMETER for time-dependent prolonged effect antibiotics?

Answer 9

AUC:MIC

Question 10

What are the PK alterations that occur when the infection site is blood? (2)

Answer 10

Increased Vd and CL

Question 11

What is the PK alteration that occur when the infection site is the lungs?

Answer 11

Impaired permeability

Question 12

What is the PK alteration that occur when the infection site is bone?

Answer 12

Impaired permeability

Question 13

What is the PK alteration that occur when the infection site is the CNS?

Answer 13

Impaired permeability

Question 14

How do you optimize the dosing regimen of a blood infection? (2)

Answer 14

Add a loading dose
Increase the dose frequency

Question 15

How do you optimize the dosing regimen of a lung infection? (1)

Answer 15

Increase the dose

Question 16

How do you optimize the dosing regimen of a soft tissue infection? (1)

Answer 16

Increase the dose ONLY in OBESITY

Question 17

How do you optimize the dosing regimen of a bone infection? (2)

Answer 17

Increase dose
Increase duration of therapy

(Remember, bone infections are very serious, usually require MRI!)

Question 18

How do you optimize the dosing regimen of a CNS infection? (1)

Answer 18

Maximize dose

Question 19

What are the antibiotics WITHOUT renal dosing? (12)

Answer 19

Ceftriaxone
Linezolid
Tigecycline

Clindamycin
Oxacillin
Moxifloxacin
Metronidazole
Azithromycin
Nafcillin
Doxycycline
Erythromycin
Dalfopristin/quinupristin

CLT COMMANDED

Question 20

What is the resistance mechanism for ciprofloxacin?

Answer 20

Genetic materials are obtained externally (ie. plasmids)

Question 21

What is the resistance mechanism for vancomycin?

Answer 21

Decreased permeability of cell wall (harder for drug to permeate)

Question 22

What is the resistance mechanism for Linezolid?

Answer 22

Ribosomal protection

Question 23

Is Staph. aureus Gram positive or negative?

Answer 23

Positive

Question 24

Is S. pyogenes Gram positive or negative?

Answer 24

Positive

Question 25

Is Pseudomonas [aeruginosa] Gram positive or negative?

Answer 25

Negative

Question 26

What two bacteria do the later generations of cephalosporins cover that the earlier generations don’t?

Answer 26

Pseudomonas MRSA (cefepime specifically)

Question 27

What are the 4 classes of beta lactam antibiotics we should know?

Answer 27

Penicillins Cephalosporins Carbapenems Monobactams

Question 28

Are penicillins bacteriostatic or bactericidal? What classes of bacteria do they usually cover?

Answer 28

Bactericidal Gram + aerobes, Enterococci, MSSA *Piperacillin covers Pseudomonas *combos cover Gram-neg anaerobes

Question 29

Are cephalosporins bacteriostatic or bactericidal? What classes of bacteria do they usually cover?

Answer 29

Bactericidal Gram positive aerobes, MSSA Later gens cover pseudomonas and MRSA (cefepime)

Question 30

What classes of bacteria do carbapenems usually cover?

Answer 30

Gram positive aerobes Gram-negative aerobes Pseudomonas - exception: ertapenem ** good against extended-spectrum beta-lactamases (ESBLs)

Question 31

Are aminoglycosides bacteriostatic or bactericidal? What classes of bacteria do they usually cover?

Answer 31

Bactericidal Gram positive (Gentamicin only, in combo with cell wall active agent)

Question 32

Which aminoglycoside is the most active against Pseudomonas?

Answer 32

Amikacin

Question 33

Are tetracyclines bacteriostatic or bactericidal? What classes of bacteria do they usually cover?

Answer 33

Bacteriostatic **mainly cover atypicals Also cover Gram + aerobes, MSSA, enterococcus, some MRSA

Question 34

Are macrolides bacteriostatic or bactericidal? What classes of bacteria do they usually cover?

Answer 34

Bacteriostatic Gram + aerobes, **atypicals No Pseudomonas, Gram - anaerobe or MRSA coverage

Question 35

Is lincosamides [clindamycin] bacteriostatic or bactericidal? What classes of bacteria does it usually cover?

Answer 35

Bacteriostatic MSSA/Gram + aerobes, some MRSA, some Gram - anaerobes No Pseudomonas/atypicals coverage

Question 36

Are fluoroquinolones bacteriostatic or bactericidal? What classes of bacteria do they usually cover?

Answer 36

Bactericidal Gram + aerobes (Moxifloxacin), Gram - aerobes (Ciprofloxacin), atypicals

Question 37

Are glycopeptides [VANCOMYCIN] bacteriostatic or bactericidal? What classes of bacteria do they usually cover?

Answer 37

Bactericidal Gram + aerobes, MRSA, Enterococci NO pseudomonas, gram - anaerobe, atypical activity

Question 38

Is daptomycin indicated for pneumonia? What is the main bacteria it is used for?

Answer 38

No! Low pulmonary penetration Mainly used for MRSA

Question 39

Is TMP/SMX bacteriostatic or bactericidal? What classes of bacteria does it usually cover?

Answer 39

Bacteriostatic Gram + aerobes, MRSA, P. carinii

Question 40

Are nitroimidazoles/metronidazole bacteriostatic or bactericidal? What classes of bacteria do they usually cover?

Answer 40

Bactericidal **Gram + and - anaerobes!

Question 41

Are oxazolidinones [linezolid] bacteriostatic or bactericidal? What classes of bacteria do they usually cover?

Answer 41

Bacteriostatic Gram + aerobes, MRSA, Enterococci