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D&D > Exam 4 - Antibiotic Mayhem > Flashcards

Exam 4 - Antibiotic Mayhem Flashcards

1
Q

Cell Wall Synthesis Inhibitors and Mechanism of Action

A

Penicillins - Stage 3 CW
Cephalosporins - Stage 3 CW
Vancomycin - Stage 2 CW
All are bactericidal

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2
Q

Penicillin Antibiotics (6)

A

Penicillin G - narrow spectrum (IV/IM)
Penicillin V - narrow spectrum (oral)
Dicloxacillin - penicillinase resistant (+MSSA)
Amoxicillin+Clavulanate (extended+ßlac inhibitor)
Ampicillin (extended)
Piperacillin-Tazobactam (anti-pseudomonal, IV only)

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3
Q

Penicillin Excretion and Adverse Reactions

A

Renal excretion - dose adjustment
Anaphylaxis (Type I, rare) - switch to Macrolides
Rash (common) - Cephalosporins OK
Extended spec: superinfection (CDAD)

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4
Q

Cephalosporin Antibiotics

A

1st Gen: Cefazolin (IV/IM), Cephalexin (oral)

3rd Gen: Ceftriaxone (parenteral only, good CNS)

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5
Q

Cephalosporin Excretion and Adverse Reactions

A

Renal excretion - dose adjustment

3rd Gen: superinfection (CDAD)

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6
Q

Vancomycin

A

Poor oral
Renal excretion
AR: Redman syndrome, oto/renal toxicity
Must monitor Cp levels

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7
Q

Protein Synthesis Inhibitors and Mechanisms of Action (4)

A 
Macrolides - 50S subunit (23S rRNA)
Tetracyclines - 30S subunit
Clindamycin - 50S subunit
Aminoglycoside - 30S subunit (-CIDAL)
Most are bacteriostatic
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8
Q

Macrolides Antibiotics and Absorption

A

Azithromycin
Erythromycin (inhibit P450)
Clarithromycin (inhibit P450)
Good oral and IV

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9
Q

Macrolides - Adverse Reactions

A 
GI upset (esp Ery)
DDI - P450 inhibition (Ery and Clar)
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10
Q

Macrolides - Coverage

A

Used if penicillin hypersensitivity

+Atypical

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11
Q

Tetracycline Antibiotics and Elimination

A

Doxycycline - oral, biliary excretion
Tetracycline - oral, renal excretion
Crosses placenta

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12
Q

Tetracyclines Adverse Reactions

A

Abnml bone/tooth development (Ca2+ chelation)
n/v, diarrhea (tetra>doxy)
Fungal superinfection
DDI - metal cations in stomach

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13
Q

Tetracyclines - Coverage

A

Broad version of Macrolides

Expanded to G- (including bacteroides)

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14
Q

Clindamycin - absorption, elimination, adverse reactions

A

Oral, IV
Hepatobiliary excretion
Bone penetration
Severe diarrhea/pseudomembranous colitis (C. Diff)

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15
Q

Aminoglycosides absorption, elimination, use, adverse reactions

A 
parenteral only
Renal excretion
G- aerobes
AR: Oto/renal toxicity
Must monitor Cp levels
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16
Q

Inhibitors of DNA Function and Mechanisms of Action

A

Fluoroquinolones - DNA gyrase
Nitrofurantoin - reduced, damage DNA
Metronidazole - reduced, interfer w/ DNA function
Sulfamethoxazole+trimethoprim - folate metabolism
BACTERICIDAL

17
Q

Fluoroquinolone Antibiotics - absorption and exrection

A

Ciprofloxacin - renal
Levofloxacin - renal
Moxifloxacin - hepatic
Oral or IV

18
Q

Fluoroquinolone adverse reactions

A

Superinfections (CDAD)

DDI - antacids, decrease absorption

19
Q

Fluoroquinolone coverage

A

G- including pseudomonas (except Moxi)

Atypical

20
Q

Nitrofurantoin

A 
Urinary antiseptic (rapid kidney excretion)
UTI tx (especially if TMP-SMX resistance)
AR: GI upset
21
Q

Metronidazole absorption, excretion, use, AR

A

oral
hepatic exrection
covers anaerobic bacteria (necessary for activation)
Antabuse reaction - inhibits aldehyde dehyrdogenase
(avoid EtOH or n/v, HA, flushing)
Candidal superinfection

22
Q

Sulfamethoxazole+trimethoprim MOA and absorption

A

Bacteriostatic if used alone
Bactericidal if combo
Oral and IV

23
Q

SMX/TMP AR

A

kernicterus in neonates

Hypersensitivity skin reactions

24
Q

Pregnancy concern

A

Doxycycline
Aminoglycosides
TMP-SMX
Fluroquinolones (arthropathies)

25
Q

Not PO

A

Aminoglycosides
Pip-Taz
Vancomycin
Ceftriaxone

26
Q

Covers pseudomonas

A

Aminoglycosides
PIP-Taz
Ceftriaxone
FQ - Ciprofloxacin, Levofloxacin

27
Q

Covers C. Diff

A

Metronidazole

Vancomycin

28
Q

Select for C. Diff

A

Amox-clav
Clindamycin
Fluroquinolones
Ceftriaxone

29
Q

DQ-CRIMES

A

Doxycycline: non-renally eliminated
Quinolones: ciprofloxacin (renal) but inhibitor of P450
Clindamycin: non-renally eliminated
Rifampin
Isoniazid
Metronidazole: EtOH - inhibition of aldehyde metabolsim
Erythromycin-like: inhibitior of P450 (A-OK)
Sulfonamides: N-acetylated to more lipid soluble (renal crystalluria)

30
Q

Most G+ Cocci coverage

A

Penicillin
Clindamycin
Macrolides
FQ - Levofloxacin

31
Q

Strep pyo/pneumo coverage

A

Amoxicillin

32
Q

MSSA coverage

A 
Enzyme resistance
1st gen cephalosporins
Amox-clav
Clindamycin
Macrolides
33
Q

MRSA coverage

A 
Altered target resistance
Doxycycline
TMP-SMX
Clindamycin
Vancomycin (IV)
34
Q

Neisseria gon/men coverage

A

Ceftriaxone (good CNS penetration)

35
Q

Most G- rods/E. Coli coverage

A

Aminoglycosides
Nitrofurantoin
Amoxicillin (/Clav)
1st gen Cephalosporin

36
Q

Most anaerobes coverage

A

penicillins
PIP-Taz
Clindamycin

37
Q

Bacteroides coverage

A

Pip-Taz

Clindamycin

38
Q

Atypical coverage

A

Macrolides

Doxycycline

D&D (6 decks)

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