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PTP&M: Infectious Disease > Gram Positive (Carreno) > Flashcards

Gram Positive (Carreno) Flashcards

1
Q

Penicillin Coverage

A

Strep pneumo
E. coli
PSSA
NO MOD/HIGH COVERAGE

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2
Q

Penicillin Distribution

A

WIDELY DISTRIBUTED

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3
Q

3rd Gen Cephalosporins (6)

aka “3rd Gen Ceph”

A 
Cefdinir
Cefixime
Cefoperazone
Ceftaxime
Ceftazidime
Ceftriaxone

MOA: prevent transpeptidation reaction

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4
Q

3rd Gen Ceph Coverage

A

G+: Strep pneumo, MSSA
G-: E.coli, Kleb pneumo

NO HIGH COVERAGE

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5
Q

3rd Gen Ceph Distribution (4)

A

CNS (good)
Intra-abdomen
Urine
Skin

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6
Q

Type 1 beta-lactam allergy
+
Conditions

A

Immediate
IgE-mediated

Anahpylaxis within minutes

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7
Q

Type 2 beta-lactam allergy
+
Conditions

A

Production of cytotoxic Abs
IgG + IgM mediated

Thrombocytopenia, nephritis, dose/duration dependent

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8
Q

Type 3 beta-lactam allergy
+
Conditions

A

IMMUNE COMPLEX MEDIATED
Formation of immune complexes
IgG + IgM

Serum sickness within 7-14d

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9
Q

Type 4 beta-lactam allergy
+
Conditions

A 
CELL MEDIATED (NO ABs)
T-cell dependent

Inflammation + contact dermatitis

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10
Q

Macrolides

A

Eryhtromycin
Clarithromycin
Azithromycin

MOA: bind 50S subunit, prevent peptide bond formation

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11
Q

Macrolide Coverage

A 
S.pneumo
\+
H.influenza
M. catarrhalis
Mycoplasma
Chlamydia
Leginoella
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12
Q

Macrolide Distribution

A

Upper Resp
Lower Resp
Tissues (i.e. cervix, ovaries, prostate)

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13
Q

Key Clinical Uses:

Erythromycin

A

Strep pneumo

Promotility agent

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14
Q

Key Clinical Uses:

Clarithromycin

A

Community Acquired Pneumonia (CAP)
Mycobacterium Avium Intracellularae (MAI)
H.pylori

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15
Q

Key Clinical Uses:

Azithromycin

A 
URTI (upper respiratory infections)
CAP
MAI
Cystic Fibrosis
COPD exacerbations
Chlamydial infections
Gonorrhea (@ high doses)
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16
Q

Macrolide: ADEs

A

Diarrhea
Vomiting
QT-prolongation
CYP3A4 interactions (E > C > A) i.e. STATINS

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17
Q

Fluoroquinolones

A

MOA: Toposiomerase/gyrase inhibition

ATYPICAL BACTERIA
Moxifloxacin (G+)
Levofloxacin (broad/both)
Ciprofloxacin (G-)

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18
Q

Coverage: Moxifloxacin

A

G+
Strep pneumo
E.coli, Kleb pneumo, G- anaerobes

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19
Q

Coverage: Levofloxacin

A

BROAD (both)
Strep pneumo
Ecoli, Kleb pneumo, PSAR

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20
Q

Coverage: Ciprofloxacin

A

G-
NO G+ activity
E.coli, Kleb pneumo, PSAR

21
Q

Fluoroquinolone Absorption/Bioavailability

A

Moxi + Levo –> 100%

Cipro –> 80%

22
Q

Fluoroquinolone Distribution

A

Lungs: Moxi + Levo
Urine: Levo + Cipro
Intra-abdomen: Moxi, Levo, Cipro

23
Q

Fluoroquinolone Excretion

A

Renal: Levo + Cipro
Hepatic: Moxi

24
Q

Major Fluoroquinolone ADE

A 
QT Prolongation
Tendinitis + Tendon Rupture
Hypersensitivity
N/V
Diarrhea
Dizziness
Headaches
Insomnia
25
Q

ABCs of Staph aureus

A 
A --> absence of resistance elements
B --> beta-lactamase presence
C --> changes in PBP
D --> d-ALA-d-ALA alterations (VRSAs)
E --> extra-thick walls
26
Q

Penicillinase-Resistant Penicillins (2) + Dosing

A 
Oxacillin
Nafcillin
2g IV q4h (SAME FOR BOTH)
NO ADJUSTMENT FOR RENAL
-monitor liver enzymes + interstitial nephritis
27
Q

Penicillinase-Resistant Penicillins: Coverage

A

NO G- ACTIVITY

Strep pneumo, MSSA

28
Q

Penicillinase-Resistant Penicillins: Distribution

A

Blood
Skin
Urine (?)

29
Q

1st Gen Cephs (4)

A

Cefazolin (PO)
Cephalexin (IV)
Cephadroxil (PO)
Cephalothin (IV)

30
Q

1st Gen Cephs: Coverage

A

Strep pneumo, MSSA

E.coli

31
Q

1st Gen Ceph: Distribution

A

Skin
Urine
(POOR CNS)

32
Q

Beta-lactam + beta-lactamase inhibitor (3)

A

Amoxacillin/Clavulanate
Ampicillin/Sulbactam
Pipercillin/Tazobactam

33
Q

Coverage: Amox/Clav + Amp/Sulbactam

A

Strep pneumo, MSSA
E.coli
**sulbactam selectively toxic vs. acinetobacter

34
Q

Coverage: Piper/Tazo

A

Strep pneumo, MSSA
E.coli, Kleb pneumo, PSAR
**additional G- anaerobe coverage

35
Q

Coverage: Vancomycin

A

Strep pneumo, MSSA, MRSA, E.faecalis
**NO G-
IV –> MRSA and PO –> C.diff

36
Q

Distribution: Vancomycin

A

Low PO Bioavailability
Blood
Urine
Lung, bone, CNS, heart (?)

37
Q

Distribution: Daptomycin

A

Skin
Heart
(Inactivated in lungs)

38
Q

Coverage: Daptomycin

A

Strep pneumo, MSSA/MRSA, E.faecalis

**NO G-

39
Q

Daptomycin ADEs

A

Skeletal muscle toxicity
Concurrent use of statin
Eosinophili pneumonia (rare)

40
Q

Telavancin: Type + ADEs

A

Lipogylcopeptide
QTc prolongation + red-man syndrome
2x potential nephrotoxicity as vancomycin

41
Q

Linezolid: Coverage

A

Strep pneumo, MSSA/MRSA, E.faecalis

**NO G-

42
Q

Linezolid: Distribution

A

Low serum concentrations
EXCELLENT for lungs
Skin
Urine

43
Q

Linezolid: Info and ADEs

A

100% Bioavailability
No renal dose adjustment

Serotonin response syndrome
Peripheral/otic neuropathy
Thrombocytopenia/anemia

44
Q

Tigecycline: Coverage

A

Strep pneumo, MSSA/MRSA, E.faecalis
E.coli, Kleb pneumo
+ H.influenza, M.catarrahlis, Acinetobacter

45
Q

Tigecycline: Distribution

A

Intra-abdomen
Skin
Lungs (?)
VERY LOW SERUM/URINE concentrations

**adjust for hepatic dysfunction

46
Q

Tigecycline: ADEs

47
Q

Ceftaroline: Coverage

A

Strep pneumo, MSSA/MRSA

E.coli, Kleb pnemo

48
Q

Ceftaroline: Distribution

A

Lungs
Skin
Other (?)

**adjust for CrCl < 50mL/min

PTP&M: Infectious Disease (9 decks)

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