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Great Syndromes Abx Flashcards

1
Q

Penicillin MOA:

A

Cell wall synthesis, binding to PBP

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2
Q

Penicillin Coverage:

A

G(+) - Streps, Most all G(+) G (-) - N. Meningitides, T. Pallidum

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3
Q

Penicillin SE:

A

Hypersensitivity, Diarrhea, BM suppression

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4
Q

To treat enterococci w/ penicillin:

A

add gentamycin

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5
Q

Amphicillin MOA:

A

Inhibit cell wall synthesis (PBP)

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6
Q

Amphicillin Coverage:

A

G positive: Staph, Entero, Listeria G(-): H. influenzae, 1/2 of E.coli

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7
Q

Penicillinase resistant penicillins:

A

IV: “NOM” - Naficillin, Oxacillin, Methicillin PO: “CD” - Cloxacillin, Dicloxacillin

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8
Q

Penicillinase resistant penicillins coverage:

A

G (Positive) - KILLS S. aureus!!! Does NOT work for Enterococcus and Neisseria

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9
Q

Penicillinase resistant penicillins S/E:

A

Phlebitis, Interstitial Nephritis, Neutropenia, LFT Elevations

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10
Q

Ticarcillin/Piperacillin coverage:

A

Gram Negative! Pseudomonas (Combine with aminoglycoside)

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11
Q

Ticarcillin/Piperacillin S/E:

A

Increases bleeding time, sodium loading, hypokalemia. (Less S/E with piperacillin which is 4x more active than ticarcillin

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12
Q

1st Generation cephalosporins:

A

Cephalexin (PO), Cephazolin (IV)

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13
Q

2nd generation cephalosporins:

A

Cefuroxime (IV or PO), Cefoxitin (Abd infxns), Cefaclor (SE-Erythema multiforme)

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14
Q

Trends in Cephalosporins:

A

W/ increasing generation, drugs have more G- coverage and less G positive coverage. They also have decreased resistance.

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15
Q

Cross reaction w/ penicillins and cephalosporins:

A

8% w/ previous pen. Rxn, 2% w/o previous rxn to penicillin

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16
Q

Cephalosporin S/E:

A

Hypersensitivity Reaction, GI, Interstitial nephritis, Hematology abnormalities

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17
Q

What cephalosporin is associated w/ biliary “sludging”:

A

Ceftriaxone (Rocephin)

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18
Q

3rd Generation Cephalosporins:

A

Ceftriaxone (IM & IV), Cefotaxime (IV), Ceftazidime (IV)

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19
Q

4th generation Cephalosporin:

A

Cefepime (IV)

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20
Q

1st generation cephalosporin Uses:

A

Uncomplicated UTI and staph infections

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21
Q

2nd generation cephalosporin uses:

A

sinusitis

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22
Q

3rd generation cephalosporin uses:

A

Bactremia, Pneumonia, PCN resistant Strep pneumo, N. meningitidis

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23
Q

4th Generation cephalosporin uses:

A

Really bad sick folks: Neutropenic fever.

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24
Q

Carbapenems:

A

Imipenem, Meropenem

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25
Carbapenems Coverage:
VAST! G Pos., -, & Anaerobes
26
Imapenem SE:
Seizures
27
Beta-Lactamase Inhibitor combos:
Unasyn, Zosyn, Augmentin, Timentin
28
Augmenten is a combination of:
Amoxacillin & Clavulanic Acid
29
Zosyn is a combination of:
Piperacillin & Tazobactam
30
Glycopeptides:
Vancomycin, Telavicin
31
Vancomycin MOA:
Cell wall synthesis inhibitor.
32
Vancomycin Mech of resistance:
Change in terminus peptidoglycan
33
Vancomycin Coverage:
Gram Positive: MRSA, Amp (R) Entercocci, PCN (R) S. Pneumo, C. Diff (PO, after trying flagyl)
34
Rapid infusion of Vancomycin:
Red-man syndrome - not an allergic reaction
35
Vancomycin SE:
Ototoxicity, nephrotoxicity
36
Telavancin SE:
Ototoxicity, Nephrotoxicity, teratognic (Worse than Vancomycin)
37
Televancin Uses:
Used for skin/soft tissue infections & ventilator related pneumonia.
38
Daptomycin MOA:
Inserts lipid tail, depolarizes, DNA/RNA/Protein synthesis interrupted, cell death. Has a rapid kill curve and post-antibiotic effect.
39
Daptomycin coverage:
MRSA, MSSA, VRE, Staph epi. Not good for pneumonia.
40
Daptomycin SE:
Myopathy (Measure CPK weekly)
41
Quinupristin-Dalfopristin MOA:
Protein Synthesis inhibitor
42
Quinupristin-Dalfopristin coverage:
MRSA, MSSA, VRE, Staph epi. Not E. faecalis
43
Quinupristin-Dalfopristin S/E:
p450 inhibition. Phlebitis, myalgias, Inc unconj bilirubin. Give in a central line.
44
Linezolid & Tedizolid MOA:
Protein synthesis inhibitor
45
Linezolid & Tedizolid resistance:
Mutation in 23s ribosome binding site.
46
Linezolid & Tedizolid Coverage:
MRSA, MSSA, VRE, Staph epi.
47
Linezolid & Tedizolid S/E:
Bone Marrow Suppression, Serotonin syndrom
48
Aminoglycosides:
Gentamycin, Tobramycin, Amikacin, Streptomycin
49
Aminoglycosides MOR:
Ribosomal resistance (TB), Decreased uptake (Pseudomonas), Enzyme modification (Most common)
50
Aminoglycosides S/E:
Ototoxocity, Nephrotoxicity, Neuromuscular blockade (reversed by calcium)
51
Aminoglycosides Dosing:
Strong post-antibiotic effect allows once daily dosing.
52
Quinolones:
Ciproflaxcin, Levofloxacin
53
Quinolones MOA:
Inhibit DNA replication (topoisomerases, gyrase target)
54
Quinolones, what causes reduced efficacy:
Magnesium (Supplement), Low pH (inside abscess)
55
Quinolones Resistance mechanisms:
Mutated topoisomerases, increased drug efflux
56
Quinolones Uses:
UTI w/ GNR, Pseudomonas, PCN resistant S. pneumoniae, Intracellular bugs, Typhoid
57
Quinolones S/e:
GI, Skin (hypersynsetivity, phototox), Visual, prolonged QT, Tendenitis, Arthropathy, Altered glycemic control
58
Quinolones, not to be used in:
Pedi - melts cartilage
59
Tetracyclines:
Tetracycline - Short, Doxycycline - Long
60
Tetracyclines MOA:
Static; Decreased protein synthesis
61
Tetracyclines MOR:
Decreased influx
62
Tetracyclines Coverage:
Rickettsia, Mycoplasma, Chlamydia, Lyme Dz, ACNE, GPC, SOME GNR, CA MRSA
63
Tetracyclines S/E:
Tooth discoloration (<9yo), Thrombophlebitis, GI, Hepatotoxicity, Fanconi Syndrome, Phototoxicity, D-D int.
64
Glycyclines:
Tigecycline
65
Glycyclines MOA:
Inh. 30s ribosome (bacteriostatic)
66
Glycyclines Coverage:
GPC (MRSA), Anaerobes, GNR on skin, soft tissue, intraabdominal infxns. (not Pseudomonas)
67
Glycyclines CI:
Never in PG or Pedi
68
Macr0lides:
Erythromycin, Clarithromycin, Azithromycin
69
Macrolides MOA:
50s, dec prot synth, bact static
70
Macrolides MOR:
binding site alteraation (50s)
71
Macrolides Spectrum of coverage:
E, C, A (Decreasing pos and increasing neg with descending order)
72
Uses of Macrolides:
H. Pylori (CA), M. avium (AC), Legionella, Campylobacter, Chlamydia, mycoplasma, diptheria
73
Macrolides S/E:
Stim gastric motility (E), Pyloric stenosis in neonates, cholestatic hepatitis, reversible hearing loss, D-D interactions (Torsades w/ Seldane)
74
Lincosamides:
Clindamycin
75
Clindamycin MOA:
50s ribosime, inhibits prot synthesis
76
Clindamycin Coverage:
Gram pos and anerobes
77
Clindamycin Uses:
CA MRSA, Mixed abdominal infxns, Lung abscess, Acne, Toxo
78
Clindamycin SE:
C. diff. (Usually w/in 1 week, up to 4-6 weeks post)
79
Chlomramphenicol MOA:
50s sub unit, decreased prot synthesis
80
Chlomramphenicol MOR:
Chlomramphenicol acetyltransferase
81
Chlomramphenicol Coverage:
Everything, also has CNS penetration
82
Chlomramphenicol S/E:
Gray Baby syndrome, bone marrow toxicity, aplastic anemia
83
Rifampin MOA:
Inhibits RNA synthesis
84
Rifampin Uses:
TB, synergy for some GPC, prop. N. meningitidis, Prop. H. influenzae
85
Rifampin MOR:
resistance arises rapidly when used as mono therapy
86
Rifampin SE:
Turns everything orange, decreased efficacy of OCP, Hepatotoxicity, D-D interactions
87
Imidazole:
Metronidazole
88
Metronidazole MOA:
Draws "off electrons" ad interfears w/ energy production
89
Metronidazole Coverage:
Anerobes (Giardia); Gram positives are less vulnerable
90
Metronidazole SE:
Disulfiram reaction, peripheral neuropathy, Encephalopathy, Seizures
91
Sulfonamides:
Trimethoprim-sulfamethoxasole (Bactrim)
92
Bactrim MOA:
disturbs folate production
93
Bactrim coverage:
Gram positive and negative; Uncomplicated UTI, Prop PCP, Nocardia, S. aureus, Malaria, Toxo
94
Bactrim SE:
hypersensitivity, SJS, Hemolysis (G6PD), BM suppression, Crystaluria, Displaces bilirubin from albumin
95
Polymyxins:
Colistin (Polymyxin E)
96
Colistin MOA:
Detergent
97
Colistin Coverage:
Last ditch effort for Pseudomonas and Acinetobacter
98
Colistin SE:
Nephrotoxicity, neurotoxicity

Great Syndromes (4 decks)

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