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Great Syndromes > Great Syndromes Abx > Flashcards

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
Q

Carbapenems Coverage:

A

VAST! G Pos., -, & Anaerobes

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26
Q

Imapenem SE:

A

Seizures

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27
Q

Beta-Lactamase Inhibitor combos:

A

Unasyn, Zosyn, Augmentin, Timentin

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28
Q

Augmenten is a combination of:

A

Amoxacillin & Clavulanic Acid

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29
Q

Zosyn is a combination of:

A

Piperacillin & Tazobactam

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30
Q

Glycopeptides:

A

Vancomycin, Telavicin

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31
Q

Vancomycin MOA:

A

Cell wall synthesis inhibitor.

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32
Q

Vancomycin Mech of resistance:

A

Change in terminus peptidoglycan

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33
Q

Vancomycin Coverage:

A

Gram Positive: MRSA, Amp (R) Entercocci, PCN (R) S. Pneumo, C. Diff (PO, after trying flagyl)

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34
Q

Rapid infusion of Vancomycin:

A

Red-man syndrome - not an allergic reaction

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35
Q

Vancomycin SE:

A

Ototoxicity, nephrotoxicity

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36
Q

Telavancin SE:

A

Ototoxicity, Nephrotoxicity, teratognic (Worse than Vancomycin)

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37
Q

Televancin Uses:

A

Used for skin/soft tissue infections & ventilator related pneumonia.

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38
Q

Daptomycin MOA:

A

Inserts lipid tail, depolarizes, DNA/RNA/Protein synthesis interrupted, cell death. Has a rapid kill curve and post-antibiotic effect.

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39
Q

Daptomycin coverage:

A

MRSA, MSSA, VRE, Staph epi. Not good for pneumonia.

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40
Q

Daptomycin SE:

A

Myopathy (Measure CPK weekly)

41
Q

Quinupristin-Dalfopristin MOA:

A

Protein Synthesis inhibitor

42
Q

Quinupristin-Dalfopristin coverage:

A

MRSA, MSSA, VRE, Staph epi. Not E. faecalis

43
Q

Quinupristin-Dalfopristin S/E:

A

p450 inhibition. Phlebitis, myalgias, Inc unconj bilirubin. Give in a central line.

44
Q

Linezolid & Tedizolid MOA:

A

Protein synthesis inhibitor

45
Q

Linezolid & Tedizolid resistance:

A

Mutation in 23s ribosome binding site.

46
Q

Linezolid & Tedizolid Coverage:

A

MRSA, MSSA, VRE, Staph epi.

47
Q

Linezolid & Tedizolid S/E:

A

Bone Marrow Suppression, Serotonin syndrom

48
Q

Aminoglycosides:

A

Gentamycin, Tobramycin, Amikacin, Streptomycin

49
Q

Aminoglycosides MOR:

A

Ribosomal resistance (TB), Decreased uptake (Pseudomonas), Enzyme modification (Most common)

50
Q

Aminoglycosides S/E:

A

Ototoxocity, Nephrotoxicity, Neuromuscular blockade (reversed by calcium)

51
Q

Aminoglycosides Dosing:

A

Strong post-antibiotic effect allows once daily dosing.

52
Q

Quinolones:

A

Ciproflaxcin, Levofloxacin

53
Q

Quinolones MOA:

A

Inhibit DNA replication (topoisomerases, gyrase target)

54
Q

Quinolones, what causes reduced efficacy:

A

Magnesium (Supplement), Low pH (inside abscess)

55
Q

Quinolones Resistance mechanisms:

A

Mutated topoisomerases, increased drug efflux

56
Q

Quinolones Uses:

A

UTI w/ GNR, Pseudomonas, PCN resistant S. pneumoniae, Intracellular bugs, Typhoid

57
Q

Quinolones S/e:

A

GI, Skin (hypersynsetivity, phototox), Visual, prolonged QT, Tendenitis, Arthropathy, Altered glycemic control

58
Q

Quinolones, not to be used in:

A

Pedi - melts cartilage

59
Q

Tetracyclines:

A

Tetracycline - Short, Doxycycline - Long

60
Q

Tetracyclines MOA:

A

Static; Decreased protein synthesis

61
Q

Tetracyclines MOR:

A

Decreased influx

62
Q

Tetracyclines Coverage:

A

Rickettsia, Mycoplasma, Chlamydia, Lyme Dz, ACNE, GPC, SOME GNR, CA MRSA

63
Q

Tetracyclines S/E:

A

Tooth discoloration (<9yo), Thrombophlebitis, GI, Hepatotoxicity, Fanconi Syndrome, Phototoxicity, D-D int.

64
Q

Glycyclines:

A

Tigecycline

65
Q

Glycyclines MOA:

A

Inh. 30s ribosome (bacteriostatic)

66
Q

Glycyclines Coverage:

A

GPC (MRSA), Anaerobes, GNR on skin, soft tissue, intraabdominal infxns. (not Pseudomonas)

67
Q

Glycyclines CI:

A

Never in PG or Pedi

68
Q

Macr0lides:

A

Erythromycin, Clarithromycin, Azithromycin

69
Q

Macrolides MOA:

A

50s, dec prot synth, bact static

70
Q

Macrolides MOR:

A

binding site alteraation (50s)

71
Q

Macrolides Spectrum of coverage:

A

E, C, A (Decreasing pos and increasing neg with descending order)

72
Q

Uses of Macrolides:

A

H. Pylori (CA), M. avium (AC), Legionella, Campylobacter, Chlamydia, mycoplasma, diptheria

73
Q

Macrolides S/E:

A

Stim gastric motility (E), Pyloric stenosis in neonates, cholestatic hepatitis, reversible hearing loss, D-D interactions (Torsades w/ Seldane)

74
Q

Lincosamides:

A

Clindamycin

75
Q

Clindamycin MOA:

A

50s ribosime, inhibits prot synthesis

76
Q

Clindamycin Coverage:

A

Gram pos and anerobes

77
Q

Clindamycin Uses:

A

CA MRSA, Mixed abdominal infxns, Lung abscess, Acne, Toxo

78
Q

Clindamycin SE:

A

C. diff. (Usually w/in 1 week, up to 4-6 weeks post)

79
Q

Chlomramphenicol MOA:

A

50s sub unit, decreased prot synthesis

80
Q

Chlomramphenicol MOR:

A

Chlomramphenicol acetyltransferase

81
Q

Chlomramphenicol Coverage:

A

Everything, also has CNS penetration

82
Q

Chlomramphenicol S/E:

A

Gray Baby syndrome, bone marrow toxicity, aplastic anemia

83
Q

Rifampin MOA:

A

Inhibits RNA synthesis

84
Q

Rifampin Uses:

A

TB, synergy for some GPC, prop. N. meningitidis, Prop. H. influenzae

85
Q

Rifampin MOR:

A

resistance arises rapidly when used as mono therapy

86
Q

Rifampin SE:

A

Turns everything orange, decreased efficacy of OCP, Hepatotoxicity, D-D interactions

87
Q

Imidazole:

A

Metronidazole

88
Q

Metronidazole MOA:

A

Draws “off electrons” ad interfears w/ energy production

89
Q

Metronidazole Coverage:

A

Anerobes (Giardia); Gram positives are less vulnerable

90
Q

Metronidazole SE:

A

Disulfiram reaction, peripheral neuropathy, Encephalopathy, Seizures

91
Q

Sulfonamides:

A

Trimethoprim-sulfamethoxasole (Bactrim)

92
Q

Bactrim MOA:

A

disturbs folate production

93
Q

Bactrim coverage:

A

Gram positive and negative; Uncomplicated UTI, Prop PCP, Nocardia, S. aureus, Malaria, Toxo

94
Q

Bactrim SE:

A

hypersensitivity, SJS, Hemolysis (G6PD), BM suppression, Crystaluria, Displaces bilirubin from albumin

95
Q

Polymyxins:

A

Colistin (Polymyxin E)

96
Q

Colistin MOA:

A

Detergent

97
Q

Colistin Coverage:

A

Last ditch effort for Pseudomonas and Acinetobacter

98
Q

Colistin SE:

A

Nephrotoxicity, neurotoxicity

Great Syndromes (4 decks)

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