HIPSHER Antibiotics Q19-32 Flashcards
List the commonly used fluoroquinolones by trade and generic names
- Ciprofloxacin (Cipro)
- Levafloxacin (Levaquin)
- Moxifloxacin (Avelox)
What is the MOA for fluoroquinolones?
MOA : bacteriacidal
• not as potent as beta-lactams
• CANNOT be used with staph aureus, enterococcus (except with UTI) even if sensitive
Describe the anti-microbial spectrum of fluoroquinalones and the infections they are used for-
CAP: levofloxacin or moxifloxacin
Intra-abdominal : moxifloxacin
Complicated UTI and Prostatitis: Levofloxacin & Cipro
What is the BBW for fluoroquinolone?
Tendon Rupture
What are the side effects worth noting for fluoroquinolone?
- confusion,
- hallucinations
- HA
- dizziness
- tendon rupture (BBW)
- QT prolongation
- C.diff colitis
- fluoroquinalones potentiate warfarin
List the commonly used macrolides by trade and generic name
- Erythromycin
- Azithromycin (Zithromax)
- Clarithromycin (Biaxin)
MOA of macrolides and typical use of macrolides?
• bacteriostatic
o atypical CAP- combine with better strep pneumoniae coverage for empiric CAP coverage,
o chlamydia
o urethritis,
o MAC
What are ADR associated with macrolides?
- QT prolongation,
- increased LFT,
- potentiates warfarin [erythro and clarithro only]
List the commonly used aminoglycosides
Gentamycin
Tobramycin
MOA for ahminoglycosides?
Bactericidal - concentration dependent killing
• post-antibiotic effect - even when the drug is gone the bacteria is still stunned
What are the 2 indications for ahminoglycosides?
enterococcal endocarditis, nosocomial infections
What are the toxicity risks with ahminoglycosides?
nephrotoxicity, ototoxicity
• toxicity can be limited by obtaining peak and trough levels
List the commonly used tetracyclines
Tetracycline
Monocycline
Doxycycline
What is the MOA for tetracycline?
Bacteriostatic
When should tetracyclines we used in therapy?
cellulitis- covers
MRSA
COPD exacerbations-anti-inflammatory effect
CAP - use doxy
acne)
When should tetracyclines not be used?
UTI’s!!!!
What are ADR with tetracyclines?
Photosensitivity
Teeth staining and reduced bone grows in children and pregnant women
What is the MOA of vancomycin?
weakly bactericidal and time dependent killing- stay above MIC
What organisms are covered by vancomycin
staph including MRSA, strep, enterococcus- but use a beta lactam if you have MSSA; oral vancomycin used for C.diff colitis
ADRs related to Vancomycin
red man syndrome- lengthen infusion, rash, nephrotoxicity- adjust dose based on trough
MOA of bactrim?
Bacteriostatic
Organisms covered by Bactrim?
some gram negatives, gram positives including MRSA
Which infections do we use bactrim for?
use for uncomplicated UTI, purulent cellulitis, PCP prophylaxis
ADRs for Bactrim?
rash, fever, hyperkalemia, Steven- Johnson syndrome, potentiates warfarin)
MOA of clindamycin?
bacteriostatic
Antimicrobial activity of clindamycin?
• Antimicrobial activity:
o anaerobes
o gram positives including MRSA- don’t use if resistant to Emycin
What infections should you use clindamycin for?
o anaerobic infection above the diaphragm
o cellulitis
o MRSA infx-has anti-inflammatory activity
ADRs of clindamycin?
C-DIFF!!!!
rash
MOA metronidazole?
bactericidal
What are the organisms that metronidazole covers and in what infections should you use metronidazole?
• Antimicrobial activity: anaerobes and protoxoans, C.Diff • Infections: o anerobic infx below the diaphragm o protozoans o C-diff
what are the ADRs associated with metronidazole?
o metallic taste
o neuropathy
o disulfuram reaction w/ EtOH
o potentiates warfarin
When should you use nitrofurantoin?
Coverage of some gram negatives and with uncomplicated UTIs
What is the MOA for Rifampin?
• MOA: bactericidal
• Therapy:
o use w/ other abx for synergy in prosthetic joint or surgical hardware infection
o TB
Briefly describe the infections for which we use linezolid
MRSA and VRE
What are precautions for using linezolid?
with SSRIs
Myelosuppression
With what infections do you use daptomycin?
MRSA & VRE
When can you not use daptomycin?
Lung infections
Muscle Damage
