Misc. Antibiotics

Question 1

1st gen cephalosporin

Answer 1

Cephalexin, Cefazolin

Question 2

2nd gen group 1

Answer 2

cefuroxime, cefaclor
cefuroxime penetrates into CSF well
Good against MSSA

Question 3

2nd gen group 2

Answer 3

cephamycins; cefoxitin, cefotetan
good for dirty surgery

Question 4

General Cephalosporin

Answer 4

Beta-lactam active
Generations get better G(-) coverage and worse G(+) covergage gen 1-4
Require dose adjustment for reduced renal clearance
Cross-sensitivity issue 1-3% for PCN hypersensitivity rxns

Question 5

Monobactam

Answer 5

Beta-lactam active
Aztreonam - only drug
Great G(-) coverage, including pseudomonas
Key - unlikely cross-sensitivity for PCN, cephalosporin except for ceftazidime; no renal toxicity

Question 6

Thienamycins (carbapenems)

Answer 6

Beta-lactam active
Imipenem-cilastin, merepenem, ertapenem
Extremely broad (to the point that you avoid using them) - G+, G-, pseudomonas coverage (except ertapenem)
NO MRSA
lowers seizure threshhold

Question 7

Aminoglycosides

Answer 7

Protein synthesis inhibition
Gentamycin, tobramycin, amikacin, neomycin, streptomycin
BBW - ototixic, neprototoxic
End in CIN - coverage includes negative (PSEUDOmonas included)
crushes (cytotixc) incus, nephrons
Required dose adjustment for decr renal fxn

Question 8

Tetracycline

Answer 8

Protein synthesis inhibition
Minocycline, Tetracycline, DOXYcycline
G(+), including MRSA, G(-), atypicals, weird stuff
Required dose adjustment for decr renal fxn
Avoid cations, milk etc
Key - can’t lie down due to esophageal irritation, photosensitivity, GI intolerance, Fanconi syndrome
Avoid giving to kids under 8 due to potential bone growth issue

Question 9

Bacteriostatic

Answer 9

ECSTaTiC
Erythromycin
Clindamycin
Sulfonamides
Tetracyclines
Trimethoprim
Chloramphenicol

Question 10

Bacteriocidal

Answer 10

Very Finely Proficient At Cell Murder
Vancomycin
Fluoroquinolones
Penicillins
Aminglycosides
Cephalosporins
Metronidazole

Question 11

Macrolides

Answer 11

Protein synthesis inhibition
Azithromycin, clarithromycin, erythromycin
Targets G(+), G(-), atypicals (with azithromycin)
Clarithromycin, erythromycin good against Mycobacterium avium compex
Required dose adjustment for decr renal fxn
QTc prolongation, extended half life (in arithro)

Question 12

Erythromycin Metabolism

Answer 12

Many drug interactions due to CYP450 metabolism

Question 13

Lincosamides

Answer 13

Protein synthesis inhibition
Clindomycin
Good G(+), including MSSA, MRSA, great G(-) anaerobe activity
Great bone penetration
Can cause pseudomembranous colitis
Esophageal irritation - lots of water, no lying down
No dose adjustment required

Question 14

MRSA Antibiotics

Answer 14

BCCD, LVD
Bactrim (sulfamethoxazole/trimethoprim),
Clindamycin, Ceftaroline, Docycline, Linezolid, Vancomycin, Daptomycin

Question 15

Pencillins

Answer 15

Beta-lactam active
Blackbox - hypersensitivity, GI issues, hematologic issues
Four classes: natural penicillins, penecillinase resistant (anti-staph), aminopenicillins, Becta-lactam inhibitors (includes antipseudomonal)
All dose adjust for renal insufficiency

Question 16

Pseudomonas antibiotics (A A C C C L M Z)

Answer 16

Aztreonam, Amingolycosides, Ciprofloxacin, Ceftazidime, Cefipime, Levoflaxin, Meropenem, Zosyn (piperacillin-tazobactam)

Question 17

Natural Penicillin

Answer 17

med of choice for syphillis, strep
oxacillin, nafcillin, dicloxacillin
G(+)

Question 18

Penicillinase-resistant

Answer 18

Anti-staph
G(+), MSSA

Question 19

Aminopenicillins

Answer 19

Ampicillin, Amoxicillin
G(+), G(-)
Good for listeria

Question 20

Beta-lactam inhibitors

Answer 20

Amoxicillin-clavulanate, ampicillin-sulbactam
G(+), G(-), anaerobes
Includes anti-pseudomonal - piperacillin-tazobactam

Question 21

Antibiotics that do no require dose adjustment

Answer 21

ON ACE MED
Oxacillin
Nafcillin

Azithromycin
Clindamycin
Erythromycin

Moxifloxacin
Ceftriaxone
Doxycycline

Question 22

Fluoroquinolones

Answer 22

DNA gyrase inhibitor
Ciprofloxacin, levofloxacin, moxifloxacin
Cipro > levo for G(-) coverage and pseudomonas
Moxifloxacin best for G(+), atypicals, anaerobes
Levo almost 100% PO bioavailability
Adverse - GI symptoms, phototoxicity, acchilles tendon risk in older men
liver toxicity, QTc prolongation

Question 23

Sulfa

Answer 23

Inhibition of bacterial folic acid, stops bacterial cell growth
Trimethoprim (TMP)/Sulfamethoxazole
great distribution, including CSF
G(+), G(-). aerobes
(A) drug of choice for MRSA cellulitis

Question 24

TMP adverse

Answer 24

Crysatalization risk in kidneys requires keepng hydration
Increases anticoagulation of warfarin due to competitive binding
Contraindicated in dialysis patients
May cause Steven Johnson Syndrome (epithlial, mucosal condition)

Question 25

Nitromidazole

Answer 25

Metronidazole
Active in all anaerobes and treats CDif
Interacts with warfarin and alcohol

Question 26

Drugs that treat C. Dif

Answer 26

Oral vanco
Metronidazole

Question 27

Oxalinediones

Answer 27

Protein synthesis inhibition
Linezolid
Excellent G(+) activity, active against MRSA

Question 28

Lipopeptides

Answer 28

Binds to cell membrane and depolarizes it and ultimately leads to cell death
Daptomycin

Question 29

Protein inhibition classes

Answer 29

Aminoglycosides, Tetracyclines, Macrolides, Lincosamides