Miscellanous abx spectra Flashcards
Examples of fluoroquinolones
Ciprofloxacin
Levofloxacin
Moxifloxacin
Delafloxacin
Fluoroquinolone activity is bacteri____
bactericidal
Bug coverage of ciprofloxacin
Entero
Non entero
H. influ
Pseudomonas
Atypicals
What are the two respiratory fluoroquinolones?
Levofloxacin
Moxifloxacin
Bug coverage of levofloxacin
Entero
H. influ
Strep
Aypicals
Pseudomonas
MSSA
Levofloxacin can/cannot be used for pyelonephritis because ______
Can NOT be used for pyelonephritis (only UTIs) because of its high urinary excretion
Bug coverage of moxifloxacin
Entero
H. influ
Strep
Atypicals
Pseudomonas
MSSA
Moxifloxacin can/cannot be used for UTIs because ______
Can NOT be used for UTIs because it has limited penetration into urine
Bug coverage of delafloxacin
Entero
H. influ
Strep
Atypicals
MSSA
MRSA
Pseudomonas
VSE
Adverse effects of fluoroquinolones
Arthropathy/tendonitis (avoid in pregnancy and peds)
Peripheral neuropathy
QT prolongation
Liver toxicity/hepatitis
Confusion (caution elderly)
Photosensitivity
C. diff infection
List the risk factors for fluoroquinolone tendinitis
> 60 yo
Corticosteroid use
Solid organ transplant
Pediatric
Strenuous activity
Renal failure
Tendon disorder
When should fluoroquinolones be avoided in patients with heart conditions?
Prolonged QTs: Males > 450, Females > 460
Uncorrected hypokalemia
Patients on quinidine, procainamide, amiodarone, sotalol
List the pertinent drug interactions of fluoroquinolones
Chelation with cations
Hypoglycemia with diabetes medications
Increased risk TdP with antiarrhythmics
Bug coverage of TMP/SMX
MSSA
MRSA
H. influ
Entero
Strep
Adverse effects of TMP/SMX
Hypersensitivity
GI upset
Nephrotoxicity
Risk kernicterus in fetus (avoid in last month of pregnancy)
What are the pertinent drug interactions with TMP/SMX?
AVOID warfarin and methotrexate
(2C8/2C9 inhibition)
Bug coverage of rifampin
Mycobacterium
MRSA
MSSA
Strep
Rifampin is never given as ______
monotherapy
Adverse effects of rifampin
Hypersensitivity
Liver dysfunction/hepatitis
Discoloration of body fluids
Leukopenia
Rifampin is a potent ______ of CYP enzymes
Inducer – do a thorough med review!
List the commonly encountered interactions with rifampin
Azoles
Cyclosporine
Tacrolimus/sirolimus
Warfarin
Oral contraceptives
HIV antivirals
Statins
Which antibiotic is used for the prophylaxis and treatment of UTIs
Nitrofurantoin (E. coli)
Adverse effects of nitrofurantoin
Reduced efficacy in CrCl < 50
Pneumonitis/pulmonary fibrosis
Avoid in pregnancy > 38 weeks due to fetal hemolytic anemia
Which antibiotic is a prodrug that is susceptible in anaerobes only?
Metronidazole
