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2. Anti-Infectives > PCN/Cephalosporins > Flashcards

PCN/Cephalosporins Flashcards

1
Q

Amoxicillin brand name

A

Amoxil, Moxatag, Trimox

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2
Q

Amoxicillin susceptible pathogens

A

Gram-: H. influenzae, E. coli, P. mirabilis, N. gonorrhoea

Gram+: streptococci (including faecalis), nonpenicillinase-producing staphylococci and D. pneumoniae

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3
Q

Amoxicillin indications/dosage

A

adults infected with susceptible pathogens: 250-500mg q8h or 500-875mg q12h
children: 20-45mg/kg/day in divided doses. (125 and 250mg forms given q8h and 200 and 400mg forms given q12
gonorrhea and other infections due to N. gonorrhoeae
Adults: 3G as a single dose
prepubertal children >2y: 50mg/kg amoxicillin + 25mg/kg probenecid as single dose

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4
Q

Amoxicillin mechanism

A

inhibits bacterial cell wall synthesis via acylation of transpeptidase enzyme

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5
Q

Amoxicillin distribution

A

most body tissues excluding CSF, except when meninges are inflamed

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6
Q

Amoxicillin excretion

A

excreted unchanged in urine

20% protein bound

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7
Q

Amoxicillin drug interactions

A

changes GI flora, may disrupt absorption of oral contraceptives
renal excretion decreased with probenecid
theoretical: don’t use with bacteristatic antibiotics, bactericidal nature depends on rapid growth of bacteria to exert effects

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8
Q

Amoxicillin CI/precautions

A

CI with hypersensitivity to PCN/cephalosporins
estimated cross-sensitivity is 5-16%
caution in renal function impairment
report persistent or severe diarrhea to physician

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9
Q

Amoxicillin pregnancy category

A

B

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10
Q

Amoxicillin ADR’s

A

nausea, vomiting, DIARRHEA, hives, itching, RASH

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11
Q

Amoxicillin patient education

A

prefer to take on empty stomach (1h before or 2h after meals) with full glass of water
chewable: MUST be chewed before swallowing, or mixed with food
take at even intervals around the clock
complete full course of therapy
keep suspension refrigerated, discard after 14 days

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12
Q

Amoxicillin + ClavK brand name

A

Augmentin (XR)

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13
Q

Amoxicillin + ClavK Indications/organisms

A

sinusitis and otitis media due to beta-lactamase producing strains of H. influenzae and B. catarrhalis
lower respiratory tract infections due to beta-lactamas producing strains of H. influenzae
skin and skin structure infections due to beta-lactamase producing strains of Staph aureus, E coli, and Klebsiella species
urinary tract infections due to beta-lactamase producing strains of E. coli, Klebsiella species, and Enterobacter species
recurrent acute otitis media due to Strep pneumo, H. flu, and M. cat characterized by antibiotic exposure for AOM in past 3 months and either

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14
Q

Amoxicillin + ClavK dosing

A

sinusitis, AOM, LRTI, SSTI, UTI’s
Adult: ‘250’ q8h or ‘500’ q12h if less severe, ‘500’ q8h or ‘875’ q12h if more severe
children: 25-45mg/kg/day of amoxicillin, in equally divided doses BID
recurrent AOM: Augmentin ES 600 at 90mg/kg/day divided BID
Acute sinusitis or CAP: 2 augmentin XR q12h for 10 days (sinusitis) or 7-10 days (CAP) with meals

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15
Q

Amoxicillin + ClavK

A

Amoxicillin: bacteriocidal. Inhibits bacterial cell wall synthesis via acylation of transpeptidase enzyme
ClavK: binds competitively to active sites of B-lactamase enzymes, rotecting PCN’s from destruction

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16
Q

Amoxicillin + ClavK excretion

A

excreted unchanged in urine
20% protein bound
ClabK absorbed more readily when taken with food

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17
Q

Amoxicillin + ClavK drug interactions

A

may disrupt absorption of oral contraceptives
renal excretion decreased by probenicid
should not be given with -static ABX as -cidal ABX rely on rapid growth of bacteria to exert pharmacological effects

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18
Q

Amoxicillin + ClavK CI/Precautions

A

CI in hypersensitivity. Crossreactivity with cephalosporins 5-16%
caution: renal impairment
different tablets are not equal!! ClavK component does not translate

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19
Q

Amoxicillin + ClavK ADR’s

A

nausea, vomiting, DIARRHEA, hives, itching, RASH

20
Q

Amoxicillin + ClavK patient education

A

prefer to be taken AT START of mealto enhance of absorption
take at even intervals around the clock
complete full course
follow chewables with full glass of water
keep suspension refrigerated, discard AFTER 10 DAYS

21
Q

Cefdinir brand name

A

Omnicef

22
Q

Cefdinir bacteria treated

A

S. aureus, S. pneumo, S. pyogenes, H. influenzae, H. parainfluenzae, . cat, S. epi, Strep. agalactiae, Citrobacter diversus, E. coli, K. pneumo, and P mirabilis

23
Q

Cefdinir indications/dosage

A

CAP in adults, acute exacerbations of chronic bronchitis in adults, acute maxillary sinusitis, pharyngitis/tonsilitis, uncomplicated SSTI, AOM in children
all: 600mg/day in 1-2 doses

24
Q

Cefdinir mechanism

A

3rd gen cephalosporin

inhibits cell wall synthesis via acylation of transpeptidase enzyme

25
Q

Cefdinir drug interactions

A

aluminum or magnesium antacids and iron supplements decrease BA of drug
probenecid inhibits renal excretion, thus increasing plasma levels

26
Q

Cefdinir CI/precautions

A

CI: hypersensitivity to PCN or cephs (~10% crossreactivity)
Caution: renal impairment
do not give within 2 hours of antacids or iron
C. diff has occurred with cephs, report persistent and severe diarrhea

27
Q

Cefdinir pregnancy category

A

B

28
Q

Cefdinir ADRs

A

diarrhea, vaginal moniliasis, nausea, headache, abdominal pain

29
Q

Cefdinir patient education

A

shake suspension well
do not take antacids or iron within 2 hours of dose
discard unused suspension after 10 days
complete full course of therapy unless otherwise directed

30
Q

Cefuroxime brand name

A

Ceftin

31
Q

Cefuroxime bacteria treated

A

S. pyogenes, S. pneumo, H. flu, M. cat, S. aureus, E. coli, K. pneumo, and N. gonorrheae

32
Q

Cefuroxime indications/dosages

A

pharyngitis and tonsilitis, otitis media, LRTI’s, impetigo, UTI’s, SSTI’s: 250-500mg BID for adults, or 125mg BID for children (250mg BID for AOM)
treatment of gonorrhea is a single 1g dose

33
Q

Cefuroxime mechanism

A

2nd generation cephalosporin
inhibits cell wall synthesis via acylation or transpeptidase enzyme
Highly stable to bacterial beta-lactamases

34
Q

Cefuroxime drug interactions

A

may alter absorption of estrogens
probenecid increases serum concentration
may cause false positive for nonspecific urine glucose test, some proteinuria tests, and direct Coombs’ test
falsely elevate urinary 17-ketosteroid values
false negative for blood gluse using ferricyanide test

35
Q

Cefuroxime CI/precautions

A

CI: hypersensitivity to PCN or ceph (~10% corss-sensitivity)
caution: renal impairment
C. diff can occur, report persistent or severe diarrhea

36
Q

Cefuroxime pregnancy category

A

B

37
Q

Cefuroxime ADRs

A

DIARRHEA, HIVES, ITCHING, RASH, and nausea

38
Q

Cefuroxime patient education

A

Tablets can be taken without regard to food
take suspension with food
take at even intervals
complete full course
suspension can be stored at room temp, discard after 10 days from reconstitution

39
Q

Cefuroxime patient education

A

Tablets can be taken without regard to food
take suspension with food
take at even intervals
complete full course
suspension can be stored at room temp, discard after 10 days from reconstitution

40
Q

Cephalexin brand name

A

Keflex

41
Q

Cephalexin susceptibilities

A

Streptococci, staphylococci, E. coli, P. mirabilis, klebsiella species, H. flu, and M. cat

42
Q

Cephalexin indications/dosages

A

infections due to susceptible strains: 250mg-1g q6h.

can do 500mg q12h for strep pharyngitis, SSTI’s, and uncomplicated cystitis in patients >15y

43
Q

Cephalexin mechanism

A

1st gen cephalosporin

inhibits cell wall synthesis via acylation of transpeptidase enzyme

44
Q

Cephalexin drug interactions

A

may alter absorption of estrogens
probenecid increases serum concentration
may cause false positive for nonspecific urine glucose tests, some proteinuria tests, and direct Coombs’ test, and may falsely elevate urinary 17-ketosteroid values

45
Q

Cephalexin CI/precautions

A

CI: hypersensitivity to PCN or cephs
Caution: renal impairment
C. dif can occur with cephs, report persistent/severe diarrhea

46
Q

Cephalexin ADRs

A

nausea, vomiting, DIARRHEA, HIVES, ITCHING, RASH

47
Q

Cephalexin patient education

A

prefer to be taken on an empty stomach, with full glass of water
complete full course
keep suspension refrigerated, discard after 14 days
report persistent/severe diarrhea

2. Anti-Infectives (3 decks)

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