Pharmacology Flashcards
Mechanism of action:
Quinolones
Bactericidal
Inhibits DNA gryase
Quinolones spectrum of activity
Staphylococci (not MRSA), gram negative bacilli (Pseudomonas), Enterobacter
Adverse reactions of Quinolones
GI (nausea, vomiting, diarrhea), insomnia, headache, seizures, contraindicated in children-defects in cartilage, drug interaction with theophylline & antacids
What type of drugs are Quinolones?
Antibiotics
What type of drug is cephalosporins?
Antibiotic
Mechanism of action of cephalosporins?
Bactericidal
Inhibition of cell wall synthesis
4th generation cephalosporins agent?
Cefipime (Maxipime)
Spectrum of activity of 1st generation cephalosporins?
Staphylococci, streptococci
Gram negatives (E. Coli, P. mirabilis, shigella, salmonella)
Anaerobes (not bacteroides)
Spectrum of activity of 2nd generation cephalosporins?
Staphylococci (less active than 1st generation)
Streptococci (same as 1st generation)
More gram negative (H. Influenza, proteus, klebsiella, E. coli)
Anaerobes (cefotetan & cefoxitan active against bacteroides)
Spectrum of activity 3rd generation cephalosporins?
Staphylococci, streptococci (less active than 1st & 2nd)
Pseudomonas (ceftazadime & cefoperazone only)
Anaerobes
Spectrum of activity of 4th generation cephalosporins?
Same as earlier agents
Greater gram negatives coverage (including pseudomonas)
Adverse reactions of cephalosporins?
Hypersensitivity (cross reactivity with PCN allergy 5-15%) Neutropenia Diarrhea Bleeding Phlebitis with IV administration
B-Lactams?
Imipenem/Cilastain
(Primaxin)
Aztreonam
Spectrum of activity of Imipenem/Cilastain(Primaxin)?
Very broad
Most gram positive aerobes & anaerobes
Gram negatives ( including pseudomonas)
Anaerobes (including bacteroides)
Adverse reactions of Imipenem/Cilastain (Primaxin)?
Seizures in patients with h/o seizures
Nausea/vomiting
Spectrum of activity of Aztreonam?
Gram negative aerobes (pseudomonas)
Not active against gram positive or aerobic organisms
Adverse reactions of Aztreonam?
No major side effects
What’s dosage of Aztreonam?
1-2 gm IV q8h
What is in Augmentin?
Amoxicillin/clavulanic acid
What is Unasyn?
Ampicillin/sulbactam
What is in Timentin?
Ticarcillin/clavulanic acid
What is in Bactrim?
Tmp/smx
Trimethoprim/sulfamethoxazole
What is in Primaxin?
Imipenem/Cilastain
What is in Zosyn?
Piperacillin/tazobactam
What is in Rocephin?
Ceftriaxone
3rd generation Cephalosporins
Which drug is nicknamed “Gorillamycin”?
Imipenem because it has the broadest spectrum of any drug
What is in Avelox?
Moxifloxacin hydrochloride
What is in Invanz?
Ertapenem sodium
What is in a SMA-7 that test kidney function?
Bun- 7-21
Creat- 0.5-1.5
What do you always want to check before giving an antibiotic?
Kidney function
Allergies
If pt is already on an antibiotic
If a gram stain & C & S has been done and results if done
What is the dosing for Unasyn?
- 0g IV q 6
1. 5g IV q6 for pt with renal impairment
When is Unasyn usually used?
It is a good initial IV choice for a polymicorbial infection
Diabetic infection
What is an alternative to Unasyn for a patient with a PCN allergy?
Cipro/Clinda
Levaquin
(There are others)
Will Unasyn work against Psuedomonas?
No
What is in Augmentin? Dosing?
Amoxicillin/clavulanic acid
500 or 875 mg one tab po bid
875mg/125mg
Amox/clavu acid
How much clavulanic acid is in Augmentin 500mg? For Augmentin 875mg?
Both have 125mg
Does Augmentin work on pseudomonas?
Nope
When is Augmentin usually used?
It is a good oral drug for polymicorbial infection
Diabetic infection
po dog and cat bites (pasturella multiocida)
Indications for Zosyn?
Infections of skins and skin structures, including DM foot infection
Dosing Zosyn?
3.375g IV q 4-6
Renal dose 2.25g IV q 4-6
Alt dose 4.5g IV q4-6
Will Zosyn work on Pseudomonas?
Yes
% of cross sensitivities between cephalosporins and PCN?
1-5%
What is Timentin?
Ticarcillin/clavulanic acid
What to watch out for with Ticarcillin?
Increased Na+ load by 5.2meq/g
What is the Na+ load of Ticarcillin?
5.2meq/g
Dosing Timentin?
3.1g IV q4-6
What is Timentin’s coverage?
Polymicorbial, broad spectrum including pseudomonas
What is the drug of choice for a diabetic foot infection with a penicillin allergy?
Clindamycin
How are PCN’s excreted?
All are renal except for Mezlocillin, Azlocillin Piperacillin (The ureidopencillins are 20-30% renal)
Name 2 IV alternative antibiotics for PCN allergic patients
Clindamycin Levaquin Vancomycin Bactrim (There are others)
Which PCN’s are anti-Psuedomonal?
The fourth and fifth generation PCN's Ticarcillin, Timentin Piperacillin, Zosyn Carbenicillin, Mezlocillin, Azlocillin 2-4th generation Quinolones FAT CIA FORTAZ