Quinolones and Tetracyclines Flashcards
What are two adverse effects of aminoglycosides
high peaks: ototoxicity
high troughs: nephrotoxicity
what bacteria coverage does aminoglycosides have
excellent gram (-) little synergy for gram (+)
Aminoglycosides: gent, tobra, amikacin which one do we go to North Carolina for levels
amikacin
Aminoglycosides: what is neomycin used for
gut decontamination
Vancomycin covers what oragnisms
gram (+)
drink Vanc: treat C.diff
Linelozid what is it used for
VRE MRSA
Quinipristin, Dalfopristin what is it used for
MRSA VRE
Mupirocin what is it used for
topically MRSA
Colistin what is it used for
tough gram (-)
Fosfomycin what is it used for
MDR UTI
Tigecycline what is it used for? not used for? when do we use this drug
does not treat bacterimia treats tissue well tier 2 or 3 MRSA VRE
Daptomycin what is it used for? what makes this drug worse?
everything but lungs(inactivated with lung surfactant)
good tissue penetration
-worse if on Statin
Telavancin should be used when?
not use for if have Vancomcin allergy
Sulfonamides, what happens when patient has sulfur reaction
steven johnson syndrome
how do you reduce nephrotoxicity risk for sulfonimides
-plenty hydration for patient
what do you use Nitrofurantian for
UTI
MRSA VRE
methanamine
UTI prophylaxis
which macrolide is best tolerated
Azithromycin
which microlide is worst for drug drug interactions
E-mycin
which microlide causes a metallic taste
clarithromycin
which microlide can we use for a gastronephresis for diabetic patient
E-mycin
what E-mycin do we not use in pregnancy
estelate
what does clindomycin cover? who is it good for? what is it’s MERSA sensitivity
positive (staph, strep)
anaerobes
good for diabetic food patient or someone who is allergic to penicillin
30% MRSA sensitivity
2 adverse reactions for chloramphenicol
aplastic anemia
grey baby syndrome (levels above 50)
highest incidence of risk for cchlindomyosin
C. diff
what is the mechanism of action for Quinolones
target DNA gyrase
what type of drug is quiolones
cidal
what is the bioavailabilty for Quinolones
good
what are adverse effects of quinolones
photosensitivity
QT prolongation
mental status change
tendon rupture
at what age should you not give quinolones
caution under 18 years
what are the 3 main drug interaction for quinolones
theophylline ( breathing medication)
antacids/iron/mutlivitamins
Warfin
what does quinolones do with theophylline
can double theophylline levels
which quinolone is not impacted that much with drug-drug interaction
levofloxacin
what gram positives does Levofloxacin, moxifloxacin and gemifloxacin cover
staph and strep
what gram positives doe cipro and ofloxacin cover
not good gram + coverage
Cipro and levofloxacin cover what gram negative
SPACE
moxifloxcin covers what gram negative
SACE
which quinolone covers anaerobes
Moxifloxacin
which quinolones covers atypicals
levofloxacin
moxifloxacin
cipro
what does ciprofloxacin cover
poor gram (+) Good SPACE
what is the bioavailabilty for ciprofloxacin
excellent
use oral if possible
what does levofloxacin/gemifloxacin/moxifloxacin cover
gram + (staph/strep) PCN resistant strep pneumo Levo: SPACE Gem/Mox: SACE atypicals
Moxifloxacin is not used for what disease
UTI
what is a unique characteristic for moxifloxacin
anaerobes
what are major things quinolones treat
UTI
skin
bone and joint infection
intra-abdominal infections
what is the mechanism of action for tetracyclines
reversibly binds to 30S ribosomal unit
what type of drug is tetracycline
bacteriostatic
what decreases absorption for tetracyclines
food
what is the primary elimination for tetracyclines
renal
what is an adverse effect for tetracyclines
photosensitivity
discoloration of teeth
what is an adverse effect for demecylcoine? what can it treat
Reversible diabetes insipidius
-treats SIADH
what is a side effect of minocycline
dizziness
what syndrome related with tetracyclines
fanconi-like sydnrome
what is Fanconi-like syndrome
outdated critic acid formulation
there is a decrease absorption of TCN agents when co-administer via chelation
di- and trivalent cations
antacids
dairy products
Tetracycline interacts with what drug
Warfin
what is the spectrum of activity for tetracyclines
Graph (+) staph, strep
gram (-) H. flu, Neisseria
atypicals
what disease does Tetracyclines use for
Rickettsia infections Rocky Mountain spotted fever mycoplasma pneumonia chlamydia infections acne H. pylori
where does one get Brucellosis
unpasteurized cheeses, milk
how does one treat brucellosis
tetracyclines with gentamicin
how does one catch vibrio cholera
diarrheal disease from water
what can treat vibrio cholera
tetracyclines
Borrelia burgdorferi
lyme disease
flu-like symptoms
what can treat Borrelia burgdorferi
tetracyclines
when do you not use tetracyclines
pregnant women
children under 8
