Random Antibiotics Flashcards
Aminoglycoside MOA:
Bind to outer membrane of cell.
- Results in re-arrangement of LPS.
- Uptake is energy dependent.
- Once across membrane drug is trapped.
- Binds to 30S and 50S ribosomal subunit.
Bacteriocidal.
Concentration dependent killing with PAE.
Aminoglycoside excretion:
99% unchanged via glomerular filtration.
- Tx UTI’s
Aminoglycoside ADR:
- Thrombophlebitis.
- Nephrotoxicity (too high trough).
- Ototoxicity (too high peaks).
- Neuromuscular blockade.
Aminoglycosides spectrum of activity:
G-: - Piddly - PEK - SPACE G+: - Add-on only, not monotherapy.
Aminioglycoside lung concentrations:
Low, 40%.
Aminoglycosides (3):
- Gentamicin
- Tobramycin
- Neomycin (gut decontamination)
Vancomycin MOA:
Inhibits the biosynthesis of peptidoglycan during cell wall formation.
- Complexes with D-alanyl-D-alanine precurser.
Bactericidal
PAE
Vancomycin ADRs (8):
- Thrombophlebitis.
- Red-man syndrome.
- Neutropenia.
- Eosinophilia.
- Thrombocytopenia.
- Hypersensitivity.
- Nephrotoxicity.
- Ototoxicity (high peaks).
Vancomycin spectrum of activity:
G+:
- MRSA
- Staph epidermidis
- Strep
- Enterococcus
- Clostridium
- Bacillus anthracis
- Cornyebacteria
Quinupristin/dalfopristin (synercid) MOA:
- Irreversibly bind to the 50S ribosomal subunit.
- Q inhibits chain formation.
- D inhibitis peptide elongation.
Quinupristin/dalfopristin spectrum (5):
- MRSA.
- PCN-resistant strep pneumo.
- VRE (*not E. faecalis).
- Anaerobes
- Some G-
Linezolid MOA:
- Bind to 23S ribosomal RNA of 50S subunit.
Linezolid spectrum (4):
- MRSA
- VISA
- VRE
- PCN-resistant strep pneumo
Linezolid ADRs (3):
- Myelosupression: thrombocytopenia.
- Superinfection (yeast).
- Mitochondrial toxicity (long courses).
Linezolid drug-drug interactions:
MAOI
- Co-administration with SSRI –> serotonin storm.
Mupirocin (2):
- Topical treatment.
- MRSA colonization eradication from nares.
Colistin (4):
- Bacteriocidal.
- SPACE bug coverage.
- Nephrotoxicity and neurotoxicity.
- “Kitchen sink” - last ditch efforts.
Fosfomycin (3):
- Bacteriocidal.
- UTIs only.
- MDR pathogens:
- MRSA/VRE
- ESBL
Tigecycline indications (3):
- Complicated skin infections.
- Complicated intra-abdominal infections.
- Community acquired pneumonia (CAP).
- Does not attain high serum concentrations.
Tigecycline spectrum (4):
- MRSA/VRE.
- G- bacteria (CRE).
- Acinetobacter (not pseudomonas).
- Anaerobes (GI infections).
Daptomycin (6):
- Bacteriacidal.
- G+ coverage.
- MRSA/VRE.
- Complicated skin and soft tissue infections.
- SA and MRSA bacteremia
- Does NOT cover pneumonia.
- ADR: rhabdomyolysis, eosinophilic pneumonia
Telavancin (4):
- Semi-synthetic Vancomycin.
- G+:
- Staph, strep and enterococcus.
- Skin and soft tissue infections.
- ADR: Nephrotoxicity, Red-man syndrome, QT prolongation, pancreatitis.
