Study guide questions Flashcards
Time dependent Antibiotics
1) Beta lactams
2) Vancomycin
3) Macrolides
4) Tetracyclines
Concentration dependent Antibiotics
1) Fluoroquinolones
2) Metronidazole
3) Aminoglycosides
4) Daptomycin
Batericidal
1) Beta lactams
2) Vancomycin
3) Aminoglycosides
4) Oxazolidinones (strepto only)
5) Synercid
6) Fluoroquiolones
Bacteristatic
1) Tetracyclines
2) Oxazolidinones
3) Macrolides/Lincosamides
Penicillins (-cillin)
- Penicillin G, V
- Ampicillin, Amoxicillin
- Amp/Sulb (Unasyn), Amox/Clav (Augmentin)
- Nafcillin
- Pip/Tazo (Zosyn)
Cephalosporins (-Cef)
1) Cefazolin, Cephalexin
2) Cefoxitin, Cefotetan
3) Ceftriaxone, Cefotaxime, Ceftazidime
4) Cefepime
5) Ceftaroline
Monobactams (-nam)
-Aztreonam
Carbapenems (-penem)
- Meropenem
- Imipenem
- Doripenem
- Ertapenem
Glycopeptides
-Vancomycin
Macrolides (-thromycin)
- Clarithromycin
- Azithromycin
- Erithromycin
Lincosamides
-Clindamycin
Aminoglycosides
-Gentamicin
Oxazolidiones (-zolid)
- Linezolid
- Tedizolid
Tetracycline (-cycline)
- Tetracycline
- Doxycycline
- Minocycline
Cell wall synthesis inhibitors
- Penicillins
- Cephalosporins
- Monobactams
- Carbapenems
Protein synthesis inhibitors
- Macrolides
- Lincosamides
- Aminoglycosides
- Oxazolidinones
- Tetracyclines
Drugs that only cover gram positive
- Penicillins
- Oxazolidiones
Drugs that only cover gram negative
- Aminoglycosides
- Azteronam
- Ceftazidime
- Cipro
Lincosamides (Clindamycin)
- Covers B. frag
- Gram negative anaerob
Aminoglycosides with cell wall synthesis inhibitors
-cover gram positive and negative!
Drugs that cover MRSA
1) Ceftaroline
2) Vancomycin IV
3) Clindamycin
4) Oxazolidinoes
5) Tetracyclines
Drugs that cover C. diff
1) Vancomycin PO
2) Metronidazole
Drugs that cover B. frag
1) Unasyn
2) Augmentin
3) Zosyn
4) Cefoxitin/ cefotetan (2nd gen cephalosporins)
5) Clindamycin
Drugs that cover P. aeruginosa
1) Zosyn
2) Ceftazidime
3) Cefepime
4) Aztreonam
5) Mero/Dori/Imipenem
6) Gentamicin
Drugs that cover Atypicals
1) Macrolides
2) Tetracyclines
Drugs excreted by the liver
- Ceftriaxone
- Clindamycin
- Azithromycin
- Nafcillin
- Tigecycline
- Moxifloxacin
- Erythroycin
- Doxycycline
- Synercid
Drugs that can cross the BBB
- 3rd and 4th gen cephalosporins (IV)
- Minocycline
- Penicillin
Beta lactam MoA
- Covalently bind to transpeptidase
- Inhibiting cell wall formation
Cephalosporin Coverage
- No activity against enterococcus
- 2nd gen covers B. frag
- 3rd gen (ceftriaxone/ceftaxime) drug of choice for strep pneumo
- Ceftazidime; no gram+ coverage, but does cover P. aerugnosa
- Also is a strong beta lactamase inducer
- 4th gen cefepime covers P. aeruginosa
- 5th gen Ceftaroline covers MRSA
What does Aztreonam cover
- Aerobic gram negatives
- Including P. aeruginosa
Carbapenems coverage
- Gram positive, gram negative, and anaerobes
- Works well on Enterobacter
- Can cause seizures
Gentamicin coverage
- IMPROVES survival from gram negative sepsis
- Is an aminoglycoside
Vancomycin coverage
-Gram positive
Aminoglycoside + Vanco or beta lactam
- Work synergistically
- Treats enterococcal endocarditis
Protein synthesis inhibitors that bind to 50s subunit
1) Macrolides
2) Lincosamides
3) Streptogramins
4) Oxazolidinones
Protein synthesis inhibitors that bind to 30s subunit
1) Aminoglycosides
2) Tetracyclines
Aminoglycoside MoA
- Works on 30s ribosome
- Blocks the initiation complex formation
- Stops proofreading and ribosomal translocation
- Reversible
- Bacteriostatic
Macrolides and Lincosamides MoA
- 50s ribosome
- Blocks polypeptide exit tunnel
- Reversible, bacteriostatic
Streptogramin MoA
- 50s ribosome
- Inhibits elongation of protein
- Interferes with polypeptide chain formation
- Bactericidal
Oxazolidinones MoA
- Binds to 23s rRNA
- Prevents ribosome assembly
- Reversible, bacteriostatic
Limitation of Aminoglycosides
- To get into bug inner membrane they need oxygen
- Useless against anaerobes
- Only work on aerobic gram negative bugs
- When combined with beta lactam or vanco gentamicin improves survival in aerobic gram negative sepsis
Post antibiotic effect (PAE)
-Can be caused by aminoglycoside therapy
Aminoglycoside Black box warnings
- Nephrotoxicity
- Ototoxicity
Tetracycline strength
- Great for atypicals
a) Doxycycline- CAP, MRSA
b) Minocycline- P. acnes, meningitis, STDs, MRSA
Azithromycin half life
- 60hrs
- Purely intracellular
- Does NOT interact with P450s
- Prolongs QT interval
Clindamycin strengths
- Active against gram+ and anaerobes
- Works on MRSA
Clindamycin warning
-C. diff diarrhea
Synercid treats what
- Works on gram+ cocci except for E. faecalis
- VRE and MRSA
Oxazolidenones (Zyvox) MoA
- Protein synthesis inhibitor
- Active agains gram+ bacteria only
- Covers MRSA and E. faecium
- Bacteriostatic except for streptococcus (bactericidal)
