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Therapeutics Exam 2 > Therapeutics V Exam 2: Spectrum of Activity > Flashcards

Therapeutics V Exam 2: Spectrum of Activity Flashcards

1
Q

natural penicillins

A

Gram positive cocci and bacilli, except staph aureus; gram negative cocci, anaerobes (not Cdiff or pseudomonas)

covers most enterococcus spp

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2
Q

What is penicillin G the potential DOC for?

A 
viridans and group strep
neisseria meningitidis
corynebacterium
bacillus anthracis
clostridium perfringens and tetanani
treponema
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3
Q

penicillinase-resistant penicillins

A

MSSA (NOT MRSA)
not active against enterococcus and strep pneumo
not gram neg and anaerobes

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4
Q

aminopenicillins

A

enterococcus (more than Pen G)
ineffective against staph
H flu, ecoli, proteus

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5
Q

carboxypenicillins

A 
weak gm (+) activity
enhanced coverage of g. (-) including PSEUDOMONAS
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6
Q

what are aminopenicillins the DOC for?

A

enterococcus and listeria

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7
Q

what are carboxypenicillins not effective against?

A

klebsiella or serratia

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8
Q

what do the ureidopenicillins have good activity against?

A

group and viridans strep, pseudomonas, and some against enterococcus and enterobacteriaceae

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9
Q

what do ureido penicillins have no activity against?

A

staphylococcus

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10
Q

what is the most active penicillin?

A

piperacillin

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11
Q

what do the beta lactamase inhibitor combos have activity against?

A

MSSA and ANAEROBES! Bacteroides fagilis and B fragilis group (DOT) organisms

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12
Q

what is the SOA of first generation cephalosporins?

A

(+) MSSA

-) PEK (proteus, ecoli, klebsiella

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13
Q

what is the SOA of the second generation cephalosporins?

A

(+) MSSA, PSSP, group and viridans strep

-) HENPEK (h flu, enterobacter, neisseria, proteus, ecoli, klebsiella

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14
Q

what is the SOA of the third generation cephalosporins?

A

(+): PRSP
(-): HENPECKSSS (h flu, enterobacter, neisseria, proteus, ecoli, citrobacter, klebsiella, salmonella, shigella, serratia)

ceftazidime and cefoperazone have activity against pseudomonas!

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15
Q

what do ceftriaxone and cefoperazone have activity against?

A

pseudomonas

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16
Q

what are third gens have the best gm (+) activity out of all of them?

A

ceftriaxone and cefotaxime

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17
Q

what is the SOA of the fourth gen cephalosporins?

A

(+): staph, strep, PSSP, MSSA

(-): HENPECKSSS + pseudomonas, beta lactamase producing enterobacter, and Ecoli

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18
Q

what is the SOA of ceftaroline?

A

MRSA and PRSP, but 3rd or 4th line

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19
Q

what is the SOA of cefiderocol?

A

greatly decent with MDR gram (-): MDR strains that produce ESBLs, AmpCs, and ALL carbapenemases (KPCs, OXA-48, VIM and NDM-1)

also enterobacteriaceae and pseudomonas

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20
Q

what is the SOA of ceftolozane-tazobactam (IV)?

A

AmpC producing Pseudomonas

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21
Q

what cephalosporins are best for MSSA?

A

cefazolin and cephalexin (first gens)

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22
Q

what cephalosporins are best for MRSA?

A

ceftaroline

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23
Q

what cephalosporins are best for pseudomonas?

A

ceftazidime!!! also cefoperazone or ceftolozane-tazo, or cefepime

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24
Q

what third gen cephalosporins does NOT cover pseudomonas?

A

ceftriaxone!

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25
Q

what cephalosporins are best for resistant Gm (-) bacteria?

A

cefiderocol for ESBL, AmpC, and KPC producing

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26
Q

what cephalosporins are best for anaerobe bacteroides fragilis??

A

cefoxitin (the bestest; 2nd gen)

can also use cefotetan and cefmetazole

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27
Q

what bacteria do NO cephalosporins cover?

A

enterococcus and legionella

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28
Q

what carbapenems have the best activity against gm (+)?

A

imipenem and doripenem (good with MSSA, but not primary anti staph drugs)

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29
Q

what carbapenems have the best activity against gm (-)?

A

doripenem and meropenem

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30
Q

what are the drugs of choice for ESBL- and AmpC- producing bacteria?

A

doripenem and meropenem

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31
Q

what carbapenems have activity against KPC enterobacteriaceae as well?

A

meropenem-vaborbactam and impenem-relebactam

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32
Q

what carbapenem does not have activity against pseudomonas or acinetobacter?

A

ertapenem

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33
Q

what does ertapenem not have activity against?

A

pseudomonas or acinetobacter

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34
Q

what do carbapenems not cover??

A

C diff or MRSA, Stenotrophomonas, or atypical bacteria

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35
Q

what does aztreonam have activity against?

A

gm (-); pseudomonas

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36
Q

what is the DOC for MSSA?

A

first gen cephalosporins

37
Q

what is the DOC for streptococci?

A

first gen cephalosporins

38
Q

what should first gen cephalosporins not be used for?

A

meningitis (does not penetrate CNS)

39
Q

what cephalosporins are used for pseudomonas?

A

ceftazidime or cefeperazone

40
Q

what cephalosporins are used for PRSP?

A

cefotaxime and ceftriaxone

41
Q

what do fourth gen cephalosporins have activity against?

A

pseudomonas

42
Q

what is the DOC for surgical prohylaxis against surgical site infections?

A

cefazolin

43
Q

what is the SOA of vancomycin?

A

gm (+) aerobes and anaerobes: MRSA, MSSA, PRSP, C Diff

44
Q

what is vancomycin the DOC for?

A

MRSA and oral C diff colitis!

45
Q

what is the SOA of quinupristin-dalfopristin?

A

gm (+): VRE PRSP, MSSA, MRSA, E faecium (not faecalis)

gm (-): limited activity

46
Q

what is the SOA of oxazolidinones?

A

gm (+): PRSP, enterococcus faecium and faecalis, VRE, MSSA, MRSA, VISA, VRSA
gm (-): no activity

47
Q

what is linezolid the DOC for?

A

VRE

48
Q

what is the SOA for daptomycin?

A

Gm (+): PRSP, E faecium and faecalis, including VRE

gm (-): no activity

49
Q

what is the SOA of lipoglycopeptides?

A

gm (+): e faecium and faecalis, MSSA, MRSA, VISA

50
Q

what lipoglycopeptide has activity against VRSA?

A

oritavancin

51
Q

when should Synercid be used?

A

for VRE when vanc, linezolid, AND dapto cannot be used

52
Q

what is linezolid used for?

A

VRE infections; MRSA if vanc cannot be used

53
Q

what should dapto not be used for?

A

treatment of pneumonia since the compound is inactivated by pulmonary surfactant

54
Q

who can use lipoglycopeptides?

A

adults only!

55
Q

when are lipoglycopeptides used?

A

when vanc, linezolid, and dapto cannot be used for gm (+) aerobes

56
Q

what is the SOA of the older FQs?

A

cipro: gm (+) activity is poor

57
Q

what is the SOA of the newer/respiratory FQs?

A

enhanced gm (+): PRSP and MRSA (dela)

58
Q

what is the SOA of delafloxacin?

A

PRSP and MRSA and other gm (+)

59
Q

what FQs are used for s aureus?

A

None; DONT USE FQs FOR S AUREUS

60
Q

what FQs are used for strep pneumo?

A

levo, dela, moxi

61
Q

what FQs are not used for strep?

A

cipro

62
Q

what FQs cover pseudomonas?

A

cipro and levo

63
Q

what FQs don’t cover pseudomonas?

A

moxi or gemi

64
Q

what FQs cover legionella and atypicals?

A

all of them!

65
Q

what FQ does NOT cover anaerobes?

A

moxifloxacin

66
Q

What do the macrolides cover?

A

PSSP, but poor activity against PRSP (Clarithromycin, then erythromycin, then azithromycin)

legionella

67
Q

what do the macrolides not cover?

A

enterobacteriaceae

68
Q

what does erythromycin NOT cover?

A

H flu

69
Q

what are macrolides used for clinically?

A

RTIs, atypical community acquired pneumonia

70
Q

what do the aminoglycosides cover?

A

gm (+) aerobes: primarily gentamicin
gm (-): very active PPPEEACKSSS and morganella (proteus, pseudomonas, providencia, enterobacter, ecoli, acinetobacter, citrobacter, klebsiella, salmonella, shigella, serratia)

71
Q

what aminoglycoside covers mycobacteria?

A

streptomycin

72
Q

what is the biggest bacteria that aminoglycosides cover?

A

pseudomonas

73
Q

what aminoglycoside has some activity against ESBLs, AmpC, and KPC producing bacteria?

A

plazomycin

74
Q

what are aminoglycosides inactive against?

A

anaerobes

75
Q

what combo drug causes synergy with aminoglycosides?

A

beta lactams or other cell wall active agents

76
Q

what do tetracyclines cover?

A

PSSP, MSSA, H flu, legionella, and chlamydophila

77
Q

what are tetracyclines resistant to?

A

enterobacteriaceae

78
Q

what do the tetracycline analogues cover?

A

MSSA and MRSA (very last line), EEAACKSS (enterobacter, e coli, acinetobacter, aerominas, citrobacter, klebsiella, serration, strenotrophomonas)

79
Q

what are tetracycline analogues not active against?

A

proteus mirabilis or pseudomonas!

80
Q

what does bactrim cover?

A

S aureus (including MRSA and CA-MRSA), and pneumocystis!

81
Q

what does bactrim not cover?

A

pseudomonas

82
Q

what is bactrim the drug of choice for?

A

pneumocystis

83
Q

what do the polymyxins cover?

A

PEEACKSSS, acinetobacter including MDR strains, and pseudomonas including MDR strains

84
Q

what are polymyxins not active against?

A

burkholderia, proteus, providencia, serratia, and brucella

85
Q

what does clindamycin cover?

A

MSSA, Ca-MRSA, and above the diaphragm anaerobes (besides C diff)

86
Q

what does clindamycin not cover?

A

c diff

87
Q

what does metronidazole cover?

A

bacteroides fragilis and C diff!!!!

88
Q

what is metronidazole the DOC for?

A

c diff

89
Q

what does metronidazole not cover?

A

ANY AEROBES

Therapeutics Exam 2 (5 decks)

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