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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
what cephalosporins are best for resistant Gm (-) bacteria?
cefiderocol for ESBL, AmpC, and KPC producing
26
what cephalosporins are best for anaerobe bacteroides fragilis??
cefoxitin (the bestest; 2nd gen) can also use cefotetan and cefmetazole
27
what bacteria do NO cephalosporins cover?
enterococcus and legionella
28
what carbapenems have the best activity against gm (+)?
imipenem and doripenem (good with MSSA, but not primary anti staph drugs)
29
what carbapenems have the best activity against gm (-)?
doripenem and meropenem
30
what are the drugs of choice for ESBL- and AmpC- producing bacteria?
doripenem and meropenem
31
what carbapenems have activity against KPC enterobacteriaceae as well?
meropenem-vaborbactam and impenem-relebactam
32
what carbapenem does not have activity against pseudomonas or acinetobacter?
ertapenem
33
what does ertapenem not have activity against?
pseudomonas or acinetobacter
34
what do carbapenems not cover??
C diff or MRSA, Stenotrophomonas, or atypical bacteria
35
what does aztreonam have activity against?
gm (-); pseudomonas
36
what is the DOC for MSSA?
first gen cephalosporins
37
what is the DOC for streptococci?
first gen cephalosporins
38
what should first gen cephalosporins not be used for?
meningitis (does not penetrate CNS)
39
what cephalosporins are used for pseudomonas?
ceftazidime or cefeperazone
40
what cephalosporins are used for PRSP?
cefotaxime and ceftriaxone
41
what do fourth gen cephalosporins have activity against?
pseudomonas
42
what is the DOC for surgical prohylaxis against surgical site infections?
cefazolin
43
what is the SOA of vancomycin?
gm (+) aerobes and anaerobes: MRSA, MSSA, PRSP, C Diff
44
what is vancomycin the DOC for?
MRSA and oral C diff colitis!
45
what is the SOA of quinupristin-dalfopristin?
gm (+): VRE PRSP, MSSA, MRSA, E faecium (not faecalis) | gm (-): limited activity
46
what is the SOA of oxazolidinones?
gm (+): PRSP, enterococcus faecium and faecalis, VRE, MSSA, MRSA, VISA, VRSA gm (-): no activity
47
what is linezolid the DOC for?
VRE
48
what is the SOA for daptomycin?
Gm (+): PRSP, E faecium and faecalis, including VRE | gm (-): no activity
49
what is the SOA of lipoglycopeptides?
gm (+): e faecium and faecalis, MSSA, MRSA, VISA
50
what lipoglycopeptide has activity against VRSA?
oritavancin
51
when should Synercid be used?
for VRE when vanc, linezolid, AND dapto cannot be used
52
what is linezolid used for?
VRE infections; MRSA if vanc cannot be used
53
what should dapto not be used for?
treatment of pneumonia since the compound is inactivated by pulmonary surfactant
54
who can use lipoglycopeptides?
adults only!
55
when are lipoglycopeptides used?
when vanc, linezolid, and dapto cannot be used for gm (+) aerobes
56
what is the SOA of the older FQs?
cipro: gm (+) activity is poor
57
what is the SOA of the newer/respiratory FQs?
enhanced gm (+): PRSP and MRSA (dela)
58
what is the SOA of delafloxacin?
PRSP and MRSA and other gm (+)
59
what FQs are used for s aureus?
None; DONT USE FQs FOR S AUREUS
60
what FQs are used for strep pneumo?
levo, dela, moxi
61
what FQs are not used for strep?
cipro
62
what FQs cover pseudomonas?
cipro and levo
63
what FQs don't cover pseudomonas?
moxi or gemi
64
what FQs cover legionella and atypicals?
all of them!
65
what FQ does NOT cover anaerobes?
moxifloxacin
66
What do the macrolides cover?
PSSP, but poor activity against PRSP (Clarithromycin, then erythromycin, then azithromycin) legionella
67
what do the macrolides not cover?
enterobacteriaceae
68
what does erythromycin NOT cover?
H flu
69
what are macrolides used for clinically?
RTIs, atypical community acquired pneumonia
70
what do the aminoglycosides cover?
gm (+) aerobes: primarily gentamicin gm (-): very active PPPEEACKSSS and morganella (proteus, pseudomonas, providencia, enterobacter, ecoli, acinetobacter, citrobacter, klebsiella, salmonella, shigella, serratia)
71
what aminoglycoside covers mycobacteria?
streptomycin
72
what is the biggest bacteria that aminoglycosides cover?
pseudomonas
73
what aminoglycoside has some activity against ESBLs, AmpC, and KPC producing bacteria?
plazomycin
74
what are aminoglycosides inactive against?
anaerobes
75
what combo drug causes synergy with aminoglycosides?
beta lactams or other cell wall active agents
76
what do tetracyclines cover?
PSSP, MSSA, H flu, legionella, and chlamydophila
77
what are tetracyclines resistant to?
enterobacteriaceae
78
what do the tetracycline analogues cover?
MSSA and MRSA (very last line), EEAACKSS (enterobacter, e coli, acinetobacter, aerominas, citrobacter, klebsiella, serration, strenotrophomonas)
79
what are tetracycline analogues not active against?
proteus mirabilis or pseudomonas!
80
what does bactrim cover?
S aureus (including MRSA and CA-MRSA), and pneumocystis!
81
what does bactrim not cover?
pseudomonas
82
what is bactrim the drug of choice for?
pneumocystis
83
what do the polymyxins cover?
PEEACKSSS, acinetobacter including MDR strains, and pseudomonas including MDR strains
84
what are polymyxins not active against?
burkholderia, proteus, providencia, serratia, and brucella
85
what does clindamycin cover?
MSSA, Ca-MRSA, and above the diaphragm anaerobes (besides C diff)
86
what does clindamycin not cover?
c diff
87
what does metronidazole cover?
bacteroides fragilis and C diff!!!!
88
what is metronidazole the DOC for?
c diff
89
what does metronidazole not cover?
ANY AEROBES

Therapeutics Exam 2 (5 decks)

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