What Ron says we need to know.... Flashcards
When is it indicated to use more than one prophylactic antibiotic in surgury?
If the case lasts more than 4 hours
If you have a high MIC do you need more or less drug to kill the organism?
High MIC = More drug needed
Infections that require empiric anaerobe coverage
Dental Aspiration Pneumonia Intra-abdominal PID Gas gangrene Diabetic foot ulcers
What drugs empirically cover anaerobes?
Carbapenams Clindamycin (Cleocin) Moxyfloxacin (Avolex) Metronidiazole (flagyl) Pip/Tazo (Zosyn) Amp/Sulb (Unasyn)
What infections need empiric pseudomonas coverage?
NOSOCOMIAL - PNA, UTI, Meningitis
Severe diabetic foot ulcer
Puncture would through shoe
Burns
What drugs empirically treat pseudomonas?
Levoquin (Levafloxacin) Pip/Tazo (Zosyn) Carbapenams - NOT ERTAPENAM Cefepime (Maxipime) Cipro Ceftazadime (Fortx)
What infections need empirically treated for MRSA?
Prulent cellulitis
Post opp wounds
Nosocomial PNA and Meningitis
What drugs empirically treat MRSA?
Doxycyclin Clindamycin Bactrim Linezolid Vancomycin
What types of infection need to be empirically treated for enterococcus?
Intrabdominal/bilary infections
UTI
CLABSI
What drugs empirically treat enterococcus?
Amox/Clauv (Augmentin) Amp/Sulb (Unasyn) Pip/Tazo (Zosyn) Vancomycin Daptomycin Cipro Levaquin Linezolid Nitrofurantoin - UTI
and PNC lol
What is the MOA for beta-lactams?
bactericidal
What organisms are not covered by cephalosporins?
CEPHALOSPORINS HAVE NOT ENTEROCOCCAL COVERAGE
Most anaerobes
What are the first generation cephalosporins(2) and when should they be used?
Cefazolin (Ancef)
Cephalexin (Keflex)
Used for MSSA, strep
Sx prophylaxis, non-purulent skin infections
What are the 2nd (3) generation cephalosporins and when should they be used?
3rd generation cephalosporins:
ceFOXitin (Mefoxitin)
ceFUR-OXime (Ceftin)
ceFAClor (Ceclor)
Gram negative and some anaerobes
Used for surgical prophylaxis and URI
What are the third generation (3) cephalosporins and when should they be used?
3rd Generation cephalosporins:
cefTRIAXone - Rocephin
cefeTAZidime -Fortaz
cefDINIR -Omnicef
empiric UTI, PNA, Meningitis
What is the one 4th generation cephalosporin that we need to know and what is it indicated for?
Cefepime
+, - and PSUEDOMONAS
What is the one 5th generation drug we need to know and what is it indicated for
Ceftaroline - Teflaro
ONLY CEPH THAT COVERS MRSA
What is special about coverage with carbapenams and what is a CI/ADR?
Carbapenams have the broadest coverage +, -, ESBL and anaerobes
increased SZ risk
What is the monobactam drug and what microorganisms does it cover?
Monobactam = aztreonam
Covers ONLY GRAM (pseudomonas)
What are the commonly used fluroquinolones?
Levofloxacin - Levaquin
Moxyfloxacin
Cipro
What organisms are covered by fluroqunolones?
Atypicals - mycoplasma
When can fluroquinolones such as Levofloxacin and CIprofloxacin be used as monotherapy?
Complicated UTI
Prostatitis
CAP
What is the BBW for fluroquinolones?
Tendone rupture, myasthenia gravis pts, C. DIFF
What are the macrolides? (3)
Erythromycin
Azythromycin- Zithromax
Clarithromycin- Biaxin
What drug can be used for MAC?
Clarithromycin - Biaxin (in CLAR skies BI(axin)RDS fly)
When are macrolides used?
DOC for atypical such as chlamidia, mycoplasma and legionella
atypicals and empiric PNA
What are ADR with macrolides?
QT prolongation, increased LFT, potentiates warfarin
What are the commonly used aminioglycosides? When are they most commonly used?
Gentamycin
Tobramycin
Used for endocarditis and nosocomial infections
What is the MOA for aminoglycosides?
bactericidal, concentration dependent killing and a post antibiotic effect
What are toxicities associated with ahminoglycosides and how are they limited?
oto and nepho toxicity
Limited by monitoring peak and trough levels
What tetracyclines are most commonly used?
Minocycline - Minocin
Doxycyclin - Adoxa
Tetracyclin-`
When should tetracyclines be used?
For unusual such as Lyme disease, rickettsiae, tularemia Doxy covers MRSA COPD CAP Acne
NOT IN UTI
What are the ADR with tetracyclines?
Teeth staining
photosensitivity
When should bactrim be used?
MRSA
uncomplicated UTI
PCP prophylaxis
What are the serious drug reactions associated with bactrim?
hyperK
SJS
potentiates warfarin
What microbes are covered with clindamycin?
anaerobes ABOVE DIAPRAGM
MRSA - do not use if resistant to emycin
What are ADRs with clindamycin?
C DIFF
What microbes are covered my metronidazole/flagyl?
anaerobes below diaphragm
protozoans
C-DIFF
What are the ARDS associated with metronidazole?
Metallic taste
Neuropathy
Warfarin interaction
Rxn with EtOH
What organisms are covered by nitrofurantoin and when is nitrofurantoin used?
nitrofurantoin - gram negatives
UNCOMPLICATED UTI
When is linezolid used? Ci?
MRSA/VRE
do not use with SSRIs or Myelosuppresed patients
When is daptomycin used? CI?
MRSA/VRE
can’t use for lung infections
something about muscle damage lol
