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PR3151 CA1: Antibiotics (NUS Pharmacy) > Principles of Antimicrobial Use > Flashcards

Principles of Antimicrobial Use Flashcards

1
Q

Bactericidal vs Bacteriostatic
(Hint: 6 vs 4)

A

Bactericidal:
1. Bacteria Cell Wall Inhibitors
2. Aminoglycosides
3. Fluoroquinolones
4. Cotrimoxazole
5. Polymyxins
6. Lipopeptides

Bacteriostatic:
1. Tetracyclines
2. Macrolides
3. Sulfonamides
4. Trimethoprim

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2
Q

Food-drug interactions (Antibiotics and antifungals)

A
  1. Tetracycline
  2. Fluoroquinolone
  3. Posaconazole and Itraconazole
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3
Q

Oral administration available

A

Cell Wall Synthesis Inhibitor:
1. Penicillin V
2. Penicillinase Resistant Penicillins (Also Parenteral)
3. Aminopenicillins & Augmentin (Also Parenteral)
4. 1st and 2nd Gen Cephalosporin

Protein Synthesis Inhibitor:
1. Tetracyclines (Doxycycline also parenteral)
2. Neomycin
3. 50S Ribosomal Subunit Inhibitors (Also parenteral)

DNA Synthesis Inhibitor:
1. Fluoroquinolones (Also parenteral)
2. Cotrimoxazole (Also parenteral but oral more common)

Others:
Nitrofurantoin
Metronidazole

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4
Q

Poor CSF penetration

A

1st and 2nd generation cephalosporins, Aminoglycoside, Macrolide, Clindamycin

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5
Q

Renal Clearance

A
  1. Cell Wall Synthesis Inhibitors (Except Ceftriaxone)
  2. Aminoglycosides (Except Neomycin)
  3. Others: Tetracycline, ciprofloxacin, nitrofurantoin, cotrimoxazole
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6
Q

Drugs generally safe in pregnancy and lactation

A

Beta Lactams and Macrolides

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7
Q

Caution drugs during pregnancy

A

Tetracyclines, fluoroquinolones, cotrimoxazole

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8
Q

Drugs to be avoided in renal impairment

A

Aminoglycosides, High-dose Vancomycin, Sulfonamides

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9
Q

Drugs to be avoided in hepatic impairment

A

Anti-TB agents (Pyrazinamide), Amoxicillin-clavulanate

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10
Q

Immunocompromised patients should receive what kind of drugs and what kind of therapy

A

Bactericidal drugs and Combination therapy

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11
Q

What should be done for severely ill patients when prescribing antibiotics?

A

Initiate active antibiotics ASAP and use broad spectrum coverage

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12
Q

Poor CSF penetration

A

1st and 2nd generation cephalosporins, Aminoglycosides, Macrolides, Clindamycin

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13
Q

Drugs used to treat CNS infections

A

Penicillins, 3rd to 4th generation cephalosporins, Meropenem, Vancomycin

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14
Q

Drugs used for prostatitis

A

Ciprofloxacin and cotrimoxazole

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15
Q

Concentration-dependent bacterial killing abx

A

Aminoglycosides, Fluoroquinolones, Metronidazole, Daptomycin

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16
Q

Time-dependent killing abx with no persistent effect

A

Beta Lactams

17
Q

Time-dependent abx with persistent effect

A

Vancomycin, Tetracyclines, 50S Ribosomal Subunit inhibitors

18
Q

PK-PD targets for concentration-dependent bacterial killing

A

Optimized Peak/MIC ratio (Cmax = 8-10x MIC)

19
Q

PK-PD target for time dependent bacterial killing with no persistent effect

A

Optimize %T > MIC (40-70% of dosing interval above MIC)

20
Q

PK-PD target for time dependent bacterial killing with persistent effect

A

Optimize AUC:MIC ratio

Vancomycin - 400 to 600
Fluoroquinolone - >30 (+); >125 (-)

20
Q

PK-PD target for time dependent bacterial killing with persistent effect

A

Optimize AUC:MIC ratio

Vancomycin - 400 to 600
Fluoroquinolone - >30 (+); >125 (-)

21
Q

Abx with Prokinetic effect

A

Erythromycin

22
Q

PD interactions causing QTc prolongation

A

Macrolides, Fluoroquinolones, Azoles

23
Q

PD interactions causing Nephrotoxicity

A

Aminoglycosides, Vancomycin, Amphotericin B, Sulfonamides

24
Q

PD interactions causing myelosuppression

A

Cotrimoxazole, Linezolid

25
Q

PD interactions causing photosensitivity

A

Tetracyclines, Fluoroquinolones, Sulfonamides

26
Q

PD interactions causing serotonergic syndrome

A

Linezolid

27
Q

Antimicrobials with good bioavailability

A

Fluoroquinolones, metronidazole, Cotrimoxazole, Linezolid

28
Q

Common antibacterials NOT requiring renal dose adjustment

A

• Azithromycin
• Cloxacillin
• Ceftriaxone
• Clindamycin
• Doxycycline
• Fusidic acid
• Linezolid
• Metronidazole
• Tigecycline
• Isoniazid
• Rifampicin

29
Q

Common antibacterials that MAY REQUIRE dose adjustment in hepatic impairment

A

 Ceftriaxone
 Clindamycin
 Fusidic acid
 Metronidazole
 Rifampicin
 Tigecycline

PR3151 CA1: Antibiotics (NUS Pharmacy) (11 decks)

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