antibiotics

Question 0

T:MIC

Answer 0

B-lactams
Linezolid
Bactrim (tmp-smx)
Tetracyclines
Macrolides

Question 1

Cmax: MIC

Answer 1

• fluoroquinolones
• aminoglycosides
• daptomycin

Question 2

AUC:MIC

Answer 2

Fluoroquinolones
VANCOMYCIN* (for MRSA inf. ratio should be >400)
daptomycin 
Azithromycin
Linezolid

Question 3

Minimum bactericidal concentration (MBC)

Answer 3

Minimum concentration of drug to kill 99.9% of initial bacterial load
-signifies a > or equal to 3log drop in bacteria

Question 4

Penicillin cross reactivity

Answer 4

Penicillins>cephalosporins (5%)> carbapanems (<1%)

Question 5

Host factor: AGE

Answer 5

Avoid in young children:
Tetracyclines and fluoroquinolones

C/I in newborns
-chloramphenicol and sulfonamides

Question 6

Host factor: organ dysfunction RENAL

Answer 6

Age related
Calculate CrCl
may need dose adjustment

Question 7

Host factor: organ dysfunction

LIVER

Answer 7

Neonates may not be fully developed
Cirrhosis
Calculate Child-Pugh score

Question 8

Genetic cond.

Slow acetylators

Answer 8

Increased risk of isoniazid peripheral neuropathy

Question 9

Genetic cond.

G6PD deficiency

Answer 9

At risk for HEMOLYSIS with

• Dapsone
• Antimalarials
• Nitrofurantoin

Question 10

Penicillin

Answer 10

Penicillin G...
Penicillin procaine
--
-Strep. Group A mostly
-~enterococcus ;some resistance
-DOC for treponema pallidum (syphillis)
- limited gram (-)

Question 11

Aminopenicillins

Answer 11

AMOXICILLIN
AMPICILLIN
--
-Strep., listeria (gram (+))
- improved enterococcus coverage
- improved gram (-) compared to PCN
not a good empiric therapy for suspected gram (-) bact. Because of resistance

Question 12

Cause QTc prolongation

Answer 12

Quinolones and Macrolides

Question 13

Known for DDI inh. Of CYP450

Answer 13

Macrolides

Clarithromycin>erythromycin> azithromycin

Question 14

Bind 30S unit of ribosome

Answer 14

Aminoglycosides (bactericidal) and Tetracyclines (bacteriostatic)

Question 15

Avoid admin. with di/tri-valent cations to avoids chelation

Answer 15

Tetracyclines and Fluoroquinolones

Question 16

DOC for pneumocystis jiroveci and stenotrophomonas

Answer 16

SMX/TMP (bactrim)

Question 17

SMX/TMP

Answer 17

Base dose on trimethoprim component when doing weight based.

AE: rash, Steven-Johnson syndrome, Hyperkalemia

Question 18

Bind 50s unit of ribosome

Answer 18

Chloramphenicol (FYI)
Macrolides
Clindamycin
Linezolid

Question 19

Taking with alcohol causes awful N/V

Answer 19

Metronidazole

Question 20

Cannot be used for pneumonia

Answer 20

Daptomycin, (mech: depolarizes bact. cell wall –> loss of intercellular contents and death)

because it is inactivated by surfactant in the lungs

Question 21

DOC for VRE

Answer 21

Daptomycin
Linezolid
Tigecycline

Question 22

DOC for extended spectrum B-lactamases (gram (-))

Answer 22

Carbapanems

Question 23

Drugs with MRSA coverage

Answer 23

Vancomycin (DOC)
Daptomycin
Linezolid
Ceftaroline
Tigecycline
Quinipristin/ Dalfopristin (synercid)
Telavancin

Question 24

Drugs with Pseudomonas coverage

Answer 24

Quinolones

• cipro
• levo

Polymyxin B (typically last line)
Mech: binds cell membrane and increases permeability 

Aminoglycosides 
Mech: binds 30S prevents protein synthesis (proof reading process)
-gentimicin
-Tobramycin
-Amikacin

Piperacillin/tazobactam (extended spectrum penicillin with B-lactamase inh.)

Cephalosporins

• Cefapime - fourth gen
• Ceftazadime- third gen

Carbapenems

• Meropenem
• Imipenem/ Cilastatin
• Doripenem
• NOT ERTAPENEM

Question 25

What bacteria is coagulate positive?

Answer 25

Coagulase is used to differentiate between S.Aureus and other staph inf.

Question 26

What bacteria are tested with catalase?

Answer 26

Catalase is produced by all Staph sp. but not by Strep. sp.

Question 27

What bacteria are non-lactose fermenting?

Answer 27

• Salmonella
• Shigella
• Pseudomonas

If test shows a non lactose fermenting organism, want to give stronger ABX against pseudomonas just in case even though it may not have been identified.