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Pod Exam 2 > 35/36: Antibiotics - Smith > Flashcards

35/36: Antibiotics - Smith Flashcards

(52 cards)

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1
Q

spectrum of activity for Pen G

A
  • Streptococcus Group A and B
  • Group D Streptococcus (enterococcus)
  • Anaerobes, except Bacteroides
  • Gonococci
  • Staphylococcus less than 10%
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2
Q

often used for ear infections

A

amoxicillin/ampicillin

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3
Q

spectrum of activity for amoxicillin/ampicillin

A
  • Streptococcus, including Group D
  • Some gram negative coverage (E. coli, H. influenzae, P. mirabilis, Salmonella and Shigella)
  • Most Staphylococcus resistant
  • Bacteriostatic unless combined with Aminoglycoside
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4
Q

CONDM anitbiotics

A 
semisynthetic penicillins
Cloxacillin
oxacillin
nafcillin
dicloxaillin
methicillin

(penicillinase-resistant)

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5
Q

what metabolizes nafcillin

A

liver

- covers staph, except MRSA

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6
Q

extended-spectrum penicillins and beta-lactamase inhibitors common combinations

A
  • Ticarcillin / Clavulanic Acid (Timentin)
  • Ampicillin / Sulbactam (Unasyn)
  • Amoxicillin / Clavulanic Acid (Augmentin)
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7
Q

which drugs have a high sodium load?

A
  • ticarcillin/clavulanic acid (timentin) [120 mg/g sodium load]
  • ampicillin/sulbactam (unasyn)
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8
Q

*** do two 250 mg augmentin oral tabs = 1 500 mg augmentin tab

A

NO

  • because all pills contain 125 mg of clavulanic acid
  • too much clavulanic acid causes GI side effects
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9
Q

how does unasyn compare to timentin?

A
  • more active against gram + than timentin

- less active against gram - than timentin

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10
Q

describe the different generations of cephalosporins

A

First Generation-Better activity against gram positive cocci

Second Generation-Less activity against gram positive, but more activity against gram negative organisms

Third Generation-Even less activity against gram positive, more activity against gram negative organisms

Fourth Generation-Best of both worlds (gram + and - )

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11
Q

common oral 1st gen cephalosporin

A

cephalexin (keflex, keftab, keflet)

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12
Q

common parenteral 1st gen cephalosporin

A

cefazolin (ancef, kefzol)

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13
Q

classify this drug: cephradine (anspor, velosef)

A

1st or 2nd gen cephalosporin

- not super common

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14
Q

20% pen-allergic patients are also allergic to…

A

cephalosporin

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15
Q

drug of choice for surgical prophylaxis

A

cefazolin

- 2g 30 min before surgery

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16
Q

elimination of ceftriaxone

A

biliary elimination

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17
Q

drug of choice for n. gonorrhea ***

A

ceftriaxone

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18
Q

longest half-life of any cephalosproin

A

ceftriaxone

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19
Q

gram + diplococcus is typically …

A

n. gonorrhea

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20
Q

elimination of cefoperazone

A

biliary elimination

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21
Q

elimination of cefepime

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A

renal excretion

22
Q

polymicrobial infection with renal insufficiency first choice

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A

cefepime (4th gen cephalosporin)

23
Q

why is cilastatin added to imipenem?

Study These Flashcards
A
  • imipenem is destroyed in kidney; cilastatin inhibits renal enzymes preventing degradation
24
Q

“gorillamycin”

Study These Flashcards
A

imipenem/cilastatin (primaxin)

- very broad spectrum

25
indications fro invanz/ertapenem [carbapenem]
anaerobic (gas gangrene, etc)
26
name the aminoglycosides
gentamicin (garamycin) tobramycin (nebcin) amikacin (amikin)
27
spectrum of activity for aminoglycosides
- - Gentamicin best activity against Serratia - - Tobramycin best activity against P. aeruginosa - - Amikacin reserved for organisms resistant to other two
28
adverse reactions aminoglycosides
nephrotoxicity, ototoxicity, neuromuscular blockade
29
aminoglycosides are always infused over _____ minutes
- 30 | - neuromuscular blockade is risk with rapid admin
30
what do you do when peak is high and trough is normal?
Peak high and trough normal - decrease dose Peak low and trough normal - increase dose Peak normal and trough high - increase time Peak normal and trough low - decrease time
31
name the most common antianaerobic agents
metronidazole (flagyl) | clindamycin (cleocin)
32
adverse rxn metronidazole
``` metallic taste disulfiram reaction (alcohol reaction) ```
33
treatment of pseudomembranous colitis
``` #1 metronidazole (oral) or #2 vancomycin (oral) *** never put pt on anti-GI motility drug if they have this condition (want the bad to come out) ```
34
causes pseudomembranous colitis (antibiotic associated diarrhea)
clindamycin (because doesn't work against c. diff)
35
metabolism of metronidazole
liver | - clindamycin is also metabolized by liver
36
can kill MRSA, MRSE, and enterococci
vancomycin
37
red man syndrome
- adverse effect of vancomycin - should give over 45-60 min to prevent - peak less than 30ml/min and trough less than 10 ml/min
38
turns body fluids red (contact lenses) and a rash
rifampin
39
only use for oral vancomycin
pseudomembranous colitis
40
used for TB
rifampin | - always in combo with other drugs
41
name the quinolones we might use
- CIPROFLOXACIN (CIPRO) - LEVOFLOXACIN (LEVAQUIN) - TROVAFLOXACIN (TROVAN) (only life-threatening infections)
42
does ciprfloxacin cover streptococcous?
no - Excellent coverage against gram negative organisms, including Pseudomonas - Mild Staphylococcus and no Streptococcus coverage
43
adverse reactions with cipro/ciprofloxacin
- Theophylline and derivatives (caffeine) will be potentiated - Antacids and Fe will decrease absorption - Cartilage degeneration and tendon rupture (*do not use on juvenille pts - premature growth plate closure)
44
which antibiotic might cause an achilles tendon rupture?
quinolones class
45
Similar indications as Ciprofloxacin (Cipro), but dosage is once a day
levaquin
46
what is bactrim?
trimethoprim/sulfamethoxazole | 1:5 ratio
47
name the macrolides
- - ERYTHROMYCIN (E-MYCIN, EES, ERYTHROCIN) - - AZITHROMYCIN (ZITHROMAX/ Z-PAK) - - CLARITHROMYCIN (BIAXIN)
48
Z-PAK?
azithromycin 5 days of therapy 2 - 250 mg first day 1 each day from days 2 through 5
49
can macrolides be used for pen-allergic pts?
yes
50
drug of choice borrelia burgdorferi/ lyme disease
tetracyclines
51
side effects of tetracycline
sun sensitivity and graying of teeth
52
why is linezolid a good drug?
- no dose adjustment for renal impairment | - works against Strep. D (VRE), Staph. aureus (MRSA), Staph. epidermidis (MRSE), Pasteurella multocida

Pod Exam 2 (16 decks)

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