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Flashcards in Antibiotics Deck (36):
1

Most potent gram positive coverage of all PCN =
(Non/beta-lactamase) producing gram + ___, ___
Also ____.

Indications:

Natural penicillins: PCN VK, PCN G

Non-beta lactamase
COCCI (Staph, Strep, Enterococci)
ANAEROBES (Clostridium)

Meningococcus (although negative)

Strep pharyngitis
Oral/dental infections**
Syphilis**

2

Only group of PCN's effective vs beta-lactamase bugs on their own

(Narrow/broad) spectrum against ___.

Indications:

Penicillinase-resistant ("anti-staphylococcus"): Nafcillin, Dicloxacillin, Oxacillin

Narrow, Gram +, primarily vs beta-lactamase producing staphylococcus

Staph skin/soft tissue infection

3

Amino-penicillins =
Gram (+/-) coverage
T/F: Active against beta-lactamase producing bugs.

Indications:

Amoxicillin, Ampicillin

Gram positive AND negative coverage
False. NOT for beta-lactamase. Active vs ENTEROCOCCUS

Indications:
UTIs in pregnancy
AOM
H. flu, E. coli, L. monocytogenes, GBS, Proteus, Salmonella

4

Augmentin =
Unasyn =

Coverage:

Indication for each:

Amino-penicillins WITH beta-lactamase inhibitor:
Augmentin = amoxicillin + Clauvulanate
Unasyn = ampicillin + sulbactam

-Beta-lactamase (M. Catarrhalis, H. flu, E. coli, B. fragilis)
-Anaerobes

Augmentin: AOM, sinusitis, ABECB, Dental infections, bites
Unasyn: skin/soft tissue infections

5

Broadest spectrum penicillin =
Reserved for ___

Piperacillin/Tazobactam (Zosyn)
Ticarcillin/Clavulanate (Timentin)

Suspected pseudomonal infection
E. coli, Proteus mirabilis, pseudomonas

6

Abx that lowers seizure threshold

Carbapenems: Imipenem, Meropenem

7

broadest spectrum of ALL abx

Carbapenems: Imipenem, Meropenem

8

What generation of cephalosporin?
1. Ceftriaxone (Rocephin)
2. Cephalexin (Keflex)
3. Cefazolin (Ancef)
4. Cefepime (Maxipime)
5. Ceftaroline (Teflaro)
6. Cefaclor (Ceclor)
7. Cefuroxime
8. Cefoxitin (Mefoxin)

1. Ceftriaxone (Rocephin) : 3rd
2. Cephalexin (Keflex): 1st
3. Cefazolin (Ancef): 1st
4. Cefepime (Maxipime): 4th
5. Ceftaroline (Teflaro): 5th
6. Cefaclor (Ceclor): 2nd
7. Cefuroxime: 2nd
8. Cefoxitin (Mefoxin): 2nd

Increasing level of gram negative activity and loss of gram positive from 1st to 4th generation.

9

Indications of cephalosporin:
1st gen:
3rd gen:
4th gen:
5th gen:

1st gen: skin, soft tissue infection (staph,strep), surgical prophylaxis

3rd gen: Meningitis**, Gonorrhea, CAP (GOOD CNS penetration)
Ceftazidime: coverage vs pseudomonas

4th gen: Pseudomonas

5th gen: BROADEST: Positive (MRSA), Negative

10

Aztreonam =

Coverage:

Monobactam

Gram negative ONLY (including pseudomonas)

11

Vancomycin coverage:
Mechanism of action:

Gram + only**, MRSA

MOA: inhibits phospholipids, peptidoglycans

12

Bacitracin coverage:
Indication:

Gram +

Topical for wounds.
Nephrotoxic**

13

Polymyxin coverage:
Indication:

Gram negative

Topical ophthalmic, otic
Nephrotoxic and neurotoxic**

14

All of the following are cell wall synthesis inhibitors EXCEPT:
A. PCN
B. Macrolides
C. Cephalosporins
D. Carbapenems

B. Macrolides are protein synthesis inhibitors.

15

Macrolides =

Erythromycin
Azithromycin
Clarithromycin

16

CI of Macrolides

Patients on Niacin, Statins

17

Best atypical coverage

Azithromycin
(Mycoplasma, Chlamydia, Legionella)

18

Caution in patients taking warfarin, theophylline, carbamazepine, digoxin

Erythromycin d/t inhibit cytochrome p450, many drug-drug interactions

19

SE of macrolides

GI
Especially erythromycin

20

SE of tetracyclines

Photosensitivity*
Dental staining*
Hepatotoxicity*
GI disturbances

Do NOT use in <8 y/o

21

Clindamycin coverage

Gram +
Most anaerobes above diaphragm

22

MC cause of C. dif

Clindamycin

23

Tetracyclines =

Doxycycline
Tetracycline
Minocycline

24

Aminoglycosides =

Coverage:

SE:

Gentamicin, Tobramycin, Neomycin, Amikacin, Streptomycin

Gram NEGATIVE only

SE: Ototoxic, Nephrotoxic

25

All of the following are protein synthesis inhibitors EXCEPT:
A. Macrolides
B. Chloramphenicol
C. Tetracycline
D. Fluoroquinolone
E. Aminoglycosides

D. Fluoroquinolones are DNA synthesis inhibitors

26

Chloramphenicol
Coverage:
SE:

Broad spectrum, severe anaerobic infections, unresponsive
GOOD CSF penetration

Bone marrow suppression
Gray baby syndrome*

27

Linezolid
Coverage:
MOA:

Gram POSITIVE ONLY. MRSA, Vancomycin resistent enterococcus, enterococcus faecium, faecalis

Protein synthesis inhibitor

28

All of the following are fluoroquinolones EXCEPT:
A. Ciprofloxacin
B. Moxifloxacin
C. Gentamicin
D. LEvofloxacin

C. Gentamicin is a aminoglycoside

29

CI in pregnancy

Fluoroquiinolones
Tetracyclines

30

May exacerbate myasthenia gravis

Fluoroquinolones

31

SE: Tendon rupture

Fluoroquinolones

32

Red man's syntrome

Vancomycin

33

SE: prolonged QT

Macrolides
Fluoroquinolones

34

Abx that may cause macopapular rash in pts w/ infectious mononucleosis

Ampicillin

35

Tx of lung abscess

Clindamycin
Augmentin

36

Considerations when taking tetracycline (3)

- Milk and aluminum-containing antacids: decrease absorption
- Warfarin: increase anticoagulant effect
- Oral contraceptives: decrease efficacy