Flashcards in Antibiotics Deck (50)
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1
Primaxin: Gorillamycin
What is it?
MOA?
Coverage?
Doseage?
Risk:
-Imipenem and cilastatin (inhibits dehydropeptidase)
- bind PCN binding proteins inhibiting cell wall synthesis
-Coverage: very broad spectrum of activity, serious systemic infections, for use with very resistant bugs
500mg IV q6h
High risk of seizures
2
Meropenem
What is it?
MOA?
Coverage?
Doseage?
- A carbapenem
-binds PCN binding proteins to inhibit cell wall synthesis
-Coverage: strep, pseudomonas, bacteroides
-500mg IV q8: 1g IV q8
3
Invanz
What is it?
MOA?
Coverage?
Doseage?
Ertapenem
-binds PCN binding proteins to inhibit cell wall synthesis
-Coverage: MSSA, Strep, Aerobes. Used for moderate-severe foot infections
DOES NOT COVER PSEUDO
Dose: 1g IM/IV qday
4
Gentamicin
What is it?
MOA?
Coverage?
Doseage?
Side effects?
an Aminoglycoside
-Protein synthesis inhibitor, binds irreversibly to 30S
- Covers: serratia
-Dose: 1-1.7mg/kg IM/IV q8
Side effects: ototoxicity, nephrotoxicity
5
Tobramycin
What is it?
MOA?
Coverage?
Doseage?
an aminoglycoside
-Protein synthesis inhibitor, binds irreversibly to 30S
-Covers pseduo aeruginosa
Dose: 1-1.7mg/kg IM/IV q8
Side effects: ototoxicity, and nephrotoxicity
6
Amikacin
What is it?
MOA?
Coverage?
Doseage?
An aminoglycoside
-protein synthesis inhibitor, binds irreversibly to 30S
-reserved for organisms resistant to gentamycin and tobramycin
Dose: 7.5 mg/kg IM/IV q12h
Side effects: ototoxicity and nephrotoxicity
7
Penicillin G
-MOA
-Coverage
-Doseage
MOA: acts on penicillin binding protein to inhibit cell wall synthesis
-Coverage: anaerobes, Strep, nonpenicillinase staph, nonpenicillinase gonococci
Dose: 1.2-40million units IM or IV qd
8
Penicllin V
-MOA
-Coverage
-Doseage
acts on penicillin binding protein to inhibit cell wall synthesis
Coverage: anaerobes, strep, nonpenicillinase staph, and nonpenicillinase gonococci
Dose: 250-500 mg po qd
9
Ampicillin
-MOA
-Coverage
-Doseage
acts on penicillin binding protein to inhibit cell wall synthesis
-coverage: E.coli, P.mirabilis, Shigella , Salmonella, bacteroides, enterococci
Dose: 250-1000mg PO, IM, IV q4-6
COverage
10
Amoxicillin
-MOA
-Coverage
-Doseage
MOA: acts on penicillin binding protein to inhibit cell wall synthesis
Coverage: E.coli, P.mirabilis, Shigella, Salmonella, bacteroides, enterococci
Dose: 250-500mg PO TID
11
Dicloxacillin/Cloxacillin
-MOA
-Coverage
-Doseage
MOA: acts on penicillin binding protein to inhibit cell wall synthesis
Coverage: DOC for MSSA
Dose: 250-500mg po bid/qid oral
12
Nafcillin
-MOA
-Coverage
-Doseage
MOA: acts on penicillin binding protein to inhibit cell wall synthesis
Coverage: DOC for MSSA
Dose 1-2grams IV q4-q6
13
Oxacillin (Bactocill)
-MOA
-Coverage
-Doseage
MOA: acts on penicillin binding protein to inhibit cell wall synthesis
- Dose: 250-500mg IV/IM q4-6
14
Timentin
-Makeup
-MOA
-Coverage
-Doseage
What to look out for?
Ticarcillin/clavulonic acid
MOA: acts on penicillin binding protein to inhibit cell wall synthesis
Coverage: covers pseudo
Dose: 3.1gm IV q4-6
Watch for increased NA levels
15
Zosyn
-Makeup
-MOA
-Coverage
-Doseage
Piperacillin/tazobactam
MOA: acts on penicillin binding protein to inhibit cell wall synthesis
Coverage: covers pseudo
Dose: 3.375-4.5 grams IV q8
16
Unasyn
-Makeup
-MOA
-Coverage
-Doseage
ampicillin/sulbactam
MOA: acts on penicillin binding protein to inhibit cell wall synthesis
Indicated for polymicrobial diabetic foot infections
Dose: 1/5-3.0 grams IV q6
DOC MSSA
17
Augmentin
-Makeup
-MOA
-Coverage
-Doseage
amoxicillin/clavulonic acid
MOA: acts on penicillin binding protein to inhibit cell wall synthesis
COverage: gram+ and bacteroides
Dose: 875 gm oral BID
18
Which Penicillins are hepatically cleared (4)
Mezlocillin, Azlocillin, Nafcillin, Piperacillin
19
First generation Cephalosporins (3)
Cephalexin, Cefadroxil, Cefazolin
20
Cephalexin
Brand name
MOA
Coverage
Doseage
Keflex
MOA: acts on penicillin binding proteins to inhibit cell wall synthesis
Covers: more Gram +
DOC for staph
Dose: 250mg-500mg PO BID
21
Cefadroxil
Brand name
MOA
Coverage
Doseage
Duricef
MOA: acts on penicillin binding proteins to inhibit cell wall synthesis
Coverage: more Gram +
DOC for staph
Dose: 30mg/kg/day PO BID
22
Cefazolin
Brand name
MOA
Coverage
Doseage
Ancef
MOA: acts on penicillin binding proteins to inhibit cell wall synthesis
Coverage: more Gram +
DOC for staph
Dose 2 grams IV prior to surgery
23
Second generation cephalosporins (2)
Cefaclor, and Cefuroxime
24
Cefaclor
Brand name
MOA
Coverage
Doseage
Ceclor
MOA: acts on penicillin binding proteins to inhibit cell wall synthesis
Coverage: similar Gram + as 1st generation.
More upper resp coverage
Dose:250-500mg PO q8
25
Cefuroxime
Brand name
MOA
Coverage
Doseage
Ceftin
MOA: acts on penicillin binding proteins to inhibit cell wall synthesis
Coverage: simmilar Gram + as 1st generation.
More upper resp coverage
Dose: 250-500mg PO BID
26
Third generation Cephalosporins (3)
Ceftriaxone, ceftazidime, cefdinir
27
Ceftriaxone
Brand name
MOA
Coverage
Doseage
Rocephin
MOA: acts on penicillin binding proteins to inhibit cell wall synthesis
Coverage: less gram + than previous gen. But now more gram negative.
Empiric/ DOC for neisseria-septic joint
Dose: 1-2grams IV q day
28
Ceftazidime
Brand name
MOA
Coverage
Doseage
Fortaz
MOA: acts on penicillin binding proteins to inhibit cell wall synthesis.
Coverage: less gram + than previous generations but now more gram -. COVERS PSEUDO
Dose: 1gram IV/IM BID
29
Cefdinir
Brand name
MOA
Coverage
Doseage
Omnicef
MOA: acts on penicillin binding proteins to inhibit cell wall synthesis
Coverage: less gram + than previous generations but now more gram -.
USED BY internal med
Dose: 300mg PO BID
30
Fourth gen Cephalosporin
Cefepime
31
Cefepime
Brand name
MOA
Coverage
Doseage
Maxipime
MOA: acts on penicillin binding proteins to inhibit cell wall synthesis
Coverage: Similar Gram + to 1st gen and Gram - similar to 3rd gen. INCLUDING PSEUDO
Similar coverage to zosyn
Dose: 2g IV BID
32
Fifth generation Cephalosporin (1)
Ceftaroline
33
Ceftaroline
Brand name
MOA
Coverage
Doseage
Teflaro
MOA: acts on penicillin binding proteins to inhibit cell wall synthesis
Coverage: broad spectrum similar to fourth gen and active against MRSA.
Dose: 600 mg IV BID
34
Ciprofloxacin
Brand name
MOA
Coverage
Doseage
What to be weary of
Cipro
MOA: inhibit bacterial DNA topoisomerase (gyrase)
Coverage: Gram-.
DOC-pseudo
Dose:250-750mg PO BID
OR 200-400mg IV BID
Be careful: active people, open growth plates, supplements will decrease absorption
35
Levofloxacin
Brand name
MOA
Coverage
Doseage
What to be weary of
Levaquin
MOA: inhibit bacterial DNA topoisomerase (gyrase)
Coverage: empiric antibiotic, mainly Gram-
Dose: 250-500mg PO/IV
Be careful: active people, open growth plates, supplements will decrease absorption.
36
Moxifloxacin
Brand name
MOA
Coverage
Doseage
What to be weary of
Avelox
MOA: inhibit bacterial DNA topoisomerase (gyrase)
Coverage: empiric oral antibiotics. Covers everything but those that are resistant. Better anaerobic coverage in diabetic foot infections.
Dose: 400mg qd PO
Be careful: active people, open growth plates, supplements will decrease absorption.
37
Macrolides (3)
Azithromycin, clarithromycin, erythromycin
38
Erythromycin
MOA
Coverage:
Doseage:
Metabolism:
MOA: inhibit protein synthesis by binding to 50 S subunit
Coverage: S.pyogenes, S.pneuomonia, S. aureus.
Chlamydia, gonorrhoeae, syphilis.
Campylobacter
Dose: 250-500mg PO BID
Max: 4g daily
Metabolized by the liver
39
Azithromycin
MOA
Coverage
Doseage
MOA: inhibit protein synthesis by binding to 50s subunit.
Coverage:
- S.aureus
-S.pyogenes
-Strep agalactiae
Dose:
-500mg PO day 1
-250mg qday 2-5
40
Clarithromycin
Brand name
MOA
Coverage
Doseage
Biaxin
MOA: inhibit protein synthesis by binding to the 50s subunit.
Coverage:
-Staph aureus
-S.pyogenes
-Mycoplasma, chlamydia, mycobacteria
Dose: 250mg PO BID
41
Tetracyclines
MOA
Coverage
Contraindications
MOA: act on 30 S subunit of bacterial ribosome inhibiting translation
Coverage: broad spectrum
active against community MRSA
Contraindicated in pregnancy
42
Clindamycin
Brand name
MOA:
Coverage:
Doseage
Metabolism
Cleocin
MOA: inhibits protein synthesis through 50s ribosome subunit
Coverage: most gram positives and anaerobes.
-including bacteroides fragilis
Dose:
--foot infections: 300-450mg tid PO
--osteo due to MRSA: 600mg tid po
Metabolized by liver
43
Metronidazole
Brand name
MOA
Coverage
Doseage
flagyl
MOA: binds to DNA and disrupts its structure
Coverage: anaerobes (gram+ and gram-)
Dose: 500mg TID PO
44
Trimethoprim-sulfamethoxazole
Brand name:
MOA:
Spectrum of activity:
Dosing:
Caution?
Bactrim
MOA: inhibit bacterial synthesis of THF
Spectrum of activity: aerobic G+ and G-
-DOC for community acquired MRSA
Dosing:
-TMP/SMX: 80mg/400mg or 160mg/ 800mg
Caution for people with folate deficiency
45
Daptomycin
Brand name :
MOA:
Spectrum of activity:
Dosing
Cubicin
MOA: depolarizes bacterial membranes, inhibits protein, DNA and RNA synthesis
Spectrum of activity: MSSA, MRSA and VRE.
DOC for MRSA infection when vanco is not allowed
Dosing:
Skin infections: 4mg/kg IV qday
46
Tigecycline
Brand name:
MOA:
Spectrum of activity:
Dosing:
Side effects
Tygacil
MOA: binds 30s inhibiting protein synthesis
Spectrum: very broad.
-MRSA,MRSE, PRSP, and VRE
-multi-drug resistant organisms
Dose: start at 100mg IV and 50mg IV q12h
Side effects: high seizure rates
47
Vancomycin
Brand name:
MOA:
Spectrum:
Dosing:
Peaks and troughs
Vancocin
MOA: binds to the building blocks (NAG and NAM) of peptidoglycan to inhibit cell wall synthesis
Spectrum:
-DOC: for MRSA
Also covers enterococcus and Strep
Dosing:
-Oral:125mg and 250mg
-IV: 1g q12 hours (slow infusion over 1 hour)
Must measure peaks and troughs with administration. (10-20mL is normal)
Red man syndrome is treated with diphenhydramine
48
Rifampin
Brand name:
MOA:
Spectrum
Dosing:
Common Side effects
Rifampicin
MOA: inhibition of DNA-dependent RNA polymerase leading to suppression of RNA synthesis and cell death
Spectrum:
-TB
-Endocarditis
-Hansen Disease
-Anthrex
Dosing: 300mg-600mg PO/IV
Side effects: reddening of the mucosa. As well as urine, sweat, saliva or tears
49
Linezolid
Brand name
MOA
Spectrum of activity
Dosing:
Zyvox
MOA: binds at the P site at the ribosomal 50S subunit
Spectrum:
-VREF
-Hospital acquired pneumonia
-endocarditis
-anthrax
Dosin: 600mg PO/IV q12 hours
50
