Flashcards in Antibiotics (Final Exam-Spring Semester) Deck (30):
For what pathogens would you want to use synergy (two abx together)?
Enterococcus endocarditis or bacteremia
What is PAE and what drug is an example of this?
Post Antibiotic Effect - organism growth is suppressed for a period of time after drug concentration falls below MIC
Aminogylcosides --> why they are dosed once daily!
What are the two types of antibiotic resistance?
Intrinsic and Acquired
Intrinsic: naturally occuring
Acquired: normally sensitive organism becomes resistant
What is staphylococcus' resistance pattern and what drugs will not treat it?
They produce beta-lactamase
Don't use penicillins
(Can use penicillinase-resistant PCN)
MRSA resistance pattern and what drugs cannot be used to tx?
Alterations in penicillin binding protein
Can't use any penicillins, cephalosporins, some fluroquinolones
Strep resistance pattern and what drugs cannot be used to tx?
Alterations in binding sites
Penicillins and macrolides
Enterococcus resistance pattern and what drugs cannot be used to tx?
Alterations in target site
Pseudomonas resistance patterna nd what drugs cannot be used to tx?
Reduced permeability and Beta lactamase production (which is not inhibited by b-lactamase inhibitors)
PCN, cephalosporin, carbepenems, aminoglycosides, fluroquinolones
Advantages of oral administration of abx?
Patient's prefer it
Reduce exposure to pathogens via IV site
Increases pt motility
Potential for early discharge
Decreases personnel time
MOA of beta lactams
Bind to penicillin binding proteins and inhibit cell wall synthesis --> cell death
What are the 4 penicillins?
1. Natural penicillins
3. Penicillinase Resistant Penicillins
4. Extended spectrum penicillins
Cephalexin and Cefazolin are what generation cephalosporins?
Cefuroxime and Cefoxitin are what generation cephalosporins?
Cefpodoxime and ceftriaxone are what generation cephalosporins?
Cefepime is what generation cephalosporin?
Ceftaroline is what generation cephalosporin?
You are giving penicillins to a patient. What drug interactions must you worry about?
It decreases renal tubular secretion of PCN causing inc. serum levels
What should you warn a patient of when prescribing a 2nd generation penicillin?
GI upset or diarrhea...especially if giving amox/clavulanate
Name the types of antibiotics that work to inhibit penicillin binding protein to inhibit cell wall synthesis and therefore promote cell death
If a patient is allergic to PCN (a true allergic reaction) then what antibiotics should be avoided?
You are treating a patient with vancomycin IV. Their labs come back and the culture shows vancomycin resistant enterococci. Would you switch this patient to a different antibiotic? If so, which one?
What are the two abx that can be used to tx VRSA?
Newer gen. cephalosporin --> ceftaroline (IV)
Your patient shows symptoms consistent w/ cellulitis. What tx do you initially give?
Penicillinase resistant PCN
- Oxacillin (IV)
- Nafcillin (IV)
A patient comes to the ER with community acquired pneumonia and also states that they stop breathing when given penicillin. What is a good drug choice to treat this patient?
Macrolide...I would use azithromycin
Which abx bind to the 30S ribosomal subunit and therefore inhibit protein synthesis leading to cell death?
Which abx bind to the 50S ribosomal subunit and therefore inhibit protein synthesis leading to cell death?
What is the first line tx for CA-MRSA?
What are some options in treating uncomplicated UTIs
Fluoroquinolone (Cipro, Levo, Oflo, Norf,) .....NOT Moxifloxacin
What are some options in treating complicated UTIs
Fluoroquinolones (Ciprofloxacin, Ofloxacin, Norfloxacin, Levofloxacin)