Antibiotics: Quinolones, Macrolides, Tetracyclines, Sulfonamides Flashcards
(23 cards)
Azithromycin: Dosing
Z-pak: 500 mg on day 1, then 250 mg on days 2-5
Tri-Pak: 500 mg x3 days
NO RENAL DOSE ADJS
Macrolides (Az,Clari, Ery): AE
AE:
-QTP (ery > azi > clari)
-Hepatoxicity
-Myasthenia gravis exacerbation
-Clarithromycin: caution in CAD
-Taste perversion
-SJS/TEN/DRESS
-Ototoxicity
CC mac and TOM in the SQL
Macrolides: Most to Least QTP Risk
ery > azi > clari
Macrolides: CI
CI:
-Cholestatic jaundice, hepatic dysfunction with prior use
-Clarithromycin/Erythromycin: DO NOT USE with lovastatin or simvastatin
-Clarithromycin: use with colchicine in renal/hepatic imp
CH CELS CC HR
Erythromycin: EES conversion
E.E.S 400 mg = 250 mg
erythromycin base or stearate
No renal dose adj needed for erythromycin
Macrolides: DDIs
-EC: CI with simvastatin and lovastatin
-Warfarin, doacs
-Caution with QTP agents
Doxycycline: Indications
Broader indications than others
-CAP
-Tickborne/rickettsial
-Chlamydia
-Mild CA-MRSA skin
-VRE UTIs
NO RENAL DOSE ADJS
CC TUMR
Tetracyclines: W/AE/Notes
Warning:
-Children < 8, pregnancy, BF: suppresses bone growth and discolors teeth
-Photosensitivity (hyperpigmentation, SJS/TEN/DRESS)
-Minocycline: DILE
Notes:
-IV:PO is 1:1 for doxy/mino
-Take with 8oz water
-Doxycycline: sit upright for at least 30 min after (avoid esophageal irritation)*
<8 PBF TB, PSPS, MD
Tetracyclines: DDIs
-Antacids, polyvalent cations
-Sucralfate
-Bismuth
-Bile acid resins
-Dairy: avoid 1 hr before and 2 hr after tetras
4 ABCDs are BS
Sulfonamides: CI/AE/W
CI:
-Sulfa allergy
-Anemia due to FA def
-Infants < 2 months
-Renal/hepatic disease
W:
-SJS/TEN/TTP (thrombotic thrmocytopenic purpura)
-Hemolytic anemia (+ Coombs OR G6PD def)
-Blood dyscrasia (agranulocytosis/aplastic anemia)
AE:
-Photosensitivity
-Hyperkalemia
-Crystalluria (take 8oz water)
SKILF STAB KC
Bactrim: Dosing
Dose based on TMP component
SS
400 mg SMX/80 mg TMP
DS
800 mg SMX/160 mg TMP
Al products are formulated with a SMX:TMP ratio = 5:1
Sulfonamides: DDIs
-Warfarin
-Methotrexate
-Levoleucovorin
Respiratory Quinolones
-Levofloxacin
-Moxifloxacin
(enhanced Strep pneumonia/atypical coverage)
Only Quinolone NOT USED for UTIs
Moxifloxacin
-does not concentrate in urine
Quinolone with MRSA Activity
Delafloxacin: preferred in skin infections suspected by MRSA
Quinolone with NO Renal Adjustments
Moxifloxacin
Quinolones: BBW/CI
BBW:
-Tendon rupture
-Peripheral neuropathy
-CNS (seizures, tremors)
(usually use for last line in sinusitis, bronchitis, uncomplicated UTI)
CI:
-Avoid in myasthenia gravis
-Avoid in children (musculoskeletal tox)
-Avoid in pregnancy/BF
quin CC MT PP
Quinolones: AE
AE:
-QTP (moxi > levo > cipro)
-BG disturbance (hypo/hyper)
-Psychiatric disturbance (agitation, lack of attention, disorientation, delirium)
-Photosensitivity
-ND, HA, dizzy, SJS/TEN
PS PQS
Quinolones: Most to Least QTP Risk
Moxi > Levo > Cipro
Ciprofloxacin Oral Suspension
-Shake vigorously for 15 seconds before each dose
-Do not put through an NG or other feeding tube (the oil-based suspension adheres to tubing)
Cipro
-Can crush IR tablets, mix with water, and give via feeding tube
-Hold tube feedings 1 hr before and 2 hr after each dose
Antipseudomonal Quinolones
-Ciprofloxacin
-Levofloxacin
Quinolones: IV to PO Ratio
1:1 for
-Levo and moxi
Quinolones: DDIs
-Antacids, Mg, Al, phosphate, Ca, iron, zinc (polyvalent cations, the +)
-Lanthanum, sevelamer (separate)
-Other QTP agents
-Cipro: theophylline, caffeine, tizanidine (CI with tizanidine)
CTCT CALS
