NAPLEX > Antimicrobials > Flashcards

Antimicrobials Flashcards

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1
Q

Gentamicin

A

Class: Aminoglycosides

TD: 1-2.5 mg/kg/dose
EID: 4-7mg/kg/dose

IV, IM, ophthalmic, topical

Renal: Q8H (CrCl >60), Q12H (40-60), Q24H (20-40), or PRN (

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2
Q

Tobramycin

A

Class: Aminoglycosides

TD: 1-2.5 mg/kg/dose
EID: 4-7mg/kg/dose

IV, IM, ophthalmic, inhaled (TOBI)

Renal: Q8H (CrCl > 60), Q12H (40-60), Q24H (20-40), PRN (

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3
Q

Streptomycin

A

Class: Aminoglycosides

Dosing: 15 mg/kg IM Q24H (max 1g)
25-30 mg/kg IM 2-3x Qwk
(max 1.5g)

Renal: Q24-72H (CrCl 10-50), Q72-96H
(

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4
Q

Amikacin

A

Class: Aminoglycosides

TD: 5-7.5 mg/kg/dose
EID: 15-20 mg/kg/dose

IV, IM

Renal: Q8H (CrCl >60), Q12H (40-60), Q24H (20-40), PRN (

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5
Q

Natural Penicillins

A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal (except Enterococci)

Coverage: Strep (DOC for Group A), some Enterococcus, PO anaerobes, Syphilis; minor Staph (

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6
Q

Penicillin V

A

Pen VK
Class: Natural Penicillins

Dosing: 125-500 mg PO Q6H

Tablet, suspension

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, taste disturbance, rash, BMS, AIN, C.diff infection, seizures (accumulation)

Tablet taken on empty stomach
Suspension should be refrigerated

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7
Q

Aminoglycosides

A

MOA: 30S & 50S subunit binding that inhibits protein synthesis
Concentration-dependent killing
Peak/AUC
Bactericidal

Coverage: Gm (-) species; Gent/Strepto provide synergy for Gm (+) infections when combined with Beta lactams or Vanc

BBW: neurotoxicity, nephrotoxicity, fetal harm (Category D)

Monitoring: Hartford Nomogram (extended interval dosing)

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7
Q

Penicillin G

A

Benzathine (Bicillin L-A) & Procaine (Bicillin C-R)
Class: Natural Penicillins

Dosing: 1.2-2.4 MU IM
Frequency varies on indication

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

BBW: can cause cardiorespiratory arrest or death if given IV

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8
Q

Penicillin G (Aqueous)

A

Pfizerpen-G
Class: Natural Penicillins

Dosing: 2-4 MU IV Q4-6H

Renal dose adjustments

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

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9
Q

Aminopenicillins

A

MOA: inhibits transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal (except Enterococci)

Coverage: Strep, Enterococcus (DOC), Listeria, and limited Gm (-)
No MSSA, Klebsiella,
Moraxella, or SPICE A
E. faecium usually resistant

Pregnancy Category B

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10
Q

Amoxicillin

A

Amoxil, Trimox, Moxatag
Class: Aminopenicillins

Dosing: 250-500 mg PO Q8H
500-875 mg PO Q12H
775 mg XR PO Q24H

Tablet, chewable, capsule, suspension

Renal dose adjustments

DOC: AOM, H. pylori, IE ppx

SE: hypersensitivity (inc. anaphylaxis), taste disturbance, GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

PO suspension refrigerated for taste; stable 14D at RT
Moxatag taken w/in 1 hour of meal end
PO bioavailability 75-90%

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11
Q

Amoxicillin/Clavulanate

A

Augmentin, Augmentin XR, Amoclan
Class: Aminopenicillin/Beta-lactamase

Coverage: anaerobes
No SPICE A

Dosing: 500 mg PO TID
875 mg PO BID
2g XR PO BID

Tablet, chewable, suspension

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), taste disturbances, GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

CI (XR only): hx of cholestatic jaundice, hepatic dysfunction, or CrCl

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12
Q

Ampicillin

A

Class: Aminopenicillins

Dosing: 250-500 mg PO Q6H
1-2g IV Q4-6H

IV, IM, capsule, suspension

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), taste disturbance, GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

PO on empty stomach (1H prior/2H after)
IV only compatible in NS; stable at RT for 8H

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13
Q

Ampicillin/Sulbactam

A

Unasyn
Class: Aminopenicillin/Beta-lactamase Inhibitor

Coverage: anerobes, Acinetobacter
No SPICE

Dosing: 1.5-3G IV Q6H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

Only compatible in NS

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14
Q

Antistaphylococcal Penicillins

A

MOA: inhibits transpeptidation in cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal (except Enterococci)

Coverage: MSSA (DOC) & Strep
No MRSA or Coag (-) Staph

Pregnancy Category B

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15
Q

Nafcillin

A

Class: Antistaphylococcal Penicillins

Dosing: 1-2g IV/IM Q4-6H

IV, IM

No renal dosing adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, hepatitis/increased LFTs, BMS, AIN, C.diff infection, seizures (accumulation)

Most tolerated in class (better for long-term therapy)

Vesicant (tx: hyaluronidase & cold packs)

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16
Q

Oxacillin

A

Class: Antistaphylococcal Penicillins

Dosing: 250-2000 mg IV Q4-6H

No renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, hepatitis/increased LFTs, BMS, AIN, C.diff infection, seizures (accumulation)

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17
Q

Dicloxacillin

A

Class: Antistaphylococcal Penicillins

Dosing: 125-500 mg PO Q6H

No renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, taste disturbances, rash, hepatitis/increased LFTs, BMS, AIN, C.diff infection, seizures (accumulation)

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18
Q

Ureidopenicillins
&
Carboxypenicillins

A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing
Bactericidal (except Enterococci)

Coverage: MSSA, Strep, Gm (-) organisms inc. SPICE A, anaerobes (d/t beta-lactamase inhibitors)

Pregnancy Category B

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19
Q

Piperacillin/Tazobactam

A

Zosyn
Class: Ureidopenicillin/Beta-lactamase

Coverage: anerobes, SPICE A
No MRSA, VRE, Coag (-) Staph,
atypicals (CML), ESBLs

Dosing: 3.375-4.5g IV Q6-8H
Extended infusion dosing

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

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20
Q

Ticarcillin/Clavulanic Acid

A

Timentin
Class: Carboxypenicillin/Beta-lactamase Inhibitor

Coverage: anerobes, Stenotropomonas, SICE A
No Pseudomonas or
Enterococci

Dosing: 3.1g IV Q4-6H

SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, AIN, C.diff infection, seizures (accumulation)

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21
Q

Penicillin Drug Interactions

A

Probenecid: reduced PCN renal elimination

Methotrexate: increased [MTX]

Tetracyclines (& bacteriostatic agents): reduced PCN effectiveness by slowing bacterial growth

Mycophenolate: reduced active metabolites d/t impaired enterohepatic recirculation

Warfarin: increased INR (except Dicloxacillin & Nafcillin)

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22
Q

1st Generation Cephalosporins

Study These Flashcards
A

MOA: inhibit transpeptidation of cell walls by binding PBPs
Time-dependent killing (t/AUC)
Bactericidal

Coverage: MSSA, minor Strep, Proteus, E.coli, Klebsiella (PEK)

BBW: PCN cross-reactivity

Pregnancy Category B

23
Q

Cefadroxil

Study These Flashcards
A

Class: 1st Generation Cephalosporins

Dosing: 500-1000 mg PO Q12H

Renal dose adjustment

SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)

24
Cefazolin
Ancef, Kefzol Class: 1st Generation Cephalosporins DOC for severe MSSA infections in PCN allergic patients Dosing: 1-1.5g IV/IM Q8H Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)
25
Cephalexin
Keflex Class: 1st Generation Cephalosporins Dosing: 250-1000 mg PO Q6H Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)
26
2nd Generation Cephalosporins
MOA: inhibit transpeptidation of cell walls by binding PBPs Time-dependent killing (t/AUC) Bactericidal Coverage: MSSA, Strep, Haemophilus, Neisseria (HNPEKS) BBW: PCN cross-reactivity Pregnancy Category B
27
Cefaclor
Class: 2nd Generation Cephalosporins Dosing: 250-500 mg PO Q8H Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)
28
Cefotetan
Class: 2nd Generation Cephalosporins Coverage: anaerobes (B. fragilis has high resistance rates), reduced Gm (+) Dosing: 1-2g IV/IM Q12H Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation) N-methylthiotetrazole (NMTT) side chain causes hypoprothrombinemia & disulfiram-like reaction
29
Cefoxitin
Class: 2nd Generation Cephalosporins Coverage: anaerobes, reduced Gm (+) Dosing: 1-2g IV/IM Q6-8H Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)
30
Cefprozil
Class: 2nd Generation Cephalosporins Dosing: 250-500 mg PO Q12H-24H Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)
31
Cefuroxime
Ceftin, Zinacef Class: 2nd Generation Cephalosporins Dosing: 250-1500 mg Q8-12H PO, suspension, IV, IM Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation) Suspension taken with food
32
3rd Generation Cephalosporins
MOA: inhibit transpeptidation of cell walls by binding PBPs Time-dependent killing (t/AUC) Bactericidal Coverage: Strep, minor Staph, Serratia (HNPEKS), enteric Gm (-) rods BBW: PCN cross-reactivity Pregnancy Category B
33
Cefdinir
Omnicef Class: 3rd Generation Cephalosporins Dosing: 300 mg PO Q12H 600 mg PO Q24H Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)
34
Cefditoren
Spectracef Class: 3rd Generation Cephalosporins Dosing: 200-400 mg PO Q12H Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation) Tablets take with food
35
Cefixime
Suprax Class: 3rd Generation Cephalosporins Dosing: 400 mg PO div Q12-24H Tablets, chewable Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation) Chewable tablets contain phenylalanine
35
Cefotaxime
Claforan Class: 3rd Generation Cephalosporins Dosing: 1-2g IV/IM Q4-12H Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)
36
Cefpodoxime
Class: 3rd Generation Cephalosporins Dosing: 100-400 mg PO Q12H Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)
36
Ceftazidime
Fortaz, Tazicef Class: 3rd Generation Cephalosporins ``` Coverage: Gm (-) inc. Pseudomonas No Gm (+) or anaerobes ``` Dosing: 1-2g IV/IM Q8-12 Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation)
37
Ceftibuten
Cedax Class: 3rd Generation Cephalosporins Dosing: 400 mg PO Q24H Renal dose adjustment SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation) Take suspension on empty stomach
38
Ceftriaxone
Rocephin Class: 3rd Generation Cephalosporins Dosing: 1-2g IV/IM Q12-24H No renal dose adjustment ``` SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation) CNS toxicity (encephalopathy, AMS, seizures) ``` CI: hyperbilirubinemic neonates, concurrent use of Ca-containing IVs in neonates
39
4th Generation Cephalosporins
MOA: inhibit transpeptidation of cell walls by binding PBPs Time-dependent killing (t/AUC) Bactericidal Coverage: Strep, minor Staph, HNPEKS, & SPICE A, weak anaerobes BBW: PCN cross-reactivity Pregnancy Category B
41
Cefepime
Maxipime Class: 4th Generation Cephalosporins Coverage: Weak anaerobes No Enterococcus DOC neutropenic fever Dosing: 1-2g IV/IM Q12-24H Renal dose adjustment ``` SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation) CNS toxicity (encephalopathy, AMS, seizures) ```
42
5th Generation Cephalosporins
MOA: inhibit transpeptidation of cell walls by binding PBPs Time-dependent killing (t/AUC) Bactericidal Coverage: Staph (inc. MRSA), VRSA, Strep, Enterococcus (inc. VRE), HNPEKS No ESBL or Pseudomonas BBW: PCN cross-reactivity Pregnancy Category B
44
Ceftaroline fosamil
Teflaro Class: 5th Generation Cephalosporins Dosing: 600 mg IV Q12H Renal: 400 mg (CrCl 30-50), 300 mg (15-30), 200 mg (
45
Ceftolozane/Tazobactam
Zerbaxa Class: 5th Generation Cephalosporin/Beta-lactamase Inhibitor Dosing: 1.5g IV Q8H Renal: 750 mg (CrCl 30-50), 375 mg (15-29) SE: hypersensitivity (inc. anaphylaxis), GI upset, drug fever, rash, BMS, AIN, C.diff infection, seizures (accumulation) Indications: complicated intra-abdominal infections & UTIs
46
Cephalosporin Drug Interactions
Probenecid: reduced PCN renal elimination Warfarin: increased INR by inhibition of Vit K-dependent clotting factors
48
Carbapenems
MOA: inhibit transpeptidation of cell walls by binding PBPs Time-dependent killing (t/AUC) Bactericidal Coverage: Gm (+), Gm (-) inc. SPICE A & ESBLs No atypicals, MRSA, VRE, Stenotropomonas BBW: PCN cross-reactivity, CNS adverse effects (seizures, AMS) Pregnancy Category B/C (Imipenem)
49
Imipenem/Cilastatin
Primaxin Class: Carbapenem/DHP-1 Inhibitor Dosing: 250-1000 mg IV Q6-8H SE: hypersensitivity (inc. anaphylaxis), rash, GI upset, BMS, seizures (accumulation) Highest risk of seizures with renal impairment
50
Meropenem
Merrem Class: Carbapenems Dosing: 500-2000 mg IV Q8H Renal: Q12H (CrCl 26-50), 1/2 dose Q12H (10-25), 1/2 dose Q24H (
51
Ertapenem
Invanz Class: Carbapenems Coverage: no Pseudomonas or Acinetobacter Dosing: 1g IV/IM Q24H Renal: 500 mg (CrCl
52
Doripenem
Doribax Class: Carbapenems Dosing: 500 mg IV Q8H Renal: 250 mg (CrCl 30-50), 250 mg Q12H (11-29) SE: hypersensitivity (inc. anaphylaxis), GI upset, rash, BMS, seizures (accumulation) Increased mortality/decreased cure rate in HCAP/VAP- do not use
57
Carbapenem Drug Interactions
Probenecid: reduced PCN renal elimination Depakote: decreased [VPA] lessens seizure control
58
Monobactams
MOA: inhibit transpeptidation of cell walls by binding PBPs Time-dependent killing (t/AUC) Bactericidal ``` Coverage: Gm (-) inc. Pseudomonas No Gm (+) ``` Pregnancy Category B Can be used in PCN allergic patients
59
Aztreonam
Azactam IV, Cayston Class: Monobactams Dosing: 500-2000 mg IV Q6-12H Renal: 50% normal (CrCl 10-30), 25% (
62
Fluoroquinolones
MOA: inhibits topoisomerase IV & II (DNA gyrate) & prevents DNA supercoiling, promoting breakage of double-stranded DNA Coverage: Gm (+), Gm (-), atypicals Respiratory FQ (G/L/M): enhanced Strep & atypical C/L: Pseudomonas BBW: tendon inflammation/rupture, QT prolongation, peripheral neuropathies, CNS effects, photosensitivity Pregnancy Category C Caution with use in children

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