General Drug class review

Question 1

PCN V and G

Answer 1

G - IV/IM
V - oral

Strep

Question 2

Antistaphlococcal

Answer 2

Naf, Ox, Clox, Diclox, Methacillin

Question 3

CarboxyPCN

Answer 3

Ticarcillin - Pseudo

Sodium overload

Question 4

UreidoPCN

Answer 4

Piperacillin - Pseudo

Question 5

Beta-lactamase Inhibitors

Answer 5

add staph and anaerobe coverage

Question 6

Cephalosporins

Answer 6

cephamycin, 3rd, 4th - diabetic foot wound

Staph - 1st, 2nd, 4th

5th - MRSA

Ceftriaxone (3rd gen) - meningitis

Antipseudomonal - Ceftaz, Cefapime

No Enterococcus - basically

Question 7

Carbapenem

Answer 7

ESBL coverage

Imipenem/Cilstatin - seizures
Meropenem
- Staph, strep, ENTEROC*
SPACE*
Anaerobe

Ertapenem
- Strep, Staph
PEK*
Anaerobe

Question 8

Monobactam

Answer 8

Aztreonam - PCN prophylaxis

G- coverage

Question 9

Aminoglycosides

Answer 9

G-

Gent
Tobra
Amikacin - need high dose - North carolina
Neomycin - oral - gut decontamination - cholorectal surgery

PAE

NONT : neuromuscular block, ototox, nephrotox, teratogen - watch with pregnant wmn

Nephrotoxicity - monitor serum creatinine

Question 10

Vancomycin

Answer 10

G+

Endocarditis
Osteomyelitis
Meningitis

MRSA
treat CDIF

No therapeutic blood levels
Ototoxicity
Nephrotoxicity
Red man syndrome

Question 11

Linezolid

Answer 11

G+ 
MRSA
VRE infection 
Faecalis AND Faecium 
Thrombocytopenia

MOnamine oxidase inhibitor - serotonin storm . Stay away from persons antidepressants

Question 12

Quinipristin/Dalfopristin

Answer 12

Synercid
Enterococcus coverage

ONLY Faecium

(no Faecalis)

PICC/Central line

Question 13

Mupirocin

Answer 13

MRSA decolonization in nares

Question 14

Colistin

Answer 14

last ditch effort

nephoro/neurotoxicity

G-

Question 15

Fosfomycin

Answer 15

UTIs

Question 16

Tigecycline

Answer 16

bacteriostatic

don’t use for bacteremia

good for MRSA, VRE, CRE, Acinetobacter and anaerobes

Question 17

Daptomycin

Answer 17

bacteremia

gets metabolized by lung surfactants - no pneumonia treatment

Rhabdomyolysis

Question 18

Telavancin

Answer 18

synthetic vanc

Red man syndrome
long QT

Question 19

Sulfonamides

Answer 19

Folic acid synthesis - only bacteria

Nephrotoxicity!
Don’t treat pregnant women - Kernicterus - inc in fetal blood levels of unconjugated bilirubin

Question 20

Trimethoprim

Answer 20

affects tetrahydrofolate - human/bacteria

Beware in alcoholics, low folate

Question 21

Sulfa/Trim

Answer 21

Cidal effect

Staph/Strep/G+/- and atypicals

UTI
Pneumocystis carinnii pneumonia
Strenotrophamonas maltophilia

D-D intrx: warfarin, methotrexate

Question 22

Nitrofuranton

Answer 22

UTI
not enough high conc systemically

pulmonary infiltrates

G+/-

Question 23

Methanamine

Answer 23

hydrolyzed into Formaldehyde
(need acidic pH urine - not the case in catheterized patients)

ONLY UTI PROPHYLAXIS (not treatment of acute UTI)

Hepatic insufficient patients - Ammonia byproduct buildup

Question 24

Macrolides

Answer 24

Atypicals, G+

Clarithro/Azithro also have H. flu and M. Cat

biliary excretion

Erythro - long QT

Question 25

Clindamycin

Answer 25

G+ and anaerobe tissue penetration - diabetic foot wound CDIF!

Question 26

Chloramphenicol

Answer 26

CSF penetration without inflammation (Bacterial meningitis) ``` Aplastic anemia Gray baby (glucuronidation defect) ```

Question 27

Fluoroquinolones

Answer 27

Atypicals Moxi - no UTI, covers Anaerobes Levo and Moxi - Staph/Strep Cipro - G - PAE prostatitis Tendon ruptures - no children 60 yo Long QT, Mental changes Bound up by cations

Question 28

Tetracyclines

Answer 28

Atypicals Dental problems Photosensitivity Cation binding No preggos