Gram Positive (Carreno) Flashcards by Steve Lane

Penicillin Coverage

Strep pneumo
E. coli
PSSA
NO MOD/HIGH COVERAGE

How well did you know this?

Not at all

Perfectly

Penicillin Distribution

WIDELY DISTRIBUTED

How well did you know this?

Not at all

Perfectly

3rd Gen Cephalosporins (6)

aka “3rd Gen Ceph”

Cefdinir
Cefixime
Cefoperazone
Ceftaxime
Ceftazidime
Ceftriaxone

MOA: prevent transpeptidation reaction

How well did you know this?

Not at all

Perfectly

3rd Gen Ceph Coverage

G+: Strep pneumo, MSSA
G-: E.coli, Kleb pneumo

NO HIGH COVERAGE

How well did you know this?

Not at all

Perfectly

3rd Gen Ceph Distribution (4)

CNS (good)
Intra-abdomen
Urine
Skin

How well did you know this?

Not at all

Perfectly

Type 1 beta-lactam allergy
+
Conditions

Immediate
IgE-mediated

Anahpylaxis within minutes

How well did you know this?

Not at all

Perfectly

Type 2 beta-lactam allergy
+
Conditions

Production of cytotoxic Abs
IgG + IgM mediated

Thrombocytopenia, nephritis, dose/duration dependent

How well did you know this?

Not at all

Perfectly

Type 3 beta-lactam allergy
+
Conditions

IMMUNE COMPLEX MEDIATED
Formation of immune complexes
IgG + IgM

Serum sickness within 7-14d

How well did you know this?

Not at all

Perfectly

Type 4 beta-lactam allergy
+
Conditions

CELL MEDIATED (NO ABs)
T-cell dependent

Inflammation + contact dermatitis

How well did you know this?

Not at all

Perfectly

Macrolides

Eryhtromycin
Clarithromycin
Azithromycin

MOA: bind 50S subunit, prevent peptide bond formation

How well did you know this?

Not at all

Perfectly

Macrolide Coverage

S.pneumo
\+
H.influenza
M. catarrhalis
Mycoplasma
Chlamydia
Leginoella

How well did you know this?

Not at all

Perfectly

Macrolide Distribution

Upper Resp
Lower Resp
Tissues (i.e. cervix, ovaries, prostate)

How well did you know this?

Not at all

Perfectly

Key Clinical Uses:

Erythromycin

Strep pneumo

Promotility agent

How well did you know this?

Not at all

Perfectly

Key Clinical Uses:

Clarithromycin

Community Acquired Pneumonia (CAP)
Mycobacterium Avium Intracellularae (MAI)
H.pylori

How well did you know this?

Not at all

Perfectly

Key Clinical Uses:

Azithromycin

URTI (upper respiratory infections)
CAP
MAI
Cystic Fibrosis
COPD exacerbations
Chlamydial infections
Gonorrhea (@ high doses)

How well did you know this?

Not at all

Perfectly

Macrolide: ADEs

Diarrhea
Vomiting
QT-prolongation
CYP3A4 interactions (E > C > A) i.e. STATINS

How well did you know this?

Not at all

Perfectly

Fluoroquinolones

MOA: Toposiomerase/gyrase inhibition

ATYPICAL BACTERIA
Moxifloxacin (G+)
Levofloxacin (broad/both)
Ciprofloxacin (G-)

How well did you know this?

Not at all

Perfectly

Coverage: Moxifloxacin

G+
Strep pneumo
E.coli, Kleb pneumo, G- anaerobes

How well did you know this?

Not at all

Perfectly

Coverage: Levofloxacin

BROAD (both)
Strep pneumo
Ecoli, Kleb pneumo, PSAR

How well did you know this?

Not at all

Perfectly

Coverage: Ciprofloxacin

Study These Flashcards

G-
NO G+ activity
E.coli, Kleb pneumo, PSAR

Fluoroquinolone Absorption/Bioavailability

Study These Flashcards

Moxi + Levo –> 100%

Cipro –> 80%

Fluoroquinolone Distribution

Study These Flashcards

Lungs: Moxi + Levo
Urine: Levo + Cipro
Intra-abdomen: Moxi, Levo, Cipro

Fluoroquinolone Excretion

Study These Flashcards

Renal: Levo + Cipro
Hepatic: Moxi

Major Fluoroquinolone ADE

Study These Flashcards

QT Prolongation
Tendinitis + Tendon Rupture
Hypersensitivity
N/V
Diarrhea
Dizziness
Headaches
Insomnia

ABCs of Staph aureus

``` A --> absence of resistance elements B --> beta-lactamase presence C --> changes in PBP D --> d-ALA-d-ALA alterations (VRSAs) E --> extra-thick walls ```

Penicillinase-Resistant Penicillins (2) + Dosing

``` Oxacillin Nafcillin 2g IV q4h (SAME FOR BOTH) NO ADJUSTMENT FOR RENAL -monitor liver enzymes + interstitial nephritis ```

Penicillinase-Resistant Penicillins: Coverage

NO G- ACTIVITY | Strep pneumo, MSSA

Penicillinase-Resistant Penicillins: Distribution

Blood Skin Urine (?)

1st Gen Cephs (4)

Cefazolin (PO) Cephalexin (IV) Cephadroxil (PO) Cephalothin (IV)

1st Gen Cephs: Coverage

Strep pneumo, MSSA | E.coli

1st Gen Ceph: Distribution

Skin Urine (POOR CNS)

Beta-lactam + beta-lactamase inhibitor (3)

Amoxacillin/Clavulanate Ampicillin/Sulbactam Pipercillin/Tazobactam

Coverage: Amox/Clav + Amp/Sulbactam

Strep pneumo, MSSA E.coli **sulbactam selectively toxic vs. acinetobacter

Coverage: Piper/Tazo

Strep pneumo, MSSA E.coli, Kleb pneumo, PSAR **additional G- anaerobe coverage

Coverage: Vancomycin

Strep pneumo, MSSA, MRSA, E.faecalis **NO G- IV --> MRSA and PO --> C.diff

Distribution: Vancomycin

Low PO Bioavailability Blood Urine Lung, bone, CNS, heart (?)

Distribution: Daptomycin

Skin Heart (Inactivated in lungs)

Coverage: Daptomycin

Strep pneumo, MSSA/MRSA, E.faecalis | **NO G-

Daptomycin ADEs

Skeletal muscle toxicity Concurrent use of statin Eosinophili pneumonia (rare)

Telavancin: Type + ADEs

Lipogylcopeptide QTc prolongation + red-man syndrome 2x potential nephrotoxicity as vancomycin

Linezolid: Coverage

Strep pneumo, MSSA/MRSA, E.faecalis | **NO G-

Linezolid: Distribution

Low serum concentrations EXCELLENT for lungs Skin Urine

Linezolid: Info and ADEs

100% Bioavailability No renal dose adjustment Serotonin response syndrome Peripheral/otic neuropathy Thrombocytopenia/anemia

Tigecycline: Coverage

Strep pneumo, MSSA/MRSA, E.faecalis E.coli, Kleb pneumo + H.influenza, M.catarrahlis, Acinetobacter

Tigecycline: Distribution

Intra-abdomen Skin Lungs (?) VERY LOW SERUM/URINE concentrations **adjust for hepatic dysfunction

Tigecycline: ADEs

N/V

Ceftaroline: Coverage

Strep pneumo, MSSA/MRSA | E.coli, Kleb pnemo

Ceftaroline: Distribution

Lungs Skin Other (?) **adjust for CrCl < 50mL/min

Gram Positive (Carreno) Flashcards

(48 cards)