HIPSHER Antibiotics Q19-32

Question 1

List the commonly used fluoroquinolones by trade and generic names

Answer 1

• Ciprofloxacin (Cipro)
• Levafloxacin (Levaquin)
• Moxifloxacin (Avelox)

Question 2

What is the MOA for fluoroquinolones?

Answer 2

MOA : bacteriacidal
• not as potent as beta-lactams
• CANNOT be used with staph aureus, enterococcus (except with UTI) even if sensitive

Question 3

Describe the anti-microbial spectrum of fluoroquinalones and the infections they are used for-

Answer 3

CAP: levofloxacin or moxifloxacin

Intra-abdominal : moxifloxacin

Complicated UTI and Prostatitis: Levofloxacin & Cipro

Question 4

What is the BBW for fluoroquinolone?

Answer 4

Tendon Rupture

Question 5

What are the side effects worth noting for fluoroquinolone?

Answer 5

• confusion,
• hallucinations
• HA
• dizziness
• tendon rupture (BBW)
• QT prolongation
• C.diff colitis
• fluoroquinalones potentiate warfarin

Question 6

List the commonly used macrolides by trade and generic name

Answer 6

• Erythromycin
• Azithromycin (Zithromax)
• Clarithromycin (Biaxin)

Question 7

MOA of macrolides and typical use of macrolides?

Answer 7

• bacteriostatic

o atypical CAP- combine with better strep pneumoniae coverage for empiric CAP coverage,
o chlamydia
o urethritis,
o MAC

Question 8

What are ADR associated with macrolides?

Answer 8

• QT prolongation,
• increased LFT,
• potentiates warfarin [erythro and clarithro only]

Question 9

List the commonly used aminoglycosides

Answer 9

Gentamycin

Tobramycin

Question 10

MOA for ahminoglycosides?

Answer 10

Bactericidal - concentration dependent killing

• post-antibiotic effect - even when the drug is gone the bacteria is still stunned

Question 11

What are the 2 indications for ahminoglycosides?

Answer 11

enterococcal endocarditis, nosocomial infections

Question 12

What are the toxicity risks with ahminoglycosides?

Answer 12

nephrotoxicity, ototoxicity

• toxicity can be limited by obtaining peak and trough levels

Question 13

List the commonly used tetracyclines

Answer 13

Tetracycline
Monocycline
Doxycycline

Question 14

What is the MOA for tetracycline?

Answer 14

Bacteriostatic

Question 15

When should tetracyclines we used in therapy?

Answer 15

cellulitis- covers
MRSA

COPD exacerbations-anti-inflammatory effect

CAP - use doxy

acne)

Question 16

When should tetracyclines not be used?

Answer 16

UTI’s!!!!

Question 17

What are ADR with tetracyclines?

Answer 17

Photosensitivity

Teeth staining and reduced bone grows in children and pregnant women

Question 18

What is the MOA of vancomycin?

Answer 18

weakly bactericidal and time dependent killing- stay above MIC

Question 19

What organisms are covered by vancomycin

Answer 19

staph including MRSA, strep, enterococcus- but use a beta lactam if you have MSSA; oral vancomycin used for C.diff colitis

Question 20

ADRs related to Vancomycin

Answer 20

red man syndrome- lengthen infusion, rash, nephrotoxicity- adjust dose based on trough

Question 21

MOA of bactrim?

Answer 21

Bacteriostatic

Question 22

Organisms covered by Bactrim?

Answer 22

some gram negatives, gram positives including MRSA

Question 23

Which infections do we use bactrim for?

Answer 23

use for uncomplicated UTI, purulent cellulitis, PCP prophylaxis

Question 24

ADRs for Bactrim?

Answer 24

rash, fever, hyperkalemia, Steven- Johnson syndrome, potentiates warfarin)

Question 25

MOA of clindamycin?

Answer 25

bacteriostatic

Question 26

Antimicrobial activity of clindamycin?

Answer 26

• Antimicrobial activity: o anaerobes o gram positives including MRSA- don’t use if resistant to Emycin

Question 27

What infections should you use clindamycin for?

Answer 27

o anaerobic infection above the diaphragm o cellulitis o MRSA infx-has anti-inflammatory activity

Question 28

ADRs of clindamycin?

Answer 28

C-DIFF!!!! rash

Question 29

MOA metronidazole?

Answer 29

bactericidal

Question 30

What are the organisms that metronidazole covers and in what infections should you use metronidazole?

Answer 30

``` • Antimicrobial activity: anaerobes and protoxoans, C.Diff • Infections: o anerobic infx below the diaphragm o protozoans o C-diff ```

Question 31

what are the ADRs associated with metronidazole?

Answer 31

o metallic taste o neuropathy o disulfuram reaction w/ EtOH o potentiates warfarin

Question 32

When should you use nitrofurantoin?

Answer 32

Coverage of some gram negatives and with uncomplicated UTIs

Question 33

What is the MOA for Rifampin?

Answer 33

• MOA: bactericidal • Therapy: o use w/ other abx for synergy in prosthetic joint or surgical hardware infection o TB

Question 34

Briefly describe the infections for which we use linezolid

Answer 34

MRSA and VRE

Question 35

What are precautions for using linezolid?

Answer 35

with SSRIs Myelosuppression

Question 36

With what infections do you use daptomycin?

Answer 36

MRSA & VRE

Question 37

When can you not use daptomycin?

Answer 37

Lung infections Muscle Damage