Pharmacology

Question 1

Mechanism of action:

Quinolones

Answer 1

Bactericidal

Inhibits DNA gryase

Question 2

Quinolones spectrum of activity

Answer 2

Staphylococci (not MRSA), gram negative bacilli (Pseudomonas), Enterobacter

Question 3

Adverse reactions of Quinolones

Answer 3

GI (nausea, vomiting, diarrhea), insomnia, headache, seizures, contraindicated in children-defects in cartilage, drug interaction with theophylline & antacids

Question 4

What type of drugs are Quinolones?

Answer 4

Antibiotics

Question 5

What type of drug is cephalosporins?

Answer 5

Antibiotic

Question 6

Mechanism of action of cephalosporins?

Answer 6

Bactericidal

Inhibition of cell wall synthesis

Question 7

4th generation cephalosporins agent?

Answer 7

Cefipime (Maxipime)

Question 8

Spectrum of activity of 1st generation cephalosporins?

Answer 8

Staphylococci, streptococci
Gram negatives (E. Coli, P. mirabilis, shigella, salmonella)
Anaerobes (not bacteroides)

Question 9

Spectrum of activity of 2nd generation cephalosporins?

Answer 9

Staphylococci (less active than 1st generation)
Streptococci (same as 1st generation)
More gram negative (H. Influenza, proteus, klebsiella, E. coli)
Anaerobes (cefotetan & cefoxitan active against bacteroides)

Question 10

Spectrum of activity 3rd generation cephalosporins?

Answer 10

Staphylococci, streptococci (less active than 1st & 2nd)
Pseudomonas (ceftazadime & cefoperazone only)
Anaerobes

Question 11

Spectrum of activity of 4th generation cephalosporins?

Answer 11

Same as earlier agents

Greater gram negatives coverage (including pseudomonas)

Question 12

Adverse reactions of cephalosporins?

Answer 12

Hypersensitivity (cross reactivity with PCN allergy 5-15%)
Neutropenia 
Diarrhea 
Bleeding
Phlebitis with IV administration

Question 13

B-Lactams?

Answer 13

Imipenem/Cilastain
(Primaxin)
Aztreonam

Question 14

Spectrum of activity of Imipenem/Cilastain(Primaxin)?

Answer 14

Very broad
Most gram positive aerobes & anaerobes
Gram negatives ( including pseudomonas)
Anaerobes (including bacteroides)

Question 15

Adverse reactions of Imipenem/Cilastain (Primaxin)?

Answer 15

Seizures in patients with h/o seizures

Nausea/vomiting

Question 16

Spectrum of activity of Aztreonam?

Answer 16

Gram negative aerobes (pseudomonas)

Not active against gram positive or aerobic organisms

Question 17

Adverse reactions of Aztreonam?

Answer 17

No major side effects

Question 18

What’s dosage of Aztreonam?

Answer 18

1-2 gm IV q8h

Question 19

What is in Augmentin?

Answer 19

Amoxicillin/clavulanic acid

Question 20

What is Unasyn?

Answer 20

Ampicillin/sulbactam

Question 21

What is in Timentin?

Answer 21

Ticarcillin/clavulanic acid

Question 22

What is in Bactrim?

Answer 22

Tmp/smx

Trimethoprim/sulfamethoxazole

Question 23

What is in Primaxin?

Answer 23

Imipenem/Cilastain

Question 24

What is in Zosyn?

Answer 24

Piperacillin/tazobactam

Question 25

What is in Rocephin?

Answer 25

Ceftriaxone | 3rd generation Cephalosporins

Question 26

Which drug is nicknamed "Gorillamycin"?

Answer 26

Imipenem because it has the broadest spectrum of any drug

Question 27

What is in Avelox?

Answer 27

Moxifloxacin hydrochloride

Question 28

What is in Invanz?

Answer 28

Ertapenem sodium

Question 29

What is in a SMA-7 that test kidney function?

Answer 29

Bun- 7-21 | Creat- 0.5-1.5

Question 30

What do you always want to check before giving an antibiotic?

Answer 30

Kidney function Allergies If pt is already on an antibiotic If a gram stain & C & S has been done and results if done

Question 31

What is the dosing for Unasyn?

Answer 31

3. 0g IV q 6 | 1. 5g IV q6 for pt with renal impairment

Question 32

When is Unasyn usually used?

Answer 32

It is a good initial IV choice for a polymicorbial infection | Diabetic infection

Question 33

What is an alternative to Unasyn for a patient with a PCN allergy?

Answer 33

Cipro/Clinda Levaquin (There are others)

Question 34

Will Unasyn work against Psuedomonas?

Answer 34

No

Question 35

What is in Augmentin? Dosing?

Answer 35

Amoxicillin/clavulanic acid 500 or 875 mg one tab po bid 875mg/125mg Amox/clavu acid

Question 36

How much clavulanic acid is in Augmentin 500mg? For Augmentin 875mg?

Answer 36

Both have 125mg

Question 37

Does Augmentin work on pseudomonas?

Answer 37

Nope

Question 38

When is Augmentin usually used?

Answer 38

It is a good oral drug for polymicorbial infection Diabetic infection po dog and cat bites (pasturella multiocida)

Question 39

Indications for Zosyn?

Answer 39

Infections of skins and skin structures, including DM foot infection

Question 40

Dosing Zosyn?

Answer 40

3.375g IV q 4-6 Renal dose 2.25g IV q 4-6 Alt dose 4.5g IV q4-6

Question 41

Will Zosyn work on Pseudomonas?

Answer 41

Yes

Question 42

% of cross sensitivities between cephalosporins and PCN?

Answer 42

1-5%

Question 43

What is Timentin?

Answer 43

Ticarcillin/clavulanic acid

Question 44

What to watch out for with Ticarcillin?

Answer 44

Increased Na+ load by 5.2meq/g

Question 45

What is the Na+ load of Ticarcillin?

Answer 45

5.2meq/g

Question 46

Dosing Timentin?

Answer 46

3.1g IV q4-6

Question 47

What is Timentin's coverage?

Answer 47

Polymicorbial, broad spectrum including pseudomonas

Question 48

What is the drug of choice for a diabetic foot infection with a penicillin allergy?

Answer 48

Clindamycin

Question 49

How are PCN's excreted?

Answer 49

``` All are renal except for Mezlocillin, Azlocillin Piperacillin (The ureidopencillins are 20-30% renal) ```

Question 50

Name 2 IV alternative antibiotics for PCN allergic patients

Answer 50

``` Clindamycin Levaquin Vancomycin Bactrim (There are others) ```

Question 51

Which PCN's are anti-Psuedomonal?

Answer 51

``` The fourth and fifth generation PCN's Ticarcillin, Timentin Piperacillin, Zosyn Carbenicillin, Mezlocillin, Azlocillin 2-4th generation Quinolones FAT CIA FORTAZ ```