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Flashcards in Random Antibiotics Deck (22):
1

Aminoglycoside MOA:

Bind to outer membrane of cell.
- Results in re-arrangement of LPS.
- Uptake is energy dependent.
- Once across membrane drug is trapped.
- Binds to 30S and 50S ribosomal subunit.
Bacteriocidal.
Concentration dependent killing with PAE.

2

Aminoglycoside excretion:

99% unchanged via glomerular filtration.
- Tx UTI's

3

Aminoglycoside ADR:

- Thrombophlebitis.
- Nephrotoxicity (too high trough).
- Ototoxicity (too high peaks).
- Neuromuscular blockade.

4

Aminoglycosides spectrum of activity:

G-:
- Piddly
- PEK
- SPACE
G+:
- Add-on only, not monotherapy.

5

Aminioglycoside lung concentrations:

Low, 40%.

6

Aminoglycosides (3):

- Gentamicin
- Tobramycin
- Neomycin (gut decontamination)

7

Vancomycin MOA:

Inhibits the biosynthesis of peptidoglycan during cell wall formation.
- Complexes with D-alanyl-D-alanine precurser.
Bactericidal
PAE

8

Vancomycin ADRs (8):

- Thrombophlebitis.
- Red-man syndrome.
- Neutropenia.
- Eosinophilia.
- Thrombocytopenia.
- Hypersensitivity.
- Nephrotoxicity.
- Ototoxicity (high peaks).

9

Vancomycin spectrum of activity:

G+:
- MRSA
- Staph epidermidis
- Strep
- Enterococcus
- Clostridium
- Bacillus anthracis
- Cornyebacteria

10

Quinupristin/dalfopristin (synercid) MOA:

- Irreversibly bind to the 50S ribosomal subunit.
- Q inhibits chain formation.
- D inhibitis peptide elongation.

11

Quinupristin/dalfopristin spectrum (5):

- MRSA.
- PCN-resistant strep pneumo.
- VRE (*not E. faecalis).
- Anaerobes
- Some G-

12

Linezolid MOA:

- Bind to 23S ribosomal RNA of 50S subunit.

13

Linezolid spectrum (4):

- MRSA
- VISA
- VRE
- PCN-resistant strep pneumo

14

Linezolid ADRs (3):

- Myelosupression: thrombocytopenia.
- Superinfection (yeast).
- Mitochondrial toxicity (long courses).

15

Linezolid drug-drug interactions:

MAOI
- Co-administration with SSRI --> serotonin storm.

16

Mupirocin (2):

- Topical treatment.
- MRSA colonization eradication from nares.

17

Colistin (4):

- Bacteriocidal.
- SPACE bug coverage.
- Nephrotoxicity and neurotoxicity.
- "Kitchen sink" - last ditch efforts.

18

Fosfomycin (3):

- Bacteriocidal.
- UTIs only.
- MDR pathogens:
- MRSA/VRE
- ESBL

19

Tigecycline indications (3):

- Complicated skin infections.
- Complicated intra-abdominal infections.
- Community acquired pneumonia (CAP).
* Does not attain high serum concentrations.

20

Tigecycline spectrum (4):

- MRSA/VRE.
- G- bacteria (CRE).
- Acinetobacter (not pseudomonas).
- Anaerobes (GI infections).

21

Daptomycin (6):

- Bacteriacidal.
- G+ coverage.
- MRSA/VRE.
- Complicated skin and soft tissue infections.
- SA and MRSA bacteremia
- Does NOT cover pneumonia.
- ADR: rhabdomyolysis, eosinophilic pneumonia

22

Telavancin (4):

- Semi-synthetic Vancomycin.
- G+:
- Staph, strep and enterococcus.
- Skin and soft tissue infections.
- ADR: Nephrotoxicity, Red-man syndrome, QT prolongation, pancreatitis.