Sing L2 Flashcards
(106 cards)
1
Q
what are the 5 aminoglycosides?
A
- Amikacin
- Gentamicin
- Tobramycin
- Streptomycin
- Plazomicin
2
Q
what are the 5 tetracyclines?
A
- Doxycycline (Vibramycin)
- Minocycline (Minocin)
- Tetracycline
- Eravacycline
- Omadacycline
3
Q
what is the 1 glycylcline?
A
tigecycline
4
Q
what are the 3 macrolides?
A
- Azithromycin
- Clarithromycin
- Erythromycin
5
Q
what is the 1 macrocylic?
A
fidaxomcin
6
Q
what is the 1 lincosamide?
A
clindamycin
7
Q
what are the 2 oxazolidinones?
A
- Linezolid
- Tedizolid
8
Q
what is the 1 streptogramin?
A
quinupristin/dalfopristin
9
Q
what is the 1 pleuromutilin?
A
lefamulin
10
Q
which classes of drugs inhibit bacterial protein synthesis by binding to the 30S subunit?
A
aminogylcosides
tetracyclines
glycyclines
11
Q
which classes of drugs inhibit bacterial protein synthesis by binding to the 50S subunit?
A
macrolides
lincosamide
oxazolidinones
streptogramins
chloramphenicol
12
Q
which classes of drugs inhibits bacterial protein synthesis throught interactions with the A- and P- sites of the peptidyl transferase center in the 23s ribosomal RNA of the 50S subunit?
A
pleuromutilin
13
Q
what class of drugs are bactericidal?
A
aminoglycosides
14
Q
what class of drugs are bacteriostatic?
A
tetracyclines
glycyclines
macrolides
lincosamide
oxazolidinones
15
Q
what class of drugs are bactericidal when used in synergy?
A
streptogramins
16
Q
what class of drugs can be both bactericidal or bacteriostatic?
A
pleuromutilins
17
Q
pleuromutilins can be bacteriostatic or bactericidal, what does this depend on?
A
the bug
18
Q
what are the 2 dosing strageties for aminoglycosides?
A
traditional and extended interval dosing
19
Q
are aminoglycosides typically used as monotherapy?
A
rarely
20
Q
what class of drugs are concentration-dependent?
A
aminoglycosides
21
Q
what class of drugs are AUC:MIC dependent?
A
tetracyclines
glycyclines
macrolides
streptogramins
22
Q
what class of drugs are time-dependent?
A
lincosamide
oxazolidinones
pleuromutilines
23
Q
when used alone aminoglycosides only cover what organism?
A
gram-negative
24
Q
when used in synergy aminoglycosides can cover?
A
gram-positive
typically used with beta-lactams or vancomycin
25
which aminoglycoside has activity for P. aeruginosa?
amikacin
26
which tetracyclines cover MRSA?
doxycycline
minocycline
omadacycline
27
which aminoglycoside has activity for M. tuberculosis?
streptomycin
28
which tetracyclines cover VRE?
doxycycline
29
what respiratory pathogens do tetracyclines cover?
atypicals
streptococcus pneumoniae
30
which tetracyclines cover the respiratory pathogens?
doxycycline
31
which tetracyclines cover tick-borne/rickettsial disease?
doxycycline
32
is tetracycline used for the H. pylori reigmen?
yes
33
does tetracycline have activity against gram-negative bacilli?
no
poor activity
34
does tigecycline have broad or narrow activity?
broad
35
what MDROs does tigecycline cover?
MSSA
MRSA
VRE
and many gram-negative rods
36
what are macrolides mainly used for coverage against?
respiratory tract infections (atypicals)
37
what is fidaxomicin only used for coverage for?
C. diff
38
what MDRO does clindamycin have coverage against? community or hospital acquired?
MRSA
community
39
what two organisms does clindamycin mainly provide coverage against?
anaerobes
gram-positives
40
when do you use the D-test? what does it test for?
when using clindamycin for MRSA
it tests for inducible resistance
41
when performing the D-test if it is sensitive to clindamycin, but resistant to _________ additional screening should be done to to test for inducible resistance
erythromycin
42
how do you interpret to D-test?
A “D” shaped zone of inhibition will occur around erythromycin on the dish = positive result
AVOID clindamycin if the D-test is positive (especially in serious infections)
43
oxazolidinones provide broad coverage against what organisms?
gram-positive
44
oxazolidinones provide broad coverage against what MRDOs?
MSSA
MRSA
VRE
atypicals
45
quinupristin/dalfopristin provide broad coverage against what type of organism?
gram-positive only
46
quinupristin/dalfopristin provide broad coverage against what MRDOs?
MSSA
MRSA
VRE
generally reserved for infections caused by MRSA or VRE that are refractory to other treatments – NOT a first line therapy
47
is chloramphenicol broad or narrow?
broad
48
pleuromutilins provide coverage against what disease? what organisms
CAP (only approved indication)
organisms: atypicals and strep pneumoniae
49
pleuromutilins provide coverage against what MDROs?
MRSA
VRE
50
aminoglycosides are used in synergy to treat what?
complicated UTI (typically combined with zosyn)
51
what agent is used to treat drug-resistant TB?
streptomycin
52
what agent is used in inhaled form to treat pneumonia in CF?
tobramycin
53
which agent may have utility in treatment of UTI caused by CRE?
plazomicin
54
tetracyclines are combined with beta-lactams for the treatment of what?
monotherapy for inpatient CAP
55
doxycycline is DOC for treatment of what infections?
tick-borne diseases such as RMSF and lyme disease
56
doxycycline is typically combined with rocephin to treat what?
gonococcal infections and C. trachomatis
57
tetracyclines may be used chronically to treat what?
acne
58
tetracycline may be used for the treatment and prophylaxis against what organism in some areas?
malaria
59
is tigecycline a first-line or last-resort option?
last-resort
60
what should tigecycline not be used to treat?
bacteremia (it distributes extensively into the tissues)
61
macrolides are used in combination with beta-lactams to treat what?
CAP
62
macrolides are used in HIV/AIDS patients for treatment/prevention of what?
MAC infection
63
which macrolide is used to treat H. pylori?
clarithromycin
64
which macrolide is used off label to stimulate GI motility?
erythromycin
65
which macrolide is used for COPD exacerbations d/t a combined antibacterial and anti-inflammatory effect?
erythromycin
66
what is used as an alternative to treat multiple infections when a patient has a penicillin allergy?
clindamycin
67
topical clindamycin may be used for what?
acne
68
clindamycin is used to treat what staph and strep coverage?
skin infectioins
69
clindamycin is used to suppress toxin production in what syndrome? what organisms?
toxic shock syndrome
organisms: staph or group A strep
70
oxazolidinones is primarily used to treat what type of infections?
MDROs such as MRSA and VRE
71
is chloramphenicol commonly used?
no its a last line option
72
what is pleuromutilins only label indication?
CAP
73
what agent has a BBW for C. difficile infection, and is the highest risk CDI causing antibiotic?
clindamycin
74
what class can cause nephrotoxicity and ototoxicity (BBW)?
aminoglycoside
75
is aminoglycoside nephrotoxicity reversible or irreversible?
reversible
76
is aminoglycoside ototoxicity reversible or irreversible?
irreversible
77
what class has a BBW for fetal harm?
aminoglycoside
78
what agent has a BBW for increased all-cause mortality?
tigecycline
79
what agent has a BBW for potentially fatal blood dyscrasias (Gray Baby Syndrome)?
chloramphenicol
80
what class can cause esophageal irritation? counseling points?
tetracycline
take with full glass of water and food
sit/stand upright for 30 min after taking
81
what agent may cause arthralgias and myalgias?
quinupristin/dalfopristin
82
what agent is associated with hepatotoxicity and pancreatitis?
tigecycline
83
what agent can potential cause DILE?
minocycline
84
what class can cause photosensitivity?
tetracycline
85
what agent can cause phlebitis? what do you flush lines with?
quinupristin/dalfopristin
86
what classes may cause QTc prolongation? except maybe what agent, which is generally well tolerated?
macrolides and lefamulin
except azithromycin
87
what agent may cause severe hematologic (myelosuppression) and neurologic toxicities? when are these especially at risk?
linezolid
if the agent is used for more than 14 days
88
who is at higher risk for aminoglycoside-associated nephrotoxicity?
Pre-existing renal impairment
Concomitant nephrotoxic medications
Advanced age
Dehydration
89
who should avoid tetracycline agents? Why?
Children – accumulation may occur in the teeth (permanently discolor) and long bones (stunt growth)
Pregnant/breastfeeding – stunt skeletal development
90
which class can chelate with multi-valent cations? what will this due to absorption?
tetracyclines
decrease absorption
91
what agent may cause serotonin syndrome? what agents should you avoid co-adminstering?
linezolid
MAOIs
92
what other class of antimicrobial may tetracyclines antagonize?
penicillins
93
which macrolides are a potent CYP3A4 inhibitor? what agents can't you give with these?
clarithromycin
erythromycin
cant:
simvastatin
lovastatin
amiodarone
94
do aminoglycosides require renal adjustment?
yes
95
which tetracycline requires renal adjustment?
tetracycline
96
does tigecycline require renal adjustment?
no
97
which macrolide requires renal adjustment?
clarithromycin
98
does clindamycin require renal adjustment?
no
99
do the oxazolidinones require renal adjustment?
no
100
does Synercid require renal adjustment?
no
101
does chloramphenicol require renal adjustment?
no
102
does lefamulin require renal adjustment?
no
103
does lefamulin require hepatic adjustment?
yes, child pugh C
104
which antimicrobials have activity against pseudomonas?
Amikacin
Gentamicin
Tobramycin
Plazomicin
105
which antimicrobials have activity against MRSA?
Doxycycline
Minocycline
Omadacycline
Tigecycline
Clindamycin
Linezolid
Tedizolid
Quinupristin/dalfopristin
Lefamulin
106
which antimicrobials have activity against VRE?
Doxycycline
Tigecycline
Linezolid
Tedizolid
Quinupristin/dalfopristin
Lefamulin
