things to remember Flashcards

(46 cards)

1
Q

Natural PCN’s

A

great for streptococcus species

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2
Q

Aminopenicillins

A

drug of choice for enterococcus

DONT FOR GET LISTERIA

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3
Q

dicloxacillin
oxacillin
nafacillin

A

Drug of choice against staphylococcus

DOSE Adjust LIVER

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4
Q

Pipercillin

A
Streptococcus
VSE
Neiserria
PSUEDOMONAS
GP anaerobes
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5
Q

Aminopenicillinase/Beta lactatmase inhibitor

A
streptococcus
VSE
GNR
HNM
Anaerobes (+/-)
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6
Q

Antipusedomonal/betalactamase

A
Streptococcus
VSE
MSSA
GNR
HNM
Psuedomonas 
Anaerobes (+/-)
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7
Q

2nd gen cephs

A

URI and walking pneumonia

streptococcus
GNR
HNM
Few anaerobes

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8
Q

3rd gen ceph

A

great empiric therapy

URI/UTI/Otitis media

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9
Q

Ceftazidime

A

GNR
HNM
psuedomonas

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10
Q

Cefepime

A

most broad spectrum (great empiric therapy)

Streptococcus
MSSA
GNR
HNM
Psuedomonas 

Renal dose adjust esp in elderly

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11
Q

Ceftraroline

A
Streptococcus
VSE
MSSA
GNR
HNM
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12
Q

Ceftazadime/Betalactam

A

GNR
HNM
Psuedomonas

Reserved for SPACE pathogens

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13
Q

Ceftolozane/Tazobactam

A

Streptococcus
GNR
HNM
Psuedomonas

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14
Q

Carbapenems

A

SPEFICALLY FOR MDR(SPACE PATHOGENS) or SEPTIC SHOCK

very resistant to betalacamases

streptococcus 
VSE
MSSA
GNR
HNM
Psuedomonas
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15
Q

Ertapenem

A
streptococcus 
VSE
MSSA
GNR
HNM
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16
Q

Meropenem/betalactamase inhibitor

A

Drug of choice for patients wit carbapenem -resistant enterobacter

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17
Q

Aztreonam

A
Safest drug to give with allergies 
\$\$\$\$$
Always given in tandem to get with GP covering agent 
GNR
HNM
Psuedomonas
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18
Q

Glycopeptides MOA

A

inhibit PBP from cross linking peptidoglycan

only susceptible to gram pos drugs only (except VRE)

bacteriostatic drugs

Streptococcus 
VSE
MSSA
MRSA
GP+
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19
Q

Vanco IV vs. PO

A

infections (random levels vs. troughs

MRSA- 15-20
MSSA 10-20

PO-Cdiff (smaller doses no monitoring )

20
Q

Tetracycline MOA

A

inhibit protein synthesis
prevent tRNA binding to 30s ribosomal subunit

bacteriostatic

dose adjustments: liver

21
Q

Doxycycline and Tetracycline

A
•	Strepto
•	MSSA
•	MRSA
•	HNM
•	Atypical 
don't give in children less than 8 because of enamel genesis vestibular toxicity and photosensitivity 

dose adjustments: liver

22
Q

Minocycline

A
Minocycline (MINO ATYPICAL)
•	Strepto
•	MSSA
•	MRSA
•	HNM
dose adjustments: liver
23
Q

Tigecycline

A

everything but VRE and Atypical
dose adjustments: liver

**CAN BE USED FOR MDR GNR INFECTIONS

24
Q

Omadacycline

A
Omadacycline: Same + HM and Atypical 
•	Strepto
•	VRE
•	MSSA
•	MRSA
•	GNR
•	HM
•	Atypicals 
dose adjustments: liver
25
Eravacycline:
``` Eravacycline: Same + Anaerobes • Streptococcus • VRE • MSSA • MRSA • GNR • Anaerobes ```
26
Fluroqoquinolones
inhibit both DNA gyrase and Topoisomerase (prevents DNA from Replicating) Bactericidal black box warning and lots of bad ADR's
27
Ciprofloxacin
Ciprofloxacin -bacteriocidal *DOSE ADJUST RENAL* • VSE • GNR*bold • Psuedomonas*bold
28
Levofloxcain
Levofloxcain-bacteriocidal → RESPIRATORY FLUROQUINOLONE *DOSE ADJUST RENAL* * Streptococcus * VSE * GNR* * HNM* * Psuedomonas* * Atypicals
29
Moxifloxacin
``` Moxifloxacin → Respiriatory Covers: • Streptococcous • GNR* • HNM* • Pseudomonas* • Atypical • Anaerobes ```
30
Oxifloxacin
``` Oxifloxacin – bacteriocidal Covers: • Streptococcous • MSSA • GNR* • HNM* • Pseudomonas* ```
31
Delafloxacin
``` Delafloxacin → Respiratory Fluroquinolone Dose adjust renal Covers • Streptococcus • MSSA • MRSA • GNR* • HNM* • Pseudomonas* • Atypical ```
32
Macrolides MAO
inhibits protein synthesis prevents tRNA binding to 50s ribosomal subunit bacteriostatic streptococcus H+ Atypicals H. pylori think Jersey shore StHAHp clarith and erytho inhibit drug metabolism by CYP enzymes dose adjustment liver
33
Clindamycin MOA
inhibit protein synthesis (prevents tRNA binding to 50s ribosomal subunit) bacteriostatic streptococcus MSSA GP+ multiple day dosing to avoid side effects -associated with c. diff infections Dose adjustment LIVER
34
Metronidazole
GP+ anaerobes esp. C. diff ADRs peripheral neuropathy GI intolerance metallic tase
35
Bactrim MOA
inhibits formation of nucleic acids by inhibiting folic acid synthesis SMX inhibits pteroate ***TMP inhibits folate reductase → dosing is based on this component ``` streptococcus MSSA MRSA GNR HNM ```
36
AMINOGLYCOSIDES
irreversibly bind with 30s subunit causing mRNA to be misread Bacteriocidal ``` Synergistic coverage for GPC endocarditis streptococcus VSE VRE MSSA MRSA ``` by themselves GNR Psuedomonas MONITOR PEAKS AND TROUGHS --HAVE POST ANTIBIOTIC EFFECT (2-4hrs)
37
Aminoglycoside dosing gold standard
high bolus at beginning
38
Aminoglycoside dosing for people with kidney issues?
give smaller doses more frequently
39
Nitrofurantoin
SUSCEPTIBLE GNR → used to treat UTI's (CYSTITIS) *** CrCl must be greater than 50 -- dependent on renal function to be therapeutic in bladder
40
Nitrofurantoin MOA
Metabolized within the bacterial cell to reactive intermediates that destroy DNA and ribosomal proteins Bacterialcidal
41
Oxazolidinones
binds to 5Os subunit and doesn't let 30s attach → no protein synthesis occurring bacteriostatic ``` Streptococcus VSE VRE MSSA MRSA GP+ anaerobes ``` ADR's thrombocyopenia and serotonin syndrome Dose adjust liver
42
Daptomycin MOA
binds with calcium and creates holes in phospholipid membrane bacterialcidal ``` Streptococcus VSE VRE MSSA MRSA GP+ anaerobes ``` particularly used for MRSA and VRE infections
43
Quinupristin/Dalfopristin
``` VSE VRE MSSA MRSA GP+ anaerobes ``` particularly used for VRE infections Liver bactericidal
44
Rifampin
bactericidal inhibits RNA polymerase and prevents RNA production can develop resistance when used for long time Induces CYP enzymes and increases clearance of many drugs MSSA MRSA +HN LIVER
45
Fosfomycin MOA and coverage
Inhibits enzyme Mur A→ inhibits cell wall synthesis bacterialcidal ``` VSE VRE MSSA MRSA GNR (accept acinobacter) Pseudomonas ``` only therapeutic in bladder → used for mild UTI's
46
Fidaxomicin MOA
binds to RNA polymerase and doesn't let transcription occur covers specifically C-diff (refractory c-diff) very $$$