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27 Cards in this Set
- Front
- Back
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how does MRSA and VRE gain resistance?
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mutation of cell wall binding protein
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What is the most common method of abx resistance
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transfer of plasmids
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What do you do it peak level of drug is too high?
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decrease the dosage
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What do you do if the trough level is too high?
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decrease the frequency
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What is PCN sensitive to? What does it leave out?
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sensitive to GPC's, GPR, beta- hemoytic strep, anthrax. NOT sensitive to staph, enterococcus
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What is ampicillin/amoxicillin sensitive to?
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same as PCN plus enterococci
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What is Unasyn (amp/sulbactam) Augmentin (amox/clavulinic acid) sensitive to?
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broad spectrum, GOOD enterococci, NO pseudomonas, serratia, acinetobacter
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What is ticarcillin/pipercillin sensitive to?
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ANTI- pseudomonal and enterococci!!!, GNR
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Timentin (ticarcillin/clav.) Zosyn (pipercillin/sulbactam)
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broad spectrum- GPC, GNR, anaerobes, PLUS antipseudomonal, acinetobacter, serratia AND enterococcus
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1st gen cephalosporins?
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cefazolin (ancef- longest T1/2- good for prophy), cephalexin- good for GPC's- staph, strep
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2nd gen cephalosporins?
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cefoxitin, cefotetan, cefuroxime- GPC, GNR +/- anaerobic coverage (NO enterococcus, psedo, acinetobacter, serratia)
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3rd gen cephalosporins?
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ceftriaxone, ceftazidime, cefepime, cefotaxime- GNR mostly +/- anaerobic (COVERS entero, NO pseudo, acinetobacter, serratia)
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Monobactam (aztreonam)?
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GNR- pseudomonas, acintobacter, serratia
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Carbapenems (meropenem, imipenem)
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broad spectrum, NO- MEPP- MRSA, Enterococcus, Proteus, Pseudomonas
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Cilastatin
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prevents renal hydrolysis of carbapenems and increases T1/2
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Bactrim?
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GNR +/- GPC, NOT effective for enterococcus, pseudomonas, acinetobacter, serratia
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Quinolones (cipro, levo, trovafloxacin)
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GPC, GNR, NOT effective for enterococcus, IS effective for pseudomonas, acinetobacter, serratia
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aminoglycosides (gent, tobra, amikacin)
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GNRs!!! good for pseudomonas, acinetobacter, serratia. NOT effective for anareobes (need O2)
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aminoglycoside resistance mechanism
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modifying enzymes leading to decreased active transport
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Erthromycin (macrolides)
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good for CAP, atypical pna; binds motilin R- prokinetic
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Linezolid, Synercid (streptogramin, quinupristin, dlafopristin)
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GPCs- VRE, MRSA
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Tetracycline
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GPC, GNR, syphilis
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Chloramphenicol
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anaerobes SE- gray baby syndrome, decreased BM, aplastic anemia
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Clindamycin
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anaerobes, some GPC- good for asp pna, can tx clostridium perfringens
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Metronidazole
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SE- disulfram-like rxn, peripheral neuropathy
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Effective for enterococcus
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vanc, amp/amox, gent with amp, zosyn, 3rd gen cephalosporins
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Effective for pseudomonas (double cover), acinetobacter, serratia
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ticarcillin/piperacillin, timentin/zosyn, aminoglycosides (gent, tobra), fluoroquinolones
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