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25 Cards in this Set

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Aminoglycosides MOA?
Penetrate bacteria and bind irrersibly to the 30s bacterial ribosomes.
Bactericidal like penicillins and cephalosporins.

Usually IV, not into CSF or eye.
Excellent levels in urine and kidney. Excretion is entirely renal so adjust for renal.
Big time variation in volume of distribution and rate of excretion, no standard dose. Peak and trough method. SDD single daily dose method could work too for >7 days.
Aminoglycosides the names?
Gentamicin, tobramycin, and streptomycin (now only used in TB)
Aminoglycosides side effects?
Renal and/or ototoxicity and not always reversible.

narrow toxic-therapeutic window.
Aminoglycosides in synergy with? for what?
w/ penicillin, ampicillin, or vancomycin = for enterococci

w/ anti-pseudomonas pencillins = p. aeruginosa and many hospital acquired gram -'s.

UTI, bacteremia
Tetracyclines inactivated by?
milk, antacids, metallic ions
tetracyclines HCL vs. doxycycline
tetra is shorter half life while doxy is longer and preferred for better compliance.
Tetracycline general?
Good in tissues limited in CSF.
-tetra excreted in urine vs. doxy in feces so preferred in renal failure.
-category D
-hepatoxicity in mother and dental deformities in children
-avoid in children less then 8
Doxycycline use?
Most S.pneumoniae, h.influenzae, m.catarrhalis and atypical pulmonary pathogens.
Genital chlamydia and mycoplasmas.
Tetracyclines doxy's common use?
-CAP in those younger then 50
-acute exacerbations bronchitis
-chlamydia trachomatis genital infections, prostatitis
-RMSF, ehrlichiosis
Quinolones MOA?
inhibits DNA gyrase, a bacterial enzyme essential in DNA replication.
Quinolones names and generations?
Ciprofloxacin (2nd gen)
Levofloxacin (3rd gen)
Gatifloxacin (3rd gen)
Moxifloxacin (4th gen)
Ciprofloxacin general
-mainly for gram -'s, most p. aeruginosa
-good for atypical pulm. pathogens.
-NOT good for s. pneumoniae (pneumococcus)
Levofloxacin general
-enhanced activity against s. pneumoniae including 95%+ resistant strains.
-many enterobacteraciae
-NOT GOOD FOR p.aeruginosa like ciprofloxacin. or anaerobes
Trovofloxacin general
-hepatotoxic problems with death
-limited use, good for pneumococci, p.aeruginosa, and anaerobes
Gatifloxacin general
-watch for selecting for resistnace and increasing QT interval
-enhanced activity against CAP and pencillin resistant s. pneumoniae over levofloxacin and ciprofloxacin.
-oral or IV
Moxifloxacin general
-improved gram + activity but less gram - activity compared to ciprofloxacin
-doesn't interfere with warfarin and theophyllin

use ciprofloxacin for gram -'s not this drug.
Use which quinolones in penicillin resistant s. pneumoniae pneumonia
Ofloxacin general
active against C. trachomatis and gram -.
used alot in urethritis NGU and std regimens!
DOC of for prostatis and UTI in quinolones family?
Ciproflaxacin... Trimethaprin sulfmethandizaole also used for prostatis too...
DOC of sinusitis, refractory otitis, actue exacerbations of COPD and CAP in the quinolones family?
toxicity of quinolonges?
can cause hypo or hyperglycemia in diabetics
mild GI
at times high QT in moxifloxacin
used to much and seeing resistance now
Vancoymycin MOA?
bactericidal inhibiting cell wall synthesis.
Vancomycin is DOC for?

and VISA strains exist now (vancomycin intermittent staph aureus)
Vancomycin uses?
-Deep IV lines related infections
-penicillin resistant s. -pneumoniae cause no resistance to vanco
-streptococci A, B, G
-gram + infection in patients allergic to beta lactams
-C. difficile but not longer used really as DOC.
Vancomycin toxicity?
Ototoxicity uncommon
Nephrotoxicity uncommon
Red man syndrome, if infused to fast!! must give slowly!
Allergic rxn with bronchospasm etc. is not due to red man, seperate entity.
Neutropenia with prolonged use.