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24 Cards in this Set
- Front
- Back
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Fosfomycin MoA
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Monurol
MoA: multiple but mostly through inhibiting N-acteylglucosamine (UDP-GicNAc) enopyruvyl transferase (MurA) for peptidoglycan synthesis |
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Fosfomycin spectrum
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Gram negative rods; Enterococcus spp.
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Fosfomycin dosing
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3 g x1 (highly concentrated in urine). May repeat x1
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Clinical uses of Fosfomycin
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UTI
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Polymixins MoA
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Disrupt the membranes by binding to phospholipids
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Are polymixins bactericidal or bacteristatic?
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Rapidly bactericidal
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What is the spectrum of polymixins?
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Gram negative: Enterobacteriaceae (not Proteus), Pseudomonas, Acinetobacter
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Clinical uses of polymixins?
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MDR VAP, bacteremia, meningitis, GI infections
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What other products are polymixins found in?
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Creams for OTC wound treatment
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Polymixin B route
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IM 2.5-3 mg/kg daily divided q4-6h
IV 1.5-2.5 mg/kg CI or divided q12h |
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Polymixin E (colistin, colistimethate sodium) route
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IM/IV 2.5 to 5 mg/kg/daily divided q6-12h
Inhaled 40-80 mg q12h |
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Metronidazole MoA
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Flagyl
MoA: creates reactive radicals that disrupt nucleic acids and proteins Prodrug activated in susceptible organisms only |
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Which drug is the gold standard for anaerobic bacteria?
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Metronidazole
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Metronidazole spectrum
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B. fragilis, prevotella, fusobacterium, H. pylori, Clostridium (C-diff)
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Metronidazole dosing route
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IV 30 mg/kg/day divided qh
PO 500 mg q8h; 2g x1 |
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Clinical uses of Metronidazole
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Anaerobic infections: bacteremia, bone and joint, GI, mouth
STIs: Trichomonas vaginitis |
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Fidaxomicin MoA
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Dificid
Non-absorbed macrocytic antibiotic MoA- inhibits RNA polymerase by binding to the DNA template-- RNA polymerase (RNAP) complex |
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Fidaxomicin spectrum
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Active against C. diff with little activity against anaerobic gram negative
Studies show may lower C. diff recurrence Similar in activity to oral vanco |
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Fidaxomicin dosing
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PO 200 mg q12h
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Fidaxomicin pricing
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10 day course >$2000
very expensive and a hard sell because similar activity to vanco |
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Which antibiotic do we worry about a disulfiram reaction with?
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Metronidazole
Coadministration with disulfiram results in psychotic or confused state |
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What are products containing disulfirams?
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Alcohol!
Avoid products containing alcohol such as OTC cold products and IV preparations (diazepam, NTG, PHT, TMP/SMX) |
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How does metronidazole affect warfarin?
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Increases risk of bleeds
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What drugs does metronidazole increase the plasma concentrations of?
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Lithium
Cyclosporine Tacrolimus CBZ PHT |
