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75 Cards in this Set

  • Front
  • Back
Fluoroquinolones MOA
inhibit DNA replication in bacterial cell wall (DNA gyrase inhibitors)
fluoroquinolones routes of admin
PO, IV, topical
FQ coverage
gram +, gram - very limtited anaerobe coverage (Avelox)
excretion of FQ
FQ meds
Norfloxacin (Noroxin) UTI only
Ciprofloxacin (Cipro)good bone penetration; 45% pseudo. resistance
Ofloxacin (Floxin)
Enoxacin (Penetrex) UTI, STD
Levofloxacin (Levaquin) HAP 65% pseudo. sens.
Moxifloxacin (Avelox) some anaerobic coverage
FQ contraindications
pts on meds known to cause QT seg prolongation
n/v/d, CNS effects, phototoxicity, liver toxicity, connective tissue problems, QT segment elongation
FQ great "switch" drug secondary to __________ when taken po
approx 100% bioavailability
Vancomycin MOA
inhitibs wall synthesis
Vancomycin coverage
Must have MRSA if using on pt with staph
Vancomycin routes of admin
IV or oral (no absorption) is acutally topical to GI lumen
Vancomycin SE
"red man", ototoxicity, ?nephrotoxicity (pt also on aminoglycoside)
when should peak and trough levels be check when using Vanco?
never, unless renal dysfxn or endocarditis
excretion of Vanco
renal, but not dialyzed
Daptomycin (Cubicin) MOA
unique mechanism; binds to bacterial cell wall causing rapid depolarization of membrane potential (decrease replication)
Daptomycin coverage
gram +, MRSA and ?VRE
daptomycin is alternative to ______
Linezolid (Zyvox) MOA
unique mechanism; binds to 50s ribosomal subunit, prevens translation
Linezolid coverage
gram +, MRSA, VRE
Linezolid routes of admin
IV and PO both give 100% bioavailability
Metronidazole (Flagyl) coverage
anaerobes and some parasites
Metronidazole routes of admin
PO, IV, topical
Metronidazole SE
GI (nausea, metalic taste), peripheral neuropathy (prolonged use), disulfiram-like rxn (etoh, perfume/cologne)
antifungal agents
amphotericin B, Fluconazole (difulcan, Miconazole (Monistat), Flucytosine (Ancobon), Ketoconazole (Nizoral), Itraconazole (Sporanox), Clotrimazole (Myclelex), Echinocandins, Boriconazole(Defend)
1st line non albicans tx
amphotericin B
1st line candida albican tx
Fluconazole (tx only c. albicans)
topical cream suppository
Miconazole, Flucytosine, Ketoconazole
tx for c. albicans and aspergilas
Itraconazole and Boriconazole
Flucytosine coverage
non albicans
Echinocandins coverage
candida albicans, c. glabrata, c tropicalis
Best anitfungal around
Amphotericin B (ampho "terrible")
Amphotericin B admin
IV, irrigational, topical, liposomal preparations
dosing of Amphotericin B
1/2 mg/kg Q D also hydrocortisone to decrease SE
Amphotericin B SE
electrolyte imbalance (decrease Mg, K), renal toxicity, hepatotoxicity
other antifungals
Nystatin (Mycostatin)-topical for thrush
Terbinafine (Lamisil)-cream or po for onychomycosis
Urinary Antispetics
Ntrofurantoin (Macrodantin) negative SE in pregnancy
Nalidixic acid (Negram) indwelling catheters
Methenamine mandelate (Mandelamine) breaks down formaldihyde ototoxicity
Pentamidine coverage
Pentamidine admin
IV (tx only)or inhalation (only for prophylaxis)
Pentamidine SE
hyper and hypoglycemia-FSBS QD
electrolyte disturbance-dec K
renal dysfxn-BUN and creatinine
Antiviral agents for Herpes
acyclovir (Zovirax), Famcylovir (Famvir), Velacyclovir (Valtrex) PO and IV, don't use topical unless liver dysfxn and must have tx
Antivirals for CMV
Gancylcovir (Cytovene), Valgancyclovir (Valcyte) IV, PO, intraocular
Foscarnet (Foscavir)
Cidofovir (Vistide) tx with IV then oral for life
antivirals for tx of influenza
Amantadine (symmetrel), Rimantadine (Flumadil), Zanamavir (Relenza)-inhaled, Oseltamivir (Tamiflu)-oral
concentration-dependent killing exhibited by
FQ and aminoglycosides
Concentration-dependend killiing defined as
rate and extent of bacterial killing maximized at high concentrations (doses)
usually occurs when drug concentration is ____ the MIC
10 times
MIC is
minimum inhibitory concentration
Time-dependent killing defined as
killing activity depends on the time drug concentration remains above MIC
time-dependent killing exhibited by
beta-lactams, vancomycin, clindamycin, and ees
dosing stratey for Time dependent killing
maximize time above MIC
(should be above MIC 50%)
bacteriology of community acquired respiratory infxn
s. pneumoniae, h. influenzae, k. pneumoniae, m. catarrhalis, mycoplasma, legionella, TB
bacgteriolgoy of nosocomial acquired resp. infxn
s. aurea, p. aeruginosa, enerobacger cloacae, fusobacterium species, peptococcus, legionella
tx comm. acquired resp. infx
PCN, Amox, 2nd gen. ceph., macrolides, FQ
tx nosocomial resp. infx
pipercillin/tazobactam, ticaricillin/clavulanic acid, 3rd gen. ceph, add aminoglycoside, FQ, macrolide
CNS infxns:
children/young adults
s. pnuemonia, e. coli, listeria
h. flu, s. pneumonia, n. meningiditis
s. pneumo, n. meningiditis
CNS infxns:
s. pneumo, n. meningiditis
s. pneumo, n. meningiditis, e. coli, klebsiella, listeria
CNS infxns:
closed head trauma
open head trauma
s. aureus, s. epidermiditis, gram -
s.pneumo, h. flu
look at environ (sewage ditch vs concrete)
CNS tx:
must penetrate CNS
Bacteriology of endocarditis
s. viridans, s. epidermidis, entercoccus, c. albicans
tx endocarditis
PCN, vancomycin, add aminoglycoside, long duration
prophylaxis of endocarditis
dental/oral procedure: amox 3g 1 hr prior, 1.5 g 6 hr later
GI/GU procedure: ampicillin, amox, gentamicin
bacteriology of skin and ST infxn
Cellulitis: strep and staph
add DM
pseudomonas and anaerobes
Tx skin and ST infxn
cefzolin, macrolides, amp/sulbactam or ticarcillin/cavulanic acid
FQ with metronidazole
GI infxn tx
travellers diarrhea
psuedomembranous colitis
h. pylori
pepto-bismol, TMP/SMX, doxy, FQ
oral metronidazole adn vanco
amox, clarithromycin, tcn, metronidazole plus PPI
bacteriology of intra-abdominal infx
gram +: enterococcus
gram -: e.coli, enterobacter cloacae, acineobacter
anaerobes: bacteroides
tx intra-abdominal infx
2nd and 3rd gen. ceph
extended spectrum pcn
bacteriology of UTI
e.coli, enterococcus, klebsiella, proteus
tx UTI
sulfa, trimethoprim, 1st gen ceph, nitrofurantoin, FQ
bacteriology of STD
syphyllis, gonorrhea, chlamydia, gential herpes, trichomoniasis
tx STD
syphillis:pcn, spectinomycin
Gonorrhea:3rd gen ceph, ofloxacin, enoxacin, cipro
chlamydia:doxy, ees,FQ,azith
Gent herpe: acyclovir, famcyclovir
trich: metronidazole
bacteriology of osteomylitis
hematogenous:staph, gram neg
adjacent infx:staph, gram neg, anaerobes
vascular insuff:staph, g -, anaerobes
tx osteomylitis
bone penetration, IV, oral therapy (cipro)
azithryomicin doesn't cover
cipro doesn't cover
nosocomial infxn tx
need broad spectrum and somthing to cover gram - (aspiration)
ventilation associated pneumonia caused by
pseudomonas aeruginosa