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268 Cards in this Set
- Front
- Back
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beta lactamase resistnat penicillins
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dicloxacillin
nafcillin oxacillin |
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dicloxacillin admin
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oral
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dicloxacillin dosage
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250mg 4x/day
500mg 2x/day |
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nafcillin trade name
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unipen
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nafcillin admin
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oral/paternal
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oxacillin trade name
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bactocil
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oxacillin admin
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oral/paternal
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dicloxacillin, nafcillin, oxacillin spectrum
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Beta lactamase resistance S. aureus
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carboxypenicillins
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carbenicillin
ticarcillin |
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ureidopenicillins
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mezlocillin
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piperazine penicillins
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piperacillin
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extended spectrum penicillins
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carboxypenicillins
ureidopenicillins piperazine penicillins |
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spectrum from carboxypenicllins, ureidopenicillins, piperazine penicillins
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additionally gram - aerobes and anaerobes
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piperacillin excellent against what
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pseudomonas
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zosyn
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piperacillin/tazobactam
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zosyn dosage
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IV 3.375 g a6h
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augmentin
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amoxicllin/clavulanic acid
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augmentin dosage
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po 875 mg bid
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timentin
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ticarcillin/clavulanic acid
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timentin dosage
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IV 3.1g q6h
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unasyn
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ampicillin/sulbactan
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unasyn dosage
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IV 3.0g q6h
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spectrum for zoysn, augmentin, timentin, unasyn
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beta lactamse producing s. aureus, n. gonorrhea, anerobes
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unasyn now unreliable for what
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gram - infections
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zoysn good for what
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pseudomonas at higher dose
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antibiotics should be continued for how many days
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10 days
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what should you watch for with carboxypenicillins
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hypokalemia or hypernatremia
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penicillin drug interactions
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warfarin, oral contraceptives, probenecid, aminoglycosides, methotrextrate
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first generation cephalosporins
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cephalexin, cephadroxil, cefazolin
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cephalexin trade name
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keflex
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cephadroxil trade name
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duricef
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keflex admin
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oral
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duricef admin
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oral
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cefazolin trade name
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ancef
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ancef admin
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IV
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spectrum of first gen cephalosporins
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mostly gram +: staph, staph epi, strep
proteus, e. coli, klebisella some anerobes |
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PEcK
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gram - spectrum for 1st gen cephalsporins
proteus, e. coli, klebseilla |
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second gen cephalosporins
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cefuroxime
cefuroxime (IV), cefoxitin |
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cefuroxime oral trade name
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ceftin
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cefuroxime IV trade name
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zinacef
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cefoxitin trade name
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mefoxin
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ceftin admin
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oral
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zinacef admin
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IV
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mefoxin admin
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IV
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second gen cefs spectrum
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gram + like 1st gen
gram -: H influenza, enterobacter aerogenes, neissera species, proteus mirabilis, E. coli, klebseilla pneumoniae, serratia |
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HEN PEcKS
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gram - coverage of 2nd gen cefs
H influneza, E. coli, Niessiera, proteus, enterobacter aerogenes, klebsiella, serratia |
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third gen cefs
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cefixime, cefpodoxime, ceftriaxone, ceftazidime
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cefixime brand
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suprax
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cefpodoxime brand
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vantin
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ceftriazone brand
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rocephin
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ceftazidine brand
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fortaz
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admin for 3rd gen cefs
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IV
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spectrum for 3rd gen cefs
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less gram +
superior gram - |
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fortaz (ceftazidine) is good for what
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pseudomonas
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cefdinir brand
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ominicef
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ominicef(cefdinir) spectrum
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staph and strep as good or better than 1st gen
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4th gen cefs
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cefipime
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cefipime brand
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maxipime
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cefipime(maxipime) spectrum
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gram - aerobes including psuedomonas
more active against staph than 3rd gen |
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extnded spectrum cefs
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ceftobiprole
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ceftobiprole spectrum
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HA MRSA and aerobic gram + and -
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only cef to treat HA MRSA
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ceftobiprole
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cefs cross sensitivity to what
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penicillins
|
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what cefs are not likely to cause rxn
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cefdinir and cefuroxime
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carbapenams
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imipenam
meropenem etrapenam |
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carbapenams are contraindicated in who
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penicllin allergic patients
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meropenem brand
|
merrem
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ertapenam brand
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invanz
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primaxin
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imipenam-cilastin
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primaxin spectrum
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most gram + and gram - aerobes
excellen anaerobic |
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what species are resistant to primaxin
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MRSA, soem pseudomonal species and mycoplasms
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primaxin is contra when
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penicillin allergies and patients with siezure history
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who usually prescibes primaxin
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ID specialist
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merrem(meropenem) spectrum
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gram negative aerobes superior to imipenam
staph and strep inferior to imipenam |
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merrem(meropenam) is less likely to do what
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cause siezures
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what is the spectrum of IVanz(ertapenem)
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gram + aerobes and anerobes
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ivanz(ertapenem lower extermity coverage is what
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more limited on gram - aerobic pathogens
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ivanz(ertapenem) dosing
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once a day IM or IV
1g q24hr |
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ivanz dosing with hemodialysis
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500mg q24h atleast 6hr b4 hemodialysis
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what is the caution with ivanz
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siezure risk in patients wtih CNS disorder and/or renal compromise
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ivanz(ertapenem) drug interactions
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probenicid
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doripenem
|
in phase 3 trials
|
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doripenem spectrum
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broad including pseudomonas
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monobactams can be given to who
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patients with penicillin allergies
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monobactams
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azactam(aztreonam)
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azactam(azteronam) spectrum
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gram - aerobes
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azactam(aztreonam) admin
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IM or IV
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does azactam(aztreonam) cover psuedomonas
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no
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azactam is often used in what patients
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renal insufficiency or those recieving dialysis
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aminoglycosides
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gentamycin
tobramycin amikacin |
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aminoglycosides spectrum
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gram - aerobes
CA MRSA |
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when are peak and trough levels drawn with aminoglycosides
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peak 30 min after dose
trough 30 min befor nxt dose |
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adverse effects of aminoglycosides
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ototoxicity
nephrotoxicity hypokalemia hypomagnesia |
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aminoglycosides should not be given to who
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diabetics or patients with myasthenia gravis
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irreverisble side effect of aminoglycosides
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ototoxicity
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hypokalemia is side effect of what aminoglycoside
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gentamycin
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hypomagnesia is side effect of what aminoglycosides
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gentamycin and amikacin
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glycopeptides
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vanco
dalbavancin telavancin |
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oral vanco used for what
|
C diff
|
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IV vanco uses
|
HC MRSA
endocarditis prophylaxis who are allergic to beta lactams |
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are staph and streph susecptible to vanco
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yes but should be reserved
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how is vance dosed
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by weight
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what is vanco dosing
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50kg=750mg
50-74kg=1000mg 75-90= 1250mg >90=1500mg |
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what is trough dose for vanco
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5-10mg/L
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what should be done if vanco trough is >15
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double dosing internval
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adverse effects of vanco
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ototoxicity, nephrotoxicity, vestibular imbalance, thrombophelebitis, red man syndrome
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what causes red man syndrome with vanco
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too fast of an infusion
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2nd gen glycopeptide awaiting approval
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dalbavancin(zevin)
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dosing on dalbacvancin(zevin)
|
once weekly IV
1000mg followed by 500mg |
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dalbavacin spectrum
|
MRSA, strep,
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glycopeptide awaiting FDA approval
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telavancin
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MOA for telavancin
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inhibits cell wall growth, disrupts plasma membrane barrier
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telavancin spectrum
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HA MRSA
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long acting tetracycline
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doxycycline, minocycline
|
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intermediate acting tetracycline
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metacycline
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short acting tetracycline
|
teteracycline HCL
|
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tetracycline specturm
|
gram + aerobes
CA-MRSA, E coli, klebsiella, enterobacter, vibrio vulnificus, mycobacterium marium, rickettsial, chlamydia |
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adverse effects of tetracyclines
|
GI, cutaneous, photosensitivity,
|
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doxycycline may cause this
|
photoonycholysis
|
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side effect of minocycline
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hyperpigmentation
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never give tetracyclines to who
|
pregnant or children
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what limits absorption of tetracyclines
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food, antacids, milk, or iron
|
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interaction for tetracyclines
|
digoxin and accutane
|
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tetracyclines may cause what
|
acute pancreatitis
|
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do not take doxycycline at what time
|
before going to bed may cause erosive esophagitis risk
|
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tetracyclines may also have what properties
|
antiinflammatories
|
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macrolides
|
erythromycin, calrithromycin, azithromycin
|
|
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erythromycin is on what list
|
do not use list
|
|
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what is the spectrum for zithromax(azithromycin)
|
gram + aerobes
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azithromycin brand
|
zithromax
|
|
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what is dosing for zithromax(azithromycin)
|
500mg 1st day
250mg qd for next 4 days |
|
|
zithromax(azithromycin) has a long what
|
intracellular half life
|
|
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where do macrolides undergo detoxification and excretion
|
in the liver and in the bile
|
|
|
where are macrolides catalyzed
|
by cytochrome P450 family
|
|
|
major drug interactions of macrolides
|
digoxin (increase)
HMG CoA reductase inhibitors (increase coumadin(increase) |
|
|
lincosamides
|
clindamycin
|
|
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clindamycin brand
|
cleocin
|
|
|
clindamycin(cleocin) spectrum
|
gram + aerobes and anerobes
fulminant group A strep incfections |
|
|
if something is resistant is erythro what will it soon be resistant to
|
clindamycin
|
|
|
ADR of clindamycin(cleocin)
|
diarrhea and psuedomembranous colitis
|
|
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uses of clindamycin(cleocin)
|
preop prophalaxis for foot and ankle surgery and bacterial endocarditis in adults allergic to penicillin
|
|
|
what is dosage of cleocin(clinda) for prophylaxis
|
600mg 1hr before surgery
many hospitals recommend 900mg |
|
|
increased frequency of this is due to what with clindamycin(cleocin)
|
respiratory paralysis due to interactions with muscle relaxants baclofen(lioresal) or diazepam(valium)
|
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clinda has penetrates what well
|
bone
|
|
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when is clinda good surgical prophylaxis
|
before implant
|
|
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chloramphenicol is on what list
|
do not use
|
|
|
chloramphenicol spectrum
|
serious anerobic infections
|
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chloramphenicol is last resort for what
|
vancomycin resistant enterococcus
|
|
|
ADR of chloramephenicol
|
gray baby syndrome, severe bone marrow toxicity, aplastic anemia
|
|
|
sulfonamides
|
trimethoprim sulfamethoxazole
|
|
|
what are trade names of the sulfonamides
|
bactrim or septra
|
|
|
what is spectrum for sulfamethoxazole-trimethoprim
|
gram - aerobes
CA-MRSA |
|
|
when should sulfamethoxazole-trimethoprim be used with caution
|
over 50
taking oral sulfonylureas |
|
|
what ist the risk with sulfonamides and patients takeing sulfonylureas
|
hypoglycemia
|
|
|
what might be the interaction of sulfonamides with methotrexate
|
enhance bone marrow suppression
may precipitate ITP |
|
|
sulfonamides greatly increase effect of what
|
coumadin
|
|
|
sulfonamides may cause what
|
acute pancreatitis
|
|
|
fluorinated 4-quinolones
|
ciprofloxacin
levofloxacin ofloxacin moxifloxacin |
|
|
fluoroquinolones can be responsible for what
|
flase positive result in urine assay for opiates
|
|
|
what patients should be warned when on fluoroquinolones
|
those taking a drug screen
|
|
|
what might occur when taking fluoroquinolones
|
torsaeds de pointes and ventricular fibrillation due to prolonged QT interval
|
|
|
trade name for ciprofloxacin
|
cipro
|
|
|
spectrum for cipro
|
gram - aerobes
|
|
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cipro is the most active quinolone against what
|
pseudomonas
|
|
|
cipro is FDA approved for what
|
gram - infection of bone and joint
|
|
|
cipro is contraindicated when
|
in chlidren less than 18 and pregnant and nursing women
|
|
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cipro should not be used as what in foot infections
|
single agent
|
|
|
what has been reported with cipro
|
tendonitis or tendon rupture
|
|
|
do not give these within 2 hrs of cipro
|
sulcralfate, antacids, metal cations, multi-vitamins
|
|
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drug interactions of cipro
|
theophylline, warfarin, caffiene, ddI, phenytoin, NSAIDs
|
|
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what is the risk of drug interactions with cipro
|
seizures
|
|
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what is dose of cipro
|
750mg q12h po
|
|
|
what is trade name of levafloxacin
|
levaquin
|
|
|
spectrum for levaquin
|
gram + and gram - aerobes including niessera gonorrhea
|
|
|
levaquin exhibits this
|
post antibiotic effect vs gram + organisms
|
|
|
levaquin if FDA approved for what
|
uncomplicated skin and soft tissue infections
|
|
|
don't give these within 2 hr of levaquin dose
|
sulcralfate, antacids, metal cations, multi-vitamins
|
|
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drug interactions of levaquin
|
ddI, warfarin, phenytoin
|
|
|
what is levaquin contrinidacted in
|
pregnant women or children under 18
|
|
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what is dosage of levaquin
|
500mg q24h po or IV
|
|
|
trade name for moxifloxacin
|
avelox
|
|
|
spectrum for avelox
|
broad spectrum
|
|
|
avelox show some resistance to what
|
staph aureus
|
|
|
avelox is FDA approved for what
|
treating complicated and uncomplicated skin and soft tissue infections
|
|
|
avelox(moxifloxacin) is only quiniolone acitive against what
|
anerobes
|
|
|
avelox has activity against this
|
bacteroides fragillis
|
|
|
when might avelox be a good choice in lower extermity
|
diabetics with inoperable atherosclerosis
|
|
|
avelox may be effective against what
|
tuberculosis
|
|
|
what are drug interactions of avelox
|
antacids, sucralfate, ddI, warfarin, phenytoin
|
|
|
rifamycins
|
rifampin
|
|
|
rifampin should never be used as what
|
single agent
|
|
|
rifampin spectrum
|
staph epi, n. gonorrheae, mycobacteria
|
|
|
what happens to body fluids with rifampin
|
turn organe
remove contact lens |
|
|
rifampin enhances what
|
hepatic metabolism
|
|
|
combine what with rifampin for vanco resistant MRSA
|
sufamethoxazole-trimethoxazole or ciprofloxacin
|
|
|
what is dosage for combo therapy for MRSA
|
300mg bid po
|
|
|
streptogramins
|
synercid
|
|
|
synercid
|
quinopristin/dalfopristin
|
|
|
spectrum of synercid
|
VRE, MRSA, MRSE,
|
|
|
synercid should be reserved for what
|
multi resistant organisms
|
|
|
synercid admin
|
IV only
|
|
|
synercid induces what
|
P450 3A4
|
|
|
adverse effects of synercid
|
arthralgias, myalgias, nausea, injection site reactions, elevated hepatic function tests, thrombophlebitis
|
|
|
oxazolidinones
|
zyvox(linezolid)
|
|
|
linexolid trade name
|
zyvox
|
|
|
zyvox(linezolid) spectrum
|
resistant gram + aerobes
VRE, MRSA, VRSA, enterococcus |
|
|
zyvox has great what
|
oral and bone penetration
|
|
|
what should be monitored wkly with linezolid(zyvox)
|
CBC
|
|
|
what has been reported by patients on zyvox(linezolid)
|
myelosuppression including anemia, leukpenia, pancytopenia, and thrombocytopenia, N, V, peripheral or optic neuropathy
|
|
|
what should zyvox be coadministered with with caution
|
SSRI and other antidepressants
|
|
|
cyclic lipopeptide
|
cubicin
|
|
|
trade name for daptomycin
|
cubicin
|
|
|
spectrum for cubicin(daptomycin)
|
resistant gram positive aerobes
|
|
|
what is cubicin(daptomycin) dosing for MRSA and VRSA
|
QD
|
|
|
what should be monitored with cubicin
|
CPK levels wkly
|
|
|
drug interactions of cubicin
|
tobramycin
|
|
|
adverse effects of cubicin
|
daptomycin induced myopathy potentiated by statins
|
|
|
dosage for cubicin
|
4mg/kg q24h
|
|
|
glycylcyclines
|
tygacil
|
|
|
tigecycline trade name
|
tygacil
|
|
|
tygacil(tygecycline) spectrum
|
broad spectrum including MRSA and VRE
|
|
|
tygacil does not cover what
|
pseudomonas
|
|
|
no what is needed with tygacil
|
renal dose adjustment
|
|
|
ADR of tygacil
|
N, V, may cause permanent discoloration of teeth during tooth development
|
|
|
tygacil admin
|
IV only
|
|
|
tygacil dose
|
100mg initial
50mg q12h |
|
|
what drugs require no renal adjustment for renal problems
|
clindamycin and erythromycin
|
|
|
creatinine clearance
|
(140-age)*(ideal body weight)/(72*serum creatinine)
|
|
|
what is different in creatnine clearance in females
|
multiply by .85
|
|
|
ideal body weight for males=
|
50+2.3 for every in over 5ft
|
|
|
ideal body weight for females=
|
45.5+2.3 for every in over 5ft
|
|
|
antibiotics that require no renal adjustment
|
clindamycin(cleocin)
azithromycin(zithromax) doxycycline(vibramycin) moxifloxacin(avelox) |
|
|
antibiotics not safe for nursing mothers
|
chlormephenicol, ciprofloxacin, metronidazole
|
|
|
what should infants be monitored for with penicillins
|
rash, diarrhea, or thrush
|
|
|
when are vanco, azitrhromycin, and aminoglycosides still safe
|
during breast feeding
|
|
|
what should happen if you are breastfeeding and on metronidazole
|
stop temporarily and resumed 24hr after final dose
|
|
|
what antibiotics should be avoided by nursing mothers
|
quinolones, suflonamides, tetracyclines, and clindamycin
|
|
|
oral antifungal agents
|
intraconazole, terbinafine, fluconazole, griseofulvin
|
|
|
trade name for intraconazole
|
sporanox
|
|
|
intraconazole spectrum
|
dermatophytes, candida, molds
|
|
|
rare ADR with intraconazole
|
GI, rash, headaches, hepatotoxicity
|
|
|
drug interactions of intraconazole
|
mevacor/zocor, halcion/versed, quinidine, orap, tikosyn, erythromycin, calcium channel blockers
|
|
|
indications for intraconazole
|
onychomycosis, tinea pedis,
|
|
|
dose of intraconazole
|
pulse therapy two 100mg capsules bid for 1wk out of month x3
|
|
|
do not use intraconazole in what patients
|
CHF
|
|
|
intraconazole is a potent inhibitor of what
|
450 3A4
|
|
|
terbinafine trade name
|
lamisil
|
|
|
terbinafine spectrum
|
dermatophytes
|
|
|
rare adverse reactions of terbinafine
|
fatal blood dyscrasias, headache, abnormal taste, green vision, hepatotoxicity, liver failure
|
|
|
drug interactions for terbinafine
|
cimetidine, rifampin, caffeine, cyclosporine, nortriptyline
|
|
|
indications for terbinafine
|
onychomycosis
tinea pedis |
|
|
dosing for terbinafine
|
250mg qd x 3 mo
|
|
|
terbinafine is potential inhbitor of what
|
450 2D6
|
|
|
trade name for fluconazole
|
diflucan
|
|
|
fluconazole spectrum
|
dermatophytes, candida, molds
|
|
|
drug interactions of fluconazole
|
similar to itraconazole also oral sulfonylureas
|
|
|
adverse reactions of fluconazole
|
severe skin reactions
alopecia |
|
|
dose for fluconazole
|
pulse 300mg wkly
|
|
|
trade name for griseofulvin
|
Gris-PEG
|
|
|
indication for grieofulvin
|
chronic tinea pedis
|
|
|
dosage of griseofulvin
|
250mg bid (4-8wks)
|
|
|
adverse effects of griseofulvin
|
skin rashes, paresthesias, headache
|
|
|
drug interactions of griseofulvin
|
oral contraceptives
warfarin barbiturates |
|
|
antiparasitic agents
|
thiabendazole (mintezol)
|
|
|
trade name for thiabendazole
|
mintezol
|
|
|
indication for thiabendazole
|
treatment of cutanea larva migrans
|
|
|
dose of thiabendazole
|
ivermectin 200 micrograms per kg po x 1 dose for 1-2days
|
|
|
other effective dosage of thiabendazole
|
10% aqueous solution qid is effective
|
