Osce Review: Antibiotics

Front 1

Penicillins
1. How do they work?
2. What are 2 important considerations when using
3. AEs

Back 1

1. cell wall inhibitor
2. time > MIC is impt, adjust for renal fx
3. allergy, diarrhea, CBC issues

Front 2

Natural PCN
1. Examples
2. effective against?
3. DOC

Back 2

1. Pen G (IM), Pen VK (PO)
2. narrow, strep, neisseria, gonorrhea, lyme, meningitis
3. DOC = ST, syphilis

Front 3

Extended specture or Amino PCN
1. Examples
2. Effective against
3. DOC

Back 3

1. Amoxicillin (PO), Ampicillin (PO or IV)
2. strep, Ent, H. flu, Neiss, H. pylori
3. DOC = AOM

Front 4

Amino PCN + beta-lactamase
1. Examples
2. Effective against

Back 4

1. Amox/clavulanate (PO), amp/sulbactam (IV)
2. sinusitis, UTI

Front 5

Anti-staph PCN
1. Examples
2. effectrive against
3. DOC

Back 5

1. Dicloxacillin (PO), methicillin, naficillin (IV), oxacillin (IV)
2. skin infxn, osteomyelitis
3. DOC = MSSA, MSSE

Front 6

Anti-pseudomonal PCN + beta lactamases
1. Examples
2. effective against

Back 6

1. Piperacillin/tazobactam, ticaricillin/clavulanate
2. GI, psuedomonas

Front 7

What should be done when treating against pseudomonas?

Back 7

*always cover w/ 2 drugs that have different MOA

Front 8

How do the cephalosporin generations correspond with Gram stain effectiveness?

Back 8

Generation 1 = Gm +, generation 3/4 = Gm (-)

Front 9

1st Generation Cephs
1. Examples
2. Use

Back 9

1. Cephalexin (PO), Cefazolin (IV)
2. skin, UTI, osteomyelitis

Front 10

2nd generation Cephs
1. Examples
2. Use

Back 10

1. cefuroxime (PO), cefoxitin (IV), cefotetan (IV)
2. OM, RTI, UTI

*Anaerobe coverage = IV

Front 11

What two 2nd generation cephs are effective against anaerobes?

Back 11

*IV forms
*Cefoxitin, cefotetan

Front 12

3rd generation cephs
1. Examples
2. Effective against

Back 12

1. ceftriaxone (IM/IV), cefipime, ceftazadime
2. RTI, UTI

**cefipime/ceftazidime = psuedomonas

Front 13

What two 3/4 gen cephs are effective against pseudomonas?

Back 13

*Cefipime
*Ceftazidime

Front 14

What is the DOC for gonorrhea and meningitis?

Back 14

Ceftriaxone

Front 15

What are 2 things to consdier when giving cephs?

Back 15

*adjust for renal fx
*cross-sensitivity w/ PCN (5-10%)

Front 16

Carbapenums
1. Examples
2. Used for
3. AEs

Back 16

1. Imipenum, meropenum, ertapenum
2. broad = nosocomial, polymicrobial
3. cross-sensitivity w/ PCN (100%), imipenum = sz, AE = GI

Front 17

Monobactams
1. examples
2. used for
3. AE

Back 17

1. Aztreonam
2. Gm (-) & pseudomonas
3. AE = GI

Front 18

What AE can be seen with Vancomycin?

Back 18

*ototoxicity, nephrotoxicity, Red Man's syndrome (infused too rapidly)

Front 19

Vancomycin
1. Use
2. DOC

Back 19

1. Gm (+)
2. MRSA, MRSE, PCN allergy
**PO = C. diff (isn't absorbed well so stays in gut)**

Front 20

What is the general pattern with how FQs work?

Back 20

Gm (-) --> Gm (+)

Front 21

FQs:
1. AE
2. CI

Back 21

1. GI, CNS, TENDON INFLAMM, QT prolong
2. <18yo, Pg

Front 22

2nd gen FQs
1. Examples
2. Use
3. Best for

Back 22

1. Ciprofloxacin, Ofloxacin
2. Gm (-), pseduo
3. UTI

Front 23

3rd gen FQs
1. Examples
2. Use

Back 23

1. Levofloxacin
2. Resp FQs, gm (-) & gm (+)

Front 24

4th gen FQs
1. Examples
2. Use
3. Best for

Back 24

1. Moxifloxacin
2. Resp FQ, gm (+)
3. CAP

Front 25

TMP/SMX
1. how does it work?
2. AE

Back 25

1. blocks folate pathway
2. photosensitivity, hyperkalemia (w/ ACEi/ARB), renal toxicity

Front 26

TMP/SMX
1. Trade names
2. uses
3. DOC

Back 26

1. Bactrim or Septra
2. Gm (-)
3. PCP & uncomplicated UTI

Front 27

Macrolides
1. how do they work?
2. AE

Back 27

1. blocks protein synthesis
2. GI

Front 28

Erythromycin
1. unique info
2. use
3. DOC

Back 28

1. most GI AE & drug intxn of macrolides
2. pertussis
3. DOC = M. pneumo

Front 29

Clarithromycin
1. unique info
2. use

Back 29

1. most bioavailability of macrolides
2. better than erythro + tick coverage

Front 30

Azithromycin
1. unique info
2. use

Back 30

1. HIGH intracellular uptake, no drug intxn in macrolide category
2. STIs, URTIs, LRTIs

Front 31

What 3 antibiotic classes have high intracellular uptake?

Back 31

*macrolides, FQs, tetracyclines

Front 32

What 2 antibiotics can cause ototoxicity and nephrotoxicity?

Back 32

*Aminoglycosides
*Vancomycin

Front 33

Aminoglycosides
1. Examples
2. AEs

Back 33

1. gentamycin, tobramycin
2. ototoxic, nephrotoxic

Front 34

Gentamycin
1. Abx category
2. Use

Back 34

1. aminoglycoside
2. Gm (-), nosocomial, serious staph

Front 35

Tobramycin
1. Abx category
2. Use

Back 35

1. aminoglycoside
2. pseudomonas

**Tobra = BEST pseudomonas coverage**

Front 36

Clindamycin
1. AE
2. use
3. DOC

Back 36

1. pseudomembranous colitis
2. Gm (+) & anaerobes
3. DOC = B. frag

Front 37

Metronidazole
1. AE
2. Vd

Back 37

1. CNS, disulfiram like reaction w/ EtOH
2. large Vd

Front 38

Metronidazole
1. use
2. DOC

Back 38

1. anaerobes, parasites, protozoans
2. DOC = C. diff

Front 39

Tetracyclines
1. AE
2. Examples

Back 39

1. teeth discoloration (CI <8yo, Pg), photosensitive, GI
2. Doxycycline, tetracycline, minocycline

Front 40

Tetracyclines
1. examples
2. Use
3. DOC

Back 40

1. doxy, tetra, mino
2, broad spectrum (Gm +, Gm (-), anaerobe, STI, ticks/bugs); Respiratory, genital, systemic
3. DOC = Lyme Dz (doxy)

Front 41

Infect Me Man
1. AOM
2. Sinusitis
3. Acute Bronchitis

Back 41

*S. pneumo, H. flu, M. cat

Front 42

Infect Me Man
1. Meningitis

Back 42

*S. pneumo, H. flu, Neisseria, meningitis

Front 43

Infect Me Man
1. Pneumonia

Back 43

*Staph, S. pneumo, H. flu, pseudomonas, mycoplasma

Front 44

Infect Me Man
1. Bowel perf or appy

Back 44

*Staph, Enterococcus, EK, pseudomonas

Front 45

Infect Me Man
1. UTI

Back 45

EKP, enterococcus

Front 46

Infect Me Man
1. Osteomyelitis

Back 46

*Staph A

Front 47

FQ interaction with antacids & iron salts?

Back 47

*chelation (decreases absorption)