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109 Cards in this Set
- Front
- Back
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what is the only example of a monobactam?
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aztreonam
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how must aztreonam be administered?
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IV or IM
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what types of bacteria classes are monobactams not effective against? (2)
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anaerobes
gram + |
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what type of gram negatives does monobactam not cover?
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actinobacter
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what is monobactam effective against?
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gram negatives
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how is monobactam cleared?
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renally
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what are 2 major adverse effects of monobactam?
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hypersensitvity
hepatotoxicity |
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what is monobactam's niche?
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good gram negative coverage and safe for patients with beta-lactam allegies
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what generally happens to gram negative activity as you increase the cephalosporin generation?
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increases
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what generally happens to gram positive activtity as you increase cephalosporin generations?
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decreases slightly but overall remains strong
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how is cephalexin administered?
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orally
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what is cephalexin?
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1st generation cephalosporin
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what bacteria is resistant to all cephalosporins?
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enterococcus
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what are 2 first generaiton cephalosporins?
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cephalexin and cefazolin
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how is cefazolin administered?
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IV only
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what is cefazolin?
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1st generation cephalosporin
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what are 1st generation cephalosporin primarly used for?
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MSSA or select lesser gram negatives
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what are 5 therapeutic uses for 1st generation cephalosporins?
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cellulitis
puncture wounds bacteremia cystitis surgical prophylaxis |
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how long is the 1/2 life for 1st generation cephalosporin?
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very short (which means frequent dosing)
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how are 1st generation cephalosporins excreted?
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renally
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what are 2 2nd generation cephalosporins?
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ceftoxitin
cefotetan |
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what is cefoxitin?
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2nd generation cephalosporins
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what is cefotetan?
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2nd generation cephalosporins
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how is cefocitin administered?
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IV only
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how is cefotetan administered?
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IV only
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what generation is known as the anti-anaerobic cephalosporin?
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2nd generation cephalosporins
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when are 2nd generation cephalosporins used?
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primarily used when both gram negative and anaerobic coverage is needed
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what are 3 therapeutic uses for 2nd generation cephalosporins?
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intra-abdominal infections
pelvic inflammatory disease surgical prophylaxis |
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what are 4 3rd generation cephalosporins?
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cefotaxime
cetriaxone ceftazidime cefpodoxime |
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what is cefotaxime?
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3rd generation cephalosporins
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how is cefotaxime administered?
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IV only
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what is ceftriaxone?
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3rd generation cephalosporins
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how is ceftriaxone administered?
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IV only
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what is ceftazidime?
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3rd generation cephalosporins
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how is ceftazidime administered?
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IV only
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what is cefopodoxime?
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3rd generation cephalosporins
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how is cefopodoxime administered?
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orally
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what 2 3rd generation cephalosporins are the work horses?
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cefotaxime, ceftriaxone
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what are the 4 therapeutic uses for cefotaxime and ceftriacone?
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meningitis
pneumonia bacteremia intra-abdominal infections |
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what 3rd generation cephalosporin has pseudomonal coverage but also noticeably weaker gram positive activity?
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ceftazidime
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what is one of the only beta lactams that does not require renal adjustment because it has biliary excretion?
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ceftriaxone
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what is the only 4th generation cephalosporin?
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cefepime
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what is cefepine
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4th generation cephalosporin
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how is cefepime administered?
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IV only
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what expanded coverage does cefepime offer? (2)
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pseudomonas
actinobacter |
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what are 6 indications of cefepime?
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nosocomial infections
bacteremia pneumonia febrile neutropenia intra-abdominal infection meningitis |
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what are 4 adverse reactions of cephalosporins?
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allergic reactions
hematologic effects hepatotoxicity sludging of the gallbladder |
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when should you always avoid cephalosporins?
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if there is any history of anaphylaxis to beta-lactams
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what are 3 hematological effects of cephalosporins?
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thombocytopenia
neutropenia hemolysis |
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what cephalosporin has pseudolithiasis as a side effect?
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ceftriaxone
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what route do you usually begin treating HA-MRSA with?
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IV
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what are 5 typical sites of infection fo HA-MRSA?
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pneumonia
endocarditis bacteremia severe skin/soft tissue infections osteomyelitis |
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how is treatment often started for CA-MRSA?
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oral therapy
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what are 2 typical sites of infection for CA-MRSA?
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skin/soft tissue
communit acquired pneumonia |
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what type of drug is vanco?
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glycopeptide
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how does vanco work?
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blocks the formation of glycosidic bonds and peptide crosslinks
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what is vanco active against? (4)
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strep
staph (including MRSA) enterococcus listeria |
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which form of staph should vanco not be used to treat?
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beta-lactam sensitive
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what type of listeria is vanco not effective against?
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menigitis (CNS forms)
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what has historically been the 1st line drug for HA-MRSA?
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vanco
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what is vanco doing based on? (2)
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total body weigh and renal function
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when would you administer vanco orally?
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for a GI infection (colitis)
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what type of infection does IV vanco not work for?
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GI infections
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what is the best monitoring tool for vanco toxicity?
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troughs
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what does the target trough for vanco depend on?
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the disease state
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what are 2 toxicities that can result from vanco?
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ototoxicity and nephrotoxicity
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what can the patient suffer from with cochlear toxicity in vanco? (2)
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tinitus
hearing loss |
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what can the patient suffer from with vestribular toxicity in vanco? (3)
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ataxia
vertigo nystagmus |
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what is red man's syndrome due to?
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excessive infusion of vanco
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what are the symptoms of red man's syndrome? (6)
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fever
chills itching rash redness in the face redness in the torso |
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what is vanco doing based on? (2)
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total body weigh and renal function
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when would you administer vanco orally?
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for a GI infection (colitis)
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what type of infection does IV vanco not work for?
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GI infections
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what is the best monitoring tool for vanco toxicity?
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troughs
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what does the target trough for vanco depend on?
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the disease state
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what are 2 toxicities that can result from vanco?
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ototoxicity and nephrotoxicity
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what can the patient suffer from with cochlear toxicity in vanco? (2)
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tinitus
hearing loss |
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what can the patient suffer from with vestribular toxicity in vanco? (3)
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ataxia
vertigo nystagmus |
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what is red man's syndrome due to?
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excessive infusion of vanco
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what are the symptoms of red man's syndrome? (6)
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fever
chills itching rash redness in the face redness in the torso |
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how is televancin administered?
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IV only
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what is dosage based on with telavancin?
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weight
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how is telavancin cleared and how does this affect the drug?
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cleared renally but adjusted doses may decrease the efficacy
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what advantages does telavancin have over vanco?
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do not need to monitor trough levels
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what are 6 adverse effects of televancin?
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nephrotoxicity
prolongation of QT interval foamy urine taste disturbances nausea/vomiting avoid use in pregnancy |
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what drug is taking over vanco's role?
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daptomycin
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what is a clyclic lipopeptide?
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daptomycin
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what is daptomycin?
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a cyclic lipopeptide
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what is daptomycin's MOA?
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inserts itself into the cell wall thus detroying the wall and resulting in efflux
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what makes daptomycin unique?
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it directly kills bacteria
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how is televancin administered?
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IV only
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what is dosage based on with telavancin?
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weight
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how is telavancin cleared and how does this affect the drug?
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cleared renally but adjusted doses may decrease the efficacy
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what advantages does telavancin have over vanco?
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do not need to monitor trough levels
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what are 6 adverse effects of televancin?
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nephrotoxicity
prolongation of QT interval foamy urine taste disturbances nausea/vomiting avoid use in pregnancy |
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what drug is taking over vanco's role?
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daptomycin
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what is a clyclic lipopeptide?
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daptomycin
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what is daptomycin?
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a cyclic lipopeptide
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what is daptomycin's MOA?
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inserts itself into the cell wall thus detroying the wall and resulting in efflux
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what makes daptomycin unique?
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it directly kills bacteria
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what is daptomycin active againt? (3)
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strep
staph enterococcus |
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what is daptomycin primarily used for? (2)
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HA-MRSA and VRE
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what are 3 other conditions daptomycin can be used for?
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bacteremia
complicated skin infections endocarditis |
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what is daptomycin never used for and why?
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pneumonia because surfactant renders it ineffective
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how is daptomycin administered?
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IV
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what is dosage based on with daptomycin?
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weight
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how si daptomycin cleared?
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renally
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what is a major adverse effect of daptomycin?
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msucle pain/weakness
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what are the 3 weight based-dosage medications?
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vanco
daptomycin telavancin |
