Presby Manual - Antibiotics

Front 1

mechanism of action of PCN

Back 1

-bactericidal
- act on PCN binding protein to inhibit cell wall synthesis

Front 2

adverse rxns of PCN

Back 2

-hypersensitivity
-neutropenia
-thrombocytopenia
-myoclonic seizures
-diarrhea
-transient elevation of LFT's
-high Na (esp with ticarcillin)

Front 3

Spectrum of Natural PCN (G and V) -tthese are the 1st generations

Back 3

-streptococci, non penicillinase staphylococci, non penicillinase producing gonococci, anerobes

Front 4

spectrum of aminopenicillins (Ampicillin, Amoxicillin) - these are 3rd generation

Back 4

streptococci, enterococci, gram negs (Ecoli,Pmirabelis,Shigella,Salmonella)

Front 5

Pen G dose

Back 5

1.2-40 million units IM or IV qd

Front 6

Pen V dose

Back 6

250-500 mg po qid

Front 7

Ampicillin dose

Back 7

250-1000 mg PO, IM, IV q4-6 hrs

Front 8

Amoxicillin dose

Back 8

250-500 mg PO tid

Front 9

Semi Synthetic PCN (penicillinase resisitant) - these are the 2nd generations

Back 9

Methicillin, Oxacillin, Nafcillin, Cloxacillin, Dicloxacillin

Front 10

spectrum of semi synthetic penicillinase resistant PCN

Back 10

staph (not MRSA), streptococci

Front 11

Extended Spectrum PCN (anti pseudomonal)- these are the 4th generation

Back 11

Carbenicillin, Mezlocillin, Pipercillin, Ticarcillin, Azlocillin

Front 12

spectrum of 4th generation extended spectrum PCN

Back 12

-increased garm neg (pseudomonas, enterobacter)
-streptococci
- not active against staph

Front 13

Penicillin/B-lactamase inhibitor combos

Back 13

-ticarcillin/clavulanic acid
-piperacillin/tazobactam
-ampicillin/sulbactam
-amoxicillin/clavulanic acid

Front 14

Timentin; name and dose

Back 14

3.1 g IV q4-6 hr

Front 15

Zosyn; name and dose

Back 15

3.375-4.5 gm IV q 8 hr

Front 16

Unasyn; name and dose

Back 16

1.5-3.0 gm IV q 6 hr

Front 17

spectrum of Penicillin/B-lactamase inhibitor combo drugs (Timentin, Zosyn, Unasyn, Augmentin)

Back 17

-staph (not MRSA), strept, anerobes,gram neg (pseudomonas, enterobacter)

Front 18

Augmentin; name and dose

Back 18

875 mg po bid

Front 19

how many generations of cephalosporin are there

Back 19

4

Front 20

how many generation of PCN are there

Back 20

3

Front 21

mechanism of action of cephalosporin

Back 21

-bactericidal
-inhibition of cell wall synthesis
-beta lactam abx (less susceptible to penicillinases)

Front 22

1st generation cephalosporins

Back 22

-cefadroxil(Duracef, Ultracef)
-Cefazolin (Ancef, Kefzol)
-cephalexin (Keflex, Keftab)

Front 23

spectrum of 1st generation cephalosporins

Back 23

-staph, strept (most G pos)
-gram neg (PECK and shigella,salmonella)
-anerobes

Front 24

2nd generation cephalosporins

Back 24

-staph, strept (less then 1st)
-more gram neg (HENPECK)
-anerobes

Front 25

HEN

Back 25

Hpylori, Enterobacter, Neisseria

Front 26

PECK

Back 26

Pmirabalis, Ecoli,Klebsiella pneumonia

Front 27

3rd generation cephalosporins

Back 27

-Ceftaxidime (Fortaz)
-Ceftizoxime (Cefizox)
-Ceftriaxone (Rocephin)
-Moxxalactam (Maxam)

Front 28

best generation of cephalosporins for staph and strept

Back 28

1st generation - Ancef, Keflex

Front 29

best generation of cephalosporin for gram neg coverage

Back 29

4th gen - Maxipime

Front 30

adverse rxns of cephalosporins

Back 30

-hypersensitivity (cross rxn with PCN sensitivity)
-neutropenia
-diarrhea
-bleeding
-phlebitis with IV admin

Front 31

Primaxin

Back 31

-another beta lactam; Imipenem/Cilastatin combo

Front 32

Primaxin dose

Back 32

500 mg IV q 6-8 hr

Front 33

spectrum of Primaxin

Back 33

-very broad; most gram pos aerobes and anaerobes, gram neg incl pseudo, anerobes

Front 34

adverse rxn of Primaxin

Back 34

-N/V, seizures in those with h/o seizures

Front 35

Aztreonam

Back 35

-other antibiotics
-gram negative aerobes (pseudo)

Front 36

Aztreonam dose

Back 36

1-2 gm IV q 8 hrs

Front 37

mechanism of quinolones

Back 37

bactericidal that inhibits DNA gyrase

Front 38

spectrum of quinolones

Back 38

-staph (not MRSA)
-gram neg Bacilli (pseudo)
-enterobacter

Front 39

S/E of quinolone

Back 39

-N/V/D, insomnia, headache, seizures, contraindicated in kids due to cartilage, drub interaction with theophylline(asthma) and antacids

Front 40

Examples of Quinolones

Back 40

Ciprofloxacin,Enoxacin (Penetrex), Avelox, Levaquin, Ofloxacin, anything that ends in "floxacin"

Front 41

mechanism of action of aminoglycosides

Back 41

bactericidal that binds 30S ribosome to inhibit protein synthesis

Front 42

Aminoglycosides

Back 42

Gentamycin, Tobramycin,Amikacin

Front 43

Gentamycin dose

Back 43

3-5 mg/kg q 8h (peak 4-10, trough 2 ug/mL)

Front 44

Tobramycin dose

Back 44

3-5 mg/kg q 8h (peak 4-10, trough 2 ug/mL)

Front 45

Amikacin dose

Back 45

15 mg/kg q 8h(peak 20-30, trough 10 ug/mL)

Front 46

S/E of Aminoglycosides

Back 46

-irreversible ototoxicity
-reversible nephrotoxicity
-NM blockade

Front 47

peaks and troughs used in aminoglycoside dosing

Back 47

-peaks are taken 60 min after IM injection or 30 min after 30min IV infusion; troughs are taken 30 min before dose is infused

Front 48

how are doses of aminoglycosides adjusted

Back 48

based on peaks

Front 49

how are dosing intervals adjusted of aminoglycosides

Back 49

based on troughs

Front 50

what is carbapenam (Imipenem/Cilistatin= Priimaxin)

Back 50

very broad spectrum (+,-, pseudomonas)
-drug of choice in DM limb infections

Front 51

what does cilistatin do

Back 51

prevents renal inactivation of Imipenem

Front 52

what quinolone can be combined wtih Clinda or metronidazole to tx DM infections

Back 52

Ciprofloxacin

Front 53

what is the mechanism of action of Sulfonamides

Back 53

-bacteriostatic
- sulfamethoxazole disrupts folic acid production cycle of bacteria
-trimethoprim inhibits bacterial dihydrofolate reductase

Front 54

what is the spectrum of activity of sulfonamides

Back 54

- staph (incl MRSA and MRSE)
-strept
-gram neg (Pseudo)

Front 55

S/E of sulfonamides

Back 55

-hypersensitivity
-hemolytic anemia
-contraindicated in hypoglycemics and G6PD deficiency

Front 56

MC sulfonamide

Back 56

Bactrim (Trimethoprim/sulfamethoxazole)

Front 57

dosage of Bactrim

Back 57

1 DS tablet bid (160 mg trimethoprim/800 mg sulfamethoxazole)

Front 58

mechanism of action of macrolides

Back 58

-bacteriostatic
-binds 50s bacterial ribosome inhibiting protein synthesis

Front 59

spectrum of macrolides

Back 59

-staph, strept
-some anerobes

Front 60

S/E of macrolides

Back 60

-N/V
-hepatotoxicity
-thrombophelbitis with IV infusion
-hypersensitivity

Front 61

names of macrolides

Back 61

-Erythromycin(E-mycin)
-Azithromycin (Zithromycin)
-Clarithromycin (Biaxin)
-Dirythromycin (Dynabac)

Front 62

dose of E-mycin

Back 62

250-500 mg po qid

Front 63

dose of Azithromycin

Back 63

-500 mg the 1st day
-250 mg qd x 4 days

Front 64

dose of clarithromycin

Back 64

250 mg po bid

Front 65

dose of dirythromycin

Back 65

500 mg po qd