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64 Cards in this Set
- Front
- Back
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Antibiotic of choice for syphilis, given its low MIC and high susceptibility?
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Benzathie penicillin (slow release)
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Spectrum of aminopenicillins, amoxicillin and ampicillin?
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HELPS
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What drug has expanded ampicillin spectrum for treatment of Pseudomonas?
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Piperacillin
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What do B-Lactam/B-Lactamase inhibitors provide?
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Increased G-, MSSA, increased anaerobic
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Drug with activity against S. maltophilia?
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Clavulonic acid
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Drug with activity against A. baumannii?
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Sulbactam
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Cephalosporins lack coverage against what type of organism?
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Enterococcus
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What cephalosporins have anaerobic activity?
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Cephamycins (cefotetan, cefoxitin)
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Drug of choice for CAP?
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3rd generation cephalosporins (ceftriaxone, etc.), also the macrolide azithromycin
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What do 3rd generation cephalosporins not cover?
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SPICE
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What issue is there with cephalosporins and alcohol?
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Hypothrombinemia and disulfiram reactions
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Only cephalosporin not renally cleared?
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Ceftriaxone (note: causes biliary sludging in neonates)
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What penicillins are not renally cleared?
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Penicillinase-resistant penicillins (methicillin, etc.)
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What is the approximate cephalosporin cross reactivity with penicillins?
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5-15%
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Only B-Lactam good for MRSA?
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Ceftaroline
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One anaerobe that carbapenems don't cover?
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C. difficile
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What organisms doesn't ertapenem cover?
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APE
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DOC for ESBL?
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Ertapenem (more stable to hydrolysis)
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Major side effect of carbapenems?
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Seizures
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What organisms don't carbapenems cover?
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SMECK
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B-Lactam with no G+ activity?
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Aztreonam
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Which drug(s) is A. baumannii susceptible to?
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Ampicillin/sulbactam and carbapenems (except: ertapenem)
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Which antibiotic classes bind and inhibit the 30S ribosomal subunit?
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Aminoglycosides, Tetracyclines
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Why don't aminoglycosides work against anaerobes?
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Require O2 dependent transport
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Aminoglycosides of choice for nosocomial infections?
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Amikacin, tobramycin
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Unique side effect for aminoglycosides?
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Ototoxicity
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Fluoroquinolones inhibit...?
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Bacterial DNA replication by inhibiting DNA gyrase and topoisomerase
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Which fluoroquinolone lacks strep activity?
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Ciprofloxacin
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Only fluoroquinolone with anaerobic activity?
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Moxifloxacin
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Anti-pseudomonas FQs?
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Ciprofloxacin, levofloxacin
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FQ that is not renally eliminated?
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Moxifloxacin
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FQ without good bioavailability?
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Norfloxacin
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Unique side effect for FQs?
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Tendonitis/tendon rupture
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Reduced oral absorption with divalent cations due to chelation?
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Fluoroquinolones
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What drug has the spectrum of G+ only for empiric MRSA treatment?
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Vancomycin
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Method if action for vancomycin?
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Binds D-Ala/D-Ala
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Ideal trough level for measuring vancomycin efficacy?
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15-20microg/ml
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Common vancomycin side effect?
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Nephrotoxicity, ototoxicity, red man's syndrome
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What drug is bactericidal, only G+, and is used for both MRSA and VRE?
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Daptomycin
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When should daptomycin be avoided?
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In patients with pneumonia; as it can irreversibly bind to surfactant
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What drug is both not renally cleared and treats VRE?
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Linezolid
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What are some concerns with linezolid?
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Thrombocytopenia; serotonin syndrome with SSRIs and tyramine
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Mechanism of VRE?
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D-Ala/D-Ala changed to D-Ala/D-Lac(D-Ser)
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What also can treat VRE but is rarely used due to high rates of hepatotoxicity?
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Streptogramins (quinupristin/dalfopristin)
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Clarithromycin treats what unique infection?
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H. Pylori
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Biggest class concern with macrolides?
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N/V/D; QT elongation
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What is the limiting factor for telithromycin, a derivative of macrolides, used to treat CAP?
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Hepatotoxicity
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Only tetracycline that is renally eliminated and good for UTIs?
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Tetracycline
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Why should tetracyclines be avoided in children?
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Binding to teeth/bones
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Notable holes for tigecycline?
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3 P's: Pseudomonas, Proteus, Providencia
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DOC for oral anaerobes?
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Clindamycin
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Diarrhea is most commonly seen with which oral antibiotic?
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Clindamycin
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S. aureus may possess an "erm" gene encoding resistance to which of the following classes?
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MLS (macrolide, lincosamide, streptogramin)
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Sulfamethoxazole and trimethoprim ultimately block production of what, respectively?
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DHF and THF
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Bactrim (SMX/TMP) is drug of choice for which organisms?
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S. maltophilia, P. jirovecii, PCP pneumonia, nocardia
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Trimethoprim is associated with which adverse effects?
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Hyperkalemia, increased INR with warfarin
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What is the drug of choice for anaerobes, in particular for lower GI inducing C. diff?
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Metronidazole
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Rare, but cumulative, side effect for nitro-imidazoles?
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Peripheral neuropathy
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Major issue with rifampin use?
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Inducer of CYP450 leading to hepatotoxicity
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Bactericidal drug with no G+ and no anaerobic activity, but is no longer used due to additive nephrotoxicity and neurotoxicity?
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Polymixins
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What 50S inhibitor is associated with the irreversible, non dose dependent side effect of aplastic anemia?
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Chloramphenicol
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Additional side effects of chloramphenicol?
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Gray baby syndrome, bone marrow suppression
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Nitrofurantoin is used clinically to treat what?
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UTI's
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When TMP/SMX cannot be used for PCP pneumonia, what is the next drug of choice?
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Dapsone
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