- MoA: Inhibit cell wall synthesis by binding to PBPs and inhibiting final step of peptidoglycan synthesis - TIME-dependent (extend inf. times, esp. ES-cillins) - Avoid if PCN/B-lactam allergy present - Caution if pt is a seizure risk - Probenecid increases B-lactam levels Includes PCN/Cephalosporins/Carbapenems

- NEVER give Bicillin IV => death - Nafcillin is a vesicant, give with central line - Ampicillin is diluted in NS ONLY

- IV only - Monobactam - Can be used in pts with B-lactam allergy - G - coverage including pseudomonas

- Respiratory Quinolones: Moxifloxacin, gemifloxacin, levofloxacin ( my good lungs, activity against S pneumonia) - Moxifloxacin ISN'T renally adjusted; therefore, don't use for UTIs - Antipseudomonals: Levofloxacin, Ciprofloxacin - IV:PO 1:1 => moxi and levo

- MoA: binds to 50s ribosome and inhibits RNA-dependent protein synthesis - GREAT atypical coverage - Important brand/generic drugs to know, all top sellers (Zithromax, Biaxin, E.E.S.) - Commonly used for CAP, strep throat, and some others (diff. slide) - QT prolongation! - Clarithromycin and erythromycin are STRONG CYP3A4i (CI with sim/lovastatin)

- Azithromycin uses: STIs (chlamydia, gonorrhea), MAC prophylaxis - Clarithromycin uses: H. pylori - Erythromycin uses: increases gastric mobility

ID: Antibiotic Classes Flashcards by Rachel Crusius

B-Lactam MoA/Info

MoA: Inhibit cell wall synthesis by binding to PBPs and inhibiting final step of peptidoglycan synthesis
TIME-dependent (extend inf. times, esp. ES-cillins)
Avoid if PCN/B-lactam allergy present
Caution if pt is a seizure risk
Probenecid increases B-lactam levels
*Includes PCN/Cephalosporins/Carbapenems**

How well did you know this?

Not at all

Perfectly

B-Lactam Med Notes

NEVER give Bicillin IV => death
Nafcillin is a vesicant, give with central line
Ampicillin is diluted in NS ONLY

How well did you know this?

Not at all

Perfectly

Cephalosporin Drug Notes

PO options only in Group 1 third generation and earlier (rest are IV)
Ceftin (cefuroxime) comes in IV, IM, and PO
CefOtetan and CefOxitin have anaerObic activity (B. fragilis)
Ceftriaxone is only med that DOESN’T need renal dose adjustment

How well did you know this?

Not at all

Perfectly

Carbapenem Information

Used for ESBL-producing organisms and Pseudomonas
Avoid in B-lactam allergies
Caution in seizure risk pts (esp. renal failure)
ALL are IV
DON’T cover atypicals, MRSA, VRE

How well did you know this?

Not at all

Perfectly

Carbapenem Med Information

ErtAPpenem doesn’t cover PEA: pseudomonas, enterococcus, actinobacter
Ertapenem is NS stable only

How well did you know this?

Not at all

Perfectly

Aztreonam

IV only
Monobactam
Can be used in pts with B-lactam allergy
G”-“ coverage including pseudomonas

How well did you know this?

Not at all

Perfectly

Aminoglycoside MoA/Info

MoA: bind to ribosome and interfere with bacterial protein synthesis (leads to defective cell membrane)
Cover G”-“ organisms including pseudomonas, synergy for G”+”
Traditional and Extended-interval dosing ([higher] given Q24H)
Renal and ototoxicity

How well did you know this?

Not at all

Perfectly

Traditional vs Extended-Interval

Traditional: peaks and troughs (<2 mcg/mL), given q8H

- Extended-interval: random intervals/nomograms (On line? go up level), less accumulation/nephrotoxic risk/cost

How well did you know this?

Not at all

Perfectly

Quinolones MoA/Information

MoA: inhibit DNA topoisomerase and DNA gyrase which prevents bacterial DNA coiling (breaks)
Boxed warning: tendon rupture!, peripheral neuropathy, use LAST LINE
Warning: QT prolongation (avoid mult. prolonging drugs), psychiatric disturbance, photosensitivity
DON’T use in kids (effects bones/teeth/etc)
Chelates with divalent cations (iron/calcium/etc)

How well did you know this?

Not at all

Perfectly

Quinolone Med Info

Respiratory Quinolones: Moxifloxacin, gemifloxacin, levofloxacin (“my good lungs,” activity against S pneumonia)
Moxifloxacin ISN’T renally adjusted; therefore, don’t use for UTIs
Antipseudomonals: Levofloxacin, Ciprofloxacin
IV:PO 1:1 => moxi and levo

How well did you know this?

Not at all

Perfectly

Macrolide MoA/Info

MoA: binds to 50s ribosome and inhibits RNA-dependent protein synthesis
GREAT atypical coverage
Important brand/generic drugs to know, all top sellers (Zithromax, Biaxin, E.E.S.)
Commonly used for CAP, strep throat, and some others (diff. slide)
QT prolongation!
Clarithromycin and erythromycin are STRONG CYP3A4i (CI with sim/lovastatin)

How well did you know this?

Not at all

Perfectly

Macrolide Med Info

Azithromycin uses: STIs (chlamydia, gonorrhea), MAC prophylaxis
Clarithromycin uses: H. pylori
Erythromycin uses: increases gastric mobility

How well did you know this?

Not at all

Perfectly

Tetracyclines MoA/Info

MoA: binds reversibly with 30s ribosome unit
Covers CA-MRSA, Rickettsiae disease, STIs, VRE, acne (common use)
Know brand names: Vibramycin, Minocin, Solodyn
Safety issues: avoid in kids <8 yo (bone/muscle development), photosensitivity, divalent interactions

How well did you know this?

Not at all

Perfectly

Tetracycline Med Info

Doxycycline uses: tick-borne disease, CAP, chlamydia, gonorrhea
Doxycycline and minocycline are IV:PO 1:1
Minocycline is a DILE risk

How well did you know this?

Not at all

Perfectly

Sulfonamide MoA/Med/Info

MoA: inhibits part of folic acid pathway to stop bacterial folic acid synthesis
Main drug: Bactrim (SMX/TMP) - dose based on TMP (5:1 SMX:TMP)
Do not use with sulfa allergy
Not safe in preggo/BF
SJS/TEN risk
Don’t use in G6PD deficiency (hemolytic anemia - “+” Coombs)
Elevates INR when used with warfarin (inhibitor)

How well did you know this?

Not at all

Perfectly

Oral Refrigerated Abx

After reconstitution:

Penicillin VK
Ampicillin
Augmentin

How well did you know this?

Not at all

Perfectly

Abx to NOT Refrigerate

Study These Flashcards

Cefdinir (oral)
Metronidazole
Moxifloxacin
Bactrim

Abx w/o Renal Adjustments

Study These Flashcards

Antistaph. penicillins**
Ceftriaxone**
Clindamycin**
Doxycycline
Macrolides (azith and erythromycin only)
Metronidazole
Moxifloxacin**
Linezolid**

Empty Stomach Abx

Study These Flashcards

Ampicillin (oral soln/capsules)
Cefibuten susp
Levofloxacin oral soln
Penicillin VK
Rifampin
Isoniazid
Itraconazole soln
Voriconazole

1:1 IV:PO Abx

Study These Flashcards

Levofloxacin (also moxi)
Doxy and minocycline
Linezolid
Metronidazole
Bactrim

Light Protection during Admin Abx

Study These Flashcards

Doxycycline

- Micafungin

Dextrose only Abx

Study These Flashcards

Synercid
Bactrim
Amphotericin B

NS Only Abx

Study These Flashcards

Ampicillin
Ampicillin/Sulbactam
Ertapenem
Daptomycin (RF - water for reconstitution)

NS/LR Only Abx

Study These Flashcards

Caspofungin

- Daptomycin

Vancomycin MoA/Info

- MoA: inhibits cell wall synthesis by binding to d-alanine-d-alanine - PO: covers C.diff only, QID x 10d - 1st line choice for MRSA - IV dose: 15-20 mg/kg Q8-12H, TBW! - Causes nephro/ototoxicity (adjust for renal failure) - Red Man Syndrome: slow inf. rate - Don't use if MIC >= 2

Lipoglycopeptides MoA/Info

- Similar MoA and coverage to vanco - Approved for skin infections - All meds end in "-vancin" - All cause red man syndrome

Lipoglycopeptide Med Info

- Telavancin approved for HAP/VAP - Orita and dalbavancin are single-dose regimens - Telavancin warnings: fetal and kidney risk, avoid if CrCl =< 50 - Don't use telavancin with UFH or oritavancin w/in 5d of UFH use (related to effects on aPTT/PT/INR) - Tela: increases aPTT/PT/INR - Orita: increases PT/INR (acute) and aPTT (more chronically, 120 hours)9

Daptomycin MoA/Info

- MoA: binds to cell membrane and causes rapid depolarization and inhibits intracellular replication process - Brand names: Cubicin +/- RF - Similar activity to Vanco: minus C.diff and PLUS VRE - Do NOT use for pneumonia (inactivated lung surfactant) - Warning: myopathy/rhabdo - Compatible with NS or LR (NO dextrose)

Oxazolidinones MoA/Info

- MoA: Binds to 50s ribosome to inhibit translation/protein synthesis - Coverage similar to vanco + VRE - Linezolid (Zyvox) is approved for more indications and is 1:1 IV:PO - No MAOi use w/in 14 days (avoid methylene blue and other serotonergic drugs) - Myelosuppression and optic neuropathy risk - Avoid tyramine-containing foods

Synercid MoA/Info

- Quinupristin/Dalfopristin - MoA: streptogramin that binds to 50s ribosome to inhibit protein synthesis - Poorly tolerated: arthralgias/myalgias, infusion rxns, hyperbilirubiemia - D5W compatible ONLY - Phlebitis risk => central line only

Tigecycline MoA/Info

- MoA: glycylcycline binds to to 30s unit to inhibit protein synthesis (similar to tetracyclines) - Covers almost everything' - Don't use in bloodstream infections - No activity against "3 Ps:" Proteus, pseudomonas, providencia - Yellow-orange color

Polymixin Info

- Main meds: polymixin B or colistin (colisimethate sodium) - Broad spectrum coverage - Complicated dosing - Toxicity: nephrotoxicity, neurotoxicity

Chloramphenicol

- Broad spectrum coverage - Risk for gray syndrome - Many blood dyscrasias

Cleocin

- Clindamycin - MoA: lincosamide that binds to 50s and inhibits protein synthesis - Covers anaerobes! and some staph/strep - No renal dose adjustment! - D-test (positive means don't take it)

Flagyl

- Metronidazole - Anaerobic and protozoal infections coverage - IV:PO 1:1 - CI: disulfiram rxn with alcohol, avoid in preggo (esp. 1st trimester) - Increases INR (2C9 inhibitor)

Dificid

- First-line treatment for C.diff now | - PO only

Rifaximin

- Treats E.coli - Used for traveler's diarrhea and IBS with diarrhea - Less than 1% absorption

Nitrofurantoin

- MacroBID: BID - Macrodantin: QID - Drug of choice for uncomplicated UTI - Avoid w/ G6PD deficiency (hemolytic anemia, Coombs +) - Take with food - Discolors urine as brown

Fosfomycin

- Used for E.Coli, including ESBL and E.faecalis (including VRE) - Single-dose regimen

Bactroban

- Mupirocin - Topical - Used to eliminate MRSA in nares - Single use tubes, 5d therapy

ID: Antibiotic Classes Flashcards

(40 cards)