Random Antibiotics

Question 1

Aminoglycoside MOA:

Answer 1

Bind to outer membrane of cell.
- Results in re-arrangement of LPS.
- Uptake is energy dependent.
- Once across membrane drug is trapped.
- Binds to 30S and 50S ribosomal subunit.
Bacteriocidal.
Concentration dependent killing with PAE.

Question 2

Aminoglycoside excretion:

Answer 2

99% unchanged via glomerular filtration.

- Tx UTI’s

Question 3

Aminoglycoside ADR:

Answer 3

• Thrombophlebitis.
• Nephrotoxicity (too high trough).
• Ototoxicity (too high peaks).
• Neuromuscular blockade.

Question 4

Aminoglycosides spectrum of activity:

Answer 4

G-:
- Piddly
- PEK
- SPACE
G+:
- Add-on only, not monotherapy.

Question 5

Aminioglycoside lung concentrations:

Answer 5

Low, 40%.

Question 6

Aminoglycosides (3):

Answer 6

• Gentamicin
• Tobramycin
• Neomycin (gut decontamination)

Question 7

Vancomycin MOA:

Answer 7

Inhibits the biosynthesis of peptidoglycan during cell wall formation.
- Complexes with D-alanyl-D-alanine precurser.
Bactericidal
PAE

Question 8

Vancomycin ADRs (8):

Answer 8

• Thrombophlebitis.
• Red-man syndrome.
• Neutropenia.
• Eosinophilia.
• Thrombocytopenia.
• Hypersensitivity.
• Nephrotoxicity.
• Ototoxicity (high peaks).

Question 9

Vancomycin spectrum of activity:

Answer 9

G+:

• MRSA
• Staph epidermidis
• Strep
• Enterococcus
• Clostridium
• Bacillus anthracis
• Cornyebacteria

Question 10

Quinupristin/dalfopristin (synercid) MOA:

Answer 10

• Irreversibly bind to the 50S ribosomal subunit.
• Q inhibits chain formation.
• D inhibitis peptide elongation.

Question 11

Quinupristin/dalfopristin spectrum (5):

Answer 11

• MRSA.
• PCN-resistant strep pneumo.
• VRE (*not E. faecalis).
• Anaerobes
• Some G-

Question 12

Linezolid MOA:

Answer 12

• Bind to 23S ribosomal RNA of 50S subunit.

Question 13

Linezolid spectrum (4):

Answer 13

• MRSA
• VISA
• VRE
• PCN-resistant strep pneumo

Question 14

Linezolid ADRs (3):

Answer 14

• Myelosupression: thrombocytopenia.
• Superinfection (yeast).
• Mitochondrial toxicity (long courses).

Question 15

Linezolid drug-drug interactions:

Answer 15

MAOI

- Co-administration with SSRI –> serotonin storm.

Question 16

Mupirocin (2):

Answer 16

• Topical treatment.

- MRSA colonization eradication from nares.

Question 17

Colistin (4):

Answer 17

• Bacteriocidal.
• SPACE bug coverage.
• Nephrotoxicity and neurotoxicity.
• “Kitchen sink” - last ditch efforts.

Question 18

Fosfomycin (3):

Answer 18

• Bacteriocidal.
• UTIs only.
• MDR pathogens:
  
  • MRSA/VRE
  • ESBL

Question 19

Tigecycline indications (3):

Answer 19

• Complicated skin infections.
• Complicated intra-abdominal infections.
• Community acquired pneumonia (CAP).
• Does not attain high serum concentrations.

Question 20

Tigecycline spectrum (4):

Answer 20

• MRSA/VRE.
• G- bacteria (CRE).
• Acinetobacter (not pseudomonas).
• Anaerobes (GI infections).

Question 21

Daptomycin (6):

Answer 21

• Bacteriacidal.
• G+ coverage.
  
  • MRSA/VRE.
• Complicated skin and soft tissue infections.
• SA and MRSA bacteremia
• Does NOT cover pneumonia.
• ADR: rhabdomyolysis, eosinophilic pneumonia

Question 22

Telavancin (4):

Answer 22

• Semi-synthetic Vancomycin.
• G+:
  
  • Staph, strep and enterococcus.
• Skin and soft tissue infections.
• ADR: Nephrotoxicity, Red-man syndrome, QT prolongation, pancreatitis.