antimicrobial test1
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| Penicillinase resistant | Dicloxacillin
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| PCNase resistant | Nafcillin
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| PCNase resistant | Oxacillin
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| PCNase resistant | Methicillin
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| Anti-pseudo PCN | carboxyPCNs
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| CarboxyPCNs | Ticarcillin, Carbenecillin
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| Anti-pseudo PCN | ticarcillin
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| Anti-pseduo PCN | carbenecillin
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| Anti-pseudo PCN | UreidoPCN
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| UreidoPCN | piperacillin, mexlocillin
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| Anti-pseudo PCN | piperacillin
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| Anti-pseudo PCN | mexlocillin
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| Augmentin | Ampicillin & clavulonic acid
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| Zosyn | Piperacillin & taxobactam
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| 2nd gen Cephs | Cefaclor, Cefotoxin, Loracarbef
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| 3rd gen Cephs | Ceftriaxone, Ceftazidime, Cefixime
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| 4th gen Ceph | Cefepime
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| 5th gen Ceph | Ceftaroline
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| Imipenem | combined w/cilastin
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| 50s | Chloramphenicol
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| 50S | clindamycin
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| 50s | linezolid
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| 50s | macrolides
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| 50s | quinupristin
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| 50s | dalfopristin
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| macrolide | erthromycin
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| macrolide | azithromycin
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| macrolide | clarithromycin
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| 30s | tetracycline
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| 30s | tigecycline
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| 30s | spectinomycin
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| 30s | aminoglycosides
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| aminoglycoside | streptomycin
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| aminoglycoside | gentamycin
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| aminoglycoside | tobramycin
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| aminoglycoside | amikacin
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| aminoglycoside | neomycin
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| fluroquinolones | naladixic acid
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| fluroquinolones | 'floxins' - Ciprofloxin, Levofloxin, Trovafloxacin
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| Lipoglycopeptide | dalbavancin
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| lipoglycopeptide | telavancin
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| cyclic lipopeptide | daptomycin
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| tefibazumab | staph antibody
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| anti-Tb | Isoniazid
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| anti-TB | rifampin
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| anti-TB | pyrazinamide
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| anti-TB | ethambutol
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| anti-TB | rifabutin
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| anti-TB | streptomycin
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| Rifapentine | latent TB
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| isoniazid | latent TB
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| mixed amebicide | metronidazole
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| mixed amebicide | tinadazole
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| anti-leprosy | sulfones (dapson/sulfoxone)
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| anti-leprosy | rifampin
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| MOA PCNs | inhibit transpeptidases, bind PCN-binding proteins, alter configuration of PG layer
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| PCN drug of choice for | GAS, GBS, T.pallidum
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| Natural PCN | broad spectrum
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| Aminopencillins | better Gm-; Gm+ enterococci increasing resistance
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| causes interstitial nephritis | Methicillin
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| increases Na overload, platelet dysfunction, hypokalemia | carbenecillin
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| Beta Lactamase inhibitors | clavulonic acid, sulbactam, taxobactam
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| uses for beta lactamase inhibitors | hosp acquired pneumo, anaerobes
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| used for MRSA | vancomycin
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| not absorbed in GI so good for Cdiff | vancomycin
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| CNS penetration | vancomycin
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| causes red man syndrome when used IV | vancomycin
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| red man syndrome | nonimmunologic histamine release
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| MOA vancomycin | inhibits prostaglandin biosynthesis a step earlier than PCN and inhibits transpeptidases
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| uses of vancomycin | ALL G+
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| MOA cephalosporins | competitive inhibitor of transpeptidase
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| PCNs | cidal
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| cephalosporins | cidal
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| vancomycin | cidal
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| monobactams | cidal
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| carbapenems | cidal
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| 1st generation Ceph is more blank than blank | more Gm+ than Gm-
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| 3rd generation ceph is more blank than blank | more Gm- than Gm+
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| adverse effect of interfering with Vit K dependant clotting | 2nd gen ceph (cefaclor, cefoxitin, Loracarbef)
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| might be good for pseudomonas | 3rd gen ceph
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| good CNS penetration | 3rd gen ceph
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| tx meningitis | 3rd gen cep
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| tx meningitis | vancomycin
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| Cefepime | good Gm+ & Gm- coverage
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| nosocomial pneumonias (pseudomonas) | cefepime
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| empiric tx for febrile neutropenia | cefepime
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| ceftaroline | good for community acquired pneumonia
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| good for MRSA | ceftaroline
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| 1st ceph w/activity against MRSA | ceftaroline
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| 1st drug for CAP since 1998 | ceftaroline
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| broad spectrum & highly resistant to B lactamases | carbapenems
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| combined with cilastin | imipenem
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| cilastin | inhibits kidney enzyme that metabolizes the drug its combined with and protects from toxicity
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| good for MRSA | ertapenem
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| good for ESBL organisms | ertapenem
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| only Gm- | monobactams
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| used to tx septicemia | monobactams
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| single B lactam ring not fused with another | aztreonam
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| all 50s static except for | quinupristin/dalfopristin
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| chloramphenicol causes | bone marrow depression w/aplastic anemia
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| chloramphenicol causes | grey baby syndrome
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| used in Rickettsia | chloramphenicol
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| used in meningtitis when allergic to PCN, ceph | chloramphenicol
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| side effect of clindamycin | pseudomembranous c.diff
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| used when allergic to PCN & ceph | clindamycin
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| MOA clindamycin | inhibits toxin production by blocking protein synthesis
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| used in strep pyogenes & staph TSS | clindamycin
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| Gm+ | clindamycin
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| side effects of linezolid | bone marrow suppression (thrombocytopenia, anemia & leukopenia)
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| mostly Gm+ | linezolid
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| used for HAP, CAP, staph, MRSA, VRE | linezolid
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| metabolized cyp450 | macrolides
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| metabolized cyp450 | erythromyc & clarithromycin
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| causes QT prolongation | macrolides
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| interaction with anti-epileptics, warfarin, birth control | macrolides
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| have anti-inflammatory properties | macrolides
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| inhibit mononuclear cells, reduce superoxide by PMNs, modify release of cytokines, inhibit biofilms | macrolides
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| binds to 2 separate sites on protein - irreversible | quinupristin/dalfopristin
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| multi-drug resistant Gm+ cocci | quinupristin/dalfopristin
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| VRE | static quinupristin/dalfopristin
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| MSSA, MRSA, S.pyogenes | cidal quinupristin/dalfopristin
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| metabolized cyp450 | quinupristin/dalfopristin
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| side effects of quinupristin/dalfopristin | venous irritation
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| 30s | all static
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| tetracycline | also includes doxycycline
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| take this 1 hr before or 3hrs after eating | tetracycline
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| causes photosensitivity, teeth discoloration | tetracycline
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| monocycline side effects | lupus like reaction, vertigo, arthritis
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| tigecycline | slow IV infusion
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| used for MRSA, VRE, ESBL, MDR acinetobacter | tigecycline
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| NO activity against pseudomonas | tigecycline
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| spectinomycin | aminocyclitol abx, closely related to aminoglycosides
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| often used with PCN to facilitate crossing bacterial Cell wall | aminoglycosides
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| crosses CNS only with meningeal inflammation | aminoglycosides
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| oldest aminoglycoside | streptomycin
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| M/C used aminoglycoside | gentamycin
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| aminoglycoside used for pseudomonas | tobramycin
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| aminoglycoside with broadest spectrum | amikacin
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| topical, toxic aminoglycoside | neomycin
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| aminoglycoside side effects | vestibular, auditory & nephrotoxicity; neuromuscular blockade
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| Gm- enteric, Tularemia, tersinia pestis | aminoglycosides
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| Cidal | fluroquinolones
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| safe high blood levels with oral absorption and good tissue penetration | fluroquinolones
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| MOA fluorquinolones | inhibit DNA gyrase
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| good Gm- coverage | fluroquinolones
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| resistance is developind due to mutation in bacterial DNA | fluroquinolones
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| Naladixic acid | 1st generation fluroquinolones
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| side effect fluoroquinilones | tendon rupture & tendinitis
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| causes c.diff | fluroquinolones
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| side effects of ciprofloxin | inhibits GABA- and causes seizures in pt with renal insufficiency
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| used for chronic bone infxns | fluroquinolones
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| moxofloxacin | empiric coverage intra-ab infxn & broad spectrum & anaerobes
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| novel second generation lipoglycopeptide that belongs to same class as Vancomycin | dalbavancin
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| not yet FDA approved | dalbavancin
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| for hospital pt with difficult to tx MRSA | dalbavancin
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| telavancin | also a lipoglycopeptide
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| MOA telavancin | dual action - inhibits cell wall synthesis & dissipates cell membrane potential
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| qualified infectious disease product | used @ instutions with a specialist - telavancin
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| tefibazumab | monoclonal antibody that binds to the surface-expressed adhesion protein clumping factor A
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| daptomycin | newer class of cyclic lipopeptide
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| causes rapid depolarization Gm+ cell membrane potential inhibiting bacterial DNA, RNA & protein synthesis | daptomycin
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| side effect of daptomycin | constipation
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| potential for myopathy | daptomycin
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| monitor CPK when on this | daptomycin
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| broad Gm+ coverage of org resistant to methicillin & vancomycin | daptomycin
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| used in complicated skin & soft tissue infxn: MRSA, VRE, s.agalactiae | daptomycin
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| isoniazid MOA | interferes with biosyn of mycolic acid component of cell wall
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| isoniazid side effects | hepatotoxicity
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| can induce pyridoxine deficiency (Vit B6), causing pellagra manifested by peripheral neuritis, rash & anemia | isoniazid
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| rifampin MOA | inhibits DNA-dependent RNA polymerase
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| rifampin side effects | jaundice, red/orange sweat, urine, tears
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| used for TB & leprosy | rifampin
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| prophylaxis for exposure to N. meningitides | rifampin
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| induces p450 | rifampin
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| pyrazinamide | causes hepatotoxic, gout
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| ethambutol | crosses BBB
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| visual disturbance side effects | ethambutol
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| only 1st line TB that is bacterostatic | ethambutol
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| rifabutin MOA | inhibits DNA-dependent RNA polymerase
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| side effects rifabutin | uveitis, orange urine, sweat, tears
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| used in combo for prevention & tx M. avium or M. intracellulare | rifabutin
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| increases drug interactions with heart therapy | rifapentine & inh (drugs for latent TB)
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| take for 3 months | rifapentine & INH
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| take for 9 months | INH only
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| sulfonamides MOA | competitive inhibition DHPS which converts PABA in folate synthesis (important for DNA synthesis) therfore bacteriostatic
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| sulfonamides | no toxicity
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| diuretics, sulfonlylureas & acetazolamide | sulfa moity also present so beware sulfa allergy
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| sulfonamides side effects | steven-johnson syndrome, severe sun burn
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| used to treat UTIs, otitis media, sinusitis, bronchitis, MRSA | sulfonamides
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| topical silver sulfadiazine | tx burns
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| sulfadiazine | protect ppl w/RF from infx; tx toxoplasmosis
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| sulfasalazine | anti-inflammatory agent
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| metronidazole MOA | binds proteins & DNA - cell death
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| severe GI side effects | metronidazole
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| severe CNS depression in elderly side effects | metronidazole
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| drug of choice for psudomembranous colitis caused by Gm+ cdiff | metronidazole
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| tinidazole | shorter course of tx than the other amebicide
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| Leprosy | hansens disease
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| lepromatous leprosy | low cell-mediated immunity
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| lepromatous leprosy | organisms everywhere, skin, nevers, eyes, testes
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| lepromatous leprosy | leonine facies, saddle nose, peripheral neuropathy, digit absorption, blindness, infertility in men
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| tuberculoid leprosy | intact cell-mediated immunity
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| tuberculoid leprosy | difficult to isolate from skin or blood
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| tuberculoid leprosy | skin & nerves involved (1-2 superficial unilateral lesions)
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| most common cause of neuropathy worldwide | leprosy
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| Daptomycin | no activity against Gm-
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| becomes inactivated by pulmonary surfactant therefore not appropriate for pneumonia | daptomycin
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| methods to figure out MIC | dilution method & disc diffusion method
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| Bacteriocidal | have MBC similar to MIC
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| bacteriostatic | have MBC higher than MIC
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| stronger ABX | have very low MICs
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| MIC of resistant org | >2
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| four pharmacokinetic processes | absorption, distribution, metabolism, excretion
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| pharmacokinetics | how much of drug arrives at destination to have an effect
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| pharmacokinetics | determines time course of drug response & appropriate dosing strategies
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| pharmacodynamics | drug receptor interaction, pt functional status, placebo
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| pharmacodynamics | determines the nature & intensity of the response
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| pharmacodynamic/pharmacokinetic drug activity ration | PD/PK: takes into account the peak drug CONCENTRATION & length of TIME of drug exposure at site of infection - it is time/concentration!!
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| who produces beta lactamase | H. flu, M.catarrhalis, anaerobic bacteria, gonorrhea also now
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| B-lactamase production | binding is irreversible & cannot be overcome with higher dosing but CAN BE OVERCOME WITH B-LACTAMASE INHIBITORS
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jjohrden16
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