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abx indications
Clinical indications for various antimicrobials
| Question | Answer |
|---|---|
| List the 6 major bacteriocidal antibiotics | Vancomycin, FQs, penicillins, metronidazole, cephalosporins, aminoglycosides"Very Fat People Make Crappy Athletes""very fat people make crappy athletes" |
| Bacteriocidal for gram(+) cocci, gram (+) rods, gram (-) cocci, and spirochetes. | Penicillin |
| Used for S. aureus (except for MRSA) | Penicillinase-resistant penicillins (methicillin, nafcillin and dicloxacillin) |
| Used for gram (+)bacteria and gram (-) rods. Heomophilus influenzae, E. coli, Listeria monocyotogenes, Proteus mirabilis, Salmonella, enterocccia | Aminopenicillins: Ampicillin and Amoxicillin. Extended spectrum penicillin... spectrum even larger when given with clavulinic acid.Mnemonic: Amox/AMP HELPS kill enterococci (HELPS = spectrum of bacteria covered) |
| Used for tx of pseuomonal infections / gram (-) rods. Use with clavulinic acid | anti-pseudomonals: Ticarcillin, piperacillin, carbenicillin. (TCP "Takes Care of Pseudomonas") |
| Effective against Gram (+) cocci, Proteus miribilis, E. coli, Klebsiella pneumoniae. | 1st gen cephalosporins (cefazolin, cephalexin)(PEcK) |
| Effective against Gram (+) cocci, Haemophilus influenzae, Enterobacter aerogenes, Neisseria, Proteus mirabilis, E. coli, Klebsiella pneumoniae, and Serration marcescens. | 2nd gen cephalosporins (cefoxitin, cefuroxime) "HEN PEcKS"Same as 1st gen plus Haemophilus, Enterobacter aergenes, Nisseria, and Serratia marcescens. |
| High activity against gram (+) bacteria, as well as pseudomonas | 4th generation cephalosporines (cefepime, cefpiramide) |
| indicated for serious gram (-) infxon that are resistant to other beta-lactams; meningitis | 3rd generation cephalosporins: ceftriaxone (gonorrhea), ceftazidime (pseudomonas), ceftaxime. |
| Effective against gram (-) rods - Klebsiella, Pseudomonas, Serratia. No gram (+) or anaerobe activity. Indicated in pt with allergy to penicillin | Aztreonam |
| Drug of choice for enterobacter infxon | Meropenem or imipenem + cilastatin |
| Effective against gram (+) cocci, gram (-) rods, and anaerobes. | Meropenem or imepenem + cilsstatin |
| Used for serious, multidrug resistant gram (+) infxons, including C. diff and MRSA. | Vancomycin |
| what are the 2 major 30S inhibitors | Aminoglycocides and tetracyclines |
| What are the 4 major 50S inhibitors | Chloramphenicol, Erythromycin, Lincomycin, CLindomycin. (CELL) |
| ABx DOC for bowel surgery | Neomycin |
| Used for severe gram (-) rod infxonsm but has no action against anaerobes. Synergistic with B-lactam ABx, | Aminoglycosides (gentimicin, neomycin, amikacin, tobramycin, streptomycin). Nephrotoxic, Ototoxic, Teratogenic"Mean GNATS canNOT kill anaerobes" |
| Effecive against: Vibrio cholera, Acne, Chlamydia, Ureaplasma urealyticum, Mycoplasma pneumoniae, Tularemia, H. pylori, Borrelia burgdorferi (lyme disease), Rickettsia. | Tetracyclines. "VACUUM THe BedRoom" is the mnemonic for the spectrum of this drug |
| DOC for lyme disease | tetracycline "tetracYcline for lYme disease (borrelia burgdorferi)" |
| indicated for URIs, pneumonias, STDs - gram (+) cocci, Mycoplasma, Legionella, Chlamydia, Neisseria. | Mactrolides |
| Rx for pt with streptococcal infxon and an allergy to penicillin | macrolides. (strep is gram(+) so aztreonam would not work) |
| Used as an alternative to for meningitis due to Haeomophilus influenzae, N. meningitidus, Strep. Pneumoniae, as well a bacteroides and rickettsial infxon in pts with allergies and/or c/i. | Chloramphenicol. Limited use/ only used as an alternative drugUse conservatively as it is very toxic |
| First line for bacteroides infxon | Metronadazole, clindamycin, or cefoxetem. |
| Binds at 50S subunit and is used in treatment of anaerobic infxon above the diaphragm ( e.g. Bacteroides fragilis and Clostridium perfringens) | clindamycin |
| Rx for simple UTI | TMP-SMX |
| Used for gram (+), gram (-), nocardia, chlamydia and simple UTIs | Sulfonamides |
| Causes kernicterus in infants | Sulfonamides |
| Causes hemolysis in G6PD deficient pt | Sulfonamides |
| Displaces other drugs from albumin (ie; warfarin) | Sulfonamides |
| This drug is used in combination with sulfonamides for the sequential inhibirion of folate synthesis | trimethoprim |
| Used for tx of gram (-) rods of urinary and GI tract (inluding pseudomonas), as well as neiserria and some gram (+)s | FQs |
| Used for anaerobic infxon below the diaphragm | Metronidazole. |
| Used for Giardia, Entamoeba, Trichmonas, Gardnerella vaginalis, anaerobes (bacteroides and closridium) | Metronadazole (below the diaphragm: metronadazole, above: clindamycin) |
| Prophylaxis against TB | Isoniazid (INH) |
| Meningicoccal prophylaxis in contacts of children with Haemophilus influenza type B | Rifampin |
| Features of rifampin (the 4 R's) | RNA polymerase, Revs up microsomal p-450, red/orange body fluids, Rapid resistance if used alone |
| Prophlaxis and tx of influenza A that blocks viral replication/ uncoating | Amantadine |
| One of the side effects of this drug is the release of DA from nerve terminals, causing ataxia | amantadine |
| Inhibits influenza neuraminidase, for tx of influenza A and B | Zanamivir and oseltamivir |
| Inhibits synthesis of guanine nucleotides n inhibitting IMP dehydrogenase. | Ribavirin |
| Used to treat RSV and chronic hep C | Ribavirin |
| Preferentially inhibits viral DNA polymerase when phosphorylated by viral thymide kinase | Acyclovir |
| Used to treat genital herpes lesions, HSV, VZV, EBV | Acyclovir |
| Activated by viral kinase, itInhibits CMV DNA polymerase for treatment of CMV in immunocomp'd pts. | Ganciclovir |
| This viral DNA inhibitor binds to the pyrophosphate binding site of the enzyme, and does not require viral kinase activation | Foscarnet |
| Used for treatment of CMV retinitis when ganciclovir fails or in acyclovir resistant HSV | Foscarnet |
| Inhibits assembly of new virus by blocking protease release in progeny virus | Protease inhibitors: Saquinavir, ritonavir, indinavir, nelfinavir, amprenavir |
| Used during pregnancy to reduce risk of fetal transmission of HIV`` | AZT (ZIDUVIDINE) - a reverse transcriptase inhibitor that is a nucleoside |
| Non-nucleoside reverse xcriptase inhibitors | Nevirapine, efavirenz, delavirdine. "Never Ever Deliver nucleosides" |
| Antimicrobials to avoid during pregnancy | Sulfanamides, Aminoglycosides, FQs, Eryhtromycin and clarithromycin, Metronadazole,Tetracyclines, Ribavarin, Griseofulvin, Chloramphenical |
Created by:
rkirchoff
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