Clinical use of antibiotics lecture
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| Name the beta lactams | penicillin, cephalosporins, monobactams, carbapenems
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| Penicillin is #1 for what treatment? | Strep throat (Strep A)
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| Methicillin used to be treated for what? | Staph aureus
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| Why is Aztreoname called a monolactam? | Because there is only 1 lactam ring
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| Are carbapnems broad spectrum or narro? | Imipnem is broad
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| Can carbapenems treat MRSA? | No
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| Name an example of a beta lactamase inhibitor | Clavulamic acid
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| What do beta lactamase inhibitors do? | Inactivates enzyme, therefore other biotic is useful
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| What do piperacillin/TaTazobactam used against? | P. aeroginosa, anaerobes
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| What are ceftriaxones used against? | Meningitis/endocarditis/Lymes
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| What are ceftazidime/Cefepime used against? | P. Aeroginosa, meningitis
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| What is Meropenem used against? | Meningitis
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| What is Aztreonam used against? | Aerobic gram negative bacilli
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| What is the treatment for VRE? | No beta lactams
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| What is the important side effects of beta lactams? | Anaphylactic rxn, cutaneous skin rxns, destruction of blood, renal rxns, serum sickness, drug fever, systemic vasculitis, lymphadenopathy
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| In patient hx, what should you always ask? | Penicillin resistance
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| What are teh advantages of beta lactams | Well tolerated no kidney/liver toxiticity, bacteriocidal
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| What are teh disadavnatages of beta lactams? | Allergic rxns, frequent dosing,
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| What do macrolides treat? | Strep pneumoniae, strep pyogenes, H influenza, legionella, mycoplasma
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| What is the first choice treatment for atypical pneumoniae? | Azithromycine
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| What do macrolides also treat? | H. pylori, MAC, toxo, lyme
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| Strep pneumoniae is now resistant to macrolides t/f? | true
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| What is the toxicity of ketolides? | Liver
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| What is the moa of clindamyclin? | 50s ribosome, exact same site as macrolides
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| What is it used for?(Clindamycin) | Anaerobes
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| What are the side effects of clindamycin | Diarrhea, (C. difficile associated), Allergic, Abnormal LFTS
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| What is the MOA of sulfamethoxanzole? | Inhibits THPacid
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| What si teh trimethoprim/sulfamethoxazole used for? | PCP
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| What are teh main side effects of sulfa drugs? | allergic/bone marrow
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| What protozoa does metronidazole target? | Giardia, Ameobea, Trichonemas
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| What are metronidazole most effective for? | Anaerobes
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| What are the side offects of metronidazole | GI upset, metallic taste, don't drink alcohol
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| What is rifampin used for? | Mostly aerobic bacteria
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| Is rifampin used alone? | Nope, always in combination
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| What is the side effect of rifampin? | Orange
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| What do aminoglycosides cover? | Gram negative
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| What are the side effects of aminoglycosides? | Nephrotoxicity, ototoxicity,
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| What AB has a post antibiotic effect? | aminoglycosides
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| aminoglycosides time or concentration dependent? | concetnration
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| Are quinolones time or concentration dependent? | Time
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| Name one side effect of fluoronoquines | QT interval, Tendons
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| What is vancomycin used for? | MRSAs, c difficile
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| Side effects of vancomycin? | Renal toxicity, Red man
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| What is the MOA of linezolid? | Protein inhibitors
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| What is the linezolids used against? | Gram +ves
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| What is linezolids toxicity? | GI toxicity, marrow toxicity, weak MOA inhibitor (prozac like drug)
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| Wha is the moa of daptomycin? | Kills bacterial membrane
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| What should you follow iwth daptomycin? | CPK (side effect)
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| What is our last hope for killing bacteria ? | Polymixin.
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