Shared Flashcard Set

Details

Antibiotics
Antibiotics
40
Pharmacology
Graduate
10/12/2013

Additional Pharmacology Flashcards

 


 

Cards

Term

Penicillin (G)

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugs: treponema, strep,pneumococci, enterococci, neisseria, anaerobes

Disease: Syphilis, pneumococcus, maybe endocarditis, meningitis, resp, tissue infections

Resistance: beta-lactamase producers

PK: take without food, mostly IV, penetrates most tissues, renal elimination, short half life, time-dependent killing

Adverse: hypersensitivity, seizures, Cdiff

Term

Nafcillin / Oxacillin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactamase resistant beta lactam

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugs: MSSA

Disease: MSSA soft tissue and skin infection, bacteremia

Resistance: change in PBP (--> MRSA)

PK: take without food, IV, penetrates most tissues, renal elimination, short half lifetime-dependent killing

Adverse: hypersensitivity, seizures, Cdiff

Term

Amoxicillin +/- Clavulanic Acid

Type, MOA, Bugs, Disease, Resistance, PK, Adverse, Combo

Definition

Type: extended spectrum beta-lactam

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan; also gram-negatives, enters outer membrane

Bugs: Enterococci, H. influenzae, listeria, ~E. coli

Disease: Oral=sinusitis, otitis media, lower resp, endocarditis prophylaxis (before dental procedures)

Resistance: beta-lactamase producers

PK: take without food, oral, penetrates most tissues, renal elimination, short half lifetime-dependent killing

Adverse: hypersensitivity, seizures, Cdiff

Combo: with beta-lactamase inhibitor:

Amoxicillin/Clavulanic acid (oral) --> gives MSSA, E. coli, anaerobe activity

Term

Piperacillin +/- Tazobactam

Type, MOA, Bugs, Disease, Resistance, PK, Adverse, Combo

Definition

Type: extended spectrum beta-lactam

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan; also gram-negatives, enters outer membrane

BugsPseudomonas, Klebsiella, enterococci

Disease: nosocomial pneumonia, bacteremia, UTI, osteomyelitis, soft tissue infections

Resistance: beta-lactamase producers

PK: take without food, IV, penetrates most tissues, renal elimination, short half lifetime-dependent killing

Adverse: neutropenia, hypersensitivity, seizures, Cdiff

Combo: with beta-lactamase inhibitor:

Piperacillin/Tazobactam --> gives MSSA, enterococci, Klebsiella, pseudomonas

 

Term

Ampicillin +/- Sulbactam

Type, MOA, Bugs, Disease, Resistance, PK, Adverse, Combo

Definition

Type: extended spectrum beta-lactam

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan; also gram-negatives, enters outer membrane

Bugs: Enterococci, H. influenzae, listeria, ~E. coli

Disease: serious gram-negatives (IV)

Resistance: beta-lactamase producers

PK: take without food, IV, penetrates most tissues, renal elimination, short half life

Adverse: rash in mono patients, hypersensitivity, seizures, Cdiff

Combo: with beta-lactamase inhibitor Sulbactam --> gives MSSA, E. coli, Bacteroides

Term

Cefazolin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - 1st gen ceph

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan; no CNS

Bugs: gram-positives (MSSA, pneumococci, GAS), gram-negatives

DiseaseMSSA, surgical prophylaxis (S. saprophyiticus)

Resistance: beta-lactamases like ESBL and AmpC

PK: IV, penetrates most tissues, renal eliminationtime-dependent killing

Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis

Term

Cephalexin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (oral) - 1st gen ceph

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugsgram-positives (MSSA, pneumococci, GAS), gram-negatives

Disease: UTIs, cellulitis, soft tissue infections

Resistance: beta-lactamases like ESBL and AmpC

PK: oral, penetrates most tissues, no CNS, renal eliminationtime-dependent killing

Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis

Term

Cefuroxime

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (oral / IV) - 2nd gen ceph

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugs: strep, pneumococci (PCN-resistant),  E. coli, Klebsiella

Disease: sinusitis (oral), otitis media, CA-pneumonia w/macrolide

Resistance: beta-lactamases like ESBL and AmpC

PK: oral/IV, penetrates most tissues, CNS, renal eliminationtime-dependent killing

Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis

Term

Cefoxitin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - 2nd gen ceph

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugsstrep, Bacteroides, E. coli, Klebsiella

DiseaseGI / peritonitis, diverticulitis

Resistance: beta-lactamases like ESBL and AmpC

PK: oral/IV, penetrates most tissues, no CNS, renal eliminationtime-dependent killing

Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis

Term

Cefotaxime

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - 3rd gen ceph

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugsstrep, gram-negatives (E. coli, Kleb, Proteus)

DiseaseCA-meningitis, PCN-resistant pneumococcus, CA-pneumonia w/macrolide

Resistance: beta-lactamases like ESBL and AmpC

PK: IV, penetrates most tissues, CNS, renal eliminationtime-dependent killing

Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis

Term

Ceftriaxone

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - 3rd gen ceph

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugs: pneumococcus, gram-negatives (E. coli, Kleb, Proteus), neisseria gonorrhoeae

DiseaseCA-meningitis (PCN-res pneumococcus), gonorrhea (PCN-res), UTI

Resistance: beta-lactamases like ESBL and AmpC

PK: IV, penetrates most tissues, CNS, liver eliminationtime-dependent killing

Adverse: Not for neonates, derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis

Term

Ceftazidime

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - 3rd gen ceph

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugspseudomonas, gram-negatives (E. coli, Kleb, Proteus)

Diseasesepsis, febrile neutropenia, HA-meningitis, HA-pneumonia

Resistance: beta-lactamases like ESBL and AmpC

PK: IV, penetrates most tissues, CNS, renal eliminationtime-dependent killing

Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis

Term

Cefaclor

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (oral) - 2nd gen ceph

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugsstrep, pneumococci, E. coli, Klebsiella

Diseasesinusitis, otitis media

Resistance: beta-lactamases like ESBL and AmpC

PK: oral, penetrates most tissues, no CNS, renal eliminationtime-dependent killing

Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis

Term

Cefpodoxime

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (oral) - 3rd gen ceph

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugspneumococcus, gram-negatives (E. coli, Kleb, Proteus)

Disease: sinusitis, CA-pneumonia, otitis media

Resistance: beta-lactamases like ESBL and AmpC

PK: IV, penetrates most tissues, no CNS, renal eliminationtime-dependent killing

Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis

Term

Cefepime

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - 4th gen ceph

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugspseudomonas, gram-negatives (E. coli, Kleb, Proteus), S. aureus, pneumococcus

Disease: HA-meningitis, sepsis, febrile neutropenia, HA-pneumonia

Resistance: beta-lactamases like ESBL (stable against AmpC)

PK: IV, penetrates most tissues, CNS, renal eliminationtime-dependent killing

Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis

Term

Ceftaroline

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - 5th gen ceph

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

BugsMRSA, MSSA, pneumococcus, gram-negatives (E. coli, H flu, neisseria)

DiseaseCA-pneumonia, skin infections

Resistance: beta-lactamases like ESBL and AmpC

PK: IV, penetrates most tissues, CNS, renal eliminationtime-dependent killing

Adverse: derm, leukopenia, superinfection (MRSA, enterococcus, Cdiff), maculopapular rash if allergic; don't use if PCN-allergy=anaphylaxis

Term

Aztreonam

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - monobactam

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan; time-dependent killing

Bugs: pseudomonas, only gram-negatives

Disease: if PCN-allergy: HA-sepsis, pneumonia, febrile neutropenia

Resistance: beta-lactamases

PK: IV, penetrates most tissues, CNS, renal eliminationtime-dependent killing

Adverse: derm, GI, elevated liver enzymes

Term

Imipenem

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - carbapenem

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugs: broad (pseudomonas, bacteroides, MSSA, strep, enterococcus, gram - incl. EBSL), nosocomial, multi-drug-resistant organisms; if PCN/ceph don't work

Disease: "icu bugs"

ResistanceCarbapanem-resistant enterobacteriaceae (KPC, NDM enzymes)

PK: IV, penetrates most tissues, CNS, renal elimination, cross-reactive with PCN-allergydegraded by renal dihydropeptidases (add clistatin)time-dependent killing

AdverseSeizures, not for meningitis, GI, derm, 

Term

Meropenem

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - carbapenem

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugs: broad (pseudomonas, bacteroides, MSSA, strep, gram - incl. EBSL), nosocomial, multi-drug-resistant organisms; if PCN/ceph don't work

Disease: post-neurosurgery meningitis (if seizures and/or kidney disease), "icu bugs"

ResistanceCarbapanem-resistant enterobacteriaceae (KPC, NDM enzymes)

PK: IV, penetrates most tissues, CNS, renal elimination, cross-reactive with PCN-allergytime-dependent killing

Adverse: GI, derm

Term

Doripenem

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - carbapenem

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugs: broad (pseudomonas, bacteroides, MSSA, strep, gram - incl. EBSL), nosocomial, multi-drug-resistant organisms; if PCN/ceph don't work

Diseaseintra-abdominal infections, complicated UTIs, "icu bugs"

ResistanceCarbapanem-resistant enterobacteriaceae (KPC, NDM enzymes)

PK: IV, penetrates most tissues, CNS, renal elimination, cross-reactive with PCN-allergytime-dependent killing

Adverse: seizures, GI, derm

Term

Ertapenem

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: beta-lactam (IV) - carbapenem

MOA: bactericidal cell wall synthesis inhibitor - binds to PBP on transpeptidase preventing peptidoglycan

Bugs: broad (bacteroides, MSSA, strep, enteric gram-negative incl. EBSL), nosocomial, multi-drug-resistant organisms; if PCN/ceph don't work; not pseudomonas

Diseasecommunity-acquired intra-abdominal infections, UTIs (E. coli), skin and soft tissue

ResistanceCarbapanem-resistant enterobacteriaceae (KPC, NDM enzymes)

PK: 1 dose per day, IV, penetrates most tissues, CNS, renal elimination, cross-reactive with PCN-allergytime-dependent killing

Adverseseizures, pseudomembranous colitis, GI, derm

Term

Vancomycin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Glycopeptide (IV or oral)

MOA: inhibits cell wall synthesis, binds to D-Ala-D-Ala to prevent elongation and cross-linking (step earlier than beta-lactams)

Bugs: GRAM-POSITIVESMRSA (sepsis, endocarditis), PCN-res pneumococcus (meningitis), surgical prophylaxisCdiff (oral), corynebacterium JK, MDR pneumococcus, enterococcus (w/aminoglycosides), strep

* bactericidal against staph + strep

Diseasemeningitis (need high dose), sepsis, endocarditis

ResistanceVRE (enterococcus faecium), VISA (S. aureus = thicker cell wall) 

PK: IV, no GI absorption if oral, penetrates most tissues, ~CNS, renal elimination, not cross-reactive with PCN-allergyAUC drug (time-dependent killing after reaching MBC)

Adverse: phlebitis, red man syndrome (too much non-allergic histamine release = slow infusion), nephrotoxicity, ototoxicity

Term

Telavancin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Lipoglycopeptide (IV)

MOA: inhibits cell wall synthesis, binds to D-Ala-D-Ala to prevent elongation and cross-linking (step earlier than beta-lactams) AND binds to lipid molecules in PM

Bugs: Gram-positives: MRSA, MSSA, CoNS, enterococcus, strep

Disease: soft tissue infections, pneumonia

Resistance: cross w/ Vanco: VRE (enterococcus faecium), VISA (S. aureus = thicker cell wall) 

PK: IV, 1 dose per day, penetrates most tissues, ~CNS, renal elimination, not cross-reactive with PCN-allergyAUC drug (time-dependent killing after reaching MBC), no TDM

Adverse: altered taste, nephrotoxicity, QTc prolongation, teratogenic (not for pregnancy)

Term

Chloramphenicol

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: chloramphenicol - protein synthesis inhibitor - bacteriostatic

MOA: 50S subunit, indirectly inhibits peptidyl transferase = growing chain not added to new AA

Bugs: broad, staph + strep (conjunctivitis), backup for salmonella, not chlamydia

Diseasebacterial conjunctivitis (Eye drops)

Resistance: plasmid, R factor acetyltransferases

PK: IV, drops, oral (not in US), CNSliver metabolism

Adverse: GI, superinfection, myelosuppression / irreversible aplastic anemia, grey baby syndrome (toxic because neonates have less liver enzyme activity)

Term

Chlortetracycline (not used much)

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Tetracycline - protein synthesis inhibitor - bacteriostatic

MOA: 30S subunit, blocks charged tRNA binding to A site

--> enters bacteria via active transport or passive diffusion (gram-negatives only)

Bugs: CA-mycoplasma, chlamydia, legionella, rickettsiae

Disease: intracellular bacteria

Resistance: plasmid, increased efflux

PK: take on empty stomach b/c tetracyclines are chlelators (and lose antibiotic power), crosses placentaliver metabolism

Adverse: staining kids' teeth, photosensitivity, not in pregnancy, GI, kidneys?

Term

Doxycycline

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Tetracycline - protein synthesis inhibitor - bacteriostatic

MOA: 30S subunit, blocks charged tRNA binding to A site

--> enters bacteria via active transport or passive diffusion (gram-negatives only)

Bugs: malaria, Borrelia burgdorferi (Lyme), CA-mycoplasma, chlamydia, legionella, rickettsiae, bartonella quintana (trench fever), leptospira, borrelia

Disease: intracellular bacteria

Resistance: plasmid, increased efflux

PKtake on empty stomach b/c tetracyclines are chlelators (and lose antibiotic power), crosses placenta, excreted in feces = GOOD FOR KIDNEY PATIENTS, 2x per day dosing

Adversestaining kids' teethphotosensitivity, not in pregnancy, GI, kidneys?

Term

Minocycline

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Tetracycline - protein synthesis inhibitor - bacteriostatic

MOA: 30S subunit, blocks charged tRNA binding to A site

--> enters bacteria via active transport or passive diffusion (gram-negatives only)

Bugs: CA-mycoplasma, chlamydia, legionella, rickettsiae, meningococcal carriers

Disease: intracellular bacteria

Resistance: plasmid, increased efflux

PK: metabolized in liver, take on empty stomach b/c tetracyclines are chlelators (and lose antibiotic power), crosses placenta, 2x per day dosing, oral

Adversestaining kids' teethphotosensitivity, not in pregnancy, GI, kidneys?

Term

Demeclocycline

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Tetracycline - protein synthesis inhibitor - bacteriostatic

MOA: 30S subunit, blocks charged tRNA binding to A site

--> enters bacteria via active transport or passive diffusion (gram-negatives only)

Bugs: CA-mycoplasma, chlamydia, legionella, rickettsiae, but not used as antibiotic --> against ADH-secreting tumors

Disease: intracellular bacteria

Resistance: plasmid, increased efflux

PKtake on empty stomach b/c tetracyclines are chlelators (and lose antibiotic power), crosses placenta, 2x per day dosing, oral

Adversestaining kids' teethphotosensitivity, not in pregnancy, GI, kidneys?

Term

Tigecycline

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Glycylcycline - protein synthesis inhibitor - bacteriostatic

MOA: 30S subunit, blocks charged tRNA binding to A site

--> enters bacteria via active transport or passive diffusion (gram-negatives only)

Bugs: MRSA, empiric monotherapy

Disease: severe infections (MRSA, intra-abdominal and skin infections)

Resistance: not substrate for efflux pump

PK: no renal adjustment needed for kidney patients (liver metabolized?), 1 dose per dayIV

Adversestaining kids' teethphotosensitivity, not in pregnancy, GI

Term

Azithromycin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Macrolide - protein synthesis inhibitor - bacteriostatic

MOA: 50S subunit, blocks translocation from A to P site

Bugs: GAS, Bartonella hensalae, Chlamydia (psittaci, pneumoniae, trachomatis for ocular and genital infections), mycoplasma pneumoniae

Disease: pharyngitis, cat scratch fever, chlamydia, walking pneumonia

Resistance: plasmid, reduced cell membrane permeability, esterases (enterobacteria), methylase (modified ribosomal binding site); cross-resistance w/ lincosamides (clindamycin) & streptogramins

PK: good oral bioavailability (peak delayed by food), most body tissues (higher in tissue than blood), elimiated unchanged in urine, not CYP450 metabolized, 2-4 day half life, oral/IV/eye

Adverse: Gi, derm, eosinophilia, hepatic problems?, not in pregnancy, QT interval problem in elderly

Term

Erythromycin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Macrolide - protein synthesis inhibitor - bacteriostatic

MOA: 50S subunit, blocks translocation from A to P site

Bugs: Bordetella pertussis, chlamydia trachomatis, legionella pneumophila, mycoplasma pneumoniae

Disease: whooping cough, newborn conjunctivits/pneumonia, legionnaires disease, walking pneumonia

Resistance: plasmid, reduced cell membrane permeability, esterases (enterobacteria), methylase (modified ribosomal binding site)

PK: biliary excretion, CYP450 inhibitor, good oral bioavailability, most body tissues, oral/IV/eye

Adverse: Gi, derm, eosinophilia, hepatic problems?, not in pregnancy, QT interval problem in elderly

Term

Clarithromycin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Macrolide - protein synthesis inhibitor - bacteriostatic

MOA: 50S subunit, blocks translocation from A to P site

Bugs: GAS, mycoplasma pneumoniae, corynebacterium diphtheria

Disease: pharyngitis, walking pneumonia, diphtheria

Resistance: plasmid, reduced cell membrane permeability, esterases (enterobacteria), methylase (modified ribosomal binding site)

PKliver metabolism, renal excretionCYP450 inhibitor, good oral bioavailability, most body tissues, oral/IV

Adverse: Gi, derm, eosinophilia, hepatic problems?, not in pregnancy, QT interval problem in elderly

Term

Clindamycin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Lincosamide - protein synthesis inhibitor - bacteriostatic

MOA: 50S subunit, blocks translocation from A to P site

Bugsbacteroides, endocarditis prophylaxis, GAS

Diseaseperitonitis, pharyngitis

Resistance: plasmid, methylase (modified ribosomal binding site), enzymatic inactivation; cross-resistance w/ macrolides & streptogramins

PK: oral and IV, good oral bioavailability, crosses placenta & breast milk, not CNS, renal & biliary excretion, oral/IV

Adverse: Gi, Cdiff + pseudomembranous colitis, neutropenia, derm (HIV); don't use w/macrolides

Term

Quinupristin/Dalfopristin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Streptogramin - protein synthesis inhibitor - bactericidal (70% Dalfo = "A", 30% Quinu = "B")

MOA: 50S subunit, constricts exit channel: Dalfo makes Quinu bind better; Quino inhibits protein elongation (like macrolide)

Bugs: resistant gram-positives pneumococcus (PCN-res), VRSA, MRSA, VRE, MSSA, MSStrepA

Diseaseresistant gram-positive infections

Resistance: dalfo inactivation, change quinu binding site, efflux of molecule; cross-resistance w/macrolides and lincosamides (clindamycin)

PK: IV, hepatic metabolism: CYP3A4 inhibitor, non-renal elimination, post antibiotic effect

Adverse: infusion-related, arthralgia/myalgia if hepatic insufficiency

Term

Linezolid

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Oxalidinone - protein synthesis inhibitor - bactericidal/static

MOA: 50S subunit (23S part), inhibits initiation

Bugsgram-positives: strep (bactericidal), staph, enterococcus (bacteriostatic)

Diseaselast resort for resistant gram-positives

Resistance: ribosomal binding site change (enterococci)

PK: IV or oral (~100% bioavailable), low protein binding, non-enzymatic oxidation into 2 metabolites, no dose change needed for kidney patients, no CYP metabolism

Adversethrombocytopenia, optic + peripheral neuropathy, weak MAO inhibitor (serotonin syndrome)

Term

Amikacin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Aminoglycoside - protein synthesis inhibitor - bactericidal

MOA: 30S subunit, misreading of mRNA template, inhibits translocation

Bugspseudomonas, E. coli, enterobacter, klebsiella, proteus, serratia

Disease: nosocomial pneumonia and febrile neutropenia (w/ceftazidime or cefipime), endocarditis (w/vanco)

Resistance: plasmid, impaired entry, inactivating transferases, change in binding site

PKconcentration-dependent killingpost antibiotic effect, one large dose per daypoor oral bioavailability (used for GI), IV, renal elimination, TDM needed

AdverseOtotoxicity (auditory impairment), Nephrotoxicity, careful with other drugs that cause similar things (loop diuretics); synergy w/ beta lactams

Term

Gentamycin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Aminoglycoside - protein synthesis inhibitor - bactericidal

MOA: 30S subunit, misreading of mRNA template, inhibits translocation

Bugspseudomonas, E. coli, enterobacter, klebsiella, proteus, serratia

Diseasenosocomial pneumonia and febrile neutropenia (w/ceftazidime or cefipime), endocarditis (w/vanco)

Resistance: plasmid, impaired entry, inactivating transferases, change in binding site

PKconcentration-dependent killingpost antibiotic effect, one large dose per daypoor oral bioavailability (used for GI), IV, renal elimination, TDM needed

AdverseOtotoxicity (vestibular impairment), Nephrotoxicity, careful with other drugs that cause similar things (loop diuretics); synergy w/ beta lactams

Term

Streptomycin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Aminoglycoside - protein synthesis inhibitor - bactericidal

MOA: 30S subunit, misreading of mRNA template, inhibits translocation

Bugs: mycobacteria tuberculosispseudomonas, E. coli, enterobacter, klebsiella, proteus, serratia

Disease: tuberculosis, nosocomial pneumonia and febrile neutropenia (w/ceftazidime or cefipime), endocarditis (w/vanco)

Resistance: plasmid, impaired entry, inactivating transferases, change in binding site

PKconcentration-dependent killingpost antibiotic effect, one large dose per daypoor oral bioavailability (used for GI), IV, renal elimination, TDM needed

AdverseOtotoxicity (vestibular impairment), Nephrotoxicity, careful with other drugs that cause similar things (loop diuretics); synergy w/ beta lactams

Term

Tobramycin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Aminoglycoside - protein synthesis inhibitor - bactericidal

MOA: 30S subunit, misreading of mRNA template, inhibits translocation

Bugspseudomonas, E. coli, enterobacter, klebsiella, proteus, serratia

Diseasenosocomial pneumonia and febrile neutropenia (w/ceftazidime or cefipime), endocarditis (w/vanco)

Resistance: plasmid, impaired entry, inactivating transferases, change in binding site

PKconcentration-dependent killingpost antibiotic effect, one large dose per daypoor oral bioavailability (used for GI), IV, renal elimination, TDM needed

AdverseOtotoxicityNephrotoxicity, careful with other drugs that cause similar things (loop diuretics); synergy w/ beta lactams

Term

Daptomycin

Type, MOA, Bugs, Disease, Resistance, PK, Adverse

Definition

Type: Cyclic lipopeptide - bactericidal

MOA: Depolarizes bacterial cell membrane -> rapid cell death

Bugsgram-positives (MSSA, MRSA, GAS, E. faecalis)

Disease: skin infections, endocarditis?

Resistance: ?

PK: IV, mostly protein-bound, no hepatic metabolism, renal and biliary excretion (adjust dose if kidney patient)

Adverse: monitor creatine phosphokinase, may decrease conduction velocitycardiorespiratory (diaphragm); not for pneumonia; interaction w/ statins

Supporting users have an ad free experience!