DCPA Antibiotics
Help!
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| Colonization | Presence of microbe in a host does not cause a specific immune reaction or infection (Do NOT Tx w/ Abx)
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| Empiric Therapy | Abx choice based on clinically most likely pathogen
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| Definitive Therapy | Abx choise based on identified pathogen & susceptibilty patterns
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| De-escalation | Adjustment of Abx regimen from broad to narrow spectrum
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| Collateral Damage | Unwanted negative effect of an Abx on NMF
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| Minimum Inhibitory Concentration (MIC) | Minimum [] that inhibits groth of organism
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| Antibiogram | Compilation of data for bacteria vs. abx
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| Gram (+) Cocci bacteria | S. Aureus, Staph Epidermidis, Strept Pyogenes, Strep Agalactiae, S. pneumoniae, enterococci, Strp bovis, Viridans Strep, Strep intermedius
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| S. Epidermidis infections | Associated with "hardware"
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| Enterococci infections | UTI, appendicitis
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| Strep Bovis Infections | Bowel lesion = spread of infection
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| Strep. Intermedius Infections | Abcess Formers
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| Gram (+) Bacilli Bacteria | **Usually erroneous Sample** Corneybacterium Diptheriae, Listeria Monocytogenes, Bacillus Antracis, Erysipelothrix Rhusiopathiae
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| Listeria Monocytogenes Infections | Meningitis (Can't eat cheese in 2nd/3rd trimester)
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| Gram (-) Cocci Bacteria | Neisseria Meningitidis, Neisseria Gonorrhoeae, Moraxella (Branhamella) Catarrhalis
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| Gram (-) Bacilli Bacteria | Vibrio cholerae, Campylobacter jejuni, H. Pylori, Pseudomonas Aeruginosa, Salmonella, H. Influenza, Brucella, Francisella Tularensis (Tularemia), Pasturella Multocida, Legionella Pneumophilia, Bartonella, Shigella, Enterobacter (E. Coli, etc.)
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| Pasturella Multocida Caused by... | Bites (Mouths) or Cats & dogs
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| Bartonella caused by... | Cat scratch
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| Anaerobes | Clostridium tetani, C. botulinum, C. Difficile, C. Perfringens, Bacteroides, Fusobacterium, Peptostreptococcus, Prevotella
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| Clostridium Perfringens Infection | Gas Gangrene
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| Beta-Lactum Drugs | Penicillin, Cephalosporin, Carbapenems, Aztreonam
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| Beta-Lactums MOA | Interferes with cell wall synthesis
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| Glycoprotein MOA | Interferes with cell wall synthesis
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| Fluoroquinolones MOA | Interferes with DNA replication, transcription
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| Rifampin MOA | Interferes with DNA replication, transcription
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| Aminoglycosides MOA | Binds to 30s/50s Ribosomal Subunit
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| Macrolides MOA | Binds to 30s/50s Ribosomal Subunit
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| Ketolides MOA | Binds to 30s/50s Ribosomal Subunit
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| Oxazolidinones MOA | Binds to 30s/50s Ribosomal Subunit
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| Tetracyclines MOA | Binds to 30s/50s Ribosomal Subunit
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| Streptogramins MOA | Binds to 30s/50s Ribosomal Subunit
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| Broad Spectrum Drugs | PCN (Penicillin), 3rd/4th generation Cephalosporins, Carbapenems
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| Narrow Spectrum Gram(+) Drugs | Vancomycin
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| Narrow Spectrum Gram(-) Drugs | Aminoglycosides, Aztreonam
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| Narrow Spectrum Anaerobes Drugs | Metronidazole (Flagyl)
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| Pharmacokinetics | Absorption (Bioavailability), Distribution, Metabolism, Elimination
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| Pharmodynamics | Relationship between drug concentration & effect "Antibiotic Potency"
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| Bioavailability | % of oral dose available compared to IV form (100%)
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| Clearance | Determines steady state of drug (determined by blood flow to metabolizing organ & rate of extraction of the drug from blood)
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| Volume of Distribution | Relates the amount of drug in the body to the serum drug concentration (Dependent on BMI)
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| Steady State | After 3 half lives
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| Postantibiotic Effect (PAE) | Delay before organisms recover & begin growing despite decrease concentration of drug
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| Four Primary Machanisms of Resistance. | Alterations in outer membrane permeability. Alteration in drug binding sites, Production of molecules capable of inactivating drug molecules. Active efflux of antibiotic from the bacteria.
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| Abx. dosing & duration | DONT under dose/increase duration = resistance
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| Bacterocidal Drugs | Beta Lactams, Cephalosporins, quinolones, aminoglycosides
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| Bacterostatic Drugs | Clindamycin, macrolides, sulfonamides, Tetracycline
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| Aminoglyc. Accumulation | Nephrotoxic (reversible) & Toxic to the Ear (irreversible)
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| Drugs that penatrate the BBB to the CSF | AG's, clindamycin
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| Difficult tissue to penetrate | Bone, synovial fluid, prostate, Abscesses, Peritoneal Fluid
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| DOC | Drug of Choice
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| IND | Indications
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| ADR | Adverse Reactions
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| W/P | Warnings & Precautions
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| SSSI | Skin & Soft Tissue Infections
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| Anaphylaxis | (IgE) Hives (Uticaria). Respiratory Difficulty (Bronchospasm). Swelling. Occurs within the first 72 hours.
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| Most common drug allergy | Penicillin
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| Penicillin ADR | Maculopapular rash, rash, uticarial rash, fever, bronchospasm, vasculitis, serum sickness, exfoliative dermatitis, Stevens-Johnson, Anaphylaxis (ordered in decreasing frequency & increasing severity.)
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| Penicillin half life | Short: 30-60 minutes (rapid renal excretion)
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| Penicillin Types | Natural, Penicillinase-resistant, Aminopenicillins, Extrended-spectrum ureidopenicillins, B-lactam/B-lactamase Inhibitors
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| Natural Penicillin Drugs & forms | Penicillin G (IV/IM) & Penicillin V (PO)
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| Natural Penicillin effective against... | B-hemolytic strept, most anaerobes, viridans strep, N. meningitidis.
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| Natural Penicillin DOC | Strep. Pneumoniae
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| Natural Penicillin R | Actinomyces, meningococcus, Pasteurella, S. Pneumoniae, S. pyogenes, T. Pallidum.
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| Natural Penicillin Pregnancy Category | C
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| Natural Penicillin ADR | Seizures or hemolytic anemia
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| Penicillinase-resistant penicillins drugs & forms | Oxacillin/Nafcillin (IV) & Dicloxacillin (PO-empty stomach)
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| Penicillinase-resistant penicillins effective against... | ?
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| Penicillinase-resistant penicillins ADR | GI cramps, rash, neutropenia (prolonged Rx - especially with nafcillin), acute interstitial nephritis
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| Aminopenicillin Drugs | Ampicillin (IV/PO), Amoxicillin (PO)
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| Aminopenicillin covers | Enterococci, E.coli, H. influenza, Proteus, Klebsiella
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| Aminopenicillin W/P | Renal Insufficiency & Cephalosporin allergy
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| Aminopenicillin ADR | Rash & GI upset
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| Extended-spectrum ureidopenicillins drugs & forms | Pipercillin (IV) usually used in combination!
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| Extended-spectrum ureidopenicillins covers | Anaerobes, enterobactericacae & pseudomonas
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| Extended-spectrum ureidopenicillins W/P | Severe renal impairment & allergies to cephalosporins
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| Extended-spectrum ureidopenicillins ADRs | GI & dermatology
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| B-lactamase inhibitor drugs | ampicillin/sulbactam (Unasyn - IV) Pipercillin/Tazobactam (Zosyn-IV) Aoxicillin/clavulante (Augmentin-PO)
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| Unasyn ingrediants | Ampicillin & sulbactam
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| Zosyn ingrediants | Pipercillin & tazobactam
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| Augmentin ingrediants | Amoxicillin & Clavulanate
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| B-lactamase inhibitor SE | Diarrhea (increased with clavulanate)
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| Penicillin Class drug interactions | Decrease OCP efficiancy. Increases warfarins effect.
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| Penicillin Class ADRs | Seizure potential with high doses. Inhibit platelet aggregation.
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| Cephalosporins types | 1st generation-4th generation
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| Cephalosporins pregnancy categroy | B
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| Cephalosporins ADRs | Increase C. difficile colitis & VRE
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| 1st generation cephalosporins drugs & forms | Cefazolin - Ancef(IV) & Cephalexin - Keflex (PO)
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| Cefazolin | Ancef
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| Cephalexin | Keflex
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| 1st generation cephalosporins coverage | Better gm +
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| 1st generation cephalosporins uses | surgical prophylaxis, SSSIs & UTI
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| 2nd generation cephalosporins coverage | Less gram + & more gram -
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| 2nd generation cephalosporins drugs | Cefuroxime (Ceftin) - PO. Cefotetan (Cefotan) - IV.
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| Cefuroxime (Ceftin) covers | strep, haemophilus, E. coli, Proteus, Klebsiella
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| Cefuroxime (Ceftin)uses | URI/L RTIs, Otitis Media, COPD exacerbations, sinusitis.
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| Cefuroxime | Ceftin
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| Cefotetan | Cefotan
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| Cefotetan (Cefotan) covers | B. frgilis & other bowel anaerobes
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| Cefotetan (Cefotan) uses | abdominal infections, bowel surgery prophylaxis, OB/GYN infections (PID)
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| 3rd generation cephalosporin coverage | weak gram + & good gram -
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| 3rd generation cephalosporin drugs | Ceftriaxone (Rocephin) - IV. Ceftazadime (Fortaz - IV. Cefpodoxime (Vantin) - PO. Cefixime (Suprax) - PO
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| Ceftriaxone | Rocephin
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| Ceftriaxone (Rocephin) ADRs | Biliary sludging b/c its eliminated via biliary excretion
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| Ceftriaxone (Rocephin) coverage | Severe gram (-) infection & Meningitis
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| Ceftazadime | Fortaz
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| Ceftazadime (Fortaz) coverage | Pseudomonas
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| Cefpodoxime | Vantin
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| Cefixime | Suprax
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| Cefpodoxime (Vantin) & Cefixime (Suprax) coverage | URIs & RTIs
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| 4th Generation Cephalosporin drug & form | Cefepime (IV)
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| Cefepime covers | Pseudomonas, gram (-) rods (enterobacter, serratia & citrobacter).
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| Cefepime uses | Febrile neutropenia, hospital acquired pneumonia, serious gram (-) infections.
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| Carbapenems drugs | Imipenem/cilastatin (Primaxin) - IV. Meropenem (IV). Ertapenem (Invanz)- IV.
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| Primaxin | imipenem/cilastatin
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| Carbapenems covers | gram +'s including MSSA, grams -'s & anaerobes.
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| Primaxin (Imipenem/cilastatin) uses | pseudomonas & polymicrobial infections.
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| Primaxin (Imipenem/cilastatin) ADR | N/V & decreases seizure threshhold.
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| Primaxin (Imipenem/cilastatin) W/P | Hx of seizures
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| Primaxin (Imipenem/cilastatin) pregnancy category | C
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| Meropenem ADR | Less seizures & N/V
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| Meropenem pregnancy category | B
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| Meropenem coverage decreased in | Staph & strep
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| Ertapenem | Invanz
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| Ertapenem (Invanz) does not cover | pseudomonas
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| Monobactam drug & form | Aztreonam (Azactam) - IV
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| Aztreonam | Azactam
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| Aztreonam (Azactam) coverage | Gram negative ONLY
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| Aztreonam (Azactam) pregnancy category | B
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| Aztreonam (Azactam) SE | Well tolerated
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| Aminoglycoside drugs | Gentamicin, Tobramycin & amikacin (all IV; not absorbed well)
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| Aminoglycoside coverage | Gram - (Pseudomonas)
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| Aminoglycoside decreased effectivness by | Abscesses
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| Aminoglycoside Pregnancy category | D
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| Aminoglycoside uses | Always used in combo: serious gram (-) infections or b-lactam for synergy
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| Macrolides drugs | Erythromycin (Iv, PO, Opth). Clarithromycin (Biaxin) - PO. Azithromycin (Zithromax) - IV/PO
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| Clarithromycin | Biaxin
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| Azithromycin | Zithromax
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| Macrolides Pregnancy category | B (eryth, Azith) & C (Clarith)
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| Macrolides coverage | pneumococcus, atypicals, H. influenza
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| Macrolides Uses | OM, CAP, COPD, STD
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| Macrolides ADR | GI (take with food) & QT prolongation
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| Clarithromycin (Biaxin) DOC | Eryth-sensitive strains of streptococci
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| Azithromycin (Zithromax) DOC | H. Influenza & Chlamydia
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| Azithromycin (Zithromax) half life | 68 hours
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| Fluoroquinolone drugs | Ofloxacin, ciprofloxacin (Cipro), Levofloxacin (Levaquin), Moxifloxacin (Avelox), Gatifloxacin (Tequin), Gemifloxacin (Factive)
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| Fluoroquinolone coverage | good gram (-), alright gram (+)
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| Fluoroquinolone DOC | Legionella
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| Cipro & Levaquin cover | Pseudomonas
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| Fluoroquinolone pregnancy category | C
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| Fluoroquinolone CI | <18y.o. (arthropathy)
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| Fluoroquinolone ADR | N/V/D, CNS (HA, restlessness), decrease seizure threshhold, tendon rupture (spontaneous - achilles), increase in AST/ALT
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| Fluoroquinolone DI | Aluminum/Mg antacids, sulcralfate, Ca2+, Fe2+ & Zinc - decrease absorption. Increases the effect of warfarin (except moxifloxacin & gatifloxacin)
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| Fluoroquinolone uses | CAP (includes atypicals), UTIs/pyelonephritis, COPD, acute exacerbation of chronic bronchitis, sinusitis
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| Tetracycline drugs | tetracycline, doxycycline, minocycline
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| Tetracycline coverage | Broad - including rickettsia, mycoplasma & chlamydia
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| Tetracycline pregnancy category | D
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| Tetracycline CI | < 8 y.o. (permanent discoloration of the teeth & inhibits bone growth)
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| Tetracycline Use | CAP, STD (Chlamydia), syphilis (pen-allergic pts.), Lyme dz, acne, community acquired MRSA
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| Tetracycline ADR | GI, photosensitivity, erosive esophagitis, vestibular sx (drunk/off balance), liver damage (rare)
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| Tetracycline DI | Increased effect of warfarin
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| Vancomycin Forms | IV & PO(C. difficile only)
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| Vancomycin MOA | Inhibits cell wall growth ("slowly" cidal)
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| Vancomycin coverage | gram +'s (MRSA, MRSE) & mild-mod anaerobic
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| Vancomycin pregnancy category | C
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| Vancomycin ADR | Redman syndrome (nonallergic rash on face/chest, flushing & hypotension), reversible neutopenia
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| Vancomycin administration | Given slowly (over an hour)
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| Vancomycin special abilities | Penetrates CSF
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| Clindamycin | Cleocin
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| Clindamycin (Cleocin) forms | IV, PO, Topical (acne), Vaginal
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| Clindamycin (Cleocin) class | Lincomycin
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| Clindamycin (Cleocin) MOA | Inhibits protein synthesis
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| Clindamycin (Cleocin) Coverage | **anaerobes** Strep & S. aureus (MRSA)
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| Clindamycin (Cleocin) use | anaerobic abscess, abdominal infections & Gyn
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| Clindamycin (Cleocin) ADR | N/V/D & rash - can cause C. Diff
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| Metronidazole | Flagyl
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| Metronidazole (Flagyl) MOA | Inhibits DNA synthesis
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| Clindamycin (Cleocin) coverage | anaerobes & ameoba
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| Clindamycin (Cleocin) uses | Abdominal abscess, C. diff, Rx trich, & H. pylori
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| Clindamycin (Cleocin) Pregnancy category | B (avoid 1st trimester)
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| Clindamycin (Cleocin) special abilities | Penetrate CSF
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| Clindamycin (Cleocin) ADR | N/V and alcohol reaction
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| TMP/SMZ | Trimethoprim/Sulfamethoxazole
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| TMP/SMZ (Trimethoprim/Sulfamethoxazole) forms | PO or IV
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| TMP/SMZ (Trimethoprim/Sulfamethoxazole) MOA | Inhibits folic acid synthesis (static)
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| TMP/SMZ (Trimethoprim/Sulfamethoxazole) pregnancy category | B but at 3rd trimester - term = D
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| TMP/SMZ (Trimethoprim/Sulfamethoxazole) coverage | Staph, strep, GNR's & Pneumocystis (prophylaxis for HIV pt.)
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| TMP/SMZ (Trimethoprim/Sulfamethoxazole) uses | UTIs, gram - infections, MRSA
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| TMP/SMZ (Trimethoprim/Sulfamethoxazole) DOC | PCP
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| TMP/SMZ (Trimethoprim/Sulfamethoxazole) ADR | Rash, CNS disturbances, photosensitivity, GI Sx.
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| TMP/SMZ (Trimethoprim/Sulfamethoxazole) Increase toxcity of... | warfarin, oral hypoglycemics, phenytoin, methotrexate, cyclosporin
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| Rifampin Form | PO
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| Rifampin MOA | Inhibits bacterial synthesis
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| Rifampin Uses | TB, Meningococcal prophylaxis, nasal carriers of MRSA
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| Rifampin ADR | GI upset, rash, turns secretions red-orange-brown, hepatotoxic, potent cyt P450 inhibitor
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| Linezolid | Zyvox
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| Linezolid (Zyvox) forms | IV & PO (100% available)
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| Linezolid (Zyvox) class | Oxazolidinone
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| Linezolid (Zyvox) coverage | Staph (MRSA), Coag (-) staph, strept, enterococci (VRE). Minor against anaerobes
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| Linezolid (Zyvox) ADR | Thrombocytopenia (reversible) or anemia
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| Linezolid (Zyvox) uses | variety of infections from MRSA and VRE
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| Synercid | Quinupristin/Dalfopristin
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| Synercide Quinupristin/Dalfopristin class | Streptogramin
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| Synercide Quinupristin/Dalfopristin form | IV via central line only!
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| Synercide Quinupristin/Dalfopristin coverage | MRSA, VRE
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| Synercide Quinupristin/Dalfopristin ADR | Myalgia, arthalgia
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| Synercide Quinupristin/Dalfopristin amount used | Rarely
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| Daptomycin Form | IV
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| Daptomycin coverage | MRSA
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| Daptomycin use | complicated skin & soft tissue infection
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| Tygecycline coverage | MRSA, VRE, strep, enteric GNRs, bowel anaerobes
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| Mupirocin | Bactroban
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| Mupirocin (Bactroban) form | Topical
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| Mupirocin (Bactroban) use | Impetigo due to S.aureus, group A strept (pyogenese) or decolonize the nasal passages of MRSA carriers (+/-)
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| Nitrofurantoin | Macrodantin
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| Nitrofurantoin (Macrodantin) coverage | gram +'s, enterococci, E. coli
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| Nitrofurantoin (Macrodantin) Pregnancy | B
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| Nitrofurantoin (Macrodantin) DI | decreased absorption with antacids
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| Nitrofurantoin (Macrodantin) W/P | G6PD deficiency = interstitial pulmonary fibrosis with chronic use.
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| Nitrofurantoin (Macrodantin) use | ONLY UTIS - Tx/prophylaxis
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| Bacteria that must be treated for > 4 weeks | S. Aureus bacteremia, endocarditis, ostomyelitis
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| Anti-Staphylococcal | **Nafcillin, oxacillin, dicloxacillin, cefazolin
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| Anti-MRSA | Vancomycin, Clindamycin, Doxycycline, TMP/SMZ, Linezolid, Quinupristin/dalfopristin, daptomycin, tygecycline.
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| Anti-anaerobic | Metronidazole, clindamycin, carbapenems, ceftotetan, Penicillin, B-lactamase inhibitors
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| Anti-pseudomonal | pipercillin/tazobactam, aminoglycosides, ceftazadime, cefepime, imipenem, meropenem, ciprofloxacin, levofloxacin.
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If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
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