Penicillin
Which organisms that PCN is not active against?
MRSA & atypical organism
Name a cephalosporin that active against MRSA
(Bonus 100: which generation is that?)
Ceftaroline fosamil (Teflaro)
5th generation
Name the only carbapenem that not active against Pseudomonas, Acinetobacter or Enterococcus
Ertapenem (Invanz) - PEA
Name two aminoglycosides
Gentamicin
Tobramycin
Amikacin
Streptomycin
Plazomucin
Name all three antibiotics that belong to Macrolides
Azithromycin (Zithromax, Z-pak)
Clarithromycin (Biaxin*)
Erythromycin (E.E.S., Ery-Tab, Erythrocin)
Name at least one PCN that cover MSSA (3 that in antistaphylococcal penicillins)
Dicloxacillin (Oral)
Nafcillin (Parenteral)
Oxacillin (Parenteral)
Name the only cephalosporin that contraindicates in neonates. (Hint: no renal dose adjustment)
(Bonus 100: what does it cause in neonates?)
Ceftriaxone (Rocephin*) also contraindicate for concurrent use with Ca-containing IV products in neonates </= 28 days old
(Causes biliary sludging, kernicterus)
Name an antibiotic that can be used with PCN allergy and has a similar MOA to beta-lactam
Aztreonam (Azactam) - monobactam. It has no gram-positive or anaerobic activity
Name at least one black-boxed warning for aminoglycoside
Nephrotoxicity
Ototoxicity
neuromuscular blockade
[avoid use with other neurotoxic/nephrotoxic drugs]
Name respiratory quinolone that enhanced coverage of S. pneumoniae & atypical pathogens (Hint: My Good Lung)
[Bonus 100: why do we call it respiratory quinolone?]
Moxifloxacin
Gemifloxacin
Levofloxacin
[because it can penetrate through the lung]
Name one PCN that has broad activity and is the only one that active against Pseudomonas aeruginosa.
piperacillin/tazobactam (Zosyn)
Name two cephalosporins that are active against Pseudomonas aeruginosa
(Bonus 200: name the only 2 combination cephalosporins that active against pseudomonas)
Ceftazidime (Fortaz) - 3rd generation group 2
Cefepime - 4th generation
[ceftazidime/Avibactam (Avycaz); ceftolozane/Tazobactam (Zerbaxa)]
All carbapenem only come in what form? which one has specific instructions for diluting and what is that solvent?
IV ONLY
Ertapenem must dilute in NS ONLY
How do we dose aminoglycosides?
There are two ways (gentamicin/tobramycin):
Traditional dosing - 1-2.5mg/kg/dose, CrCl >/=60: Q8H
Extended interval dosing - 4-7mg/kg frequency determine by nomogram
[underweight - TBW; obese - AdjBW)
Name two organisms that Vancomycin use for and dosing for IV
[Bonus 100 each: trough lvl, AUC/MIC lvl, and MIC cutoff number)
MRSA & C. difficile
15-20mg/kg Q8-12H
[Trough= 15-20mcg/mL; AUC/MIC= 400-600;>/= 2]
Name two PCNs that required ONLY NS to dilute
Ampicillin
Ampicillin/sulbactam
Name 2 cephalosporins active against gram-negative anaerobic: B. fragilis
(Bonus 100: cephalosporin that common use for surgical prophylaxis)
cefotetan & cefoxitin - 2nd generation
[cefazolin (Ancef*)]
Name at least one common use for 3rd generation cephalosporin group 1. (CTX & cefotaxime)
CAP
Meningitis
Spontaneous bacterial peritonitis
Pyelonephritis
How do we draw a trough and what is the cutoff number? (Traditional dosing)
Gentamicin/Tobramycin - < 2mcg/mL
What are the warning for Tetracyclines?
Children <8yrs, pregnancy & breastfeeding
Photosensitivity
DILE: only for minocycline
Syphilis
IM ONLY, not for IV use cuz it can cause cardiorespiratory arrest and death
Name 3 cephalosporins that come in Oral form
Cephalexin (Keflex)
Cefuroxime (Ceftin*)
Cefdinir (Omnicef*)
Name two common uses for carbapenem
polymicrobial infxn (eg. severe diabetic foot infection)
Empiric therapy when resistant organisms suspected
ESBL-positive infxn
Resistant Pseudomonas or Acinetobacter infxn (except ertapenem)
Name at least one BBW and at least one warning for Quinolone.
[Bonus 100 each antibiotic that belong to Quinolone]
BBW: Tendon inflammation and/or rupture; Peripheral neuropathy; Seizure
Warnings: QT prolongation, decreased K/Mg, avoid in children & pregnancy/breastfeeding, photosensitivity, caution w/ CVD, can cause hypo- & hyperglycemia
[Ciprofloxacin, Levofloxacin, Moxifloxacin, Delafloxacin, Gatifloxacin, Gemifloxacin, Ofloxacin]
Bactrim: contraindication, warning, at least one side effect, and at least one organism in opportunistic pathogens that its active against.
[Bonus 100: what component is the dose based on?]
[Bonus 100: single strength dose of Bactrim]
CI = Sulfa allergy
Warning = Skin rxn (SJS/TEN, TTP), G6PD deficiency (hemolysis risk)
SE = Photosensitivity, hemolytic anemia (+ Coombs test), increased K, crystalluria (take w/ 8oz of water)
Opportunistic pathogens = Pneumocystis, Toxoplasmosis
[Dose based on the TMP (trimethoprim) component]
[400mg SMX / 80mg TMP]