Allman - AG, Vanc, Linezolid, Dapt, Tig, Tele Flashcards Preview

POD Exam 2 > Allman - AG, Vanc, Linezolid, Dapt, Tig, Tele > Flashcards

Flashcards in Allman - AG, Vanc, Linezolid, Dapt, Tig, Tele Deck (25):
1

Aminoglycoside Mechanism of action

- Binds to outer membrane of cell resulting in a rearrangement of LPS
- Taken up into the cell (energy dependent)
- Irreversibly trapped in bacterial cytoplasm
- Bind to 30S and 50S ribosomal subunits --> decreased protein synthesis and increased misreading of mRNA
- BACTERICIDAL

2

Aminoglycoside PAE

After exposure to inhibitory concentrations of AMGs, continued killing continues.
Concentration dependent killing

3

Aminoglycoside Absorption

Poorly absorbed from GI tract --> no oral form for a systemic infection

4

Aminoglycoside Distribution

Lung concentrations only 25-50% of those IN SERUM (poor)
CSF = 20% with inflammation

5

Aminoglycoside Excretion

Unchanged; ALL RENAL

6

Types of AMGs (4)

Amikacin
Gentamicin
Tobramycin
Neomycin

7

Which AMG is used ORALLY to wipe out gut flora?

Neomycin

8

2 most common adverse effects with AMGs?

Ototoxicity - 8th Cranial Nerve (peaks)
Nephrotoxicity -- (troughs)

9

AMG spectrum of activity

*ONLY synergy with gram positive organisms
*All Gram neg through SPACE

10

What type of AMG is reserved for TB and only available from the manufacturer?

Streptomycin

11

AMG hartford nomogram dosing?

7mg/kg

12

What is the benefit of individualizing dosages?

Decreased toxicities

13

Vancomycin mechanism of action

Inhibits the biosynthesis of peptidoglycan polymers during cell wall formation

*PAE*

Bactericidal for multiplying organisms

14

Vancomycin spectrum of activity

All Gram + except VRE
Hap
Endocarditis
Osteomyelitis

*Good for MRSA when penicillin allergy present.
*Closely monitored by CDC to prevent resistance

15

Vancomycin Absorption

Poorly absorbed in GI tract; Must by give via IV except for C Diff

16

Vancomycin Distribution

CSF ONLY with inflammation

17

Vancomycin Excretion

Unchanged; ALL RENAL

18

Vancomycin Adverse Effects

Red Man/Red Neck Syndrome
Nephrotoxicity
Ototoxicity

19

Quinupristin/Dalfopristin Facts

- Individually static, together tidal
- Both bind 50S (diff sites)
- GRAM +
- VRE
- Infusion requires PICC Line or Central Line

20

Linezolid Facts

-Expensive
- 23 S Ribosome
- Oral is 100% bioavailable (oral = IV)
- RESISTANT GRAM + (VRE, VISA)
*** Drug-Drug Interaction: SSRI bc Linezolid is an MAOI and together they cause a serotonin storm.

21

Colistin Facts:

- Kitchen Sink
- bacteriocidal
- Polymyxin E
- Great Gram - coverage (SPACE)
- last resort antibiotic for resistant bugs

22

Fosfomycin Facts:

- bacteriocidal
- resistant UTIs
- MDR pathogens (MRSA, VRE, ESBL, SPACE)
- 1 dose (3 grams)
- GI upset

23

Tigecycline Facts

- static
- skin infections
- CAP
- NOT for bacteremia (doesn't get into blood well)
- tier 3 drug: high mortality?
- MRSA/VRE
- CRE (carbapenem resistant enterobacteria)
- Anaerobes

24

Daptomycin Facts:

-Cidal
- Excellent Gram + coverage
- MRSA, VRE
- skin and soft tissue infections
- INACTIVATED BY LUNG SURFACTANT (NOT good for pneumonia)
- Side effect = rhabdomyolysis

25

Telavancin Facts:

- semi-synthetic derivative of Vancomycin
- skin and soft tissues
- MRSA
- Red Man Syndrome
- Nephrotoxicity