Antibiotic Work Sheet

Sulfamethoxazole + Trimethoprim Cellular Target Ciprofloxacin Amoxicillin + Clavulanic Nitrofurantoin

Dihdropteroate synthetase DHFR

DNA gyrase Topoisomerase IV
altered target efflux ↓ entry

PBP transpeptidase
beta-lactamase

Damages DNA

Primary mech. of resistance

efflux ↓ entry altered or target PABA

Nothing significant

Primary Elimination Primary mech. of drug-drug interactions Acute Hemolysis (G6PD def) Static or Cidal

Renal

Renal

Renal

Renal

Displacement from albumin

+
C

C

C

+
C

CSF entry

+ -

+
(with inflamed meninges)

+

Effective Against Pseudomonas Effective against MRSA Effective against enterococci

+

Fill in the blanks for each of the drugs and characteristics. To make the info most general, try to avoid using excessive descriptions as much as possible. For example, use + and – as much as possible. Or single letters to indicate response (e.g., to indicate a static agent…use an S.) To indicate mechanisms of drug interactions…use short hand…such as P450 to indicate induction of P450 enzymes.

Aminoglycosides (gentamicin) Cellular Target Primary mechanism of resistance Primary elimination Primary mechanism of drug-drug interaction Static or cidal 30S Tetracyclines (doxycycline) 30S efflux Ribosome protection Renal (to some extent) Dox & mino – bile milk antacids Macrolides (erythromycin) 50S Altered binding site efflux Metabolism (CYP3A4) Inhibits CYP450 (azithro does not) modifying enzymes Renal (GF) C S C CSF entry + (mino exception) - Effective against MRSA Effective against Pseudomonas - .

Vancomycin Cellular target Binds ala-ala Amoxicillin PBP Cephalexin PBP Imipenem PBP Aztreonam PBP (G only) - Sensitive to β -lactamase Not a betalactam drug + Renal +/more resistant overall but can be sensitive to ESBLs Renal Renal ESBL Renal Primary Elimination Renal CSF entry + (with inflamed meninges) + (with inflamed meninges) + - + + + (with inflamed meninges) Cross-sensitive with pens Effective against MRSA Effective against Pseudomonas + - + - + .

Streptogramin (Q/D) Cellular target 50S Q: altered binding site. of Resistance Primary elimination Primary mech. enzyme inactivation metabolism Linezolid 50S Daptomycin Plasma membrane Primary mech. of drug-drug interaction Static/cidal Effective against MRSA Effective against VRE: faecium faecalis Altered binding site metabolism renal Inhibits CYP3A4 MAO inhibitor C C S + + - + + + + + + . enzyme inactivation D: efflux.

Coli Clostridia difficile Pseudomonas a Francisella tularensis Streptococcus pyrogenes (Pen allergic) Streptococcus pneumoniae (pen resistant) (abscess) (RMSF) (whooping cough) (inhalation) (UTI) ________ Vancomycin ___________ ________ Doxycycline ___________ ________ Erythromycin __________ ________ Ciprofloxacin or Doxycycline ________ TMP/SMX or Ciprofloxacin (Pseudomem. Colitis) ________ Metronidazole _________ (sepsis) (tularemia) (pharyngitis) ________ Gentamicin + piperacillin ________ Gentamicin ___________ ________ Erythromycin _________ (pneumonia) ________ Vancomycin or linezolid Ciprofloxacin Doxycycline Gentamicin Gentamicin + piperacillin Linezolid Metronidazole Trimethoprim/sulfamethoxazole (TMP/SMX) Vancomycin Erythromycin .MATCH THE DRUG OF CHOICE (DOC) WITH THE ORGANISM MRSA Rickettsia ricketsii Bordetelle pertussis Bacillis anthracis E.

Match the listed effect with the antimicrobial most likely associated with the effect Red man syndrome Kernicterus Pseudomembranous colitis Ruptured tendon Optic neuritis Nephrotoxicity Megaloblastic anemia Gray baby syndrome Monoamine oxidation Inhibition _____Vancomycin ________________________________ ______Sulfamethoxazole ___________________________ ______ Clindamycin _______________________________ ______ Ciprofloxacin ______________________________ ______ Ethambutol ________________________________ ______ Gentamicin ___ (Vanco) ______________________ _______ Trimethaprim ______________________________ _______ Chloramphenicol ___________________________ _______ Linezolid _________________________________ Cephalexin Chloramphenicol Ciprofloxacin Clindamycin Daptomycin Ethambutol Gentamicin Linezolid Sulfamethoxazole Trimethoprim Vancomycin .

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