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What are the Oral penicillinase resistant penicillins?
Group A strep
According to the charts, what is thespectrum for penicillinase resistant penicillins (Nafcillin)?
Gram – (including H. influenza)
What microbes are outside of the spectrum of activity for Nafcillin/penicillinase resistant penicillins?
Penicillinase resistant penicillins (Nafcillin/oxacillin/dicloxacillin/cloxacillin) are the drug of choice for what bug?
1-2 grams IV Q4H
250-500 mg PO Q6H
What is the normal dose for Penicillinase resistant penicillins (Nafcillin/oxacillin/dicloxacillin/cloxacillin)?
How is Nafcillin eliminated?
What is the half-life for Nafcillin/Dicloxacillin (Penicillinase resistant penicillins)?
What level of proteinbinding is exhibited by Nafcillin/Dicloxacillin (Penicillinase resistant penicillins)?
50-80 ug/mL for 1 gram IV
10-15 ug/mL for 500 mg PO
What arethe peack levels for Nafcillin/Dicloxacillin (Penicillinase resistant penicillins)?
Neutropenia and Thrombocytopenia in treatments > 3 weeks
What are the side effects for Nafcillin/Dicloxacillin (Penicillinase resistant penicillins)?
CBCs and WBCs for Neutropenia/thrombocytopenia when giving for a long duration (3-6 weeks)
BMP (basic metabolic profile) and a rise in SCr for Interstitial nephritis
What should you monitor for when giving Nafcillin/Dicloxacillin (Penicillinase resistant penicillins)?
Ampicillin and sulbactam
What is Unasyn?
Amoxicillin and clavulanic acid
What is Augmentin?
Sulbactam and clavulanic acid are what type of molecules?
Group A strepS. pneumonia
Some E. faecium
Gram -: H. influ, N. gonorrheae, B. fragilis some Klebsiela
What type of coverage do Unasyn have (chart)?
Ampicillin has no activity against StaphIs
Unasyn active against MSSA?
Augmentin is IV or PO?
Anything where anaerobes might be the infecting agent
What is Unasyn or Augmentin the drug of choice for?
1.5-3 grams IV Q6H
What is a normal dose of Unasyn?
500/125-875/125 mg PO Q8-12H
XL dose: 1000/62.5 2 tabs BID
What is the normal dose of Augmentin?
Normal renal activity: 1.3 hours
Renal insufficiency: 5-20 hours
Normal renal activity: 1.7 hours
Renal insufficiency: 20 hours
What is the half-life of Unasyn?
How is Unasyn eliminated?
Piperacillin and Tazobactam
What is Zosyn?
Drug of choice for intra-abdominal infections/wounds and anaerobic infections
What is the main use of Zosyn (piperacillin/tazobactam)?
Group A strep
Gram – rods:
Zosyn (piperacillin/tazobactam) has what coverage (chart)?
By what route of administration is Zosyn (piperacillin/tazobactam) available?
How is Zosyn (piperacillin/tazobactam) eliminated?
Normal renal function: 1 hour
Renally insufficient: 1 hour
Normal renal function: 3-5 hours
Renally insufficient: 3 hours
What is the T1/2 for Zosyn (piperacillin/tazobactam)?
3.375 grams IV TID
Infuse over 4 hours
4.5 grams IV TID for empiric pseudomonas
What is the normal dose of Zosyn (piperacillin/tazobactam)?
Which antibiotic is the only available monobactam?
Gram negative infections only
What is Aztreonam (Azactam) used for in general (G+ or G-)?
What does Aztreonam (Azactam) have no activity against?
Fairly good against nosocomial G- rods:
H flu, N. gonorrhoeae, E. coli, K. pneumonia, S. marcescenesPseudomonas , though not often used for that indication
What is the spectrum according to the charts for Aztreonam?
Cystic fibrosisPseudomonas infectionPCN allergic patients (who had anaphylaxis to PCNs)
What type sof G- infectionsis Aztreonam used for?
What is the dose of Aztreonam?
1-2 grams Q6-8H IV