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NP Cert Exam > 4 Antibiotics > Flashcards

4 Antibiotics Flashcards

0
Q

Gram positive bugs

A

Staphylococcus
Streptococcus
Enterococcus

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1
Q

If PCN allergic give a

Not a

A

Macrolide( like zithromax)

Not a cephalosporin!

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2
Q

Gram neg bugs

A

Everything besides a staph strep or enterococcus

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3
Q

E. Coli stands for

A

Escherichia coli. NOT enterococcus

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4
Q

Staphylococcus are usually

A 
Skin bugs
Gram +
Staph aureus. Skin
MRSA. Nl abx for staph won't work
Staph saprophyticus- UTI, vagina
Staph epidermis
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5
Q

Streptococcus

A

Gram pos

Strep pyogenes. Throat
Strep pneumoniae. Lungs
Strep viridans. Dental access, endocarditis
Strap agalactiae. Group B strep. Preg moms check bc babies inc mortality

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6
Q

Enterococcus

A

Gram pos
Enterococcus faecalis. Urinary tract
Enterococcus faecium. Urinary tract

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7
Q

Gram neg bugs

A

Everything else!

Neisseria gonorrhoeae
Neisseria meningitis

Diarrhea: e. Coli, shigella, campylobacter, salmonella
Pasturella
Mycoplasma
H. Flu
M. Cat
Proteus
Pseudomonas 
Legionella

Atypical pathogens:
Mycoplasma, H. Flu, M. Cat
Legionella

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8
Q

Atypical pathogens: of gram neg

A

Mycoplasma, H. Flu, M. Cat

Legionella

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9
Q

If you r allergic to PCN, what abx should be used w precaution

A

Cephalosporin

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10
Q

% of people allergic to PCN are also allergic to cephalosporin

Never give cephalosporin had these rxns
Give PCN if had this rxn

A

2-10% of peeps are allergic to PCN and also cephalosporin allergic

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11
Q

GIVE a cephalosporin if PCN rxn was a

A

Mobilliform rash

A drug rash is papular all over. Never red raised or itchy (allergic rashes are IgG mediated)

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12
Q

Mobilliform rash

A

Macular or maculopapular. Lesions are fixed expand slowly over several days
May itch
This is T cell mediated NOT IgG mediated like allergic/anaphylactic rash
Mobilliform rash happens more commonly with aminopcns- amox and ampicillin
Concurrent viral infxn can predispose a pt to mobiliform rashes

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13
Q

Never give suspected mono pt

A

PCN! If u give PCN to mono pt they will get an ampicillin rash, even up to a year later.

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14
Q

Be aware of beta lactam ring for two reasons

A
  1. Allergies (bc both PCN and cephalosporins share beta lactam ring)
  2. Beta lactamase: an enzyme that smart bacteria learn to produce
    That destroys the beta lactam ring
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15
Q

Augmentin is

A

PCN that has a cover over the beta lactam ring

16
Q

Name 4 penicillins

What are they good for?

A

Ampicillin
Amoxicillin
Penicillin k
Penicillin G

Good for gram pos strep and enterococcus but NOT for staph!!!!

17
Q

Extended spectrum PCN are

NOT good for
:

A

Augmentin and all its generics
Covers gram +, gram -, and beta lactamase( so give if pt had abx in last 90 days,)

Augmentin NOT for MRSA

But good for gram pos:
Strep ABCG
Enterococcus
Strep pneumoniae
DRSP 
MSSA

AND gram neg:
H flu. M. Cattaralis
E. Coli. Neisseria

18
Q

Why would a provider think the bug is a beta lactamase producer?

A

Bc pt had abx in last 90 d

19
Q

What 2 abx are good for Gram negs?

A

Tetracyclines:

  • Doxycycline (get for atypical pathogens- h flu, E. coli, legionella, mycoplasma, chlamydiaphilia, ricksetta)
  • Minocycline best choice for MSSA and CA-MSSA

Sulfonamides:
-PTMP/SMX(Bactrim, Sentra)
MRSA!!!!

20
Q

Best abx choice for MSSA and CA-MSSA?

A

Minocycline

21
Q

Best choice for MRSA? (For gram neg- MRSA behaves differently than other gram + so treat like gram neg)

Best 2nd line for MRSA?

A

Bactrim first for MRSA

If Bactrim- allergic use Minocycline (first line for MSSA)

22
Q

Cephalosporins have —– generations

Gen 1 is for
Gen two is for
Etc

A

Four!
1st gen. Skin. GRAM + only. -staph
Ex. Cephalexin (Keflex)
Cefadroxil (Duricef)

2nd generation.
GRAM + and -

If not positive if Pt has Strep or H. Flu use this! But won’t cover beta lactamase producers
Cefuroxime (cerftin)
Cefaclor (Ceclor). Got when I was little but now not good for sinus!
Cefprozil (Cefzil)

3rd gen. Twisted ring again to get beta lactamase producers but now weak gram + coverage
Weak gram +, Gram -, and beta lactamase producers

Ceftibutin(Cedax)
Cefixime(Suprax)

**Extended spectrum 3rd gen. Covers everything!!- twisted ring again and got back gram +. Give when not sure what bug it is

Gram +, gram -, and beta lactamase producers
(Not MRSA)
Ceftriaxone (Rocephin) IM
3 orals great for Peda bc taste delicious!:
-Cefdinir (Omnicef)
-Cefpodoxime (Vantin)
-Cefditoran (Spectracef)

23
Q

Cephalosporin. 1gen

What bugs and give ex

A

Gram +

Staph

Cephalexin(Keflex)
Cefadroxil (Duracef)

24
Q

What class are Cefuroxime (Ceftin) and Cefaclor (Ceclor)?

A

Cephalosporins

2nd gen- Gram + and - No beta lactamase

25
Q

If u r not sure if pt has Strep or H. Flu- what Cephalosporin to give?

A

Give (Cefuroximine)Ceftin or (Cefaclor)Ceclor
2nd gen Cephalosporin
Gram + and -

26
Q

If pt has sinus infxn and was txd 2 wks ago w Amox what Cephalosporin to give?

A

3rd gen. Bc covers beta lactamase producers

Weak gram +, gram - and beta l producers

27
Q

What Cephalosporin to give for a kid when u r not sure what bug is? Give examples

A

Extended spectrum 3rd gen cephalosporins
Gram +, gram - and beta lactamase producers

Cefdinir (Omnicef)
Cefpodoximie (Vantin)
Cefditoran(Spectracef)
All oral and taste delicious for peds!

28
Q

If PCN allergic use—– Not ——-

A

If PCN allergic use Macrolides (Erythromycin, Azithromycin, Clarithromycin)
Not Cephalosporin bc share beta lactam ring

29
Q

List 3 Macrolides
Which one doesnt work anymore?
Which 2 are good for atypicals?

A

Early gen:Erythromycin SUCKS. Wont cover much anymore

Later gen: azithromycin(Zithromax) and Clarithromycin (Biaxin)
Both very easy to consume. Z pack
Cover Atypicals - MSSA and Listeria (NOT Strept or Enterococcus)

30
Q

A ‘thromycin is a

A

Macrolide

Azithromycin
Clarithromycin

31
Q

‘Floxacin is what class?

A

Fluroquinolones

32
Q

Fluoroquinolones 2nd generation

A

Ciprofloxacin.

Gram -
Atypical pathogens
Hits below the belt!
Not respiratory bc doesnt kill strep or DRSP

33
Q

Fluoroquinolones 3rd generation

A

Respiratory And below belt. If wiggles levofloxicin will kill it!
WOW!! The idiot’s antibiotic bc it covers everything- save for peeps that can’t afford a tx failure

Only one:
Levofloxacin.  (Levoquin)
Gram -/+
Atypical pathogens
DRSP
34
Q

Respiratory Fluoroquinolones 4th gen

A

Three- give for above belt, gram +, beta lactamase producers

Moxifloxacin (Avelox)
Gemifloxacin (Factive)
Gatifloxacin (Zymat opth)
-gram +, atypical pathogens, DRSP

35
Q

Fluoroquinolones summary. 2nd, 3rd, and 4th gen

A

2nd: Ciprofloxacin gram neg atypicals below belt
3rd Levofloxacin (Levoquin) everything! Gram -/+ respiratory
4th. Respiratory quinolones
-moxifloxacin (Avelox)
-Gemifloxacin (factive)
-Gatifloxacin (Zymar opth)
Gram +, atypicals, !!!!!!DRSP!!!!!, beta lactamase producers

36
Q

Remember fluoroquinolones

A

2nd. Below belt. Cipro gram - below belt
3rd. Levofloxacin (Levoquin) all! Gram -/+ respiratory
4th. Moxi, Gemi, and Gatifloxacin. Gram +, beta lactamase producers and DRSP!! Respiratory

Remember Quin= s “ox”. Good mornin!

37
Q

Pt with UTI. Which gen Quinolone to avoid?

A

4th everyday of the week! (Resp )

38
Q

With UTI. Would u rather give a 2nd or 3rd gen quinolone and why?

A

Give 2nd- Cipro

Save Levofloxacin 3rd for bug resistant organismas

NP Cert Exam (9 decks)

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