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Antibiotics > Abx (random) > Flashcards

Abx (random) Flashcards

1
Q

What is the CRP and procalcitonin level for infection?

A

CRP >40
Procalcitonin >0.5 to start abx

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2
Q

Why is doxycycline CI in pregnancy?

A

Cross placental barrier, concentrate in metal bones and dentition (teeth)

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2
Q

What antibiotics are not suitable for pregnancy?

A

Tetracycline, fluoroquinolone, co-trimoxazole, aminoglycosides, nitrofurantoin (near term)

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3
Q

Why is fluoroquinolone CI in pregnancy?

A

Arthropathy (in animal studies)

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4
Q

Why is co-trimoxazole CI in pregnancy?

A

1st trimester: neural tube defects (folate antagonism of TMP)
3rd trimester: kernicterus

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5
Q

What are examples of time-dependent antibiotics?

A

Beta-lactams

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6
Q

What are examples of concentration-dependent antibiotics?

A

Aminoglycosides, fluoroquinolones, metronidazole

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7
Q

What drugs can be used to treat CNS infections? (can cross BBB)

A

Ampicillin, 3rd & 4th gen cephalosporin, meropenem, vancomycin

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8
Q

Why cannot use daptomycin for pneumonia?

A

It is inactivated by lung surfactants

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9
Q

Which classes are bactericidal?

A

Beta-lactams
Glycopeptides (vancomycin)
Aminoglycosides
Fluoroquinolones

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10
Q

Which classes are bacteriostatic?

A

Macrolides, clindamycin, tetracyclines, trimethoprim and sulphonamides, nitrofurantoin

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11
Q

What are QTc prolonging abx?

A

Macrolides, fluoroquinolone, azoles

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12
Q

What are nephrotoxic abx?

A

Aminoglycosides, vancomycin, amphotericin B

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13
Q

What are abx that cause photosensitivity?

A

Tetracyclines, fluoroquinolone, sulfonamides, pyrazinamide

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14
Q

What abx targets pseudomonas?

A

Pip-tazo, ceftazidime, cefepime, levofloxacin, ciprofloxacin, aminoglycosides, meropenem, imipenem, aztreonam (9)

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15
Q

What abx targets atypicals?

A

Tetracyclines, macrolides, levofloxacin, moxifloxacin (4)

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16
Q

What abx targets C diff?

A

Vancomycin (PO), metronidazole

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17
Q

What abx targets MRSA?

A

Vancomycin, tigecycline, linezolid, ceftaroline (4)
(maybe) doxycycline, co-trimoxazole, clindamycin, levofloxacin, moxifloxacin (5)

18
Q

What abx covers ESBL bacteria?

A

Carbapenems, aminoglycosides

19
Q

Which carbapenem is the odd one out in terms of coverage?

A

Ertapenem: no enterococcus and pseudomonas cover

20
Q

What to monitor for vancomycin?

A

strict I/O, infusion reaction, U/E/Cr

21
Q

Peak and trough levels for vancomycin? Target AUC/MIC? Sampling times for peak and trough?

A

Peak <40
Trough 10-15 (15-20 for MRSA)
AUC/MIC 400-600
Sampling time: 1h after end of infusion (peak), immediately before starting infusion (trough)

22
Q

Peak and trough levels for aminoglycosides? Sampling times for peak and trough?

A

Gentamicin: peak 8-10, trough <2
Amikacin: peak 25-40, trough <10
Sampling time: 1h after end of infusion (peak), 1h before starting infusion (trough)

23
Q

Which abx cannot be used in G6PD deficient patients?

A

Nitrofurantoin, FQ, co-trimoxazole

24
Q

What are atypicals?

A

Legionella sp, Mycoplasma pneumoniae, Chlamydia pneumoniae

25
Q

Tigecycline coverage

A

MRSA, VRE, streptococci, ESBL
(not pseudomonas, proteus)

26
Q

Which macrolide has the least CYP3A4 enzyme inhibition?

A

Azithromycin

27
Q

Which macrolide enhances gastric motility?

A

Erythromycin

28
Q

Which abx is used for triple therapy PUD?

A

Clarithromycin, metronidazole / amoxicillin (and PPI)

29
Q

Which abx causes ototoxicity?

A

Macrolides, vancomycin, aminoglycosides

30
Q

What abx are cleared hepatically?

A

Ceftriaxone, macrolides, clindamycin, moxifloxacin, metronidazole

31
Q

What abx are cleared renally?

A

Beta-lactams, vancomycin, tetracyclines (minocycline metabolised by kidney before excretion -> hepatic impairment dose adjustment), aminoglycosides, ciprofloxacin, levofloxacin, co-trimoxazole, nitrofurantoin

32
Q

Can linezolid be used for catheter-related bloodstream infections or catheter-site infections?

A

No

33
Q

Nitrofurantoin coverage?

A

E coli, Enterococcus (not pseudomonas or proteus)

34
Q

What antifungals are renally cleared?

A

Amphotericin B, 5-FU, fluconazole

35
Q

What causes bone marrow suppression as a side effect?

A

Linezolid, amphotericin B, 5-FU

36
Q

Antifungal CSF penetration?

A

Amp B (conventional) < Amp B (lipo) < 5-FU

37
Q

What antifungals are hepatically cleared?

A

Itraconazole, Voriconazole

38
Q

What are the common bugs involved in nosocomial infections?

A

ESKAPE (Enterococcus faecium, Staph Aureus MRSA, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.)

39
Q

Which abx are bacteriostatic normally but bactericidal at high doses?

A

Macrolides, nitrofurantoin

40
Q

Side effects of 5-FU

A

hepatotoxicity, GI side effects, bone marrow suppression

41
Q

Side effects of Amphotericin B

A
  • Fever and chills (1-3h after starting IV)
  • Nephrotoxicity (conventional causes renal vasoconstrictions and reduce GFR) -> hydrate pts
  • Electrolyte imbalances (hypoK)
  • Thrombophlebitis
  • Bone marrow suppression, anaemia
42
Q

Which abx do not have activity against Strep pneumoniae?

A

Cloxacillin, 1st gen cephalosporins, ceftazidime, aminoglycosides, ciprofloxacin

Antibiotics (11 decks)

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