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Advanced Pharmacology > Adv Pharm Final - ID > Flashcards

Adv Pharm Final - ID Flashcards

1
Q

GPC in clusters =

A

staph species

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2
Q

GPC in chains =

A

strep species

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3
Q

Gram-Positive Organisms of Importance

A
  • Staphylococcus aureus–Methicillin-susceptible (MSSA) & Methicillin-resistant (MRSA)
  • Streptococcus pneumoniae
  • Streptococcus pyogenes (Group A Strep)
  • Enterococcus faecalis and Enterococcus faecium
  • Clostridium difficile (anaerobic organism)
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4
Q

Gram-Negative Organisms of Importance

A
  • Escherichia coli (E. coli)
  • Klebsiella pneumoniae
  • Pseudomonas aeruginosa
  • Bacteroides fragilis (anaerobic organism)
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5
Q

What do we look for on asusceptibility panel?

A
  • Organism and drugs thatwere tested against it
  • Minimum inhibitory concentration
  • Interpretation from MIC
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6
Q

Minimum Inhibitory Concentration values determine

A

if sensitive, intermediate or resistant

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7
Q

Concentration-dependent

A

Greater bactericidal activity as drug concentration (Cmax) exceeds the MIC

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8
Q

Time-dependent

A

Greater bactericidal activity as drug concentration remains above the MIC

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9
Q

what family does penicillin belong to?

A

beta-lactam

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10
Q

penicillin MoA

A

Bind to penicillin binding proteins (PBPs) within the cell wall–>inhibiting cell wall synthesisa–>cell lysis–>destruction

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11
Q

What are natural penicillins?

A

Penicillin G, Penicillin V

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12
Q

Natural penicillin specturm

A

Staph aureus (penicillin-susceptible), Streptococcus spp., Syphilis

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13
Q

how much gram-negative activity with natural penicillins?

A

minimal to none

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14
Q

what was penicillin initally successful against?

A

skin infections

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15
Q

what is the drug of choice for syphillis?

A

penicillin

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16
Q

IV natural penicillin

A

Pencillin G

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17
Q

PO natural penicillin

A

Pen V

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18
Q

Does Pen V have good absorption?

A

no

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19
Q

Anti-Staphylococcal Penicillins

A

Oxacillin, Nafcillin, Dicloxacillin

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20
Q

Anti-Staphylococcal Penicillins Spectrum:

A

Methicillin-susceptible Staph aureus (MSSA)

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21
Q

Drug of choice for serious MSSA infections

A

Anti-Staphylococcal Penicillins

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22
Q

Anti-Staphylococcal Penicillins half life

A

dosed every 4 hours

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23
Q

where are Anti-Staphylococcal Penicillins cleared?

A

liver

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24
Q

are most beta lactams renally adjusted?

A

yes

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25
Q

Oral option of Anti-Staphylococcal Penicillins

A

dicloxacillin

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26
Q

Why isn’t dicloxacillin commonly used?

A

requires frequent dosing

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27
Q

What were Anti-Staphylococcal Penicillins Created to treat?

A

Penicillin-resistant Staph aureus

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28
Q

What was the original Anti-Staphylococcal Penicillin?

A

methicillin

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29
Q

Why was methicillin discontinued?

A

hepatotoxicity

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30
Q

Amino-penicillins

A

Amoxicillin (Amoxil®), Ampicillin

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31
Q

Amino-penicillins Spectrum:

A

Streptococcus spp., E. coli, Haemophilus influenzae, Enterococcus faecalis

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32
Q

are Amino-penicillins reliable for Staph aureus? Why/why not?

A

no–often resistant to becta-lactamase production

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33
Q

Ampicillin route

A

IV and PO - MAINLY IV

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34
Q

Amoxicillin route

A

PO

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35
Q

What penicillins are used for otitis media and pharyngitis?

A

Amino-penicillins

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36
Q

why aren’t amino-penicillins used for hosptial infections?

A

gram negatives are usually resistant

inactivated by beta-lactamases

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37
Q

What is a Beta-lactamase?

A

Enzyme that hydrolyzes the beta-lactam ring à antibiotic becomes inactive

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38
Q

Beta-lactamase Inhibitors (drugs)

A

Amoxicillin-clavulanate (Augmentin®)
Ampicillin-sulbactam (Unasyn®)
Piperacillin-tazobactam (Zosyn®)

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39
Q

Why were beta-lactamase inhibitors developed?

A

to inhibit the activity of simple beta-lactamases

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40
Q

Which beta-lactamase inhibitor is avail IV only?

A

zosyn and unasyn

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41
Q

which beta-lactamase inhibitor is avail PO only?

A

augmentin

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42
Q

useful action of beta-lactamase inhibitors

A

preserves/expands the activity of its counterpart

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43
Q

therapuetic use of beta-lactamase inhibitors

A

hospital infections (except c diff)

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44
Q

Which beta-lactamase inhibitor is associated with high rates of GI complaints?

A

Augmentin

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45
Q

Penicillin Class Adverse Effects

A 
Hypersensitivity reactions (10%, usually rash)
Almost all agents are renally eliminated (requires adjustments)
GI intolerances (e.g. diarrhea)--mainly with oral agents
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46
Q

Which penicillins are hepatically eliminated?

A

Oxacillin, Nafcillin

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47
Q

Cephalosporins MoA

A

Inhibit cell wall synthesis

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48
Q

How are cephalasporings divided into generations

A

based on gram negative and gram positive coverage

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49
Q

Which generation of cephalasporin has the most gram-positive coverage?

A

first

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50
Q

Which generation of cephalasporin has the most gram-negative coverage?

A

fifth

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51
Q

Why where 3rd gen cephalasporins developed?

A

Developed to further expand gram-negative spectrum

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52
Q

First Generation Cephalosporins (drugs)

A

Cephalexin (Keflex®) – PO

Cefazolin (Acnef®) - IV

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53
Q

Which drug class is an alternative to anti-staphylococcal penicillin?

A

1st gen cephalosporins

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54
Q

1st gen cephalosporins Spectrum:

A

Streptococcus, Staph aureus (MSSA) – not MRSA

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55
Q

How often are 1st gen cephalosporins dosed?

A

3-4x a day

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56
Q

what are 1st gen cephalosporins commonly used for?

A

skin infections and propylaxis prior to surgeries

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57
Q

Third Generation Cephalosporins (drugs)

A

Ceftazidime
Ceftriaxone
Cefpodoxime
Cefdinir

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58
Q

Which 3rd gen cephalosporins are IV?

A

Ceftazidime and Ceftriaxone

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59
Q

Which 3rd gen cephalosporins are PO?

A

Cefpodoxime and Cefdinir

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60
Q

Third Generation Cephalosporins Spectrum:

A

Streptococcus spp., MSSA, E. coli, K. pneumoniae, Proteus spp.

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61
Q

Ceftriaxone dosing

A

once a day (for UTI, pneumonia, skin infections)/longer half life, very protein bound

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62
Q

3rd gen common indications

A

community- acquired pneumonia, skin, bacteremia, osteomyelitis, CNS infections

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63
Q

Fourth Generation Cephalosporins

A

Cefepime (Maxipime®)

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64
Q

Cefepime route

A

IV

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65
Q

4th gen ceph Spectrum:

A

Same as 3rd generation, + additional gram-negatives including Pseudomonas aeruginosa

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66
Q

4th gen ceph–cefepime is reserved for _____________

A

serious hospital-associated infections

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67
Q

Concern for ________________if 4th gen ceph not dosed properly

A

encephalopathy (including seizure)

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68
Q

highest risk for encephalopathy with 4th gen ceph

A

elderly and renal impairment

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69
Q

5th gen cephalosporin

A

Ceftaroline (Teflaro®)

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70
Q

Ceftaroline (5th gen) route

A

IV

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71
Q

Ceftaroline (5th gen ceph) spectrum

A

Covers methicillin-resistant Staph aureus (MRSA) by binding to PBP-2a

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72
Q

Does ceftaroline (5th gen ceph) cover Pseudomonas aeruginosa?

A

no

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73
Q

Which drug is approved for CAP and ABSSSI?

A

Ceftaroline (5th gen ceph)

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74
Q

Used off-label for bacteremia, endocarditis and osteomyelitis (as salvage therapy)?

A

Ceftaroline (5th gen ceph)

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75
Q

Cephalosporin AE

A

hypersensitivity

seizure if not dosed properly

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76
Q

When to request allergy test or discontinue ceph?

A

hives, swelling, anaphylaxis

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77
Q

What ceph has highest risk for seizure?

A

cefepime

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78
Q

CarbaPENEMs

A

Ertapenem
Meropenem
Imipenem/cilastatin
Doripenem

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79
Q

Carbapenem route

A

IV for all

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80
Q

Which carbapenem is also avail IM?

A

Ertapenem

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81
Q

Which class is broadest beta lactam class?

A

carbapenem

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82
Q

Which class is used as last-line options in gram-negative resistant infections

A

carbapenem

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83
Q

Carbapenem spectrum:

A

Streptococcus, MSSA, essentially all GNRs (including P. aeruginosa) and anaerobic gram-negatives

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84
Q

Which carbapenem does not cover psuedomonas?

A

ertapenem

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85
Q

Drug of choice for ESBL’s

A

Carbapenem

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86
Q

Which carbapenem has the highest risk for seizures?

A

Imipenem/cilastatin (Primaxin)

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87
Q

Which carbapenems are interchangeable?

A

Meropenem, doripenem, imipenem

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88
Q

Are carbapenems stable against many beta-lactamases?

A

yes

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89
Q

Fluoroquinolones (drugs)

A

ciprofloxacin
Levofloxacin
Moxifloxacin

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90
Q

fluoroquinolones route

A

IV and PO

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91
Q

fluoroquinolones MOA

A

Interferes with normal DNA processes by inhibiting DNA topoisomerases à leading to cell death

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92
Q

flouroquinolones spectrum:

A

Broad coverage including gram-positive (not MRSA) and gram-negatives

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93
Q

which fluor has poor streptococcus coverage?

A

Cipro

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94
Q

Do fluor have good bioavailabity?

A

yes! nearly 100%

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95
Q

Is there a problem of resistance development with fluor?

A

yes

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96
Q

Do fluor have good distrubtion among infection types?

A

yes used for nearly all infection types

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97
Q

Fluor AE

A

QTc prolongation
peripheral neuropathy
tendonitis
hyperglycemia

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98
Q

Fluor BBW:

A

Exacerbate myasthenia gravis, peripheral neuropathy, tendinitis

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99
Q

What pop are fluors contraindicated?

A

pregnant and kids

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100
Q

Tetracyclines (drugs)

A

doxycycline
minocycline
tigecycline

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101
Q

Tetracycline MOA

A

Inhibit protein synthesis by binding to the 30S ribosomal subunit and preventing tRNA from binding and forming aminoacid sequencing

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102
Q

tetracyclines spectrum:

A

Expanded gram-positive coverage (including MRSA) and gram-negative (NOT Pseudomonas)

103
Q

Do tetracyclines cover pseudomonas?

104
Q

Which tetracycline has anaerobic activty and works against VRE?

105
Q

What conditions are tetracyclines good for?

A

bone and skin infections

106
Q

What conditions are tetracyclines bad for?

A

bacteremia and urine infection

107
Q

Tetracyclines AE

A

GI intolerances
Photosensitivity
Bone deformity and teeth staining

108
Q

which tetracycline has more cases of vertigo?

A

Minocycline

109
Q

Which tetracyline has higher levels of N/V?

110
Q

Which groups are contraindicated for tetracyclines?

A

pregnant and children under 8

111
Q

Macrolides (drugs)

A

Azithromycin

Clarithromycin

112
Q

Macrolides route

A

Azithro - IV, PO

Clarithro - PO

113
Q

Macrolides MOA

A

Inhibits protein synthesis via the 50S ribosomal subunit

114
Q

Macrolides Spectrum:

A
  • variable Streptococcus spp., H. influenzae, Moraxella catarrhalis, otherwise weak gram-negative coverage
  • Respiratory pathogens that may cause CAP and other respiratory infections
  • atypicals - mycoplasma pneumoniae and chlamydophilia pneumoniae
115
Q

Which macrolide is used for chlamydia trachomitis

A

azythromycin

116
Q

What is the post-antibiotic effect with macrolides?

A

Continues to work despite subtherapeutic concentrations

117
Q

macrolides AE

A

GI upset, QTc prolongation

118
Q

Should pts take macrolides with food?

A

yes; helps minimize GI upset

119
Q

Why is Clarithromycin rarely used?

A

drug interactions (inhibits CYP 450 enzymes), increased GI intolerance and more frequent dosing

120
Q

Sulfamethoxazole-trimethoprim (Bactrim®) route

121
Q

Bactrim MOA

A

Inhibits DNA synthesis via inhibition of folic acid synthesis (synergistic activity as each component works in a different step)

122
Q

Bactrim spectrum

A

Very broad, gram-negatives (NOT Pseudomonas aeruginosa) and gram-positives (including MRSA)

123
Q

Bactrim bioavailabity

A

85% (IV and PO interchangable)

124
Q

Bactrim contraindicated

A

patients with sulfa allergies
pregnant or trying
on warfarin
potassium issues

125
Q

Use caution prescribing bactrim when

A

pt has hematological issues
renal disease
has used bactrim before (20% of ecoli are resistant)

126
Q

Bactrim is dosed based on the ____________

A

trimethorprim

127
Q

Bactrim indications

A

pneumonia, skin infections, UTI, bone infections

128
Q

Bactrim AE

A

Skin reactions (can be very severe), neutropenia, nephrotoxicity, hyperkalemia

129
Q

When to adjust bactrim?

A

renal dysfunction

130
Q

Metronidazole (Flagyl®) route

A

– IV, PO

131
Q

Metronidazole MOA

A

Damages DNA of the organism and leads to cell death

132
Q

Metronidazole (Flagyl) Spectrum:

A

Anaerobic gram-negative organisms, Clostridium difficile (C.diff) which is a gram-positive anaerobic organism

133
Q

Metronidazole (Flagyl) AE

A

GI upset, metallic taste, headache, dark urine, peripheral neuropathy

134
Q

what happens when you mix Metronidazole (flagyl) and alcohol?

A

disulfram like reaction–extreme vomiting

135
Q

Metronidazole (Flagyl) bioavailabiity

A

excellent - IV and PO interchangeable

136
Q

gram pos antibiotics

A

vancomycin, linezolid, daptomycin

137
Q

vanco MOA

A

Inhibits cell wall synthesis

138
Q

vanco spectrum

A

gram pos only

139
Q

drug of choice for MRSA

140
Q

When is vanco given IV?

A

pneumonia, CNS, UTI, bone, blood

141
Q

When is vanco given PO?

A

Clostridium difficile infection (not absorbed systemically)

142
Q

What must you do when administering IV vanco?

A

monitor drug levels for efficacy and toxicity

143
Q

Vanco AE

A

Nephrotoxicity - high levels
Ototoxicity - very high levels
Red Man’s syndrome - with rapid infusion

144
Q

What should you do when vanco pt gets red man syndrome?

A

slow the infusion time –it’s not an allergic reaction!

145
Q

when is trough measurement taken for vanco

A

serum conc taken 30 minutes prior to the 4th dose

146
Q

desired vanco concentrations for serious infections (blood and lung)

A

15 - 20 mcg/ml

147
Q

desired vanco concnetrations for mild infections (skin and UTI)

A

10-15 mcg/ml

148
Q

Linezolid route

149
Q

LInezolid MOA

A

Inhibits protein synthesis

150
Q

Linezolid spectrum

A

VERY broad gram-positive coverage including MRSA and VRE

No gram-negative coverage

151
Q

Linezolid clinical uses

A

drug-resistant enterococcus (VRE), staphylococcal infections of the lungs, patients with vancomycin intolerance

152
Q

Linezolid AE

A 
Thrombocytopenia (use > 14 days)
Drug interactions with SSRIs (may cause serotonin syndrome)
Optic neuritis (use >28 days)
153
Q

Linezolid contraindications

A

patients taking an MAO-I

154
Q

Linezolid bioavailabity

155
Q

Daptomycin MOA

A

Causes rapid depolarization leading to inhibition of protein, DNA and RNA synthesis

156
Q

Daptomycin Spectrum

A

Same as linezolid

157
Q

Is Daptomycin available PO?

158
Q

Daptomycin clinical Uses

A

Alternative agent to linezolid for resistant gram-positive infections and linezolid intolerance
NOT used to treat pneumonia (Inactivated by lung surfactant)

159
Q

linezolid Adverse effects

160
Q

what to monitor on daptomycin

161
Q

Pseudomonas aeruginosa agents

A 
piperacillin/tazobactam
ceftazidime
carapenems (except ertrapenem)
Levofloxacin
Cipro
162
Q

MRSA agents

A 
Vanco
Linezolid
Daptomycin
Tetracyclines
Bactrim
Ceftaroline
163
Q

Antifungals

A

flucanozole
voriconazole
echinocandins

164
Q

Does flucanazole have good bioavailability?

165
Q

What is the only azole that concentrates
well in the urine

A

fluconazole

166
Q

Flucanazole indication

A

C. albicans infections (thrush, UTI, blood)

167
Q

How often is flucanozole dosed for yeast infections?

168
Q

Drug of choice for invasive pulmonary aspergillosis

A

Voriconazole

169
Q

Voriconazole has excellent distribution, except for __________

170
Q

Voricanazole route

A

IV and oral

171
Q

Goal for voriconazole monitoring

A

2 - 5.5 mcg/ml

172
Q

Voriconazole AE

A

visual disturbances and hallucinations

173
Q

Azoles AE

A

increase QTc interval (except newest–isavunonazole)

liver injurry

174
Q

All azoles can inhibit __________ leading to drug interactions

A

the CYP 450 enzyme system

175
Q

Azoles can cause transient _______________

A

LFT elevations

176
Q

Echinocandins (drugs)

A

Micafungin, caspofungin and anidulafungin

177
Q

Echinocandins route

178
Q

Echinocandins distribute well with the exception of ______ and ______

A

CNS, urine

179
Q

Echinocandins is recommended for

A

coverage of candidemia in severely septic patients

180
Q

Antivirals

A

Acyclovir
Valacyclovir
Oseltamivir (tamiflu)

181
Q

Cyclovirs MOA

A

Terminates DNA replication

182
Q

Which cyclovir is only PO?

A

valacyclovir (valtrex)

183
Q

cycolivr side effects

A

headaceha and nausea

184
Q

IV cycolivr potential AE

A

nephrotoxicity

185
Q

Valacyclovir has a _____________ so it’s dosed less frequently

A

longer half life

186
Q

Valacyclovir is a _____________ that’s converted to __________

A

prodrug, acyclovir

187
Q

Oseltamivir (tamiflu) MOA

A

Treatment and/or prophylaxis via neuraminidase inhibition (halts replication)

188
Q

Tamiflu dosing for treatment of flu

A

twice a day

189
Q

tamiflu dosing for prophylaxis of flu

A

once a day

190
Q

tamiflu side effects

A

nausea and vomiting

191
Q

Empiric data

A

No culture data to guide antibiotic selection
Takes into account common pathogens
Takes into account patient history and local resistance

192
Q

Definitive data

A

based on culture data

193
Q

CAP Diagnosis

A 
Fever
Tachypnea
Cough
Sputum production (send for culture) ¤  Confusion
Fatigue
Chest X-ray showing infiltrate
194
Q

In the elderly, _______may be the only initial symptom
of CAP

195
Q

CAP usually straight forward diagnosis, except in those with ___________and_____________

A

structural lung disease, congestive heart failure

196
Q

CAP first line treatment (uncomplicated)

A

Azithromycin OR doxycycline

197
Q

CAP first line treatment (allergy or complicated)

A

Levofloxacin or Moxifloxacin

198
Q

CAP treatment duration

199
Q

Cystitis presentation

A

Urgency to urinate
Increased frequency of urination
Dysuria
Suprapubic pain/tenderness

200
Q

Cystitis diagnosis

A

Urinalysis (UA) – sample of urine analyzed for bacteria, WBC,
inflammatory markers and organism growth
Urine Culture – Should be obtained if the UA is abnormal

201
Q

Preferred Agents for cystitis

A

Nitrofurantoin (Macrobid®) – uncomplicated disease
Trimethoprim/sulfamethoxazole (Bactrim®)
Fosfomycin
Fluoroquinolones
Beta-lactams (amoxicillin-clavulanate, cefpodoxime)

202
Q

Typical duration for cystitis treatment

203
Q

____________ are NO LONGER recommended as first-line therapy for UTIs

A

Fluoroquinolones

204
Q

drug for uncomplicated cystitis

A

Nitrofurantoin

205
Q

What is the patient requirement for nitrofurantoin (macrobid)

206
Q

Minimum days of treatment of Nitrofurantoin (macrobid)

207
Q

Is nitrofurantoin (macrobid) safe in pregnancy?

208
Q

nitrofurantoin (macrobid) covers______

A

many gram negative organisms causing cystitis (eg E. coli)

209
Q

Fosfomycin use

A

refractory cases of cystitis

210
Q

Dosing for fosfomycin

A

one time (in uncomplicated disease)

211
Q

Fosfomycin side effects

A

Diarrhea, nausea (more common)

Headache and dizziness

212
Q

How often should a patient be prescribed Fosfomycin?

A

once or twice (base on cultures after)

213
Q

Fosfomycin MOA

A

interferes with cell wall syntehsis

214
Q

Sulfamethoxazole-trimethoprim (Bactrim®) for cystitis safe during pregnancy?

A

not in pregnancy

215
Q

Levo/cipro (fluors) for cystitis

A

use in allergic patients or sever/refractory cases

Avoid in pregnancy

216
Q

which fluor should be avoided for UTIs and why?

A

moxifloxacin because it has low urinary concentrations

217
Q

Beta lactams for cystitis

A

Augmentin and oral cephs

218
Q

ABSSSI drugs

A 
Cephalexin
Tetra
Bactrim
Clinda
Linezolid
Dalbavancin or ortiavancin
219
Q

Last line ABSSI drug and why

A

Clinda, GI and C. Diff

220
Q

Which ABSSI drug causes toxicites after two weeks?

221
Q

Good drug for MSSA and strep

A

cephalexin

222
Q

Drug reserved for MRSA or VRE

223
Q

Cephalexin is dosed _____ times a day

224
Q

Dalba/oritavancin is similar to __________

A

vancomycin

225
Q

Dalba/oritavancin is useful for

A

ABSSI non-compliant pts or drug resistance

226
Q

ABSSSI treatment duration

227
Q

with minimal response to ABSSSI treatment consider

A

patient compliance
resistance to agent
source issues

228
Q

When should we treat a URI with antibiotics?

A 
Strep throat
otitis externa (usually bacterial)
Otitis media with pus
Sinusitis with fever
Worsening URI not treated may be bacterial
229
Q

Strep treatment

A

Amoxicillin or augmentin in those with amox exposure

230
Q

Treatment for CAP, inpatient

A

Ceftriaxone + Azithromycin

231
Q

Treatment of CAP, inpatient with PCN allergy

A

Levofloxacin OR moxifloxacin

232
Q

gram positive anaerobic organism

233
Q

which drugs are hepatically eliminated?

A

ceftriaxone

Anti-staph penicillins

234
Q

Why would a patient need to switch from oxacillin to cefazolin?

A

hepatotoxicity

235
Q

Which class of drug is inactivated by ESBLs?

A

3rd gen cephalosporins

236
Q

Alternative to vanco

237
Q

which antibiotic can inhibit MAO?

238
Q

Daptomycin is not useful for_____________

239
Q

The number given on an antibiogram indicates

A

percent susceptible

240
Q

Of the azoles, only Flucanizole has adequate_________

A

urinary concentrations

241
Q

All azoles can cause QTc prolongations except

A

isavunonazole

242
Q

This azole can cause hallucinations

A

voriconazole

243
Q

Fungins are part of this class

A

Echinocandins

244
Q

Which ID drugs cause QT prolongation?

A

macrolides, azoles, fluoroquinolones

245
Q

Which ID drugs can inhibit CYP 450 enzymes? (and therefore cause drug interactions?)

A

clarithromycin and azoles

246
Q

Which ID drugs mess with the cell wall?

A

beta lactams and vancomycin

247
Q

which ID drugs mess with protein?

A

tetracyclines, macrolides, linezolid

248
Q

Which ID drugs mess with DNA?

A

Fluoros, Bactrim, Flagyl

249
Q

Which drug is inactivated by lung surfactant?

A

Daptomycin

250
Q

UTI drugs

A 
Macrobid
Bactrim
Fosfomycin
Fluoros
Beta-Lactams—augmentin and cefpodoxime
251
Q

Name 3 adverse effects of the Penicillin class

A

Hypersensitivity reactions - 10% of US population (esp. rash)
Almost all renally eliminated with two exceptions
GI intolerances such as diarrhea, usually more with oral agents

252
Q

Name a cephalosporin that has a long half life, is highly protein bound and can be used to treat UTIs, Pneumonia, and Skin Infection

A

ceftriaxone

253
Q

Way to remember pseudomonas aeruginosa

A

Zosyn Forts Maximize the Cipro Levo Penem

Zosyn, Fortaz (Ceftrazidime), Maxipime (Cefepime), Ciprofloxacin, Levofloxacin, carbaPenems (not ertapenem)

254
Q

What’s used with vanco for c diff?

Advanced Pharmacology (8 decks)

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