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Pharm 4 > Anti-Infective II > Flashcards

Anti-Infective II Flashcards

1
Q

What do Tetraclycines cover?

A

many Gram +, Gram -, aerobic, anaerobic, spirochetes, mycoplasms, rickettsiae (RMSF), chlymydiae, protozoa

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2
Q

What is the Tx for Lyme’s Dz?

A

Tetracycline - doxycycline

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3
Q

Name 3 tetraclyclines. Which one is the most potent?

A

tetracycline
doxycycline - most potent
minocycline

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4
Q

A patient asks you if its okay to take tetracycline at the same time as their MVI. What should you say?

A

Tetracyclines should not be combined with chelating agents like MVI, milk, iron, antacids.

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5
Q

What patients should not be given tetracyclines? Why not?

A

pregnant women and children under 8

they bind to calcium - teeth yellowing and deformities

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6
Q

Is it okay to take an expired tetracycline?

A

no, they can cause fanconi-like syndrome - renal damage

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7
Q

What is the problem with someone taking tetracycline while on vacation at the beach?

A

it causes photosensitivity and can lead to 2nd and 2rd degree burns.

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8
Q

What is minocycline used for (2)?

A

anti-inflammatory activity - acne, RA

PPX of Neisseria Meningitidis

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9
Q

Name 4 fluoroquinolones. What is the common ending?

A 
Ciprofloxacin
Levofloxacin 
Ofloxacin
Norfloxacin
"-floxacin"
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10
Q

MOA of fluroquinolones?

A

bind to and inhibit bacterial DNA-gyrase so that bacteria cannot replicate

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11
Q

What does Cipro cover? What was Cipro’s claim to fame?

A

Excellent gram -, crappy gram -, Chlamydia and anthrax.

PO coverage of pseudomonas aeruginosa (Gram -)

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12
Q

Like the ________ Cipro has great gram - coverage, crappy gram + coverage and covers PA.

A

Extended spectrum PCNs

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13
Q

_______ provides better gram + coverage than Cipro, but has limited PA coverage.

A

Ofloxacin

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14
Q

_______ is the l-isomer of ofloxacin, has better tissue penetration lending it to _____ dosing, and very good coverage of __________ (CAP).

A

Levofloxacin
QD dosing
strep pneumo

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15
Q

Norfloxacin is used most common to treat _______. It primarily concentrates in the _________, leading to low serum levels.

A

UTIs

Kidneys

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16
Q

You must avoid _________ when on fluoroquinolones.

A

Chelating agents.

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17
Q

Along with fluoroquinolones, what other Abx should you avoid chelating agents with?

A

tetracyclines

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18
Q

Lexofloxacin and Ofloxacin are different from Cipro in what way?

A

They are used for community acquired infections - better gram + coverage.

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19
Q

What patient populations should you not prescribe fluoroquinolones to?

A

Pregnant women and children under 18.

It can cause cartilage and soft tissue malformation.

20
Q

Marathon runner has a sharp pain in calf after completing a course of Abx. What drug could have caused an injury?

A

Fluoroquinolones - rupture tendons is a BBW

21
Q

T or F. Fluoroquinolones are cheap.

A

False - $$$

22
Q

What combo makes up Bactrim?

A

Trimethoprim/Sulfamethoxazole

23
Q

MOA for bactrim?

A

Inhibits the conversion of PABA–>Folinic Acid, thus inhibit DNA synthesis.

24
Q

What does bactrim cover? What does it not cover?

A

BROAD SPECTRUM - gram -/+

No coverage of anaerobes or PA

25
Q

What is bactrim commonly used for? What other Abx’s is also used for this?

A

UTIs

Norfloxacin and AminoPCN

26
Q

HIV patient has CD4 count of

A

Bactrim

PPX for PCP (Pneumocystis carinii Pneumonia)

27
Q

What is a typical dose of Bactrim?

A

DS = SMX/TMP 800/160

28
Q

What is a consideration when dosing IV bactrim?

A

IV dosing always based on TMP content.

IV dose has short half life.

29
Q

What pregnancy category is Bactrim? Is it safe for children?

A

Preg Category C

Do not use in infants

30
Q

What is kernicterus and what drug should be avoided for fear of this condition?

A

Very high serum bilirubin levels that can lead to neurological damage and mental retardation in infants.
Avoid Bactrim in infants

31
Q

Patient comes in with a severe rash that is now present in her mouth. She’s been on a course of Abx for 2 days for a UTI. What is a possible Abx that could have caused this?

A

Rash –> SJS brought on by a sulfa medication

Bactrim - Trimethoprim/Sulfamethoxazole

32
Q

Name 2 Abx that patients should avoid the sun while taking.

A

Tetracyclines and Bactrim

33
Q

T or F. Bactrim is cheap.

A

T

34
Q

T or F. Bactrim is highly PPB.

A

T

35
Q

If someone is allergic to sulfa medication (severe rash), is it okay to prescribe Bactrim?

A

No - could develop into SJS.

36
Q

Patient is diagnosed with SJS, but has now developed a staph/strep infection. What should you prescribe?

A

Anti-staphylococcal PCN - Methicillin

37
Q

What two Abx should HIV patients take when CD4 counts drop?

A

Bactrim and Azithromycin

38
Q

What does Metronidazole (Flagyl) cover?

A

Anaerobes, some protozoa (water), trichmoniases

39
Q

Flagyl was formerly the DOC for what infection?

A

C. Diff

40
Q

Metronidazole as ________ PO absorption.

A

excellent

41
Q

What should patients avoid while taking metronidazole? What may happen when taking it?

A

alcohol - it inhibits aldehyde dehydrogenase so aceta aldehyde builds up causing a disulfiram rxn - alcohol isn’t broken down fully and makes you sick if taken with alcohol.

42
Q

What is the DOC for community acquired MRSA? What lesion does this infection resemble?

A

Bactrim

Spider bite

43
Q

What are the two Abx that can cause a metallic taste?

A

Metronidazole and clarithromycin

44
Q

T or F. Bactrim and Metronidazole are cheap.

A

T

45
Q

What is the second generation metronidazole?
What is it used for?
Dose?

A

Tinidazole: long half life - singe dose

Amebiasis, giardiasis, trichomoniasis

Pharm 4 (5 decks)

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