Anti-infectives part 2 Flashcards

1
Q

Which antibiotics demonstrate gram + sensitivity?

A

gramicidin, macrolides, vancomycin, bacitracin

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2
Q

what are 2 types of concentration dependent antibiotics?

A

aminoglycosides and fluoroquinolones

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3
Q

which 3 antibiotics should you not take with food?

A

“PAT an empty stomach” = penicillins, azithromycin and tetracyclines

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4
Q

would you give cephalosporins to a hemophilic patient?

A

no - cephalosporins cause vitamin K deficiency which is important for blood clotting

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5
Q

what is the IV drug of choice for MRSA, MRSE and bacterial endophthalmitis?

A

Vancomycin

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6
Q

what drug combo is used most commonly for pediatric ocular infections?

A

Polymyxin B + Trimethoprim

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7
Q

Aminoglycosides and tetracyclines act by binding to and inhibiting which ribosomal subunit?

A

30S

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8
Q

which drugs inhibit 50S ribosomal subunit?

A

macrolides and chloramphenicol

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9
Q

which aminoglycoside has a class B pregnancy rating?

A

Tobramycin (tobradex)

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10
Q

Pseudotumor cerebri is associated with which specific aminoglycoside?

A

gentamicin

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11
Q

which are the most common aminoglycosides that can cause a type 4 delayed hypersensitivity reaction?

A

all 3 = gentamicin, tobramycin, neomycin

Neomycin is most common

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12
Q

which tetracycline do we use most commonly to treat eyelid/meibomian gland conditions?

A

doxycycline (except in children = AzaSite)

*chlamydia, meibomianitis/meibomian gland stasis, acne rosacea

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13
Q

when prescribing a tetracycline, what types of food should they avoid eating?

A

dairy products (binds to divalent calcium which renders the antibiotic dysfunctional)

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14
Q

Fanconi’s syndrome is associated with which type of drugs?

A

tetracyclines

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15
Q

which macrolides would you consider one of the safest antibiotics?

A

erythromycin and azithromycin = pregnancy class B ratings

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16
Q

which macrolide is “ok” for pregnancy and infants?

A

azithromycin

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17
Q

what type of patients should you be cautious to in giving macrolides?

A

asthmatics = macrolides augment plasma levels of theophylline

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18
Q

why should you be cautious in giving chloramphenicol to newborns?

A

grey baby syndrome

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19
Q

is trimethoprim a sulfa drug?

A

no = folic acid inhibitor

20
Q

do sulfa drugs work well in highly mucopurolent environments?

A

no = there is excessive PABA in discharge

21
Q

which topical drug is 1st line of treatment for MRSA with 95% efficacy? what is 2nd?

A

trimethoprim

tobramycin

22
Q

what folic acid inhibitor combo do you use to treat toxoplasmosis?

A

sulfadizine + Pyrimethamine

23
Q

what is a common adverse reaction of trimethoprim?

A

TMP = treats marrow poorly

bone marrow suppression

24
Q

your patient is allergic to BAK - but you need to treat their infection, which drug would you use?

A

moxifloxacin

25
Q

which drug does not exhibit bacterial resistance?

A

besifolxacin with durasite = no systemic predecessor

26
Q

tendinitis is an adverse reaction of which class of drugs?

A

fluoroquinolines

27
Q

which ocular antibiotic is least resistant to gram + infections?

A

trimethoprim/polymyxin B and besifloxacin

28
Q

which drugs are best for treating pseudomonas infections?

A

fluoroquinolones, aminoglycosides, polymyxin B

29
Q

what is the 1st line of therapy for recurrent HSV1 and HSV2 keratitis?

A

trifluridine (viroptic) - may be combined with oral acyclovir therapy

30
Q

your patient presents with acute herpetic keratitis (dendritic ulcers) - what drug will you prescribe?

A

Ganciclovir (Zirgan) - caution with cross-resistance with acyclovir

31
Q

what type of ocular involvement would you see in a patient with fungi?

A

cornea, conjunctiva, lens, CB, vitreous body and uvea

32
Q

what percentage of acanthamoeba keratitis cases are associated with CL wear > trauma?

A

85-95%

33
Q

what is the life-cycle of acanthamoeba?

A

trophozoites cysts

34
Q

which organism accounts for 50% of ocular infections (is it gram + or -)?

A

staphylococcus - gram +

35
Q

polymyxin B attacks what part of the cell and what gram type is it for?

A

cell membrane - gram negative

36
Q

which class of antibiotics attack the cell’s DNA production?

A

fluoroquinolones

37
Q

which drug class irreversibly inhibits protein synthesis?

A

aminoglycosides

38
Q

all tetracyclines should not be taken with food except which one?

A

doxycycline

39
Q

which drug class and specific drugs can treat acne rosacea?

A

tetacyclines (doxycycline and minocycline)

40
Q

what is the only tetracycline that you should take if you have malfunctioning kidneys?

A

Doxycycline

41
Q

which gram + antibiotic is the only one that permits QD dosing?

A

AzaSite (azithromycin)

42
Q

which fluoroquinolone can cause white corneal precipitates?

A

ciprofloxacin

43
Q

which antifungals do not cause hepatotoxicity?

A

echinocandins (metabolized by liver enzymes) and amphotericin B (but toxic to kidneys)

44
Q

chronic antibiotic therapy can pre-dispose patients to what type of infection?

A

fungal

45
Q

name the fungi that may attack the eye and what can make it worse?

A

canidida, crytococcus, aspergillus, fusarium, and curvularia

CL’s, steriods, trauma, immunocompromise