Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Didactic Year > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Empiric therapy

A

ABx coverage for the “likely” cause, don’t have actual culture results yet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs and symptoms of infection include

A

Fever > 38 C
Elevated WBC >10,000 cells/ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some other causes of fever, other then infection?

A

Drug induced (beta lactic, allopurinol, anticonvulsants)
Disease induced (autoimmune, malignancies)
Fever can be masked by antipyretics (NSAIDS, acetaminophen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Low WBX (<4000 cells/mL) associated with ________ outcomes

A

Poorer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some non-infectious etiologies for leukocytosis?

A

MI, trauma, leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pain/inflammation, swelling, erythema, tenderness or purulent drainage could indicate what kind of infection?

A

Superficial or Bone/joint infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pneumonia
Meningitis
Endocarditis
UTI
could indicate what kind of infection

A

Deep-seated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Flank pain associated with

A

Pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What microbiology sample should we (ideally) obtain prior to ABx therapy

A

Gram stain
Cultures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Two types of gram stain patterns

A

Positive (purple)
Negative (pink)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of shapes under gram stain

A

Cocci (sphere) or bacilli (rod)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Types of growth patterns under gram stain

A

Clusters, chains, pairs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

G+ bacteria retain ______

A

Crystal violet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

G- bacteria retain ____

A

safranin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Gram + aerobic cocci

A

Streptococcus
Enterococcus
Staphylococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Gram + aerobic bacilli

A

Corynebacterium and listeria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Gram + anaerobic cocci

A

Peptococcus
Peptostreptococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Gram + anaerobic bacilli

A

Clostridium
Propionibacterium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Gram - aerobic cocci

A

Moraxella
Neisseria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Gram - aerobic bacilli

A

Pseudomonas
H. influenza
Campylobacter jejuni
E. Coli
Salmonella
Shigella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Gram - anaerobic bacilli

A

Bacteroides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Name some atypical bacteria

A

Chlamydia pneumoniae
Mycoplasma pneumoniae
Legionella pneumophilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Obtain _______ in acutely febrile patients

A

Blood cultures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

You should coincide cultures with __________

A

Fever spikes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Sensitivity results may take up to

A

72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Sensitivity results are reported as

A

S (susceptible)
I (intermediate)
R (resistant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Positive cultures don’t always confirm _________

A

The presence of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Pneumonia associated with what pathogens

A

S. aureus (MRSA)
P. aeruginosa
Klebsiella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

IV catheter site infection associated with what pathogens

A

S. aureus
S. epidermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Susceptible

A

High-likelihood of clinical success

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Intermediate

A

Questionable likelihood of clinical success

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Resistant

A

High likelihood of therapeutic failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is an antibiogram?

A

Annual review that determines susceptibility profile for organisms, helps identify local and resistance patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

In meningitis, _______ is an important determinant of the probable organism

A

Age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How can ABx fail?

A

Empiric ABx doesn’t cover the infecting organism
Concentration of ABx is too low at infection site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What host factors can render ABx less effective?

A

Immunosuppression (due to disease or drug drug therapy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Intrinsic resistance

A

Naturally occurring
(Gram - pathogens intrinsically resistant to Vancomycin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Four categories of acquired antimicrobial resistance

A
  1. Alteration in target site
  2. Reduction in Intracellular anti microbial exposure
  3. Bypass of natural metabolic processes
  4. Drug inactivation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Important questions to ask patients while considering ABx therapy

A

Allergies
Other medications (OTC and Rx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the 3 classes of antibiotics?

A

Cell wall synthesis inhibitors
Nucleic acid synthesis inhibitors
Protein synthesis inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Cell wall synthesis inhibitors include

A

Beta-lactams
Glycopeptides
Lipopeptides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Beta-lactams mechanism of action

A

Inhibit cell wall synthesis by inhibiting penicillin binding proteins (PBPs)
Decreased integrity of peptidoglycan chain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

4 classes of penicillins

A

Natural penicillins
Penicillinase-resistant
Aminopenicillins
Extended spectrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Natural penicillins (V,G) coverage

A

Gram +
Staph - no
Strep - yes
Enterococcus (variable)

Gram-
Neisseria, syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Common uses for natural penicillins

A

Pharyngitis
Erisipelas
Syphillis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

More than 90% of staph produce _______, making them resistant to __________

A

Penicillinase, penicillins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Amino - penicillins coverage

A

Gram+
Strep, enterococcus
Gram -
Salmonella, shigella, E. Coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Common uses for amino-penicillins

A

Upper respiratory infections
H. pylori
Enterococcal infections
Skin infections
UTIs
Community-acquired pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Penicillinase-resistant penicillins coverage

A

Gram +
Staph (but not MRSA)
Strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Common uses for Penicillinase-resistant penicillins

A

B-lactamase producing staph
Cellulitis
Diabetic foot infections
Septic arthritis
Endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the #1 broad spectrum penicillin to use when we don’t know what to do?

A

Piperacillin/tazobactam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Extended-spectrum penicillins coverage

A

Gram +
Staph (not MRSA)
Strep
Enterococcus
Gram -
P. aeruginosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Uses for extended spectrum penicillins

A

Nosocomial pneumonia
Intra-abdominal infections
Skin and soft tissue infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Two predominant mechanisms of bacterial resistance to beta-lactam antibiotics

A

Production of antibiotic destroying enzymes (penicillinase, beta-lactamase, extended spectrum beta-lactamase/ESBL)

Development of altered target site
(Penicillin cannot bind to PBP, MRSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

B-lactamase inhibitors

A

Clavulanate, sulbactam,tazobactam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What do B-lactamase inhibitors do?

A

Bind to and inactive b-lactamases, so antibiotics can do their job; have no particular antibiotic action themselves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Type 1 immediate hypersensitivity

A

IgE mediated
Causes urticaria, angioedema, bronchospasm
CV collapse
Anaphylaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

4 options to work around patients Penicillin allergy

A

Perform penicillin allergy test (skin,oral challenge)
Prescribe a cephalosporin
Prescribe a non beta-lactam antibiotic
Perform a penicillin desensitization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Penicillin desensitization

A

Giving regular, small intervals in the ICU setting and monitoring reaction
Takes a lot of time, money, resources, and possibly dangerous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

1st Gen cephalosporins

A

Cefazolin
Cephalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

2nd Gen cephalosporins

A

Cefaclor, cefuroxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

3rd Gen cephalosporins

A

Ceftriaxone, cefpodozime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

4th generation

A

Cefepime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

5th Gen cephalosporins

A

Ceftaroline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What properties do cephalosporins share with penicillins?

A

MOA: target PBPs, destroy cell wall
Similarities in chemical structure: possibility for cross reactivity
Both considered first line for majority of infections (well tolerated, fairly cheap)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

The later the generation of a Cephalosporin

A

The higher the gram - coverage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

1st gen cephalosporin coverage

A

Gram+
Staph,Strep
Gram -
Proteus
E. coli
Klebsiella pneum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Uses for 1st Gen cephalosporins

A

Mild skin/soft tissue infections
Pharyngitis
Oral treatment of Mild UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

2nd Gen Cephalosporin coverage

A

Gram +
Staph, strep
Gram -
H. influenza
Gonorrhea
Proteus
E. coli
Klebsiella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

2nd Gen cephalosporin uses

A

Sinusitis
Pharyngitis
Otitis media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

1st and 2nd Gen cephalosporins generally work well against

A

MSSA or strep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

3rd gen cephalosporins coverage

A

Gram +
Strep pneumoniae
Gram -
Enterbacteriaceae, H. influenza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

3rd gen cephalosporin uses

A

CA pneumonia
Otitis media
Upper respiratory infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

4th gen cephalosporin coverage

A

Gram +
Strep
Staph

Gram -
Pseudomonas aeruginosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

4th gen cephalosporin uses

A

Meningitis
Nosocomial infections
Pneumonia
Pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

3rd and 4th gen are most commonly used for hospitalized patients with concern for gram ________ pathogens

A

Negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

5th gen cephalosporins reserved for

A

Special cases with very resistant pathogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

The only drug included in the monobactam family is

A

Aztreonam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Aztreonam coverage

A

Gram -
Including P. aeruginosa
No gram +, atypical, or anaerobic coverage
Not available by mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Carbapenems are drug of choice for _______ producing organisms

A

ESBL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Carbapenems

A

Ertapenem
Imipenem
Meropenem
Doripenem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Carbapenems coverage

A

ESBL + K. pneumoniae and E. coli
Strep, MSSA, enterococcus, pseudomonas
No activity against MRSA or Atypicals

83
Q

Ertapenem is an exception to the Carbapenems because it does not cover

A

Pseudomonas or enterococcus

84
Q

Vancomycin is a

A

Glycopeptide antibiotic

85
Q

Glycopeptide antibiotics coverage

A

Gram + bacteria

86
Q

Glycopeptides inhibit cell wall synthesis by

A

Inhibiting NAG and NAM binding

87
Q

Vancomycin is commonly used to treat

A

MRSA

88
Q

Vanco coverage

A

Gram + (MRSA, strep, entercocci, c diff)

89
Q

Potential for toxicity of vancomycin

A

Nephrotoxicity
Neutropenia, thrombocytopenia

90
Q

What do you need to do in order to give Vanco?

A

Blood monitoring
Determine the patients renal function

91
Q

Red man syndrome is side effect of which antibiotic?

A

Vancomycin

92
Q

How to treat red man syndrome/Vancomycin flushing syndrome/(VIR) Vancomycin-infusion reaction

A

After stopping the vancomycin and letting rxn calm down, slow the infusion rate
Possible antihistamine administration

93
Q

Televancin (Vibativ)

A

Lipoglycopeptide, simplified with once daily dosing
Black box warning: may cause abnormal fetal development

94
Q

Oritavancin (Orbactiv)

A

IV single dose antibiotic
Indicated for ABSSSI (acute bacterial skin and skin structure infection)

95
Q

Dalbanvancin

A

Once weekly antibiotic

96
Q

Daptomycin

A

Lipopeptide

97
Q

Daptomycin mechanism of action

A

Cyclic lipopeptide that inserts lipid tail into bacterial membrane resulting in depolarization of bacterial cell resulting in death (bactericidal)

98
Q

Daptomycin coverage

A

MRSA and VRE

99
Q

Potential for what toxicity with Daptomycin

A

Rhabdomyolosis (check CPK)

100
Q

Name the protein synthesis inhibitors

A

Aminoglycosides
Tetracyclines
Macrolides
Linezolid

101
Q

Tetracycline mechanism of action

A

Inhibits protein synthesis by binding to 30s ribosomal subunit

102
Q

Tetracycline coverage

A

Gram +
S. pneumoniae
Strep pyogenes
CA-MRSA

Gram -
E. coli Klebsiella

Atypicals
Chlamydia (pneumonia/trachomatis),
mycoplasma pneumoniae

103
Q

Use for tetracyclines

A

Respiratory infections, CA MRSA, SSTI, acne

Doxycycline: Chlamydia, Lyme

104
Q

Consideration for tetracyclines

A

Separate food containing aluminum, mag, calcium, iron by 1-2 hrs

105
Q

Tigecycline

A

Tetracycline
Higher mortality associated
FDA black box warning

106
Q

With macrolides, we want to watch out for what two things?

A

QTc prolongation
CYP450 drug interactions

107
Q

Macrolides MOA

A

Inhibit protein synthesis by binding to the 50s subunit

108
Q

Macrolides are CYP _______ inhibitors

A

3A4

109
Q

Which Macrolides are the “worst” for interactions/effects

A

(Worse to best)
Erythromycin
Clarithromycin
Azithromycin

110
Q

Macrolides can give predisposition for what unstable ventricular arrhythmia

A

Torsades de pointes

111
Q

Macrolides coverage

A

Gram +
Strep
Gram -
H influenza, gonorrhea

Atypicals
Mycoplasma pneumoniae
Chlamydia pneumoniae/trachomatis

112
Q

Uses for Macrolides

A

Alternative to penicillin
CA-pneumonia
Azithromycin: Urethritis, MAC prophylaxis

113
Q

Clindamycin type

A

Lincosamide antibiotic

114
Q

Clindamycin MOA

A

Inhibits protein synthesis by binding to the 50s subunit

115
Q

“Big” possible side effects of Clindamycin

A

C. diff

116
Q

Clindamycin coverage

A

Gram +
Staph aureus (MSSA and CA-MRSA),strep, peptostrep
Gram -
Clostridium (not c. diff)

117
Q

Clindamycin uses

A

PCN allergy
SSTI
CA-MRSA (risk for resistance)

118
Q

Oxazolidinones

A

Linezolid

119
Q

Linezolid coverage

A

Gram + MSSA/MRSA, strep, VRE

120
Q

Linezolid MOA

A

Inhibits protein synthesis by preventing combining of 50s and 30s subunit

121
Q

Risk of toxicity with Linezolid

A

Serotonin

122
Q

Aminoglycosides

A

Gentamicin

123
Q

The two styles of amino glycoside dosing are

A

1.High dose, extended interval dosing (good renal function)
2. Traditional

124
Q

Aminoglycosides rarely used _______

A

Alone

125
Q

Sulfonamides and trimethoprim MOA

A

Block nucleotide synthesis (specifically, folic acid synthesis which bacteria need to survive)

126
Q

Bactrim coverage

A

Gram +
Staph
S. pneumoniae
Clostridium tetani
Gram -
E. coli, proteus, H. influenza
Atypicals:
-Chlamydia, trachomatis

127
Q

Bactrim = frontline for

A

CA-MRSA

128
Q

Fluoroquinolones

A

Quick development of resistance Absorption is reduced when (magnesium, iron etc) are given so space 2 hours apart
Ex. Ciprofloxacin and Moxifloxacin

129
Q

Cipro MOA

A

Inhibits DNA replication by binding to DNA gyrase and topoisomerase IV

130
Q

Ciprofloxacin coverage

A

Pseudomonas

131
Q

Metronidazole good for treating

A

C-diff

132
Q

Metronidazole MOA

A

Forms free radical toxic metabolites in the bacterial cell that damage DNA

133
Q

Metronidazole, if taken with alcohol, can cause

A

“Hangover” reaction

134
Q

Metronidazole coverage

A

Anaerobes and Protozoa

135
Q

Enterococcus is never covered by

A

Cephalosporins

136
Q

What conditions are low/medium dose topical steroids used for?

A

Eczema
Irritant dermatitis
Seborrhea
Atopic dermatitis

137
Q

What conditions are high dose topical steroids used for?

A

Psoriasis, lichen planus, allergic contact dermatitis

138
Q

Examples of low strength topical steroids

A

Alclometasone, hydrocortisone base or acetate, desonide

139
Q

Examples of intermediate strength topical steroids

A

Fluticasone, hydrocortisone valerate, mometasone

140
Q

Examples of high strength topical steroids

A

Amcinonide, halcinonide

141
Q

Examples of very high strength topical steroids

A

Clobetasol, halobetasol

142
Q

What’s a common ADR with topical steroid use?

A

Cutaneous atrophy - can have telangiectases and purpura, resolves after months

143
Q

What are other/serious ADRs with topical steroid use?

A

Striae, acne, refractory rosacea, hypopigmentation, alopecia, glaucoma

144
Q

What is an ADR associated with hormones with topical steroid use?

A

Adrenal suppression and iatrogenic cushing’s
~increased with children/dose/duration/higher potency

145
Q

Treatment considerations for topical steroid use

A
  1. Use low doses on areas with increased absorption
  2. Occlusive dressings don’t use with high potency
  3. Ointments have highest effects
  4. For very high potency: don’t D/C abrupt but switch to lower strength, total dose should not exceed 50g/week, max TX duration should be 2-4 weeks
146
Q

Rules of 3

A

Ultra high potency steroid: should NOT be used for more than 3 weeks
Low-high potency steroids should NOT be used for more than 3 months

147
Q

Prescribing considerations with topical steroids

A
  1. Hydration improves absorption (Ex. Apply post shower)
  2. Most are once or twice daily
  3. Fingertip method: half fingertip is 0.5 g and covers whole area of hand
148
Q

Topical medications to treat psoriasis

A
  1. Corticosteroids (1st line)
  2. Vitamin D analogues (1st line)
  3. Retinoids (1st line)
  4. Calcineurin inhibitors
149
Q

Vitamin D analogues

A

Photosensitivity
Increased calcium levels
Very irritating (causes stinging, burning, and peeling)

150
Q

Retinoids

A

Photosensitivity
Pregnancy Category X
Very irritating (stinging, burning, and peeling)

151
Q

Calcineurin inhibitors

A

Local stinging and burning but less than Tazarotene and Vit D analogs

consider for facial or intertriginous psoriasis

152
Q

Oral psoriasis drugs (non-biologics)

A
  1. Methotrexate
  2. Cyclosporine
  3. Oral retinoid (Soriatane)
  4. Apremilast (Otezla)
153
Q

Methotrexate

A

Contraindicated in pregnancy/lactation
Caution with hepatic dysfunction

154
Q

Cyclosporine

A

Many drug interactions (with grapefruit for example)
Contraindicated in uncontrolled HTN,renal dysfunction,history of Malignancy, phototherapy

155
Q

Oral retinoid (soriatane)

A

Contraindicated in pregnancy/lactation
Avoid pregnancy for 3 years after D/C
Causes significant dryness

156
Q

Otezla

A

No serious ADR(no monitoring necessary), may cause weight loss, diarrhea, headache

157
Q

Clinical pearls regarding oral meds for psoriasis

A

Need frequent lab monitoring/pregnancy tests
Concern for drug interactions

158
Q

Biologic names for psoriasis treatment

A

Adalimmumab, Ustekinumab, Ixekizumab, Guselkumab, Risankizumab

-injections
-Expensive but very effective
Black box warnings~infections

159
Q

Drugs to treat Urtcaria

A

Antihistamines
1. First generation (diphenhydramine, doxylamine): drowsiness
2. Second generation (cetirizine, levocetirizine): no/minimal drowsiness

160
Q

Drugs for mild to moderate atopic dermatitis

A
  1. Topical steroids: mainstay of therapy, prevent and/or treat flares
  2. Topical Calcineurin inhibitors: alternative to steroids (tacrolimus, pimecrolimus)
  3. Topical phosphodiesterase-4 inhibitors (Eucrisa): alternative to steroids
161
Q

Risk vs Benefit of topical Calcineurin inhibitors

A

Benefits: Can use on any body area, no long term ADRs, no Tachyphylaxis, local ADRs are minimal
Risks: black box warning for malignancy (skin cancer and lymphoma) but relationship not firmly established

162
Q

Monoclonal antibodies for atopic dermatitis

A

Injectable mab indicated for moderate to severe atopic Derm (Dupilumab/Dupixent)

163
Q

Topical keratolytics for acne

A

Benzoyl peroxide: available OTC, oxidizes bacteria so no associated risk of resistance

164
Q

Considerations with benzoyl peroxide

A
  1. Formulation: Gels penetrate better than cream, look for “oil free”, alcohol base will increase ADRs
  2. Strength: All concentrations are equally efficacious (but higher strength associated with more ADRs)
  3. ADRs: skin irritation, contact derm, dryness, redness, peeling, stinging, photosensitive
165
Q

Topical Retinoids

A

Adapalene
Tazarotene
Trifarotene
Tretinoin

166
Q

Adapalene

A

Least irritating, available in combo with BPO, 0.1% get available OTC

167
Q

Tazarotene

A

accumulates in upper dermis, also approved for psoriasis

168
Q

Trifarotene

A

Selectively targets one type of retinoic receptor = theoretically more effective and less irritating, new and expensive

169
Q

Topical retinoid info

A

Apply to dry skin to minimize irritation

170
Q

Antimicrobial therapies for acne

A
  1. Minocycline (Amzeeq foam): topically
  2. Minocycline capsule/tab
  3. Doxycycline capsule/tab
  4. Sarecycline (seysara): Capsule/tab: used only for acne
171
Q

Safety considerations for antimicrobial acne treatments

A

Should not use an antibiotic alone due to resistance, when considering combo use drugs with different MOA (not 2 abx)

172
Q

Isotretinoin

A

Monitor LFTs, lipid panel, CBC
Pregnant patients pledge to use 2 forms of birth control along with monthly pregnancy tests
Suicide attempts?

173
Q

OTC Pediculocides

A
  1. Permethrin 1% (Nix): thought to have residual effect (newer shampoos may not)
  2. Synergized pyrethrins shampoo (Rid): Always reapply
  3. Ivermectin topical (sklice) may be good alternative if resistance is suspected
    *Note: Nix and Rid are very similar chemically, so if resistant to one, probably resistant to both
174
Q

Pediculocides (RX, non OTC)

A

Lindane
Benzyl Alcohol 5% (Ulesfia)
Malathion lotion
Spinosad suspension (Natroba)
Abametapir lotion (Xeglyze)

175
Q

Benzyl alcohol 5% (Ulesfia)

A

Suffocation based therapy
Always reapply

176
Q

Malathion lotion (Ovide)

A

Ovicidal
Wash it off after 8-10 hours

177
Q

Spinosad suspension (Natroba)

A

High ovicidal activity

178
Q

Scabicides

A

Permethrin 5% cream
Apply from neck to soles of feet
Wash off after 8-14 hours
Repeat in 48 hours
Adult dose is usually 30 g
Don’t dispense more than one tube per person (tube is 60 g)

179
Q

Fungal infection tx

A

Treatment options: topical or PO depends on location
Topical usually sufficient for: tinea corporis, pedis, cruris, and versicolor
Oral tx necessary for tinea capitis and unguium

180
Q

Fungal tx: imidazoles, triazoles

A

Clotrimazole (OTC)
Ketoconazole shampoo
Ketoconazole cream
Ketoconazole tablets
Fluconazole

181
Q

Fungal tx: allylamines

A

Butenafine (OTC)
Terbinafine tablet (RX)
Terbinafine cream (OTC)
Ciclopirox cream (RX)

182
Q

What is the Tx for a mild, purulent cellulitis infection

A

Incision and drainage, abx not required

183
Q

Ruxolitinib and abrocitinib

A

JAK inhibitors used for atopic dermatitis

184
Q

Closcoterone (Winlevi)

A

Anti androgen
For acne
New and expensive

185
Q

Ciclopirox (loprox)

A

Onychomycosis

186
Q

Cefaclor

A

2nd generation

187
Q

Cefuroxime

A

2nd generation
Lyme disease

188
Q

Cefdinir

A

3rd generation

189
Q

Moxalactam

A

3rd generation

190
Q

Which cephalosporins cover Bacteroides fragilis?

A

Cefoxitin and cefotetan

191
Q

Which cephalosporins cover pseudomonas aeruginosa

A

Ceftazidime and cefepime

192
Q

Azithromycin space with food reason

A

Increased absorption

193
Q

Erythromycin space with food reason

A

Decreased absorption

194
Q

C. Diff

A

Fidaxomicin and Vancomycin PO

195
Q

Minocycline

A

Vestibular toxicity

196
Q

Tetracycline food consideration

A

Empty stomach

197
Q

Doxycycline food consideration

A

Take with food

198
Q

Moxifloxacin vs cipro

A

Moxifloxacin is more likely to cause QT prolongation

199
Q

What can you not use Daptomycin for?

A

Cannot use for meningitis: does not distribute into CNS
Cannot use for pneumonia: destroyed by pulmonary surfactant

200
Q

Toxicity with Aminoglycosides

A

Ototoxicity and nephrotoxicity

201
Q

Aminoglycosides and cystic fibrosis

A

Sometimes given as inhaled therapy

202
Q

Nucleic Acid synthesis inhibitors

A

Sulfonamides, fluroquinolones, and metronidazole

203
Q

Metronidazole side effects

A

Dry mouth, metallic taste

Didactic Year (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions